Cannabis Doctor- How Does Medical Cannabis Actually Impact Our Body and Mind

0:00But how does cannabis actually help in our bodies and minds, or maybe both, with chronic pain? What's it doing? Yeah, so I guess people are most familiar with the two major compounds you find in cannabis. That's THC, tetrahydrocannabal, and CBD, cannabidiol. Really what they're doing is they work at three different levels, really. What they can do is modulate the transmission from, let's say you have pain in your arm, how it goes along your arm along to the spinal cord the second thing it does is it affects within the spinal cord how those signals are going up and down and then finally that sort of emotional cognitive manifestation of pain we always you know maybe many of us think about pain as just being a kind of physical sensation but it really is an emotional one cognitive one you know you think of times when you've been in pain but someone's been able to make you laugh or smile and it kind of helps to just take some of that pain away.

1:00Medical cannabis is working across those three different levels to have an effect on an individual's pain levels. Okay, so you just mentioned two things there. One was CBD. That had a massive boom about five years ago, I think. Everyone was making CBD drinks and like the CBD that you put under your tongue. I have no idea where the legalization is on that now. but is it THC the one that can give you make you high and the CBD doesn't make you high am I right in saying that yes you're right in saying that so CBD is is non-intoxicating um I wouldn't recommend this but you could take as much as it of it as you wanted and you would never get an intoxicating effect um whereas THC has that potential I think the key thing you know you mentioned about the misconceptions at the beginning of the podcast is when we're prescribing for medical cannabis we start off with that THC level low so that it's not causing that euphoria, cognitive impairment, et cetera.

2:01And we slowly titrate it up over time to reach a level whereby you're getting that clinical effect that a patient has developed tolerance to maybe those adverse events. So yeah, it's between those two that's kind of having the effect when someone takes medical cannabis. Because the CBD, people can go and buy that now from the shop. Is that right? That is correct. But I think there's two key distinctions. One is there's been studies shown of CBD that you buy on the high street, online, wherever you're able to obtain the wellness CBD products from. Often they don't contain as much or more CBD than they say they do.

2:36They may contain other contaminants that you're not necessarily wanting to take at the same time. Essentially, they're regulated as a food product. So the margin for error on everything that's contained in it is much wider. whereas CBD when it's in medical cannabis it's you know it's a medicine and so therefore the appropriate regulations are in place to make sure that you know a specific amount is prescribed and you get exactly what is in that product. So someone's saying like these drinks with CBD and do you think they're going to be having much more effect or do you think they're mostly for a claim because there might be quite small amount of CBD and I mean what like how much do you really need to have an effect.

3:16Yeah and I think this is why there was there was quite a lot of guidance from like the food standards agency particularly around in food products. When you're taking it in a food product you have no idea how that food product is affecting how much you're absorbing it. Often you need to improve the absorption of medical cannabis. Ideally you take it in a in a fatty meal and one of the most common ways in which you take medical cannabis is with an is as an oil and we would suggest people hold it under their tongue for five ten minutes to have better absorption we actually absorb it really poorly through our guts and so therefore actually if you are taking it in a drink a food product whatever it may be actually if it particularly if it's not a particularly fatty food product probably doesn't you know you're having a small amount it's not absorbed particularly well and you're probably not having that much of an effect So how much would this cost for someone then who is maybe thinking, well, I've gone through all of these routes that Simon's just mentioned, you know, like what is the cost of going on medical cannabis?

4:21Yeah, so the costs really vary depending on the condition and what may be prescribed. But typically appointments may cost anywhere in the region of 10 to 50 pounds, depending on which clinic you go through. In terms of the medications, yeah, like I said, it's a broad spectrum going from sort of low to mid hundreds of pounds per month. I think that's what makes me feel sad I mean I'm sure it does for you as a clinician as well maybe seeing people actually having these advantages and effects that helps improve their chronic pain I mean there's nothing worse than when you're in pain the whole time and knowing that actually this is really only accessible for kind of people that have a good income yeah I mean it's it's a bit of a paradox really because I work for a private medical cannabis clinic, Pure Relief, but I see it as my objective to make my job almost like obsolete and make it available on the NHS if the research shows that that's appropriate.

5:32And I hope, you know, thankfully for my employment, it will take probably a long time to show this, but I hope that in the future, we're at a point whereby we can say, you know, for all of the indications where medical cannabis is prescribed this is exactly where it should fit into someone's treatment regimen and this is where it should be appropriate on the nhs but at the moment everything is just categorized as it's you know a treatment of last resort um and so i'm hopeful in the future we will we will get to to there we'll get there how many research papers and studies have you done around this um i've um i think i've got over 80 publications on medical cannabis today which was the most surprising results to you like what was the thing where you were like wow this is this is incredible that we had this result or surprised you potentially um that's a really good question i think you know we've talked about the clinical side i think one of the really interesting things that we looked at was um maybe not so much the medical side but we looked at contamination of illicit cannabis and that was really that so um cannabis that people are buying on the streets without a prescription.

6:43We looked at samples that had been seized from police forces across the UK, and we showed that up to 90 % of those samples were contaminated by potentially harmful mold, fungi, yeasts. Some were even contaminated by bacteria like E. coli, salmonella. And we also showed that some were also contaminated by heavy metals like lead. not at really high levels but certainly if you were taking it regularly over a long period of time enough that potentially could be harmful and so i think that's that's the other flip side of it is that we know that a lot of people who can't access it for cost reasons they're not even aware that medical cannabis exists but are still like accessing it through a black market route are really putting themselves potentially at risk unknowingly by the by the contamination of of illegal cannabis.

7:38Wow. That's a really good point that you raised because I think that the fear on people hearing a conversation like this, right? And we haven't gone into all the areas and the studies of what you've seen of different health conditions yet, but it is, you know, cause it can be expensive. The easier route is to go black market. And I've seen that now loads with peptides, you know, people getting them from China, um glp1s if you're not doing it via the doctor and getting it on on the dark web um any type of drugs you know it's so much sometimes easier as a solution to be like well i've heard this well i'm gonna maybe not get it from a regulated source yeah what's like your biggest worry there with people i think i think you know my biggest worry is that people are placing their health in the hands of people who don't care about it drug dealers gangs whatever it may be whereas if you go to a regulated source you're seeing a doctor someone who's trained to look after you not only with you know from a medical point of view but emotionally like most doctors the vast majority that I've come across are very good people and want to do right by you and so I think you know that's the most important thing when people are trying to weigh up those two options and in some you know in some instances you know the cost may be comparable it's not as if illegal cannabis is is you know ridiculously cheap either and so when you're trying to weigh those up i think that's really important