All right, that is what we're going to be talking about.
This isn't a laughing matter. It's not Cheech and Chong
medicine. General Barry McCaffrey called
this Cheech and Chong medicine
states of Arizona and California in 1996, after the voters of the
of medical marijuana approved the legalization
Cannabis is medicine. It's not a joke.
And let's get into that.
where it's legal. ThereMaryland, whoops--tates
That's great. Okay, Maryland is questionable
because there you can use it
after you've been found guilty. It doesn't sound like
that's real legalization. Briefly, in the Chinese oral
history their materia medica
And either the second Chinese emperor or the mythical
Chinese emperor, also the God of pharmacy and agriculture
Shaun Nen is said to have discovered the medicinal
properties of cannabis. Sir William Osler, of course,
in his textbook of internal medicine written in the 1890s
in two subsequent editions, last one written, I think,
in 1916, all included the advice that cannabis
was the best treatment
If you are interested in for migraine headaches.
Ethan Russo, who was reading more about migraines,
Montana, and is now the North American medical
director for GW Pharmaceuticals wrote a 60-page article
in the Journal
that explores the medicinal use oof cannabis for the treatment
of migraines. He attempted for five years
to get government approval
of cannabis for migraines. to do research on the use
refused to cooperate. Cannabis, of course, was in
the United States pharmacopoeia from 1854 until 1941.
Now, let's get on to modern research, because that's
what you are concerned about. Before the modern research, in
1937, at the Marijuana Tax Act
who was the chief lobbyist hearing, Dr. William Woodward,
Association, said that for the American Medical
to this legislation and that the AMA was strongly opposed
the medical use of cannabis. the AMA knew of no dangers from
showing that marijuana was In 1949, there was a study done
I have a number of patients who have seizures who get relief
from cannabis.
in her middle 30s, who had One of those was a young woman
and had had a cerebral bleed, at the age of 17, and
another one at the age of 27. The same neurosurgeon
had saved her life twice. She was hemiparetic.
Her history was that she had
adequately treated seizures recurrentevery day.le to be
However, she said if she stayed just a little bit high
she never had a seizure.
found that if they are And many seizure patients have
they don't have seizures. If for some reason their supply
of marijuana is interrupted they start having seizures
again.
mechanism of action of cannabis, This is compatible with the
to get into later on. There were studies that were
done in the 1970s and 1980s in eight states, which
demonstrated that smoked cannabis was effective
in treating nausea
In 1985, the federal government anworked cooperatively witht.
Roxane Laboratories to get Marinol to the market.
They were concerned at the
patients who were gaining relief relatively large number of AIDS
And they wanted to have a pharmaceuticalized option.
Marinol is not marijuana. It's not pharmaceutical
marijuana.
Cannabis, as we will see later It is synthetic delta-9-THC.
I'm the number one prescriber of on, has 483 cannabinoids in it.
It does help some people. MarinoAnd it does not helpounty.
some people.
marijuana is preferable In my cto Marinol,erience,
but Marinol certainly does have clinical uses.
And those clinical uses go beyond the FDA approval.
And you know that you can prescribe drugs for off-label
indications as long as you have a defensible reason,
either from research
to write prescriptions or a strong anecdotal evidence,
As a matter of fact, 40% of all prescriptions are written
for off-label indications.
is the largest neurotransmitter Thesystem in the brain.tem
We know practically nothing about it.
It was first characterized
the Israeli scientist inwho isolated THC in 1964.m,
In 1999, GW Pharmaceutical, a phytochemical company,
that's a company that makes medications out of plants,
started doing research
Their product is now being sold within Canada by Bayer.abis.
In 2000, the California Marijuana Research Center
was started at the University of California-San Diego
School of Medicine. They have administered
in excess of 18 FDA approved
several of which have appeared smoke marijuana medical studies,
Dr. Donald Abrams is somebody iwho fought with the FDAs.
for nine years to get a study with smoke marijuana.
Finally, when he designed the study to determine
if it actually harmed people
They approved his study. with AIDS.
did not harm people with AIDS, He found out it not only
weight gain. but that it facilitated
than Marinol, and of course more effective than the placebo.
Dr. Ware
And I always think it's ironic, I mean the Canadian border
is just less than 125 miles from where I grew up.
You can go to Canada and
you can get legal tincture you can get legal marijuana,
by GW Pharmaceuticals. of cannabis made
is relief of pain with cannabis and cannabinoids.
Dr. Donald Tashkin is a very
He is a pulmonologist. good researcher at UCLA.
cannabis was a bronchodilator. His research demonstrated that
that I think he was surprised He at the results, thaty,
the incidence of lung cancer
was less than the incidence inof lung cancer in peopleis
who smoke nothing at all. And so it may actually be
a preventive in terms of cancer.
by Robert Melamed, who is Thea professor of biologyle
at the University of Colorado,
And Dr. Abrams had a recent article that appeared in
the Journal of Neurology
showing that there was a in the February issue
in people who had AIDS. 34%For those of you who havepain
a real interest in learning more
organization about this, there's a great
It's run by a nurse whose area called Patients At A Time.
treatment, which is one of of expertise is drug abuse
They have put on conferences my areas of expertise.
including world class every otresearchers.ce 2000,
Their upcoming one will have
presenting, as well as Abrams, Tashkin and Ware
medical marijuana patients. fouYou may not be aware thategal
the federal government
marijuana cigarettes a month to four medical marijuana patients
and 300 every three weeks to a fifth.
Originally, there were 15 people
But several of them have passed away, because they
had significant illnesses.
to tell you Anywabout that conference.time
Suffice to say I think
Now, if I'm able to get you itto think differently about.
cannabis, it may have to do with the fact that
you are two generations younger than I.
It took me about 20 years from first finding out
about medicinal cannabis
who is a pharmacist up in Rice Lake.
We were talking about prohibition.
And he was telling me that when he was a freshman
in pharmacy school at the University of Minnesota in 1928,
that one of their assignments was to make tincture
of cannabis.
with cannabis. It had nothing to do
with making tinctures. It had to do
pharmacologically active How to extract the
And he showed me this book, his 1927 edition of Remmington's
Textbook of Pharmacy. And on pages 999 and 1000,
it talks about cannabis.
of cannabis as an anodyne, And it talks about the use
for pain killer. which is an archaic word
indication for And that's still the number one
whether it's in Oregon, the Colorado, or California,is,
the three states that I'm somewhat familiar
with the statistics,
of the recommendations somewhere between 60% and 65%
And we'll get into that in a little bit greater detail
a little bit later. At any rate, it took me about
20 years before I finally got away from being influenced
by the propaganda that's out there.
That this was just a ruse to deal with recreational use
of cannabis.
talking about the medicinal use of a substance versus the
recreational use of a substance.
and I have a long experience, 40 years of experience involved
in one way, shape or form, in drug abuse treatment prevention
with opiate abuse.
have some abuse potential And tdoes not stop usates
from prescribing that for pain. As a matter of fact,
you have an organization here that started a support group
for people with pain. In California, there was
enough concern about physicians'
pain, that in order to have lacour license in California,ing
we must have 12 contact hours in end-of-life care
and pain management.
country, an opiate phobia and often under-prescribe opiates.
I have a lot of experience, about 800 opiate abusers
that I've treated in my role
a methadone maintenance program, as medical director of
treatment program anand an out-patientne
opiate detoxification program.
talking about that particular So I feel relarea.ly comfortable
In 2000, I started focusing on making recommendations for
the medicinal use of cannabis.
that it was medically useful, I wasbut I had an educationfact
from my patients
And I'll give you a few examples as to how useful it was.
Now, the AIDS patients as we go on with this talk.
of patients that started using were one of the first groups
Of course, it was very helpful cannabis to any great extent.
Abrams' research as an appetite stimulant.
in a double blind study. later demonstrated that
and as an anti-depressant. It's useful as an anti-nauseant
euphoria may be a side effect. And Abrams once said that yes,
with AIDS or you're treating But when you're treating people
euphoria isn't a bad thing. oAnd with cancer patients,e
again, the anti-nausea, appetite stimulant
and antidepressant effect of the drug are very important.
Now these things are not only evidenced by the clinical
experience of myself and
As a matter of fact, in Oregon, hwhere they have a mandatory.
patient identification card program, 2500 physicians
have made recommendations to one or more
of their patients.
that is a marginalized group So this isn't something
but are physicians who are of weirdoes that are out there,
And I can tell you that liyou have instant rapports.
with your patients. Somebody comes in and tells you
"Doc, I'm a paraplegic. I have excruciating pain.
I was taking enormous amounts of oxycodone.
It was causing me to be confused.
It was giving me constipation.
A friend of mine told me, And I startry this. marijuana.
And I tried it. I was able to dramatically
decrease the dose of Oxycontin
I was able to be focused. I wasn't confused.
I could play
And you begin to appreciate the utility of this drug.
And also, when the patient
and you, as the physician, tells you that
pain relieving characteristics. This is something that I know
is helping you, you have really solidified the doctor/patient
relationship. You are hearing the patient.
You are listening to them.
roll your eyes skyward On the other hand, if you
to talk about that," and say, "I don't want
a chilling effect on that is going to have
The use of cannabis the as an anti-nauseant andship.
appetite stimulant
by animal studies and paand culture studies.mented
I recently attended the 17th Neuropharmacological
Conference, October 31 to November 2,
where there were
from all over the world, presentations
college of Wisconsin. And these basic science studies
tend to complement
These are, in my experience, our clinical experience.
that cannabis is useful. the top six conditions
Sleep is something Pain, of course, number one.
And in many cases, that is very effective.
in people who have pain, nausea. it's to help treat insomnia
specific anti-arthritic effect. SomeInterestingly, there ares a
a number of people with these arthritic conditions,
or autoimmune diseases, that
that it's good at relieving. we don't know much about
restless leg syndrome, I mean, fibromyalgia,
Many people who have found complex regional pain syndrome.
find that they do get some relief, and in some cases,
a lot of relief from cannabis.
and ADHD a little bit later. I'm going to talk about ADD
effect on that. When I was at this conference,
I was sitting at a table
of course everybody there with somwas a PhD.onchos,
And I was saying that I have a number of patients
that I've treated with cannabis for ADD and ADHD.
And they've said, you know, it helped me graduate
the Maritime Academy. And then I said there was
one of my patients
get my PhD. Well all of these PhDs
at the table laughed knowingly. Nobody there admitted
that it helped them get their PhD.
But they seemed to understand what I was getting at.
Okay, and of course the migraine headache thing.
This was something that Dr. Osler was right about then.
And he's still right. Other conditions,
seizures, glaucoma. The question of
how long it decreases your inner ocular pressure
is one that I haven't been
In discussions with just clinicians, some studies
indicate four hours.
as much as 21 hours. Other studies indicate
pressure by about 25%. It decreases your intra ocular
increased inner ocular pressure So pwhen it's at about 19.bout
And 25 is generally considered, if you're over that,
you absolutely have glaucoma. So let's say that your
inner ocular pressure was 22, and you could decrease it
by a fourth,
into the safe range. you'd be down around 16 or 17,
that is very helpful. SAlso people preferg
either eating, or tinctures,
as opposed to putting drops or smoin their eyes.izing,
So this is a reasonable alternative.
I mentioned the fibromyalgia, and that sort of thing.
Of course, diabetic peripheral neuropathy
is another kind of peripheral neuropathy,
just like the AIDS
I have several diabetic patients peripheral neuropathy.
this is the only thing who have found that
We did a little study twith Crohn's Disease..
We made a questionnaire and then sent it out
to several patients of Dr. Tod Mikuriya,
who recently passed away, but has given more
recommendations than any doctor in the United States.
At one time, he was in charge of marijuana research
for NIMH
However, he thought he was there to do research
on the medicinal utility
and NIMH thought he was there to authorize research
on the dangers
or the recreational use of tof cannabis. use
So this was not a marriage
and it didn't last very long. But at any rate, Dr. Mikuriya,
myself and Dr. Hergenrather sent out questionnaires
to our patients.
is that people were able to, And what we found was,
who were seeing us-- who had Crohn's Disease
patient population. GranNevertheless, for them,cted
they were able to either
their reliance on steroids, stop their steroid use entirely,
decrease or stop
treating their Crohn's Disease. otThey had fewer stools.r
They had more solid stools. They had less abdominal pain.
There is also animal research that backs up
this clinical experience. Depression is one of the top
reasons that patients give
I had one patient who had something called
cyclical vomiting syndrome, which I had never heard of
until they came in. I now have, I think,
three patients with this. It's sometimes referred to
as migraines of the stomach.
virulent vomiting. And it is unexplained
was disturbed, because when he went into the emergency room
they looked at him as somebody
individual, and that who was an opiate-seeking
He was treated punitively by the emergency room physician,
rather than as a patient. His cyclical vomiting syndrome
is almost completely relieved by his use of cannabis.
And I suspect this is because of the CB2 receptors in the gut,
and the fact that when they are simulated,
they slow down the speed
and therefore the speed ofof transmission of waste,
through the gut allowing more time for water
to be extracted from the stool
Okay, now the mental health diagnoses are probably
the most controversial. Nevertheless, there are
a number of patients
anxiety, stress, who find relief from depression,
bipolar disorder. oI don't know whether or notr,
you place Tourette's
but Tourette's. in There's a researchere,
at UC Irvine
He was the chair of this named Daniel Piomelli.
in San Diego. NeHe has invented a numberce
of pharmaceuticals that interfere with the metabolism
of the two naturally-occurring
that we've discovered so far. One is called anandimide
and the other is 2AG. And I've forgotten what the
2AG actually stands for.
system as being intimately And he sees the endocannabinoid
attention deficit disorder, Tourette's, bipolar disorder,
panic attacks,
And that if you increase and that sort of thing.
of the naturally-occurring the amount
an external cannabinoid, cannabinoid, or if you take
You're going to thatreat those conditions.it.
And certainly, clinically, this is what we found in California.
Now, let's see if I can find one other.
Something that you may want to purchase, or Google.
I don't know the URL, but there's a newsletter
called O'Shaughnessy's. It comes out about twice a year.
The editor of this used to
of Scientific America. be on the editorial board
for the UCSF medical complex. He's a very sophisticated writer
and very dogged and very diligent.
And this particular issue discusses the various conditions
that ten of the top cannabis-recommending physicians
in California,
have found. And this might be something
that'd be worth while to look at.
Also in the archives, there's a discussion
about PTSD, ADD and ADHD. I'm going to touch on those
briefly in terms of my take on why it works to help treat
those conditions. I just wanted to take a minute
to talk about a couple
I already mentioned the first one with the person
with seizures.
who saw me two weeks ago. TA woman in her early 60s.an
She has a 20-year history of daily migraine headaches.
She recently visited
and had a migraine headache. her 84-year-old aunt in Canada
one of these cookies." And the aunt said, "Here, have
that my aunt used marijuana. And she said she had no idea
cookie, she had a part She didn't have the whole
And she said that she didn't of the cookie.
for two days after eating ha part of one cookie.he
She was in seeing me
so she could use cannabis to on a regular basison
and hopefully avoid her migraines entirely.
I had a patient who had back surgery.
He was a scuba diver. He asked his orthopedic surgeon,
can I go scuba diving?
I don't know anything Theabout orthopedic surgery,yes.
but I probably
He went scuba diving, something went dreadfully wrong.
And he became a quad for
and had excruciating pain nine mfrom T10 on down. para,
And he said that cannabis was the only thing
that prevented him
I have any number of pain patients who find
that the use of cannabis
Several of the federal has made their life tolerable.
have made the point, medical marijuana patients
so that I could "Ilegally use marijuana.se
I would gladly
if I didn't have this disease." Remember that when a patient
comes in and says this to you.
that if you are making Now, that doesn't mean
rthat you should give theml to everybody, that you
should hand them out like candy.
on the phone. In my oWe want to know people
what their diagnosis is.
what treatment they've gotten. We want to know
the last time was that they saw a physician.
And if somebody calls up, we're three or four miles
from the University of California at Santa Barbara,
so if somebody calls up sounding for all the world like
a sophomore over there at UCSB, and they say, "I can't eat
and I can't sleep." Our next question usually is,
"Have you been worked up
Because we don't make an for this?"
for sleep disorder appointment for somebody
at a sleep disorders clinic. unless they have had a work-up
First they say, "No." So theyAnd then they say,hings.
"I don't believe in doctors." We don't make an appointment
to see that person, because we don't think that they meet
a reasonable criteria for having a recommendation
for medical marijuana.
for having them come in and waste my time, and me
to waste their time and money and for them to go away angry.
Better that we say no,
an appointment for you. weNow on PTSD, this ise
probably one of the most important reasons
for you to be here today. We know that 30% of the people
coming back from Iraq,
post traumatic stress disorder. And I can tell you from seeing
patients from the Vietnam era,
and this war in Iraq, the fthat this isIraq
a very serious condition. People are hyper alert.
They're startled. They have nightmares.
They have anger.
have put them in harm's way. And we, the American people,
the Veterans Administration, And by under-funding
dealt with them. we have not adequately
government has prevented Furthermore, the federal
being able to recommend cannabis the Veterans Administration from
Now, we have a VA clinic for the treatment of PTSD.
They refer patients to me. in our community.
is a doctor. The husband of our mayor
A year or so ago, we were walking through a restaurant
and they were having supper there with their son.
He called me over so he could introduce me to his son,
and say this is one of the top
in California. marijuana-recommending doctors
of his patients that maybe He has suggested to some
he might recommend cannabis for the treatment of PTSD.
One of the founders of
and there's some flyers up here for that conference,
is Al Burn, who's a retired Lieutenant Commander in the Navy
who has PTSD. This patient here lives in
Bishop, California, which is just about 10 miles
past the end of the earth.
of town at the end of the road He lives 20 miles outside
And he says, "I try to avoid at the last house.
and not more than once a month, goibecause I can't stander,
being around people.
I'd start killing people." And if it wasn't for marijuana,
that have been traumatized There's a lot of people
And there are other people as a result of war.
as a result of rape, who have been traumatized
or growing up in a dysfunctional family
where they've been physically or sexually abused.
And cannabis is useful
of those conditions. in relieving some
the story about the PhD guy. ADD, ADHD, I told you
I've mentioned that. Crohn's Disease,
people tell me, "When I started using cannabis,
I was able to either
that I was using, or A, stop using the opiates
It has fewer side effects decreasethan opiates.to 66%."
And this is for the patients
Again these are self-selected patients, so I'm not saying that
this is a universal situation.
all kinds of studies, Nand studies with micee
who presumably have no political agenda
showing that they are able
in terms of tail flick, or to deal with hot plates,
that they are studying. whIn 1997, there were sevenngs
such studies that were presented
that was held in New Orleans. bAnd it was front page storye
in the LA Times , and that's how I became aware of it.
But these studies were done at such radical places
as the University of Minnesota, Wake Forest,
University of Texas,
In addition, there were andiscussions of paing.
at this recent conference that I came back from
in San Diego. Since cannabis is useful
in treating abdominal problems, there's little
or no abdominal pain. There's no nausea.
We know that with morphine, something like 22% of people
who you give morphine to
and vomiting. aThere's less confusiona
and dizziness.
They're able to play They're able to drive.
and their grandchildren. with their children
of pain in some instances. This decreases their perception
it allows them to concentrate Ion other thingses
rather than their pain. As I mentioned, it decreases
their reliance on opiates.
that you have pros and cons, Suffice to say
the former surgeon general, you have the editor
of the New England
And most importantly, you have Journal of Medicine.
government paid-for thInstitute of Medicine report,
that says marijuana is medicine.
with smoking They do take some dispute
But fortunately, there are as a mechanism of action.
of action. a number of other mechanisms
every western government study In terms of safety,
has recommended the legalization ever done
So one would think that othe medical use might be safe..
There was a two-year hearing
FDA Administrative Law Judge, presidFrancis Young. chief
And in his findings of fact,
was one of the safest therapeutic agents known to man.
That's the FDA's chief
telling you that, Adminot Dr. Bearman.udge
Marinol, which has more side effects than cannabis,
because it does not have
in it that cannabis does, thhas been approved by thes
Food and Drug Administration. It's one of the few,
if not the only drug, that has been upgraded
from a Schedule II drug to a Schedule III drug.
And Sativex has been approved for research
in England and Spain. And it has been approved
for sale, and has been sold in Canada by Bayer since 2005.
In December of 2005, the U.S. Food and Drug Administration
approved a Phase Three, as you know that's with people,
clinical trial
tincture of cannabis-- to determine whether or not
cannabis is made by putting the flowering tops of plants
in alcohol, leaving them there
for a couple of days, straining off the plant material
and left with the alcohol infused with the cannabinoids
and some of the phenoids
that are in the plant that have the therapeutic value.
And that has been approved
Administration for the by the Food and Drug
They just started that Phase Three clinical trial.
But I have every reason to believe that Sativex will be
available in this country in four or five years
depending upon how fast or slow the FDA process moves.
Okay, we know that it's efficacious.
I'm not going to go into this.
a number of laws Now, in California we had
that sort of clarify things. and court decisions
to recommend cannabis. Basically, it is legal for me
to patients about cannabis. ItThe federal governmentk
was enjoined from harassing or intimidating physicians
from giving medical advice, including medical advice
about cannabis. I mean, what the federal
government wanted is, if you're patients asks you,
"Doc, do you think that cannabis is good for me?"
that we should say, "I can't answer that,"
or "Well, I don't know,"
rather than what we did know. If you think that it's not good
for them, say so. If you think that it is, say so.
The Ninth Circuit Court of Appeals
has a permanent injunction
that prevents them against the federal government
and exercising our right from interfering with doctors
and our patients, from interacting with us and
asking us any medical question
including do you think that they want,
that might be useful for me? that cannabis is a medicine
own opinion as to whether or not And you need to form your
But you really have an obligation to your patient
to give them a straight answer. And you have to be careful
so that you are not influenced
abroad in our culture by thfor years and years,been
and that you base your decision on the training
that you're receiving here
and the additional training at tthat you'll receive whenin,
you go to clinical conferences, so that people are actually
talking about facts rather than about emotion and hysteria.
Okay, I'm going to-- Bearman
County Superior Court was a case involving me.
The Medical Board in California has a poor reputation
amongst physicians
the re-legalization of medical marijuana.
They wanted to subpoena a patient's records over the
patient's refusal to waive
They found a very pro-government their right to privacy.
who granted the subpoena. supeWe appealedjudge
to the appellate court. We got a 3-0 decision
in our favor. The reasoning in the decision
was stronger than if I had written it myself.
They said the Medical Board,
Their job was a investigate complaints.
They had no complaint about me. What they had was a letter
from a forest ranger
Is this legal? saying, "Is this ethical?
know what they're doing?" Do doctors
know what they're doing?
Okay. YeWe are now suing.
the Medical Board of California a second time to get the money
it cost to sue them the first time,
since they had no right to come after the records
in the first place. Oh, by the way, because
we appealed the case, they were trying to fine me
$1,000 a day
I didn't turn the records over. forAnd my finehat
would have been $115,000
In the appeal, if I had lost the case.
from the California IMedical Association.
These things are important. You need to understand
what your responsibilities are
And protecting the sanctity of as a physician.
is one of your responsibilities the doctas a physician,tionship
having nothing whatsoever to do with whether or not
you ever make a recommendation
of cannabis. for the medicinal use
what the Medical Board Okay, so let's talk about
They don't sound bad, but the fact of the matter is
that they're moving a target
makes them up as they go along. anWe need to do a good faithf
history and physical. The patients needs to be
a bona fide patient.
And we need to have a plan. We neeNow, unfortunately,ecords.
there are some doctors that are running mills out there.
What we refer to as HMO-style medicine, and we don't think
that that's right.
by forming an organization We're trying to marginalize them
of Cannabinoid Medicine. called the American Academy
ground by the first of the year. And we hope to have that off the
It's is hypothetical. If we hypothetically assume
that the Medical Board
which is quite a reach, of and we further assumeble,
that they had the power and authority and ability
to randomly select
to say, "Dr. Bearman any one of my patients
you made this recommendation?" would you explain to us why
so in a manner in which they'd be able to understand.
I got into this, because
on recreational drugs, I do expert witness work
Most of those drugs, and have since 1972.
300 where I've testified most of those cases, more than
marijuana cases, at trial, have not been
So, I'm always thinking in terms but 30 or 40 of them were.
the other side going to ask me? whaAnd that's the wayon
that I approach the history with the patient.
I want to be able to be on solid clinical grounds
when I make the recommendation
of cannabis. for the medical use
we screen people on the phone. As I mentioned,
to bring in their old records. We want them
their old records, If they don't bring in
And if they qualify, we'll do a history and physical.
a recommendation as soon as wewe get your confirmingou
medical records.
with a new patient. Do all of these things there.
I want to spend about two or three minutes here
and then give you about six or seven minutes
for questions.
Some people say well, you know, these plants, these herbs,
they're complicated.
True enough. We don't understand them.
that took me 20 years Anto sort of accept this.ngs
That manufactured medications are modern.
We know all about them, we think.
Our experience
go back to just before 1900. with manufactured medications
being the first synthetic. Aspirin
and plants go back, what a few thousand years?
A few million years?
of experience with them. We have quite a bit
apriority assume that manufactured pharmaceuticals
are somehow superior to plants. And in fact, there are
certain branches of medicine
that are a talking to Shamans, that are going into the Amazon,
at these various medications. that areOkay.ng a look
The endocannabinoid system, as I said, is the largest
neurotransmitter system in the brain.
We don't really understand it.
sensory input. It tends to moderate
the important thing. And I think this is
talking about this I'm going to kind of end
the rest of the slides and then just slip through
The way that I believe and let you read them.
is in freeing up dopamine that is trapped
in dopamine transporter.
there's an excessive amount of dopamine transporter
in a number of these conditions.
enough dopamine. And so, we don't have
system is important for doing Andis when it's releasednoid
and stimulates the next neuron
of the synapse, it causes dopamine
to come back to the neuron
that just stimulated that just released,
It depolarizes it and it makes it more difficult
for that neuron to be stimulated
coming along. Recognize that this is why
clinical impression of what's going's on
from people that have done
I'm sure that to the extent that I'm wrong, Dr. Kozee
will educate me after this. When I explain to my patients
that I think that this
they say, "Yeah, that is. iI'm able to focus.,
I'm able to concentrate.
goes away My atteor my depressionsorder
gets much, much less."
that your familiar with. Okay, so this is that schematic
that you need to keep in mind But bais the conceptoncept
of retrograde inhibition, and that the post-synaptic neuron
is going back and affecting the pre-synaptic neuron,
so that the next
will have a harder time neurastimulating that.along
And so we're having fewer,
to the midbrain, slower moving neural impulses
So people who have problems with anger associated with PTSD,
instead of having the amygdala, the rage center, overpowered,
and by rapidly moving anger impulses,
you have
but fewer. the same anger impulses,
has an opportunity to say, And the neocortex
they're likely to get angry," "Don't and so you don't.an SOB,
And you have a different outcome
than if you called him of that interaction
Okay, let's just kind of some dirty so and so.
and see what we have. This says, in words, what
I've been trying to convey. This talks about
cannabinoids and PTSD.
says the same thing over again This, again,
inhibition. Decreasing the sensory input.e
This is talking about the dopaminergic system.
Talking about its involvement in
the attention deficit disorder. This, again, talks about this,
and, you know,
the basic science stuff thiwhere my eyesinto
begin to glaze over.
The second quote came from These are some actual quotes.
by a reporter for USA Today on the use of marijuana ewed
for migraine. This was after
Kareem Abdul-Jabbar had been arrested.
He had gotten a recommendation
I was sitting in on frwhile he was out of country.e
I was talking to this reporter, and she was regaling me
with her experiences
of marijuana in college. with recreational use
of sort of chuckling And after about 20 minutes
the waitress came over and laughter,
her son had gotten. and This was a completelyefits
unsolicited comment.
have to smoke marijuana. And of course, you don't
It has 70% fewer irritants You can vaporize it.
You can use it sublingually, than smoking it.
You can take it orally. The Sativex is a spray.
It's in a metered sprayer.
this approved by regulators. The Sativex people want to get
That's why They don't want it to be abused.
It's a combination of 50% from a whole plant extract
high in THC and another whole plant extract
high in CBD.
for the therapeutic value, The THC
to dampen down the euphoria. the CBD because it tends
of administration. Marinol is an oral route
when you eat marijuana A little bit different
because 85% of it is metabolized than when you smoke it,
through the liver. on the first pass
I don't know. It means that your getting
different chemicals.
to know if it has We haveany significance, enough
or whether or not there are certain conditions
that are going to respond better
of administration tothan the oral route.te
The respiratory route does allow you
to titrate the dose.
to be in 15 to 30 seconds. Its onset of action is going
is going to be in 15 minutes. And the oral onset is going
to be 45 minutes to an hour.
The chief Administrative Recent developments.
ruled in a case involving the University of Massachusetts
that the DEA should sell
to this professor of botany who's an expert in medicinal
plants, so that he can study
components of different strains to determine which
of the chemicals
are best suited for the various conditions that
I've been telling you about.
the Journal of Neurology Of course I mentioned
and the FDA Phase III study. article by Dr. Abrams
Lester Greenspoon, Where are we at now?
the Forbidden Medicine, is saying we're at the juncture
as to whether or not
pharmaceuticalization, we're going to have
are going to be allowed or whto treat themselves.uals
In other words, will
rugged individualism prevail the traditional American
dominate? oDr. William Woodward,ns
I mentioned, said that
from the use of cannabis the AMA knows of no dangers
Marijuana Tax Act hearings. Dr. Joycelyn Elders,
former U.S. Surgeon General,
of medicinal cannabis. has come out in favor
Judge Francis Young said. I mentioned him talking about
the safety of cannabis. Rodney Dangerfield
wrote a book called,
In that book he has a picture, It Ain't Easy Being Me.
and it says, "Here I am looking at the best piece of mail
I ever got."
is, "A letter from Dr. Bearman And the rest of the caption
Now, I didn't tell him telling me to smoke more pot."
I told him that I approved to smoke more pot.
And his wife spoke at the Patients At A Time conference
we had in Santa Barbara.
She said that after he got this, And I couldn't believe this.
disinterested, like he was because he seemed somewhat
he showed his letter sort of mollifying his wife,
And when he passed away, she put to everybody.
So we know that Rodney his letter in his casket.
up in heaven, will or whereverested
he's telling his jokes. And I'm going to stop with
that.