How Prepared Are Doctors to Recommend It?
By Dr. Aseem Sappal (Original Article Published 9-23-15 by Cannabis Health Magazine)
Medical cannabis is gaining acceptance across the United States. Not only do many more Americans favor shifting the focus of the nation’s drug policy, 23 states have legalized medical marijuana and an additional 19 states proposed legislation to legalize it this year. The number of legal medical marijuana patients in the United States stands at 1.1 million and is estimated to reach nearly 2.5 million if medical marijuana were legal throughout all 50 states and DC. Add to this the momentum built for the Compassionate Access, Research, Expansion and Respect States Act (CARERS Act)—the first comprehensive medical marijuana legislation in both the U.S. House and Senate—and reform of federal marijuana laws could be just around the corner.
While patients and the country appear to be moving toward medicinal cannabis, not all doctors embrace it or are enthusiastic about signing up to provide patients with recommendations. Most medical schools don’t have curriculum in the science of cannabis or the human body’s endocannabinoid system. The long-held misconceptions about cannabis prevail and many doctors fear losing their medical licenses and practices should they make medical cannabis recommendations.
How Some Doctors Intersect With Cannabis and Its Healing Benefits
According to Mark Rosenberg, MD, FACEP, a Florida physician and researcher focused on integrative cancer therapeutics in treating end-stage cancer patients, “Patients have access to much more information today. The playing field is leveling and patients are learning about medical cannabis before some doctors.”
About two years ago patients began asking him about cannabis as an optional treatment to chemotherapy. Since then Dr. Rosenberg has been researching the correlation between cancer stem cells and non-cancer stem cells to find a treatment that could turn cancer into a manageable disease. While clinical trials are needed, Dr. Rosenberg has seen positive outcomes in patients with brain cancer who medicate with cannabis. He referred to a very impressive study where treating with medical cannabis prior to chemotherapy produced surprisingly better results compared to treating after the chemotherapy.
Physician and researcher Sue Sisley, MD, had a similar experience. She admits she didn’t hear what her PTSD veteran patients were saying about the benefits of marijuana at first. “It isn’t easy for patients to push back at doctors in general,” said Dr. Sisley. “But, the vets were making reasonable claims and they taught me a lot.”
As she learned more about her patients’ positive experiences using marijuana as a mono-therapy for a range of ailments, Dr. Sisley agreed that the standard meds used to treat PTSD weren’t working for them, came with unpleasant side effects, and were highly addictive. Today she is the principal investigator over AZ site in the current and only FDA-approved trial looking at the use of the whole marijuana plant in combat veterans with treatment-resistant PTSD.
Juan Sanchez-Ramos, PhD, MD, a physician, researcher and Professor of Neurology, has been interested in medical cannabis for a while. His clinical practice focuses on movement disorders such as Huntington’s and Parkinson’s diseases and directs research in neurodegeneration, neurotoxicology and adult stem cell biology.
“Cannabis has a long history of use as a medication, but when I first learned of Dr. Raphael Mechoulam’s discovery of isolating THC and other cannabinoids in the plant, I began to follow the literature, which has evolved quickly in Europe.”
Based on review of the literature, Dr. Sanchez-Ramos believes cannabis can be applied for treatment of involuntary movements associated with Tourette’s Syndrome, for tremor and muscle rigidity associated with Parkinson’s Disease, and for the chorea of Huntington’s Disease. Like his colleagues, Dr. Sanchez-Ramos agrees more research is needed. “Much more clinical research is needed to determine the optimal concentrations and balance of the cannabinoids for specific indications,” he said.
The International Canna Pro Expo is where the Health Care Community and Medical Cannabis Industry leaders network and learn about the Science of Cannabis.
How Can Doctors Be Better Prepared to Recommend Cannabis to Their Patients
All three of these physicians have taken an interest in cannabis as an alternative treatment option for their patients and gone a step further to study the endocannabinoid system and the existing known benefits of medicinal cannabis related to their specific specialties. They’ll be joining other physicians and medicinal cannabis experts to share their insights in Orlando, Florida at theInternational Canna Pro Expo October 2nd to 4th.
Doctors and nurses are expressly invited to the Expo and have the opportunity to earn CME/CNE credits. But anyone—entrepreneurs, growers, patients, caregivers—are all invited and welcome to attend. The curriculum will cover the state of cannabis today, medical cannabis policy, legal issues, state-by-state cannabis law briefing, best practices and mitigating risk for physicians, methods of ingestion, the science of cannabis and the endocannabinoid system, medical cannabis patient testimonials, and cannabis and specific diseases including gastrointestinal disease, movement disorders, cancer, veterans and PTSD, aging.
When asked how doctors could be better prepared—in addition to attending the Expo—all three interviewed physicians provided a perspective.
“We have been raised on the concept of one-drug, one-receptor paradigm,” said Dr. Sanchez-Ramos. “The use of combinations of active and inactive molecules found in plants is new to most physicians. The ‘entourage effect,’ which states that in some situations the combination of agents in a plant extract is more effective than any single agent needs to be part of the education of physicians.”
Dr. Sisley offered, “I’d ask physicians to consider the Hippocratic Oath they took. Treat patients as human beings and listen to them. And, rather than be mired in the politics of cannabis, learn the facts and the science of cannabis.”
Dr. Rosenberg’s response was straightforward. “Please read what’s already available,” he said. “Cannabis research has been, and is being, conducted around the world. Stay informed.”
- Joe Estes, Managing Director of International CannaPro Expo
- 6 Facts About Marijuana, Pew Research Center, April 14, 2015
- States With Legislation or Ballot Measures to Legalize Medical Marijuana, ProCon.org
- Number of Legal Medical Marijuana Patients, ProCon.org
- Momentum Continues to Build for Historic Federal Medical Marijuana Bill, Michael Collins, Huffington Post, August 14, 2015
- On Marijuana Policy, Congress Needs to Pick Up Where It Left Off, Rob Kampia, Huffington Post, September 8, 2015
He is a Professor of Business, Science and Civics, representing Oaksterdam University across the nation as a subject matter expert to health care professionals, business leaders, politicians and the media while promoting education and improving public awareness.
Dr. Sappal holds a Medical Degree from India, serves on the Scientific Advisory Board of the Health Research Institute, which works with the Oregon Medical Marijuana Program, is on the board of the Public Education Program Fund and is an advisor for the Coalition for Cannabis Policy Reform (CCPR) and ReformCA.
He has lectured at numerous cannabis business conferences, often appears on media interviews as an expert, and writes for numerous magazines on the subjects of business, dispensary operations, horticulture and compliance. Dr Sappal is responsible for training numerous managers, business executives and investors on issues of compliance and best business practices.
Oaksterdam University courses have gone on the road nationally under his leadership, with international courses on the horizon, as well as starting a research and development program for the university. Dr. Sappal has overseen the production of campus videos and commercials, marketing, job placement, pharmacy programs, mandated education programs, training, certification and legislative advocacy.