From Marijuana to Mushrooms_ A…Health and Wellness “Natural_”
Tue, Oct 17, 2023 4:54PM • 2:04:00
SUMMARY KEYWORDS
cannabis, years, plant, put, thc, state, cbd, patients, plants, coming, drug, including, part, physicians, federal prohibition, talk, chemicals, cannabinoids, give, doctors
SPEAKERS
Bill Clearfield
00:41
There you are. How you doing? Not too bad Doc. I’m headed
Bill Clearfield 00:49
for Houston tomorrow for the am mg meeting so
00:55
I was gonna go to that then ended up not
01:01
okay, I’ll let you know how it goes. Don’t want us to go to those.
01:07
I had like it. I really enjoyed the last conference we were at.
Bill Clearfield 01:13
When was that? I can’t hear you’re doing you’re muted.
01:16
I unmuted myself so you’re really gonna be in Houston tomorrow.
Bill Clearfield 01:20
Yeah, the AMG meeting at the Marriott Marquis I think
01:26
where?
01:27
Okay Marriott Marquis. I’m not. I’d have to look it up. But are you spending the night or what’s the Dr. How long are you going to be in?
Bill Clearfield 01:36
I’m going to be the other set. So Sunday. It’s a MMG. Remember, we used to go to the Trump Trump place.
01:44
Yes, I remember that. But we never went to the Houston one. I didn’t know there was one in Houston. We’ll have to meet up.
Bill Clearfield 01:53
Yeah. Last year. They were in Dallas. They used to be in the this time of year they used to go to Tucson. Okay, haven’t done that. For the last two years.
02:06
Well, we are going to have to make an appointment to meet Ty John.
02:14
I would really like that. All right. Well, I’m speaking Thursday. morning at nine and Sunday morning at nine. Okay, so other than that, I’ll be
Bill Clearfield 02:33
watching Dr. Burgess. Take care of his beard.
02:37
Okay. All right. It’s the Marissa Marquis and what part of town do they say on their
02:46
on their bro on there?
Bill Clearfield 02:48
I’ll go look it up when once we get started here. Okay. All right.
02:53
Get it for you.
Bill Clearfield 02:58
I haven’t I haven’t actually looked at it myself since.
03:02
So I’ll have to I’ll have to get it out. Okay. Okay. I’ll
03:06
have to I have a new man in my life. Oh,
03:10
there you go. Good. Yeah,
03:13
he’s he weighs about 80 pounds. And his name is racks. He’s a Siberian Husky.
Bill Clearfield 03:22
I’m gonna say that sounds.
03:24
Sounds like sounds like a four legged one. And that one sounds like a winner. Yeah, he’s a yes. Oh, boy.
03:34
He’s a high energy dog to Rex. Rex, the Wonder Dog.
03:40
Hmm. Okay.
Bill Clearfield 03:42
That’s what we like to hear. That’s you’re probably better off than the one with two legs.
03:47
Yeah. Probably right. Yeah. I always say
Bill Clearfield 03:55
it’s quarterback put them in the car, put them in the trunk in a car and drive him around for an hour who’s going to be happy to see you?
04:07
Well, I’ll tell you what, I get up at five every morning and we’re down to the river park and he has to run and then we just got back from another walk is not quite too so he boy he’s you know he’s a sled dog.
Bill Clearfield 04:23
He’s a life. There’s a lot that a lot of energy, huh? Yeah.
04:29
Okay, so the doctor
04:38
just sat down to his desk, but I haven’t seen anything since then.
04:44
Whose was that? block area. Okay. There we go. Okay. Hi, Andy.
04:56
Hey, Kent. This is wonderful tonight. A doctor block
05:05
he’s here somewhere. Yeah, yes. Not areas okay. If you really want to
Bill Clearfield 05:12
be impressed I put it in the email. I don’t know if Dr. Block if you saw in the email I put one of your videos of your of your your back. Is that your back yard? What is that exactly?
05:23
The link can you hear me? All right. Yeah, now we can the link that you put there was two episodes of a podcast series called Plant one on me. First, was actually the garden tour. The second one is of a conservatory in greenhouses that I have here. So it was all a plant thing had nothing to do with medicine and drugs. But
Bill Clearfield 05:48
yeah, we were getting away from that. I think
05:51
we’ll hit on that tonight. MRU screen or am I allowed to screen share now or what do you
Bill Clearfield 05:59
Yeah, we’re still got folks coming in. But when when? And yeah, it’s five o’clock. So here we can
06:05
Vamp it’s eight o’clock here and it’s actually beautiful. Today in Miami. It’s our first real fall season day where the humidity came down. It’s been a brutal summer. As in many places in the country. Yes.
06:19
It’s like really hot and Temecula. Where were we? We pushed 101 Yesterday, I think, oh, I don’t know. You got very unusual It was cold and then we’ve had a straight week of and supposed to drop 20 degrees in a couple days.
06:41
Well, a fun factoid Miami has never hit 100 degrees. It feels like it because the humidity. Yeah, makes it feel that way but hit 99 This past year but at the airport where things are measured. It’s never actually hit that 100 mark and
06:57
now with that humidity that has just got to be sweltering.
07:03
Yeah, but that’s the point though it rains before it doesn’t get scorched and dried out. It’s not deserty here
Bill Clearfield 07:12
I don’t know. It’s like it’s been nice here for the last six weeks 70s and 80s in a day and 50 at night. So
07:21
I’m you’re looking out your window at mountains. You don’t have such here.
07:26
Now. Hi Andy. So,
Bill Clearfield 07:35
okay, so, doctors, you know, it’s nice to see you again. Anybody who’s bored this weekend, we’ll be in Houston at the age management Medical Group. I’m speaking on Thursday and Sunday mornings and it’s a fun group. It’s not quite as frenzied as a 4am. So more laid back group so
08:03
and other than that, Dr. Robin Nice to see you. How’s your
Bill Clearfield 08:13
doctor Dr. Robin got canceled also it oh man, right. I did. You got she got she got you know, they canceled us all together. He was well you’re supposed to give a talk on functional medicine for the family practitioners and they told you not don’t come right.
08:27
Well, they said that a CFP said that they couldn’t they couldn’t get the CME from the AOA would not grant them the CME for what I was going to talk about. So I wrote back and just said you know, I don’t understand what is not CME about all of this evidence based stuff, you know, but they know I’ve I just took that as a very, very bad sign I was putting a lot of energy into the AOA this year and yeah,
Bill Clearfield 09:02
we know about that here.
09:04
I know I’m a late bloomer. I’m a late comer here, but I I went in with the bells on and we all do
09:14
so Okay,
Bill Clearfield 09:16
so anyway, I’m gonna let you introduce yourself. Are you ready? Dr. Block?
09:22
Wow, how about if I just do it as we learned some slides. I’ve got the ready to Can I ready to go my host? I will make you a host Thank you. And then I got to pull up my program here in a moment.
Bill Clearfield 09:40
You are now a co host. All right, one second. Let me just
09:43
pull up the program. Here we go.
09:50
And now I can screen share with you.
09:54
Let me just get to my
10:01
Okay, question. Can everybody see full screen? Something here? Yep, looks good. All right, good. Um, Bill and I talked about this being more of an update. I spoke with your group. It’s not quite two years ago. I think it was once COVID it though. Or could it be just before? I have a background I’m an MD So I’m an invader to your space. But nevertheless, I have a good appreciation for osteopaths and their understanding of how the body human body integrates with its environment that is not taught in allopathic school. But I’ve always looked at the world from plants health and wellness and I moved with my family as a young teenager to Miami because my grandmother opened up the first flower shop and South Beach here, but that was right after World War Two. So I’ve been with plants my whole life. I’m I’m an anesthesiologist though. So I’m supposed to know something about pharmaceutical. I’m a clinical pharmacist and physiologist if you want to put it together. Couple that with a little botanical background, and I see the world through the chemistry which is one of the things we’ll be talking about. Hopefully they I’ve got about two dozen slides. And while I can take some questions as we’re going through this I’m not quite sure about how long it will take if I want gotta go fast. I’ll go fast, but hopefully it’ll hold your attention. So what I’d like to do is after the obvious necessary commercials associated with let’s see I’m trying to advance my slide here, but I’m not getting it to click or go. Why not? Here we go. There’s the obvious disclaimer here. You were talking about CMEs and what counts? I’ve had to deal with that. on issues of controversial subjects if only because their schedule one prohibited substances that not only include marijuana, but mushrooms, obviously, psychedelics, things like that. And so, all I can say is that this particular statement there about discussing any product used off label I get around it by saying all such schedule one substances are by definition off label doesn’t mean this discredit everything I’m going to say but the key thing they’re looking for there is that I don’t have commercial interests that should influence what I’m going to say. This is a picture in one of my greenhouses I did it with the white coat because people otherwise don’t know that I’m a doc when I’m wearing my normal garden clothes. Dirty or otherwise, the only things you’ll see there are legal plants because this is my own personal greenhouse. And I’m just going to compare Florida as far as its willingness thus far. To have even accepted things like medical validity of cannabis. We’re a little backwards here at times and yet things are gradually working this out through the rest of the country. So what I’d like to talk about then, is not just the academics and maybe even some books that I’ve contributed chapters to during COVID There was a lot of free time. But then I want to talk a little bit about the chemistry of plants in general because I have a profound respect for the power of plants chemicals, as did ancient tillers. We’ll talk a little bit about the history then and how it brings its way into the 19th century American pharmaceuticals where it was for 90 years before becoming scheduled one prohibited but the Nobel Prize winning work that was recognized on plant chemistry before we start to talk a little bit about psychedelics with mushrooms Of course. We don’t really know the mechanism exactly how they work but there’s some very fascinating research being done. West Coast large lot of at Stanford strangely enough about how these drugs are actually working in the brain as with the neuro chemistry, and then talk a little bit about the politics behind this because it influences the way we all practice it actually also influences not getting CME recognition of things perhaps, but knowing that the drugs their impact on public health, which has to be part of the conversation, there is an ugly side. And then, of course, the current laws versus laws that may be changing sooner than you think from a federal level, which I’ve always regarded as good. One of the things that may be not good, it deals with loopholes in the law. I don’t know how many have heard about delta eight THC, Delta nine being the primary known for 50 years known and researched at least under the Controlled Substances Act, really the principal intoxicating substance found in cannabis. So finally, we’ll conclude with other references not only these textbooks, the first book they’re in late 2020 is because my fellowship was in pain management, but I’m training like a dinosaur. My fellowship was almost 40 years ago. So they used to teach it along with addiction medicine, and addiction. ology nowadays is siloed with psychiatry, and there’s a very interesting field because if I had to pick one specialty that was particularly polarized, it would be our psychiatry colleagues. Were some feel for anxiety compared to other medicines that certain medicines in cannabis and certain for certain patients, that’s the key may be a lot safer and more efficacious than other drugs. And yet, you have zealous and protectors of chemical abuse and dependency who think what do we need another dependence forming drug out there in cannabis? Or mushrooms? The middle book is about the chemistry I wrote the introductory chapter there for another botany colleague, his name is mahmudul Solei. And that’s a picture photograph of his farms. He actually runs for the federal government at the University of Mississippi at Oxford, it for the last 40 years. His knowledge of chemistry, farming and cannabis in particular, has been the federal government’s primary source of all research material that whatever evidence base stated there is largely comes from what he has nurtured and then finally, in the beginning of next year, Brody’s human pharmacology seventh edition, I was asked to look over the previous edition for cannabis therapeutics. That’s one chapter. I looked at the chapter and yet it needed to be rewritten. I did it. But I also found that there’s a lot written about cannabis in a different chapter in that same pharmacology textbook, and that chapters titled of drugs of illicit use and abuse was something I said I’ll do one chapter if you want me to talk about the therapeutics and perhaps even advocate for its reconsideration, but only if you let me be the primary author and write both chapters. So there’ll be two chapters in that book coming out. So moving on, then this is actually another shot from about 15 or 20 years ago of my greenhouses, and I don’t know if any of you are familiar with an author named Michael Pollan, a great last name by the way, if you’re writing about plants, although he spells it am but he wrote about in something, he wrote this about the chemical biochemical power of plants, and it’s a profound statement talking about it. He says, they nourish us and poison us. They delight our senses of sight, smell and taste. They calm our nerves and wake us up or wake us up, and they even change the content of our minds and the experience of our consciousness. He does that pretty well there in terms of phrasing a lot of the things that we just sort of understand but don’t really think about as often. I think about it, because I had a person asked me when I gave this talk, who was a garden fan of mine. They knew as I was in anesthesiology said, Hey, Doc, you know, experience of our consciousness. What does it mean to get stoned or when you’re stoned? And have to think about that because people really hadn’t asked me it quite that way before and I said, you know,
18:18
good question. But if being stoned as a change of consciousness, and we don’t really understand the magic spark of consciousness, I think we have to leave that to the poets like, like Michael Pollan with that statement. So there have been the father’s and I’m going to use that word just because that’s how they’re generally regarded. I’m sure, women had pivotal roles. But these four cultures and Chinese Egyptians, India and Greece, the fathers of medicine, were all known to have written about cannabis because they were acknowledged as the fathers in their individual cultures, because they documented their findings. That’s really why they’re regarded historically as they are. So I want to just point out that even before these times, in prehistoric times, you would have always had somebody in a tribe of early humans and probably even before agriculture was part of cultures. And that individual would be trusted almost as a healer because they knew what plants could hurt you and what plants might help you. And so they not only knew those secrets, but they had to themselves be pretty good at sustaining those plants, or they would have lost their formulary and then they’re not regarded as a good healer nor as a plant custodian. So maybe in some ways I’m combinations of that sustaining plants is critically important. And this might be an Eastern healers, ancient wisdom. It was shared generationally to ensure health and survival. Why not? I mean, it’s it’s critical information historically in primitive times. So getting more into modern times for how Miss Information and we’re living at the times now where that’s big, but it’s nothing new. And in this sense, I want to show you two classical pictures. On the left is the opium poppy on the right, is the willow tree, and none other than bear from bear aspirin frame fame has been dealing with these two plants for 150 years. And the point that I’m going to bring out here is that heroin was first synthesized in 1874 and advertised as a non addictive substitute for morphine, which was known even before then, and during 15 years. Until it was taken off the market. It was sold even including to children as a cough suppressant, it works great as a cough suppressant. But obviously, it’s much more addictive than morphine. So hence is the marketing, but the point of the year that it was taken out of out of circulation by bear is because now you had something else you had aspirin Again, bear and that in the latest eight eight latest 1800s That patented its new brand of aspirin safe and effective from the bark of the natural willow tree. Its patent was set to expire the 1930s And that’s when bear advanced aspirins generic marketing to compete with other analgesics, including cannabis, which became illegal through its really first prohibition going back to 1937 with something called the marijuana tax act that made it too expensive for people to get. So moving on then, in the mid 1940s. Finally, someone was recognized in this case, Sir Robert Robinson, a British chemist. For his work with alkaloid chemicals. We’ll talk about what alkaloids are in a minute because most pharmaceuticals from plants are using alkaloid chemicals that the plant is manufactured in many ways to either defend itself from herbivore predators, they taste bitter alkaloids, or sometimes to change the the sensorium or or other behaviors of those animals that might be eating it. I’m not talking only humans, but in this case, Robert Robinson, back in the turn of the last century, did work on cocaine and on morphine. He’s actually found for cocaine the original precursors to cocaine and by the way, cocaine is not a prohibited substance in the DEA for the Drug Enforcement Administration because the liquid form of it is used to so pledges for ear nose and throat surgery because as a local anesthetic which cocaine is it’s the only local anesthetic we use that also as a vasoconstrictor. So at the same time, it doesn’t require the need of adding say adrenaline to it like the dentist use and anybody who’s ever had some dental work and had a little adrenaline that gets into your bloodstream. It’s a memorable event. Really does act strongly with the heart. So I mentioned alkaloid chemistry, but the father of cannabinoid medicine worked particularly with lipid chemistry. Cannabis is a lipid. It’s a fat. And so the research that Dr. Professor Ms. Shulam did, which was at Hebrew University for most of his career, actually started back in the 1960s. Because his same lab going way back then, was the first to identify not only delta nine THC as being that intoxicating substance in cannabis. But he also identified the biosynthetic pathway that the plant uses in manufacturing, those cannabinoids and not only THC, but also CBD. However, the real important discovery waited 30 years longer and it’s only in the early 1990s. After I’m already in practice as an anesthesiologist that this is the sentinel event, the discovery of the body’s own ligands there’s two of them that called anandamide and to a GE that cannabis or THC is mimicking, it’s not the other way around. And in order to have a good understanding of what cannabis does, you really have to first have a biological context in which to interpret what limited evidence based data there may be for Delta nine THC, and this is what gives it to you knowing the mechanism of action on how natural cannabinoids work, what their purpose is. And that was also through the same lab of Professor Ms. Shulam. In 2016, I visited with him there. I’ve seen him here at Harvard. We’ve had some engaging conversations. Unfortunately he passed away at 92 years old this past March. And I firmly believe that this was not a controversial subject, he would have already received the Nobel Prize with his life’s work, but such as the nature of these things, and these awards for Nobel are not awarded posthumously. So I’m just bringing this up because he’s had a tremendous influence on anybody who understands a cannabis and cannabinoid endocannabinoid receptor system today.
25:23
So where does that bring us from cannabis? Let’s just jump right to mushrooms. Anybody know what those would be? On your left hints? They’re not seeds. Anybody? Okay, well, they’re spores. Mushrooms and ferns are actually propagated by microscopic tiny little spores. And those are just blown up 20 micron. Size things to where you can actually see them. The mushrooms itself are depicted in the middle and on the right there you may see it’s sitting in sort of a pile of something dark. Well, it actually grows very well in cow pastures. And you know what’s in cow pastures cow patties. And in fact, this is a picture from Cuba, and that’s why the name of the fungi filled psilocybin cubensis refers to not the Shape Cube but the country Cuba, and the University of Miami where I’m a professor of anesthesiology. Our mascot is the Ibis it’s that bird that you see in the football games. And Ibis is when they walk through these fields pick up on their feet, some of the spores and actually spread those mushrooms around. They don’t seem to get psychedelic experiences from it. But humans have long understood that it has a psychedelic impact. The difference between psychedelics though and cannabis is I can’t tell you the mechanism of action for these. So I’m asked when I give talks, what do I think about it? And I kind of differ I can tell you that its impact on depression last far longer than you could detect this drug in a person. And that’s the fascinating part of it on pain and depression. Psilocybin seems to have an enduring effect that if I’m going to put it in computer terms, those of you who remember the old days with computers were the only way to make it work properly. Again, we’re to do a hard reset, at least conceptually, that’s sort of how I think it’s working. But let’s just say that psilocybin does work between three key neurotransmitters certainly dopamine, probably serotonin, and as a third, probably oxytocin, too. And so there’s some fascinating research being done with those three chemicals, especially in the midbrain, where we have all those emotions and connections of, of neuro links neural links that spread things through the full brain, but it’s at this moment, it’s nowhere near as well understood as the mechanism of action for cannabinoids. So what I try to do is I try to diffuse the questions that I get with a little humor so bear with me, my kids tell me this is a dad joke coming up. But imagine if you would a moment if you had two magic mushrooms, and they were each trash talking each other. What might that look like? And maybe it would be something like this.
28:27
Okay, moving right on them.
28:32
I want to try to get you to take home messages now that we’re sort of more than halfway through some slides. And it’s about temptations and indulgences, the choices that you get unless you’re really going to want to know if there’s going to be a negative outcome at the end sort of reminds me of the genie parable, or you get those three wishes you know, the first two are that God gets his and then the third is the really gotcha one. And so what what I’m careful for now is with all of the misinformation that gets spread around about medicines and diseases, especially during COVID science and reason really do matter. And I’m going to be coming up with that same phrase once when we’re concluding the talk in a few minutes. Moving on then this is 1970. And this was a seminal moment because not only was cannabis categorized as prohibited, but now you had a whole new system for how the federal government through the Drug Enforcement Administration could regard substances based on a few different variables including known uses, or abuses. And with that, I’ll go into the definitions a little bit because anybody who prescribes needs to know the difference between a schedule one prohibited substance versus controlled substances which occupied schedule is called 234, and five. What I’m pointing out by wanting to show you this slide is the schema for the Controlled Substances Act was something devised largely with the control guidance between government and big pharma. That’s why I started off showing you bear Big Pharma is schema for scheduling generally is because they have several drugs lined up. So it schema is based on one molecule, generally to treat not necessarily cure one disease. And for one patent, that’s why the one molecule model that way has been for so often, how we’ve had drugs coming out of different controlled status for the last 50 years. This is now 53 years of this system of the Controlled Substances Act. So it’s probably a good time to liken that to public health. And it’s not only the last 50 years, but I want to point out this graph, which is a chart that was established and it comes actually from 2004. But look at two ends of this chart. The one on the left is tobacco smoking 2004 and certainly by far and large, huge difference between that and obesity in terms of the risks of the leading causes of preventable deaths preventable being the word, and yet you look way out to the right and the ninth position is drug abuse. Well, in the 15 years after 2004, tobacco smoking went down a lot. I mean, this is actually, you know, in the last 15 years, that’s a public health victory, folks, it really is. But at the same time, drug abuse started to go up because of lethal opioid overdoses. Now, I’m just going to show you the next 15 years from oh four, right through 19 2019. And anybody who’s been paying attention to the news during COVID fentanyl, accidental deaths, know that this likely underestimates things, but drug abuse has moved from that ninth position, trending over these 15 years all the way up to surpass motor vehicle collisions. And I’m not sure but right now if if toxins could include overdose deaths from sight of you know from additives to things including fentanyl,
32:20
this is truly encroaching. A dramatic change in public health risk over the last 15 to 20 years. And that comes to mind then what is and where is cannabis in this? So these are some classical pictures of plants depicted from the way you would show a plant because it’s depicted where it shows not only the flowering portions, but the seeds and the growth cycles. So Cannabis sativa is regarded by both the FDA the Food and Drug Administration for its safety and efficacy and use and abuse compared to the scheduling from the Drug Enforcement Administration, which is really looking at risks. And benefits and saying that something should be either prohibited or controlled, and the definitions for those be rebutted or controlled. I’ll show you in just a second, but it’s not only about that we’ll go into other plants by comparison. The key here is that a schedule one substance, by definition, has a high potential for abuse. That’s the first one there. Number two is that it says no currently accepted medical use for treatment in the United States. And that’s now what has been shown with evidence based data for at least a few limited conditions. To not be so it’s not so the third may be the gotcha one because they say elected lack of accepted safety under medical supervision. Well, now closely supervised in the data that really is being accumulated with all of the 38 states now that have medical programs is fairly abysmal for for reporting and looking at this really in a balanced way. But certainly the first two definitions of this as I’ve shown you here, no longer apply to why cannabis should be festering as a schedule one substance. There may be changes ahead though. And that’s what I’ll show you in just a moment. So there are other drugs that I told you about before, whether opium or cocaine. They’re both plant derived substances, and I’m giving you my bias as a plantsman. Then of course, we talked about tobacco, there’s tobacco right there. And if you don’t think that some other drugs aren’t just part of culture, both chocolate and coffee, if you don’t think they’re habit forming, or or have some dopamine benefits coming out. I grow both of those in my backyard legally, but they’re just part of culture. So I wanted to point that out that just because things are part of culture ranging from tobacco to coffee in particular, you know, this is the way cannabis is finding its way into a niche. And by the way, tobacco and cannabis leafs have been combined for centuries. Remember, cannabis is an old world plant. It evolved on the eastern slopes of the Himalayas, after the last Ice Ages when humans discovered it. But tobacco is a new world plant. And it had already been brought back to Europe on Columbus’s second voyage. And it wasn’t long before pipes in Europe had not only cannabis leaves, but tobacco in it because the two together biochemically create a different balance. And it’s also the reason as a trivia note here, for the words blunt spliff and joint which represent different combinations. of tobacco and cannabis leaves. Moving on then, really nowadays, physicians in those states where it’s legal or physicians who are just looking to advance things with their patients best interests at heart knowing that as a physician, they should be able to have access to different medicines. It presents a dilemma, and it’s the question of should a physician offer compassionate cannabis for use as a medicine while it’s still remains under federal prohibition? And that question is been hammered back and forth with lawyers and doctors through a thought process called medical legal ethics. And it sounds nice when you look at what the AMA says about medical legal ethics because it says a physician shall respect the law and also recognize a responsibility to seek changes in those requirements that are contrary to the best interest of the patient. Well, it sounds good but it’s very impractical if you happen to live in a state where cannabis is legal because of the state’s laws. And yet you have two licenses very frequently, not only your license to practice in the state you’re in, but also a DEA license. That for the purposes of cannabis puts one license in conflict with the other and that’s where some of these challenges are coming up if you’re looking at it purely on a medical legal basis. So what I’ve come to terms with is what I would like to approach to you is a way to look at it that is a little different view and bioethics is a different field in ethics that evolved largely after World War Two, when you had questions about the evolving science, including nuclear energy and atomic bombs, and you know, how are we going to deal with this to reap the good from it and yet, not to be stuck with the bad and ugly side nuclear weapons comes to mind, but so does stem cells. You know, when when Bush one was in office and the first stem cell research lines were being approved or validated. You had people who were saying, oh my god, we can’t create Frankenstein. We shouldn’t touch those. And so it took a bioethical conversation, which means that it’s involving not only the lawyers and doctors, but the teachers law enforcement, the patient’s themselves, clergy, everybody is part of a bioethical conversation. It’s not limited to medical legal Doctor lawyers, and so it brings the full community into the conversation. So the following two sentences for me, is what works for realizing that there is a bioethical ethical solution to the challenge above and the first might be on the basis of how patients really do use cannabis in particular, and understanding not all pain is physical. What it says here is seeking relief from the intolerable physical, psychological or spiritual symptoms of injury and disease. Is instinctual and it contributes to medicinal substances use and abuse. And so if that’s from the basis or the bias of a patient, then a physician or a healer would be saying to this the treatment of intolerable symptoms is a noble task. That society bestows upon its healers to provide humane relief. I don’t really have to think about it ethically further than that, because you got to have a moral ground from which to proceed on especially if you’re going to be doing something that our government would otherwise regard as illegal. And very often the conservative bases from organized medicine, whether it’s the AOA or AMA, they do take their bully pulpit from a very conservative base. So for me, this is how I sort of diffused their limited abilities at times to look at this outside of a medical legal context. Oops, there’s the same picture I think I showed before, but that’s the one I wanted to have. This is the new one. And so this is actually from 2018. This was a bill that was an agriculture bill. On the federal level. It’s the Ag every few years there is a agricultural Improvement Act. And in this particular year cannabis, which remember cannabis includes not only marijuana which has the intoxicating THC, but it also includes as a plant family hemp. Hemp is a textile. The history of cannabis is far more extensive for its use as a textile than its use as a drug ever thought of being Columbus’s ships and riggings the sales they’re all done with hemp, clothing, textiles now for making concrete alternatives. Hemp is and was a product that even during World War Two, the prohibition on hemp which actually started back in 1937, with the marijuana Tax Act was repealed because hemp was important to the war interest during World War Two. Hemp for victory was the Government’s program back then. But back in 2018, then the definition for hemp was excluded from cannabis marijuana. So that you could grow hemp in all 50 states and you can grow it today in all 50 states. There’s an unexpected or unintended side effect of that farm bill that I’m going to tell you about in just a moment because it’s produced something called delta eight THC. And I’m bringing this to you this was just from a few months ago, but the DEA now is having to deal with the fact that with the federal change in agriculture, now you have all 50 states growing cannabis but not for its use as a textile because everybody wanted to jump on the craze
41:46
of CBD. It almost was being marketed as a snake oil. And it isn’t oil. It’s probably an appropriate analogy is snake oil, but it’s because it was becoming the new wonder drug. Of all the things it could do. CBD is pretty darn good for relieving anxiety and so so for inflammation. That’s my summary statement. And when I’m saying pretty good for anxiety, it’s because I’m comparing it to other pharmaceutical anxiolytics. So what happened is that CBD there was a glut within the first couple of years after that 2018 Farm Bill, because everybody now and their brother in law are growing it in all 50 states. So now the market price for that CBD that these farmers went to because they thought they could make a huge profit. It’s going down the toilet. So what you can do with CBD is you can actually subject it to an acid. This is a little chemistry thing here but I want to tell you how this happens. So you get an idea for why this is such an important issue. Now, and if you’re not attuned to this, keep your eyes open for who’s getting high on what because delta eight THC is also intoxicating, but in the whole flower plant in the whole marijuana plant is produced in such small levels such small amounts that you’d have to grow acres upon acres to make one joint. I mean, it’s that rare. However, if you take CBD, and you subject it to a strong acid, you can actually close one of the rings. I’m giving you the chemical thing but you can turn it from CBD into delta eight THC, which is also intoxicating. Why is that a concern? Well, it’s a concern because in the 50 states where hemp is legal, it means that delta eight THC is well at least semi legal. Or you can say it is gray market instead of black market. And that’s a concern because delta eight THC can be sold to an 11 year old in a gas station all across the country now. And that should be a concern to you if I only told you one thing that you need to know about cannabis and kids is that the connections in kids brains are not complete when they even at 18 or 21. Or they can drink booze. It’s probably closer to the mid 20s And those neural connections those endocannabinoid guided connections in brains are represented in limited evidence based data but as an ability to problem solve, and kids who start smoking young, strong stuff and don’t stop, do show changes in IQ. And that study was done years ago and didn’t need and not Florida didn’t even but didn’t eat in New Zealand. And that is still a very important study that even though it’s not perfect, I’d love to see more.
44:51
studies that look at things proactively so that if we start studying somebody now we follow them as that study did over years of use. So the point is we know a lot about delta nine THC good and bad because it’s been looked at critically over the last 50 years because of it being prohibited. And yet we know next to nothing about delta eight THC and if you think it’s just ones like the other you could be seriously fooled by that. The subtle differences of one ring closing versus another can be huge. In this case, it impacts cannabinoid receptors and fools or sort of hijacks the endocannabinoid system, to allowing the user to feel high to get a buzz. And yet, it’s sold, as I said, Really without any guardrails including to kids. So moving on from that slide, then this was a resolution this past summer. I know we’re here in Florida and we may be backwards but this is actually something I do feel strongly enough about to have supported this and let’s just say that the mechanism for the whereas is up top there that are in small print, don’t worry about reading them. It’s just the same thing I just explained to you about how this now has been something that’s brought Delta eight THC everywhere in the country. And our Florida Medical Association supports legislative and regulatory efforts to prohibit it, as well as perhaps half of the states where it’s legal. Now we’ve advanced this, but we still really want the opportunity for proper scientific research, even if it means that that delta eight is legally access through the Farm Bill, so that it’s available to research because of having the quantities needed for effective research that you wouldn’t get if you tried to derive it purely from the plant itself. So there will be some other big big changes coming fairly soon, I think and this is what I wanted. To sort of conclude with with this last slide. Before we’re really wrapped up. About a month ago, the Biden administration announced that their health and human services secretary had finished about a year and a half study of looking at medical marijuana to see is it properly categorized as prohibited? Or might with its current research and evidence based data be properly better considered as a different controlled substance and their findings were that it is more appropriately scheduled as a Schedule three substance now I didn’t tell them where to make it. This is not me. I’m giving you the report from the HHS secretary after a year and a half of study. The reason that’s important is the announcement of just that part came out about a month or so ago. And now it has to get turned over to the Drug Enforcement Administration sort of the judicial side of Food and Drug No, they are not the ones who decide it. But the DEA now has it in their court, and they’re not really a court but under their review. I’m thinking that with the 2024 elections next November, that the timing of why this was done now, is not accidental. I think that they firmly expect to see a change or a disposition from the DEA coming before the next election. So it becomes an election year topic again. And I actually think that’s a good thing. Because federal prohibition is really stymied, not only research but access, and it’s put doctors again, right in the crosshairs of conflict because of a state license versus a federal license, where it says it’s illegal if the state says you can do it. So what that’ll do is it’ll really make three or four things quickly change one is interstate banking. And believe me, the companies who were in this who were multi state operators, who are working and jumping from one state to the other to see where they can make a quick buck. They’ll be able to ease up the banking restrictions. The next thing is it can be legally prescribed right now, even in states where it’s legal. The word prescribe which means it’s a doctor’s order, if you want to get in trouble, right, your recommendation or your your certification or whatever a given state calls it. That is not saying that none of them say the word prescribe. Write it on a prescription pad and see if it doesn’t throw up red flags for you. Right now, you cannot legally prescribe medical marijuana in any of the 50 states because of the federal guidelines on it. So what it will do by being able to be prescribed is it will have to be taught in medical schools like all other legal prescribing drugs, I can tell you being among the faculty at the University of Miami, that I’ve also served as the president of our alumni association for the medical school along with some of the deans, and they know I’d love to get this into the curriculum as far as the general subject, but they said Jeff, if we do that we’re going to have to take other stuff out of the curriculum because it’s an extensive subject. And the fact is, when the students graduate, they get an MD and I’ve been honored to give the oath of medicine when they get that MD be telling them right from wrong but that’s not when they actually can practice medicine, they first have to finish passing all three parts of their national board exams. And guess what’s not asked about on national board exams because national or federally, it’s still regarded as nothing, no known medical use. So they’re teaching in medical schools throughout the country, for the performance of their students, understandably, on that board exam. And they kind of have to because it’s the biggest determinant to their rankings of medical schools, the performance of students on the board exam. So this would change all that this would make the doctors coming out of medical schools now far more knowledgeable than most of the doctors who were peddling it today who were a lot of times older Doc’s who maybe retired maybe who remember it fondly from their youth, but I will say that on those grounds on being legally prescribed, forcing it to be educated in schools, certainly interstate banking, and also it frees up what has been an extraordinarily hard way to research controls, not controlled substances, but schedule one substances. The difference between schedule one and two also involves not only the banking but the ease of research. So schedule three may not seem low enough in the scheduling for some people. Some people say oh no what needs to be d scheduled well, don’t confuse decriminalization. With legalization, your Doc’s and, and legalization that you want to practice Legal Medicine, whichever state you’re in. So I’m going to actually start to wrap it up. And I mentioned to you about science and reason matter with this quote and it’s a take home message without some common baseline of facts without a willingness to admit new information and concede that your opponent’s making a fair point, and that science and reason matter will keep talking past each other making common ground and compromise impossible. So there’s that science and reason matter statement again. And so there is a place you can get some pretty good information. The answer page is run by two colleagues who are both anesthesiologist out of Harford. Actually, they’re at Brigham and Women’s. If you’re interested in things they have a rather advanced curriculum. On cannabis that serves at least I believe, 10 states now we’re certain states have mandated education of their doctors that want to practice in this space. I encourage you to look over there and I’ve actually contributed some things on that site as well. And that really wraps it up. Another shot at me there. In the greenhouses. And if you want some questions, I guess it took about 45 minutes or a little less than that Bill.
Bill Clearfield 53:11
Thanks, Jeff. Yeah. Great, as always. So can you see there’s a question here, thank you for the explanation of where delta eight comes from. Okay. So it’s not a question. Can you can you give us a little bit of a summary then of, you know, what? So there’s a number of our number in our group beside you. There’s Kent versus Dustin Souillac are extensively involved in in cannabis to one form or another. What’s your advice to those of us who are sort of on the outside looking in as far as prescriptions? What to look for what what to be careful of those kinds? I know you’ve touched on it, but
53:57
neither there they’re very good point. You know, last time when I spoke with this group, I talked more about the specific things the evidence based data line item wise and things like that. But I’d caution anybody who’s listening to this to do is look at this from thinking if you are going to try to practice what would your ideal standard of care be? Because I will tell you that the way most physicians in states practice, it’s by being careful just not to break the law. And in a given state, the laws and the rules and regulations may be very different than in another state. And in particular, in states which allow recreational use or adult use is the euphemism there. Those states pretty much have the clips, the medical programs because the patients are just going in buying it that way. There are benefits to doing it under a physician’s supervision, but as physicians, what I’d encourage you to look at would be a report that came out in early 2017 in January 2017, the National Academies of Sciences engineering and medicine, published an extensive meta analysis and their findings really found that cannabis was helpful for three main things and I’m going to list a fourth now, but I’m going to break things down just in a few sentences to things that have either conclusive evidence based data or substantial evidence based data, not things with a moderate or low amount. So what has conclusive evidence based data well, for THC, actually, that fits. It’s used for nausea and vomiting as an anti emetic it’s been known for 1000s of years. And there’s enough evidence based data so people say well, but there’s actually a legal drug. Now that is a synthetic form of it called Marinol. It’s on the market and you can take it for for nausea and vomiting. The problem is if you’ve ever seen a patient actually take Paranal to begin with you got to swallow it. And if you’re really throwing up a lot, that’s hard and of itself. The next thing about Marinol though is it’s only THC. And in the Balanced cannabis plant, actually mostly that CBD that I said relieves anxiety also relieves the anxiety that people who are not familiar with using cannabis encounter when they try THC. Sometimes a naive user for the first time gets very panicky, especially with higher doses and it can be quite an upsetting evening. If you’re going to a party and you don’t think that you’ve ever tried something before a co Ed having a cookie or something that she doesn’t know maybe is has enough THC in it for the first time user that can be unpleasant. So cannabis as far as a whole flower a whole balanced plant. evolved with balances between CBD and THC that mitigates many of the anxiety ridden side effects of THC that you would see through Marinol. So evidence based data is conclusive for nausea and vomiting. It’s also conclusive for CBDs use cannabidiol is used not for anxiety. But for the seizures that rarely happened to kids from a few particular types of diseases where traditional medicines for seizures don’t work. And I’m not saying you shouldn’t first go for the traditional meds but for those refractory cases CBD is shown and came out of federal prohibition. It was actually a few years ago, went from schedule one along with all the other cannabis chemicals to schedule five the least controlled, but within a year later went right to being unscheduled. So CBD being unscheduled is as I said what promulgated most of these farmers to want to grow it all over the country is the new wonder drug. If you’re a kid with those intractable seizures, and that’s all that works. It is your wonder drug. But that’s conclusive evidence based data. There is those substantial evidence based data for the pain associated with muscle spasms that come from multiple sclerosis. Ms. About 90% of patients will have at some course in their illness, intractable muscle spasms, and there is substantial evidence based data that it works for that and I’ll give you a fourth thing that has substantial evidence based data because this is the one that’s probably poorest understood. There is substantial evidence based data for the use of cannabis, in particular THC for the management of chronic pain. And I’m saying it that way because of being controversial, and because I’m a fellowship trained anesthesiologist in pain management. That’s why I was very careful to point out that not all pain is physical. I believe many patients who use cannabis for pain, equate pain with what it really is. It’s not a diagnosis pain is a symptom. of many diseases and injuries and as such, pain is really an intolerable symptom. So if pain is an intolerable symptom, please recognize that pain for the reasons that patients use cannabis can also have a psychologically intolerable symptom or if you know people who can be spiritually so upset with something that is intolerable. Those patients seem to also gravitate towards and find great relief with cannabinoids used as medicines. So there is substantial evidence based data for its use in chronic pain. But that’s not all pain. That’s just those particular patients and how I believe they are using it therapeutically. Does that answer most of what you were looking for a bill? Yep. Any other chat questions or things I’m available to you and we’re not even at an hour yet. I’m kind of tearing through this. How long is our talks usually are
Bill Clearfield 1:00:05
the dial hour, hour and a half and let’s start Colossus around then. And we could be here till the next morning if we let them.
1:00:15
Anyway, I think the most exciting thing that I wanted to speak with your group about besides some of the advices and warnings about delta eight is the fact that this next year may be the year that cannabis comes out of its federal prohibition. And you know what, it’s kind of an interesting amount of years since it went into it. Remember we said 1970 bill? Well, the fact is the first state though, that took it out of prohibition was really California. And they did so shortly after Professor Ms. Shulam identified the mechanism of action. So by the mid 1990s I think it’s 96 Is that right Ken tear California you would know this cannabis, made it legal for medical use. I mean, California made it legal for medical use. 99 look actually a cannabis going into pro edition. It actually happens 1910 1911 And strangely enough, the first state that put it into prohibition was also California. And because you had some states in the desert southwest that none other than Pancho via with vigilantes coming from Mexico, but not being the Mexican government. Remember, he was not associated with Mexican government but wanted to take back over land taken or from wars. He basically entered the United States killed some American citizens took over land. And so that really In fact, if you want to look at the first real terrorist attack on US soil, and I’m emphasizing on US soil, it might very well have been Pancho via not the World Trade Center. So that was 19 1011 by 1937. Now 27 years or so, now the popular craze across the country was we have to outlaw cannabis because it’s associated with deviance and, and terrorists and all the other subversive rhetoric that goes along with with cannabis back in those days. Well, if that’s a little over a quarter century Bill, I’m thinking that from 1996 Till now is a little over a quarter century maybe in the time that the process brings it out of prohibition. My point being it’s a process, it’s not really a moment in time, but when it does officially come out of prohibition. And it may be sooner than you think. That’s when the real floodgates open. That’s when Big Pharma comes to this right now, they’ve stayed a healthy arm’s length away, because they know they’d be breaking the law themselves. So it’s not just the big business of interstate banking and commerce from those companies in business for it it’s Big Pharma and what they’d like to see. Will that do away with the dispensary model? Will you see it in your local CVS and Walgreens and things like that? Maybe in some way, shape or form? I can’t really imagine that smoking is going to be coming up but I do know that vaping are vaporizing, mitigate some of the lung problems but vaping if you remember to had an ugly side with cannot cannabis right before COVID Anybody remember, in late 2019 kids were vaping contaminated oils, not just vape coils, but ones that had additives put into it. And they were very harmful to lungs. ventilators
1:03:43
were using they were using billions because they had gotten extraction so good. So they could get very high constant well over 90% which was difficult to run through a vape so they had to dilute it and these ignorant people that will Vitamin E is healthy for you. Let’s stick that in there.
1:04:07
Vitamin E acetate is some overnight in the popcorn industry. It was horrible. It really destroyed many young kids lungs and
1:04:18
low molecular weight polyethylene glycol, all kinds of things were used which were were very toxic
1:04:26
when so if I’m going to make an analogy to what Ken saying about additives, you can go back to the 1920s and think we didn’t think a minute about alcohols prohibition when people are cutting booze because the fact that can saying it’s so concentrated the oil that’s one of the side effects of prohibition itself. Yeah, remember the penalties if you get caught? Whether with alcohol or with cannabis, when they’re prohibited are based on how much you’re getting? What’s the weight of what you’re carrying? So, in that sense, then nobody is selling beer or wine during alcohols prohibition. Al Capone is run running. And it’s about moonshine. And the same thing is to today’s cannabis is sort of the moonshine equivalent and grown with the same stills in hills mentality by illegal sources. But the hills are no longer Appalachian. Might be the Colorado mountain, you know, Rockies they’re built, but you can tell me that I’m bringing up the analogies of prohibition concentrates and diluting them because many people died from having not just grain alcohol but ethyl versus methyl right and, you know, so there’s the same, the same players in a sense, but the same consequences of its prohibition and an illegal market would go away with the repeal of prohibition and I I think that immediately happened with alcohol is prohibition and companies like Seagrams that didn’t reluctantly stamp their feet or hold up a triple X jug with a toothless grin like somebody from Appalachian might have. They embrace the opportunity to do it legally in a liquor store under federal guidelines and secrets is still in business today. So I see this as being a step in the right direction, perhaps divisive for many in industry now who are exploiting its illegality. How do you tell somebody who has had an illegal grow for years that now because it’s legal, they have to install handicap ramps getting in and out of their grow? You know, they’re gonna say what? Yeah, so these are going to be the rollout. It’s not going to happen instantly. But I do think it’s a step in the right direction.
Bill Clearfield 1:06:50
A lot of those things are sort of like you know, don’t don’t don’t ask for some things that you might get it so I gave a talk to a group of chiropractors over the weekend. And you if you’ll recall, the there was a big push for them to be for insurance companies to pay for them. Well, now they do now they don’t want it. So it’s the same thing.
1:07:13
Limit limits that way and
Bill Clearfield 1:07:15
you missed one of them. You missed one of the great, great the sort of icons of the cannabis prohibition and that was the movie reefer madness. You know,
1:07:28
I used to have slides that I showed from that and, yeah, that was part of a campaign and yeah, scare campaigns, fear mongering, misinformation. It’s all part of the political process, you know,
1:07:45
which drove to the, you know, the International interface and control in the, in the single convention. And that’s one of the things that they actually have to dismantle for, you know, we forced it on the rest of the, you know, world
1:08:05
and the rest of the world is waiting for us to come out the World Health Organization, like you said, the United Nations Convention. Those are things that would happen right in line like dominoes after federal prohibition by the Controlled Substances Act gets considered. So this is really I believe, going to be a sentinel moment. I can’t guarantee it. A lot of people have thought this would happen before. But I haven’t seen yet one particular White House Administration come in and advance it this way with this much evidence based data. And by the way that national academies, you know, meta analysis report I told you about from early 2017. That’s a federally commissioned study. This is not like you know, somebody else doing it and saying, oh, believe our data. It’s very real. And in that sense, perhaps the thing for those on the call not to do is please don’t think that just because in your given state, cannabis can be authorized for a patient because of 50 different qualifying conditions. The four that I mentioned before nausea, vomiting, chronic pain, muscle spasms, and seizures are those that I would focus on if you have patients who really want to know about it. I will tell you one more thing about one of the things that is legal and I’m sure any of your states now. It’s it’s used for glaucoma. I have glaucoma. I’ve had problems with my left thigh and retinal detachments and all I can tell you is Glaucoma is recognized as I pressures go down when people smoke refer, but it’s stays down only for a short period of time compared to eyedrops. And because glaucoma can happen from several different mechanisms, the end result being high pressure. There are so many different better treatments for glaucoma than cannabis. Just because it might be legal in your state to get a patient refer because they have glaucoma, doesn’t mean you’re practicing good medicine. And that’s my message here. You still have to compare the other advances in medicine and what’s happened in the last 50 years under cannabis prohibition. To assess its efficacy and safety today compared to what else is available. That’s about all I think I have to say unless other questions come up bill.
Bill Clearfield 1:10:40
Question is delta eight available in dispensaries and can you get it as a gummy as an oil? How does it How does it come?
1:10:48
Yes, yes. And yes. I can’t you want to talk about that one here. I mean, the fact is delta eight being Delta eight is a typical designer drug. By the definition. A designer drug is something that’s created to stay one step ahead of the law. In this case, it’s a gray market designer drug. So while you can get it my question to you is, why would you want to get it if you can get delta nine in the same dispensary? The problem is the labeling because the things that you get, especially outside of a controlled dispensary if it has, I say controlled in the sense that it would have regulations in the state in which that dispensary is operating. There are no guardrails for where you could sell it. If it’s Delta eight in a state where like I said, it doesn’t matter how old you are, if you want to go buy it, or who can sell it. The problem is, most times and this has been looked at critically. It’s not telling you necessarily how much is in there, nor what to expect with it other than hey, I can get high on this like I could also with Delta nine. Remember this also that if you’re going to buy cannabis for a medical use, the taxation is not there. You may pay a doctor for a visit but hopefully that ensures a better outcome at least from a subjective physician’s opinion. But you also have to deal with taxing on things when it becomes illegal market for you know, adult use we say and if there’s anything that’s found out from the legal markets that way, is that if you tax it more than a certain amount, all that does is it keeps a perfectly vital black market, still working in the community where somebody’s used to getting it without paying that exorbitant tax. Here’s the other thing. Kent brought up the concentration of things but the abundance of cannabis in the United States is extraordinary. It’s a weed, it’s easy to grow. And so there is such an abundance that the actual price of the product literally goes down the toilet itself. So with the abundance of cannabis then we’ve sort of gotten away from the Pericles dictum from toxicology and that’s that the dose sometimes defines a poison, give you too much oxygen give you too much water, I can kill you with either of those things. So if somebody is truly taking it for a medical reason, the lowest effective dose is where you normally stop. That’s where that temptation indulgent smoke with the genie comes to play because if you’re going to tell that to some people who have just used it, and are used to using it and still want to keep using it because it becomes part of their I’m gonna say psyche, but part of their routine, ritual. Thank you. It’s like a tobacco cigarette. The ritual sets the chemicals in motion including dopamine, the smell of a tobacco cigarette, lighting it up. The rituals also exist with cannabis, including smoking. So when people were asking me as as the vaping problems happened in late 2019, and they’re starting to, you know, bring up oh, well, you know, what about this vaping thing? Am I better off, you know, not vaping and just having whole flower, and I’m thinking to myself, we’re going into a pandemic of a respiratory disease, no vaccines, it’s probably not the best time to take up smoking. But then again, people do what people do, and the intolerable symptoms are what I’m trying to point out. And I do believe that people use it when they hit that point, if it’s physical, one thing but psychological and spiritual abuse of cannabis is an expensive way that humans and especially in the United States, seem to be using it regularly. It’s so cheap to produce that even the drug cartels from Mexico are no longer bringing it in. They’re coming in and they’re taking it out of here. Because it’s a better quality and it’s cheaper here for them to move it in the opposite direction that it went for decades. So such as the nature of commerce and farming and all of this, but it’s fascinating to me because I had a background in healthcare science and agricultural science, but it’s the political science determining economics that I found to be my best learning curve over the last few years. And for me, that’s fascinating because they don’t teach that in medical school.
1:15:51
Alright, okay,
Bill Clearfield 1:15:54
I don’t have any other questions in the chat. Anybody else have any questions for
1:15:58
Andy has been quiet.
1:16:01
Thanks for showing up. Dr. Block.
1:16:04
Hi, how are you? And everything’s good. Wonderful
1:16:09
period, all this stuff. Very interesting. When we’re talking about the legal cap medical cannabis. If you follow the rules that they have in the state, they would cost about $5,000 just to do a workup on a patient. So the doctors get $200 for giving the card. But if you did what’s actually required by law? It would cost 1000s of dollars just for the workup. And that includes the complete elimination of any possibility of anti cancer in the patient. So who’s going to do a workup like that?
1:16:46
You know, different states have different obvious rules and regulations. Florida’s and I meet regularly with the doctors who are the authorizing physicians. I I don’t authorize patients to get it. I did do 10 years ago, the mandated CMEs there’s CMake talk again, that all those Doc’s had the first pass before they could see patients. Then I was asked to rewrite the rules of Florida’s laws as as the only doc asked to do that. So 10 years ago, I sort of saw the way that different doctors and we’ve got a big state like California, where people in one north part of the state may be very different delivery practice wise culturally than another part. And so our state’s also kind of a good example when I look at it because when I gave a similar talk to the docs here, about the importance of it potentially coming out of federal prohibition, a few of the doc’s on the call said, Oh, well, that can’t be good. It has to be completely unregulated and D scheduled because if we go from a prohibited substance to a controlled substance, anytime the federal government controls anything, it’s always bad. So that knee jerk mentality among physicians in my state, kind of made me take a step backwards and say you don’t think it would be better to have it legally prescribed? OT banked and researched because of the constraints of what prohibition schedule one does to it and has done to it for the last 55 years. I I think it’s not such a baby step at all. It’s a huge first step. And if that’s a way that it leads to a further lower scheduling, or D scheduling in the future, so be it, but it’s a very important step. And I would caution anybody who is used to seeing patients for cannabis who might be on this call into just doing business as usual, because when the federal government does come about to seeing this be rescheduled, along with it will come rules and regulations that you haven’t had to deal with in the past. I’m not saying a cost basis, Andy, I’m talking about more of what you have to do. To bring it up to a level like any other prescribed medicine, including educating on it. So I actually think that’s a good thing.
1:19:22
If it becomes impossible to do what the state medically requires, that means those doctors who are ethical refused to give the cards while those that don’t care at all, are just saying sign here. It’s 200 bucks see later. So if it was actually trying to serve the best interests of the patient, it’d be a different thing. And but this is the starting point, they never did anything before. So then in the state, they don’t know what the right hand doesn’t know what the left hand is doing. So they’re trying so I commend that.
1:19:57
I think what’s gonna happen over time though, is that cannabis would be gradually whether in terms of, of the chemicals that are extracted whether through edibles, something putting on skin under your tongue like Tropi has with Kemp, you know, or absorbable things. Cannabis overall I think will be more mainstream in practice, so that physicians regarded as one alternative of what they can use in a medical treatment regimen, not the only one. And right now, physicians who are so passionate about cannabis throughout the country, many of them have dropped their other practice and really only see patients for the purposes of providing cannabis care. I see that as being very narrow minded, and I would love to see it work its way into formulary as it would be you measure one drug compared to another one treatment modality against another there are plenty of treatments for pain that have nothing to do with drugs whatsoever. And so bringing that basically within the armamentarium of a physician’s formulary, I think is really the big changes that will happen over time
1:21:15
since you brought it up true Okay, for those that don’t know about roky Crowley on our board, runs pretty much that whole of business, factory research everything it’s pretty impressive. So if people don’t know about trophy TR, O K e.com I think yeah, that’s that’s where something like 90% of the benefit from cannabis can be found. You don’t even have to go into the THC. So the high quality CBD that’s, you know, safe, clear and all that so anyway, I highly recommended all of my patients I recommend the trophy because it’s the simplest safest and probably the cheapest way I know to go. It’s not
1:22:04
I’m gonna add something to that for those on the call who want to know why it works. It’s it’s it’s not only what the chemicals are in it, but we just talked a little while ago about how smoking has its own side effects. And this is all this is all drug, drugs getting in the body. So the fastest way to get the effects to the brain is probably right through the lungs where the blood gets through the right heart right up to the brain. And so when you consider why people smoke and traditionally have or vape it’s a pulmonary route of delivery that makes it very quick to getting up to where people feel the difference but if you were to have an edible on the other hand and actually ingest the chemicals, even balances of the chemicals, then it goes through a different metabolism. It actually takes at least half an hour sometimes as long as an hour or more to get in your system where you feel it but what you’re actually feeling very much is not simply the THC that is the intoxicating substance. Your liver metabolism converts it to hydroxy 11 THC, which is four times longer lasting and about four times more potent. So when you consider edibles, then that’s a second way of getting it smoking. ingestion. A third way might even be topical but you’ll be hard pressed to get enough in your full circulation and up to your brain by putting something in topically. Maybe good for around the bed joint or inflammation joint or things. However we’re trunky It’s a beautiful method of delivery is by vascular absorption. You absorb through your mouth that’s why nitroglycerin you haven’t a heart attack take it quick it gets in there quick when it’s taken in through the oral mucosa and same thing with rectal suppositories, if somebody has intractable vomiting chemotherapy things or just can’t swallow. A suppository could be a wonderful way because there’s a lot of vascular absorption from that end of the GI tract to so Turkey’s brilliance then is by having a measured amount that can be absorbed reasonably fast, not as fast as smoking but faster than by ingestion with the delay time. And you actually get a little closer to what you know you’re getting because it’s generally not going through stuff that you swallow that may get into the ingestion and have liver metabolism but staying where it’s put so it gets absorbed over several minutes, not a few hours. And that I think is the brilliance of the formulary. Did I say that all right can you did fabulous.
1:24:53
Thank you, Doc.
1:24:54
Thank you.
Bill Clearfield 1:24:56
Another question for you. Jeff. What what facilitates the munchies? Hi.
1:25:02
Well, you know, it’s interesting, obviously, when you’re talking about GI and this is actually a more of an advanced topic now because of things like ozempic and Manjaro and things like that. The guts a very complex place and Bill you as a hormone guy would know this particularly well, but the munchies generally has been something that you think that when you have cannabis that because it relieves nausea that it establishes the flow in the correct direction, mouth out the rear. However munchies and appetite is also part of context number one, but it was probably the first observed use of cannabis when it was used in California through San Francisco for the earliest patients who were dying from AIDS Thin Man disease. And Don Abrams was finding out that if he gave patients who had intractable vomiting from the diseases and associated problems with GI absorption that AIDS patients were getting. They were having their nausea squelched and maybe living with nutritional to see another day. It wasn’t a cure for AIDS, but it was something which was absolutely, you know, found to work there. And other research was part of the evidence based data for why it now has conclusive evidence based data that way it stimulates appetite, which brings up the question for some of the side effects you see now we talked about side effects not giving it to kids because their their neural connections aren’t there until they’re in their mid 20s. But a pregnant woman is not a good person to give it to also because the fetus is developing those same connections. But if you want to go even, you know one step further to looking at effects and side effects. There’s something called hyperemesis syndrome, where some people, particularly people who tend to use more concentrated doses and use it regularly. Instead of having nausea calmed, actually, it’s something that with the cannabis, they get intractable vomiting. The exact mechanism hasn’t necessarily been clearly understood. But I can tell you I had kidney stones years ago and I found out that when I had renal colic, which is a big, you know, colicky vagal stimulation that I would go into the shower part of his because I didn’t want to make a mess because I was throwing up and it sounds horrible, but for some reason the warm showers help my nausea go away. That is almost a pathognomonic finding in people who come to emergency rooms with a history of cannabis use and intractable vomiting. They can get very sick not just dehydrated electrical disturbances and stuff of
1:28:11
serious. So,
1:28:13
the counter side of appetite helping appetite bill is actually this, you know, could that be an autoimmune thing or, or some other mechanism, not as well understood as you need to but you go to any er Now that cannabis is so popular throughout the country, and asked the ER Doc’s about patients coming in with hyperemesis syndrome happens a lot, much more than you’d think. Now, I’m going to give you an exception to something about nausea and vomiting. But where appetites very important, and remember I said a little while ago, it wasn’t a good idea to give cannabis to a pregnant woman because of the fetus development. Well, there may be a good exception to that. I’m going to tell you that I have a good feel for other cultures. My wife is Jamaican. And she asked if I would want to go down to Jamaica and actually talk to three groups. They have doctors and nurses obviously they come up here to the States very often in practice medicine, but a third group called plant practitioners, which are herbalists and if you don’t have access to the definitive health care for somebody to go in to that fancy emergency room, get an IV to restore fluids and maybe give you some Zofran so that your nausea goes away. And herbalist would give a woman in their first trimester of pregnancy with intractable vomiting, where they can lose the baby. They would give them steeped teas using cannabis leaves, very dilute, not a lot of getting your high in that, but it’s restoring volume and it’s taking advantage of cannabis for its anti emetic affects appetite, giving you more of an appetite, not long term, not for the whole pregnancy just to get past that sensitive first trimester time that actually a lot of women get and if you didn’t have a way to advance health care in a way that we’re used to here in the States. That’s a traditional way that cannabis is used low dose, brief treatment, specific indication, and generally a good outcome. If you look at what are called Apgar scores on the web on the babies of Rastafari and women now they’re off the charts. I mean, these are bouncing, you know, babies of good weight and vitality. And so there’s a good example of a cultural use of it from a peoples that have known about it for use versus abuse. Where by the way, people don’t know this but cannabis is absolutely still illegal in Jamaica don’t let the Bob Marley Nine Mile thing and all the marketing for tourism for you. They have the British school system where school is mandatory. Kids all are in their uniforms. You gotta go to school, they protect their kids. And they are very much afraid of cannabis getting out there in their children as we should be. So, hopefully that analogy to
1:31:20
that was a great analogy.
1:31:24
Okay, great.
1:31:27
Can I see a couple of things real quickly? Sure. Yeah. Hi. Yeah. Thank you, doctor. Excellent, excellent presentation. I’m coming to you as a pharmacist and as a current owner of an r&d cannabis manufacturing company. First, as far as that goes, with Delta eight. I think we’re all totally or at least 90% against that. Delta nine THC. We’ve been doing safety studies on that for 4000 years and we can all say it’s pretty safe. Delta eight as you say, as a designer drug. I would not recommend to anybody. First of all, to reach an intoxicated state. It takes more than delta eight and then plus I’ve been hearing about some adverse effects, including some cardiac stuff. So definitely, definitely stay away from that. The pharmacist in me says Have they thought through this entire process of scheduling this as scheduled three? Where will the supply come from? I don’t think our regular wholesalers are going to carry this. i As you know there are different cultivars because there’s over 100 different cannabinoids in this plant. So who’s to say which ones are for which are you going to have to go into a pharmacy to get a controlled substance which you do now? I don’t think we’re going to get those in dispensaries or gas stations. So now you have to deal with all the logistics of that and then all of the paperwork. As we all know, with controlled substances. This is a monster if somebody really wants to tackle this, I say good luck. I like the thought and the idea but I’m not sure it was completely thought through. University of Mississippi is not going to be able to look this.
1:33:20
When does political regulators ever think anything through
1:33:27
good point? I don’t know what I was thinking.
1:33:31
Well, Bob or Robert the the fact is when I’m looking at coming out of prohibition and where it’ll be, I just had a train of thought I’m just losing there a moment when you’re talking about the last part about oh fitting where cannabis. As I said before, when I talked about the Controlled Substances Act, being something that works with one molecule, one disease and one patent. Cannabis is not one molecule Exactly. And I only analogy I gave was when I talked about how CBD mitigate some of the side effects of THC as an anxiolytic versus something that will make some people panicky on their own if they’re a naive user in particular. So when you start having not 100 cannabinoids, but look you’ve got a probably about half a dozen key cannabinoids and maybe about that many terpenoids to once you have 12 variables according to the FDA and guidelines of how you have to research each one independently and then different combinations of ones put together. It makes what the controlled substance Act does, is it makes studying something like cannabis exponentially more challenging because of how many active chemicals are working as an ensemble. There are some people who like to use the word entourage right when you take cannabinoids and you put them with the terpenes and estern entourage. I actually had this discussion with Professor Miss Shulam because he’s one of the ones who didn’t coined the word but they discussed it. I tend to be a little musical in terms of having grown up playing woodwinds and I really see it more that cannabis is more of an ensemble effect, where too much expression from one instrument versus another and you don’t have a full balanced orchestration. right onto rise generally means that THC is the soloist and everything else is chasing it. I don’t think that that’s necessarily the way to look forward to what different cannabinoids could do alone or in combination with terpenes.
1:35:41
What’s what’s interesting that there was some a couple day, half day symposium over two days that the Center for Medical Cannabis research which is based at UCSD presented some just fascinating research, looking at minor looking at the different physiologically active components whether they’re major or minor cannabinoids like combining CBD and CBN to get together or separate to improve sleep for instance, and they found that CBD actually lowered the quality that CBN generated on its own. They talked about some terpene interactions as well. And so some of the things that we just sit back and think, oh, this seems logical, are actually now being shown to either be beneficial or actually not beneficial for the symptom that so many people are commonly using phyto cannabinoids and terpenes for
1:37:02
Yeah, I agree with that. Totally.
1:37:03
I think it’s yeah, in November, that actually the the recordings from that presentation are going to be available. And if you guys want to know I’ll put it on the chat. It’s the CM CR website which is CMC r.us or ucsb.edu. And so you can go to that site in probably middle latter part of November. And they’ll have those two days of presentations, just fascinating. New information, some pre publish, they’re in the middle of the studies, but great, great new stuff.
1:37:47
Sounds great. Thank you. Thank you for that.
1:37:51
I’m gonna give one more comment about potency and min. And we talked about it a little bit in the terms of the toxicology, lowest effective dose, but because I think there’s people on this call, who range in age, I don’t know if we have any 20 Somethings here but looks like we have some people with gray hair. And today’s pot is not your father’s or your grandfather’s pot, and it’s because of what prohibition itself has done. When I said before that it produces things that are more concentrated. What happened is in 1973, Richard Evans Shelties, who is the famed Harvard, ethno botanist, discovered a plant basically what’s been named since his Afghani Kush. Number one, it’s in Kandahar, and that is a very harsh environment. 1000 foot plateaus, a lot of UV light, really not very good soils. And yet this plant which is a weed is growing there. And that particular plant of Afghani Kush, number one has a lot of THC, a lot of terpene called myrcene. And it’s a four to five foot squatty plant. Well, this is 1973, shortly after the controlled substance act, so that became the breeding darling plant dominant genetics that virtually everything you see in the stores today are progeny of so you know, why is it everything there? Well, mostly because of the last thing I said about the plant it’s a four to five foot squatty plant and in the early 70s If you were going to take a risk on growing this it’s easy to hide from a helicopter. Why because hemp is a 20 foot plant in one growing season. So all of these things coming together changed two concentrations of cannabis over the next 50 years to be as potent as it is today because of those dominant genetics. Where do I plan to be hopefully a year from now? Florida has been slow to awarding licenses for new companies but if I were a Florida license, I am a Florida licensed physician. I’ve been that for 40 years. But if I wanted to work with the plant directly, which is what I do, I breathe tropical ornamentals, and I’ve read a lot of plants. I couldn’t do it as a certifying dock in Florida. I only could do it if I were the medical director as is required by Florida Law of One of the licensed companies. So I expect that before the end of the year, and new applications that went in this past April will be awarded and I would hope that if by this time next year, that license gets awarded, and I’m the medical director of one of the companies here in my own backyard. I would love to re hybridize or reverse engineer however you want to call it maybe more heirloom plants that had a better balance of certain chemicals that it’s not only about getting high in potency anymore. It’s the way humans evolved with cannabis for most of the recorded 6000 years not the last 16
1:41:12
One more question
Bill Clearfield 1:41:13
here. Why is ganja in Jamaica called the wheat of wisdom?
1:41:20
A good question. I don’t have the exact answer. to that. But I would think that Ross Rastafari in sort of worshipping of it. It is a religious experience and sacrament that that there is a very different cultural acceptance and that’s not all Jamaica, I’m just talking about Rasta
Bill Clearfield 1:41:40
okay, I’m just reading your questions here.
1:41:44
Okay, well, I don’t know. I know despite the fact question for the night
Bill Clearfield 1:41:48
how you you got the answer to that one time.
1:41:55
Now, you’re gonna ask us about I don’t read of wisdom. Okay. And you know what, but but let me I’m gonna I’m gonna take a stab at it from a different angle. Wisdom and creative thought. So a lot of creative thought leads to what people regard as wisdom because you figure things out? Well, again, some real good research coming out of Stanford in particular in California. Looks at the creativity that some people get from cannabis, such that musicians, artists, things like that. Not that that’s equatable to wisdom, but certainly some people do it in a creative way. And what cannabis seems to do for the brain involves something called divergent versus convergent thought. Divergent thought being the first stuff you throw ideas out there, see what sticks and then as you’re looking at it, the convergent part is well if we pick this and we put it with that, and this now we’ve got a new way of putting the pieces together to where that makes sense. And that’s wisdom, maybe, I know and creativity then dopamine levels follow that divergent and convergent thought with you know, ebbing and flowing. So I don’t know exactly where the saying in Jamaica comes from. But I think it’s a fascinating neurobiological chemistry talk. Because cannabinoids have influence on all other receptor systems, including those involving dopamine, serotonin, oxytocin, those three chemicals I’ve just mentioned in combination in the midbrain and all of the effects it has to mood, wisdom, insight, and, yeah, maybe even that sixth sense that people feel but they can’t put a finger on. It’s not like touch or taste or smell of, you know, hearing sight. It’s that sixth sense that people sometimes connect to fleetingly. But I do think it involves cannabinoids and those principle three neurotransmitters dopamine, serotonin and oxytocin for why we’re human. And that’s just a little, little comment on wisdom.
1:44:25
Right. Okay. Let me anybody anything else? I would agree. I would like to.
1:44:34
Hi, thank you. I would like to put a plug in for the trophy, the creams the ammo, Jenna angelic angelic creams of your product. Dr. Crowley worked very, very well for pain.
1:44:51
Thanks. Do you still have them they are.
1:44:59
They were developed with a colleague of mine and they are available just not under their trophy brand. Okay, if you do want them. I can link you with Willow Springs and and they can take care of it. Just you know the herbs are grown on site there. It’s just a fabulous product.
1:45:22
It really is. Thank you. Sure.
Bill Clearfield 1:45:28
Okay, can’t you want to put in Dr. Blockers Do you want to put in in the chat how we can get in touch with you? Oh, yeah, sure.
1:45:38
I’m gonna put my email down here.
1:45:40
Let’s see.
1:45:44
And thank you for reading the comments when I’m giving a talk. It’s like impossible to do that. At the same time.
Bill Clearfield 1:45:50
I know I have the same issue.
1:45:54
How do I send it to everybody? All the way at the top just at the top. Thank you.
1:45:59
All the way to the top. Everybody,
1:46:03
it should say to everyone it’s a drop down under the chat.
1:46:09
Yeah, I’m looking but I see Oh, everyone a meeting Thank you. Catch up. Okay. My email is docblock Easy moniker there. My company name is nurturing nature. which strangely enough is actually what cannabinoids do even though I had that name from before knowing cannabis, and I’ll put down my direct phone if anybody wants to sometimes a quick call is better. Just because it takes a lot of time for my fingers to text messages and things like that. So I’ve enjoyed speaking with you folks again. Thank you don’t regard I do regard. You osteopaths, as my colleagues but perhaps a bit more wise, Florida only recognizes MDS and DEOs in the cannabis space. We do not recognize naturopaths and many states do and they have a much more extensive knowledge of plants of course. homeopaths of course are not recognized here either. But depending on which state you look at, for which physicians are in this space naturopaths do have a big influence not only here, but in Canada, where it’s been legal, including recreationally for a while now Health Canada publishes on cannabis and you should look at that because it’s what has not yet come out from our FDA and federal government. But it’ll give you a better balance of supporting data, literature and experiences at least of our neighboring country to the north. Health
1:47:52
candidates called Yang Great,
Bill Clearfield 1:47:57
okay. Next week, Dr. Patel is going to give us some insight on how to how to approach patients from an environmental standpoint. So she does Environmental Medicine and some of us are, do get a little bit lost, you know, in that in that space, so she’s gonna give us the How to on how to do that.
1:48:22
So that’s next week.
Bill Clearfield 1:48:23
And like I said, if you’re in the Houston area to tomorrow, over the weekend, we’ll be speaking at the age management Medical Group hmm, ag E, AG, e med.org. And they they’re a really they’re a nice group. It’s not so big, like a forum. It’s a lot more intimate and we usually do have some some pretty good sessions there. So if you’re interested in that here, let me put put that they still haven’t come out of the a century though. I tried to get them to do live streaming too. And they they insist on not doing that. So but that’s that. What can I tell you so so everybody, thank you, Dr. Bullock, thank you so much. Again, don’t be such a stranger. You always enjoy hearing from you and and you’re you know, you’re always up on the latest and again, on the email that I sent you know, you know, inviting you to this I I’ve been putting little videos and whatnot of our speakers all and Dr. Block is like a master gardener and you can explain what that video was. And you have all sorts of ones on YouTube. Just put it Dr. Bullock gardening. I mean, it’s just amazing. I mean, it’s just unreal. The the, you know, your your your thumb. Your green
1:49:54
garden is actually a destination. It is Trump just he has such a fabulous property. With such a fascinating story attached to it.
1:50:07
I’ve been doing this my whole life. My My garden is a member garden of the American public gardens Association, but I raised my family here so I’m not public the way that many public gardens really are. But I do make it a point to share it with people who are interested bill when you come back to Florida if you don’t call me next time. I’m not gonna invite you again. But you guys come running through your stop in Miami and only 20 minutes from the airport but anybody who would like to see it if you’re around, give me a call. And if we can coordinate schedules that way, I’m happy to show it to you only legal plants here but I’d say that they’re growing to as high of a horticultural standard as as many other botanical gardens that are better recognized because of their names. But it’s sort of what I like to do and it’s a hobby interest. I’ve been in the same place for 35 years. And it’s 110 year old avocado and mango grove that’s endured South Florida’s hurricanes for that time, so don’t you
1:51:15
have a mango tree that’s registered as the largest? Yeah,
1:51:23
the federal government that the Division of Forestry has a list of the champion trees are called National Champion trees. So what is the Sequoia The General Sherman tree or something and these have names, but yeah, the largest mango in the United States is in my backyard. And like I said it started as a grove back in 1916. But by 1926 it was replanted for residential. That’s when Miami really was having its roaring 20s Boom. And it was replanted, and then in mid 1926, we had the Great Miami hurricane, which pretty much put us off the map due to the depression that followed and then World War Two. So it wasn’t until the mid 1950s that Miami started. Coming back. If I said the name Jackie Gleason, or the Rat Pack.
Bill Clearfield 1:52:16
I was thinking the Rat Pack. The
1:52:21
grandmother was recognized here. She did the original interior to a hotel here when it was built called the Fontainebleau hotel. And so it gives you it’s not just me, it’s my family and I learned plants through which was my Nana. Back then I still have the key to the city of Miami Beach. for that. I don’t know we’ve got some fancy restaurants here like Joe’s stone crab. And before my family moved me here as a 14 year old which was cruel in 1969 I moved here no 14 year old wants to move. I don’t care where you live. But when when we would come down here and we would go to like a fancy restaurant while we’re visiting nanosheet without this kid show it to the maitre d come on in man like like we’re big shots. We weren’t she just had this special key that I still have and it doesn’t get me anywhere. It’s just a relic. But yeah, I’ve been doing it a long time in the same place and my bloods thin I don’t like traveling to where it gets too cold anymore Thank you
1:53:21
Doctor block and your video. I watched it a little bit. Your garden is just gorgeous. Beautiful.
1:53:29
Thank you, Bill. Bill gave a link to the second of two episodes. The first one actually, these were both filmed in January and there’s you know, now you have social plant influencers. Okay. So this lady who does this used to be an eco model where she advertise yourself as an eco model. She’s about 40 years old now. But when she went into this, she’s 510 and then I’m gonna say this as politely as I know, she’s a baby and she was when she was 20 years old. What she didn’t tell people she’s also a degreed entomologist from Cornell. So she does know what she’s talking about. And she’s very good with interviews and how she markets this but the first of the two episodes not the one billing to the first one is episode 301 that the series that she does is called Plant one on me, a great one for a lady who’s you know, a model, but Plant one on me is her series of things and the first episode that was filmed in January on last look, it’s been viewed worldwide close to 400,000 times already, which is starting to get into that viral word, you know, I hear about for social influence. So it’s kind of cool because people never knew me as an anesthesiologist now I’m a face out there in the plant world but anesthesiologist, you know, they put us in an operating room with locked floors. They put a mask on us and there’s no window so nobody knows who the hell I am when I’m doing that. The plant world is a very different profile, and it’s kind of cool, but
Bill Clearfield 1:55:12
I’ll see if I can if I can find the link. I’ll put it on next week’s email, I’ll put
1:55:17
episode 301 That’s the one that’s gotten more of the following than the one that you’ve posted.
Bill Clearfield 1:55:22
I always try to put a I’ve been trying to put on a little video of whoever the speaker is, but I’ll put that one on too because I didn’t know it was part two. So
1:55:31
you’ve been doing a really good job on that. Dr. Bill. Fabulous work.
Bill Clearfield 1:55:37
Thank you. So yeah, it was a lot of work.
1:55:41
It was a lot of work when you did it years ago.
Bill Clearfield 1:55:43
Once I got the AOS anger. out of me. We went back
1:55:49
how far back does that How many years has it been since I spoke with you guys last year was 2020 2020. Okay, well, I missed you. Thank you for remembering me and inviting me back. And if I do come up with any cultivars for cannabis in the future that are heirloom anybody ever tastes like an heirloom fruit, a strawberry, tomato, things like that grown. I don’t know how you’d compare an heirloom joint to what you may remember as a kid, but it’s not always about getting high. It’s it’s part of the overall health and wellness and I think that health and wellness whether you’re talking about botanical medicines or the hobby of gardening, you know, a lot of people use this to stay engaged with nature their backyard, because it doesn’t take all that much thought but you’re doing something you’re moving around, you’re interacting with nature in the world. For people who get in trouble with cannabis who are the couch potatoes, who sit around and get the munchies and just eaten their parents bedroom at age 40 years old and there plenty of them out there. That’s sort of what you’d caution yourself with with having some of the more modern cultivars, which are really all about THC near seen. I told you was what that particular and I’m going to give one last comment about mercy and I mentioned that that is what was in that 1973 plant that was discovered in Kandahar, lots of myrcene and lots of THC, which were the dominant genetics mirror seen is a terpene terpenes are those chemicals that get all plants there smells? And believe me if you ever watch somebody in a dispensary go through different canisters of cannabis. They’ll take the lid off, put their nose in it take a sniff if it’s doesn’t agree with them, they’re not going to go for it. And there’s some smells that would people smell they say I want that. There’s some called diesel okay, why somebody would be attracted to diesel smell? I don’t know but that’s the way we’re wired. Near seen when people smell it and it gets brought in through olfactory is not simply like lavender which is calming and relaxing. That’s why it’s in Bath soaps. Or different smells are known to be arousing, like lemon fresh things in the grocery aisle give you a sense of being clean and awake. That’s why they give it to you on your towel when they’re finishing your flight so you clean up but mere scene is not simply relaxing sedating or calming mere scene is actually hypnotic. And an anesthesiologist knows if a hypnotic patient when he sees one. The reason that hypnotics important is that it also has more memory impairment. So when you coupled THC which is known to impair memory, with mere seen there at least should be more memory impairment. If you want to see mir seen alone ala carte, all you got to do is even today you can go to Bavaria, where mere scene is the most prevalent terpene in hops hops genetically is the closest plant to procure to marijuana to cannabis. And you can go to Bavaria today and get pillows stuffed with hops as a sleep aid. So what I’m sharing with you are the ways and we didn’t go into this on this talk. If people are interested we can engage again. But smells play a lot to do with attitude how you feel about something and couple all of those chemicals with all of the cannabinoids and try to make sense of it to have it FDA approved for that reason. Good luck. That’s why most of the emphasis for that 2018 farm bill was to try and have cannabis and its chemicals considered not as a pharmaceutical, but as a nutraceutical, which has a much lower threshold of scrutiny that it has to pass. So this is just the way that the cannabis plant has evolved over the last several years. 2018 only being five years ago. It’s accelerating. I’m most excited about it coming out of federal prohibition. wherever it lands, just get it out of prohibition. Yeah.
2:00:15
Great. Okay.
2:00:17
Thanks so much, guys.
Bill Clearfield 2:00:18
Okay. Okay. Next week, we’ll have Dr. Patel, John, you got anything for us?
2:00:24
Everything’s good. And I sent him a message on the school and how we can do some stuff. So.
Bill Clearfield 2:00:29
All right, everybody else? Thank you for the
2:00:31
deers donate. I got one last question. Hi, Marie. And I talk about that a second. Interesting. Any any plants that deer don’t eat especially beautiful plants, they love all the vegetables. Sometimes in order to understand animals, whether humans and plants, you got to start to think like a plant and I know that sounds bizarre. No, I’m not smoking anything now. But what I’m pointing out is that the plants chemistry is purposeful. The plants have had a lot longer to develop a sophisticated chemistry and the Human Genome Project and to the year 2000 was followed in 2003 by the first plant genome called mouse crest, a little, little weedy kind of plant. But the reason I’m bringing up this relative to deers and what animals eat, we’re mammals. And there’s a mammal. We have mammalian brains with the way we recall things hippocampus, amygdala. And it’s interesting because if you start to think about cannabis from the plant, and the animals perspective, and you wonder why cannabis, which has been around for 60 million years, and humans only maybe for the last several 100,000 Why would the plant have held on to THC for all of those millennia? And if I were a plant, and let’s not say maybe a goat Marie, but what about if not a deer but a goat? What about if a goat comes along and you got a little cannabis field go in there and some goats come by and they eat half the field? How smart of it is the plant knowing the memory impairment that THC brings mammal brains on maybe having the animals forget where that field was the next day so it doesn’t finish them off. That’s the way you think like a plant but there has I look this is teleology. I can’t prove this. This is not for a PhD thesis. But sometimes you just got to look at it for what it is and wonder why.
Bill Clearfield 2:02:37
They just love all my flowering plants.
2:02:41
Well, I’ll tell you what. Medicines is alkaloids tastes bitter. And the plants do that to discourage animals from eating them. Animals don’t like bitter taste. See roses must taste beautiful. Wonderful.
2:02:53
Perhaps perhaps.
2:02:57
Okay, thank you, everybody.
Bill Clearfield 2:02:59
Thank you. Dr. Block. Thank you every day till late, and I’ll have this up as soon as I can. Next week, same time, same station, Dr. Patel, the week after that, we’re gonna have a special guest and I’ll let you know about that. That’s Halloween night, unfortunately. And after that the week after that. I got Jay. What’s his name? The peptide guy. Campbell. Campbell. Yeah, J Campbell. He’s going to give us the latest. The you know, as you know, we got some great news on peptides in the last two weeks. So
2:03:34
Bill every decided on doing a conference or not.
Bill Clearfield 2:03:39
Okay, stay tuned. We’re gonna we’re gonna we’re we’re, we might have had a breakthrough. So give me another day.
2:03:45
All right. Yeah. Okay.
2:03:47
Thanks. Take care, guys. Thank
2:03:49
you. Thanks, Dr. Bill.
Bill Clearfield 2:03:51
Night. Good night. Good seeing you. Good seeing everybody. And thank you for all being here so late
2:03:57
tonight