Medical marijuana panel discusses benefits of cannabis
November 11, 2014
For Dr. David Gray, using marijuana as medicine comes down to a matter of time.
The plant that has treated injuries and illnesses for thousands of years was banned only about 80 years ago, and now it's moving toward more widespread legalization, said the Breckenridge-based emergency physician who makes house calls through Summit County treating altitude sickness.
Gray was one of a dozen people, mostly middle-aged and older, who attended a panel discussion on medical marijuana Monday, Nov. 10, at Elevate CoSpace in Frisco. The event was hosted by Philip Wolf, founder of local cannabis educational tour company Cultivating Spirits.
The panel's three speakers were a doctor who prescribes cannabis, a dispensary owner and a culinarian who writes about cooking with marijuana and using it medicinally.
HISTORY AND SCIENCE
Dr. Barry Bialek, a family medicine physician who runs Dr. B's Mountain Clinic, started prescribing cannabis four years ago. He uses the word cannabis instead of marijuana.
"I refuse to use that word," he said, except when it appears in the official name of something.
He briefly referenced the history of the usage of the word marijuana in the U.S., the Marihuana Tax Act of 1937 that effectively outlawed the plant, and the controversial anti-marijuana involvement of newspaper mogul William Randolph Hearst and the powerful Du Pont family.
The word cannabis comes from Latin, and before that Greek, he said, and Hippocrates carried the plant around in his medicine bag.
The plant was first used about 4,000 years in China and is still widely used in traditional Chinese medicine, he said. Then the plant was used in India with Ayurvedic medicine.
Now, cannabis is starting to be incorporated in allopathic medicine, which is what American doctors learn in medical school.
"We had a 75-year glitch, and now we're returning to our senses," he said, "except on a federal level."
He then gave the audience a science lesson.
Every cannabis plant contains more than 100 cannabinoids.
THC, the best known cannabinoid, causes altered psychological states when activated through heating. CBD, another cannabinoid, is considered to have a wider scope of medical applications than THC, and it doesn't produce psychoactive effects.
THC reduces pain awareness, while CBD reduces pain, he said, and THC is thought to make CBD more effective.
Cannabis has been shown to stimulate the immune system and increase appetite, he said. It's also an anti-inflammatory, and it can relax vascular smooth muscle, which makes it a good asthma treatment.
The plant is used mostly for symptom management now, though researchers are starting to look at its potential to cure, especially with cancer.
Bialek, who lives in Boulder, said he's currently part of a research team at the University of Colorado there that is studying the genetics of cannabis plants found to alleviate specific symptoms.
Bialek has seen more than 12,000 patients since his practice shifted to focus on cannabis medicine.
One of those patients was a 6-year-old girl who had hundreds of seizures a week. With non-psychoactive cannabis use, she's down to one or two. He's also used cannabis successfully to treat severe psoriasis, he said, and to help veterans with PTSD venture from their homes.
Whenever he prescribes cannabis, he gives patients a tracker chart, tells them to start with an individualized low dose, then add 2 mg until they find the proper dose. His patients continue tracking their consumption and its effects to make adjustments for changes in tolerance.
As part of treatment, Bialek also discusses changes in his patient's behaviors and environmental factors.
"Like with anything else, a medicine by itself does very little good," he said.
The radical part of a U.S. doctor prescribing cannabis, Bialek said, is that the doctor is talking about plant medicine, which is not something American doctors are taught.
American physicians do, however, prescribe amphetamines, which aren't present in the human body, to kids diagnosed with ADHD.
"Our bodies don't make speed. Our bodies do make CBD and THC," he said.
Other medicines are prescribed with known negative side effects, including death, he said, while no deaths can be directly attributed to cannabis.
"It's going to be a serious problem for big pharma," he said.
For cancer patients, cannabis can offer a reason to get up in the morning, said Nick Brown, the second panelist and owner of High Country Healing, a dispensary with a Silverthorne location.
Brown spoke about working with cannabis patients of all ages, from little kids to grandparents.
More than half of those patients have sleeping problems, he said. He told a quick story about a patient who hugged him after trying medical marijuana and being able to sleep for eight hours straight for the first time in five years.
Brown said he has also used marijuana medicinally. As a high school athlete who was named the top football player in Colorado and as a student at Princeton University, Brown found that cannabis helped him wind down after practice or studying.
Bialek discussed the different ways of consuming cannabis medicinally and recommended against smoking.
The high temperatures destroy more than 80 percent of the plant's active ingredients, he said. "Anybody here like burning their dollar bills?"
Vaporizing, which uses lower temperatures, is the best way to consume for people who want fast-acting results versus the longer acting results of other methods, like sublingual administration, oral ingestion, topical applications and transdermal patches.
The last panelist to speak dove into the do's and don'ts of using medical marijuana at home.
Professional culinarian Jessica Catalana, of Dillon, author of "The Ganja Kitchen Revolution: The Bible of Cannabis Cuisine," has been using cannabis medicinally for 17 years.
Catalano explained the steps of creating tinctures and salves, which are not psychoactive and can be used like common pain pills or rubbed onto aching body parts.
"If you want to have the psychoactive effects, which are also hugely medicinal," she said, the plant must be heated.
Then she talked about how to infuse bacon grease, coconut oil and other cooking fats with cannabis. She cooks with specific strains at precise temperatures for certain times to bring out aromas and flavors to enhance dishes, she said.
The question she gets most often is how to know how much to consume when creating cannabis products at home.
"Dosage is so important. You always have to start at the lowest dose first until you find your happy dose," she said. "You eat too much, you can't go back."
Catalano walked the group through the math of buying a strain with a known percentage of THC, weighing the cannabis, calculating the milligrams of THC and then creating consistent portions based on recipe yields.
After the discussion, Gray explained that he was approached by a Breckenridge dispensary three years ago and asked to help people seeking cannabis prescriptions. He declined.
"As a physician, I was reluctant," he said. "I didn't want to be the diet pill doctor, I didn't want to be the pain pill doctor, I didn't want to be the marijuana doctor."
A few months later the dispensary owner told him if he didn't write the prescriptions, those patients would drive to Denver instead. Gray said that travel seemed too dangerous, especially in the winter, so he changed his mind.
He thought his patients would be 19-year-olds looking for legal ways to get high, he said. Instead his patients have been older people with conditions like arthritis and seriously injured younger people who he was able to wean off drugs like oxycodone.
"I thought I was going to see a bunch of stoners, and I didn't," he said. "I saw a bunch of real patients."
Wendy Basey, 68, co-owner of Elevate CoSpace, asked the experts about how cannabis could help her 9-year-old granddaughter, who doesn't sleep well because of severe eczema. Basey said she personally doesn't like smoking or eating cannabis, but she's curious about how the plant could help her migraines.
She regretted the panelists didn't talk more about the effects of cannabis on motivation, which has been one of the biggest stigmas around the plant.
Basey pointed to herself and an older couple asking questions after the panel discussion ended.
"I'm so glad to see that we don't have this stigma," she said.
The next day, Wolf said he and the three panelists decided to host the same discussion at Elevate CoSpace on Monday, Dec. 15.
"With the snow, a lot of people weren't able to get out there," Wolf said.
He also didn't see the showing he'd hoped for from members of the local medical community, so the December discussion will be targeted to the general public.
Then starting in January, he plans to continue monthly panel discussions about marijuana with different experts and speakers.
Wolf will post a video recording of Monday's event soon on the Cultivating Spirits website. For more information about the discussions, email firstname.lastname@example.org.
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