Well, here is a study, that documents that repeated and excessive hostility actually increases cytokines, which we know are involved in pain and inflammation.

I wonder if in part, this is somehow connected to the lowering of stress and inflammation from cannabis??

Now, there is one huge exception to this, but it is not a problem but another blessing. There are many patients out there who have difficulty eating due to a high anxiety state – head spinning. For these patients, when their anxiety and that vague sick feeling in their chest goes away with CBD administration, their appetite very soon increases and their anxiety pretty much vanishes.

So, it seems that THC is a better appetite stimulant in many of the Cancer and HIV patients, but we must ask in detail about the appetite issue as well as the patients emotional state before a physician can decide which approach to try first.

Here are some details of what I have been personally trying on myself with my own medication:

Knowing that oral buccal CBD/THC/Entourage has an effect of 10-12 hours for anxiety and pain, it seems reasonable that if we used our knowledge of “edibles” and how intense the THC effect can become by passing through the liver and being “hydroxylated”. This hydroxylation, the addition of an oxygen and hydrogen atom, makes the cannabinoids in a way stickier to the CB1 receptor and probably many other receptors. While THC’s agitation and toxicity is greatly enhanced by using the oral route and can cause problems, it seemed to me that since CBD goes through the same hydroxylation, we should be able to use oral CBD as a once daily medication. So far, so good and we have had an initial group of “testers” that tell us that it at times even lingers, but in a good way, into the next morning. It may be best for some patients to do their oral dose at night; we will have to see.

So, with regard to HOW we are working with the SWC collective patients and testing these oral routes, SWC makes available for no charge a few different oral preparations. This is how we are contemplating coming up with some rational way of even toying with treating women with breast cancer; this is exciting but we really do not honestly know the real benefit. On the other hand, if it were me or my wife, I would do it for sure. So if patients are very well informed, followed closely with their primary care physician, who must be onboard, we are just beginning to get into this.

The oral preparations currently being tested are:

1. CBD cookies made by the nurse at SWC. They each have 1 cc of a 13mg/6mg CBD/THC preparation. It is amazing how “incredible an edible” can be with a known dose of THC and a solid dose, it seems, of CBD.
2. Placing same dose as above, at least for now, into a 12 bottle of water and we have CBD Rich Water. As water is still legal, there should be no additional risks. :)

-Skin color
-Skin Color
-Skin Color
-The local cop
-Every zip code is different
-Most cops don’t know or don’t care
-DA’s, assistant DA’s don’t know the law or just don’t care
-Every storefront gives the patient different advise and patients are generally just lost
-Doctors and corporations charging $30 for Recs is like going back to gas prices at a buck
-Patients have no idea of what is available or possible so the $30 is fine
-Doctors are mostly paid by corporations, not physicians, so the quality is corporate

We have patients without the ability to get any information and often times the information they receive is so wrong it hurts them. Anyone who has been a “stoner” for 40 years becomes an expert solely based upon how many years they have been getting stoned. So, who are the experts?

-Lawyers
-DA’s
-Growers
-Storefront employees are always a source of brilliant information as well. NOT!

What is really crazy, I mean totally nuts/gonzo, is that the system works best for the “folks” who just want to be able to legally and socially smoke weed. Period. As this represents probably 80% or more of total Physician and Collective visits, anything we say or do really does not truly matter much, as folks are getting their weed, going home and smoking it alone or with friends….i.e. social or recreational cannabis which is quite cool.

Of course I would much rather see these folks not needing to see any physician and just smoke if they want it. Nothing more and nothing less. The patients are quite happy. Their physician visit cost $30, took just 5 minutes and the patient can often just walk next door or upstairs. The only decision is how to smoke it and who to smoke it with. Pretty cool and very simple…..THIS IS SOCIAL OR RECREATIONAL CANNABIS AND IS AWESOME AND OF COURSE NEEDS TO BE FINALLY LEGALIZED.

So, just for arguments sake, let’s say that the other 20% or so are the “real” patients. We all know who these people are when we walk into a dispensary; we also can generally see who the less ill patients are. I KNOW THAT LOOKS CAN BE DECEIVING, but we all know most of the clubs are catering to young people.

On my birthday a couple of weeks ago, I went to Venice Beach and got two recommendations from two of the “kush doctor” places. It was of course pathetic, but quite fun to be “undercover”. The most important thing I experienced was that there were not just kids getting Recs; there were plenty of people in their 40′s to 60′s. These patients, at least to my quick glance, were “real” and seemed at a glance, REALLY SICK. They received NO information and of course just think smoking and maybe vaping is the answer. God forbid they get edibles, as one of the docs I saw, told me that edibles were harmless and that I didn’t need to worry…..I could eat to my hearts content. This doc also thought that a vaporizer is a steam pot 1/2 filled with water. You heat the water, drop in the cannabis and presto, place a towel over your head and you are there. UNBELIEVABLE!!

So, this brings me to the main point of my blog/article, what are Physicians to do with the REAL SICK PATIENTS??? Having docs who know nothing is dangerous. Without any help, an elderly person can easily get into deep trouble downing a full edible. The idea of DOSABLE CANNABIS MEDICINE, is not ever mentioned. Frankly, I am not certain anyone else even uses these words.

I hate to say it, but in my experience, there are only a handful of physicians in California who have even heard of CBD/Cannabidiol and if you brought up Terpenes, well you might as well just light a fatty, sit back and relax. Save your breath.

I know for a fact that very few physicians are aware of ANY of the science out there. I doubt more than a few ever read any scientific articles on cannabis.

Don’t you want your doctor and not your pharmacy picking your blood pressure medication or antibiotics? At the same time, we accept that the collectives are in charge, that they always know best and to top it off, we are told as Physicians that we “can’t” educate our patients as that is federal “aiding and abetting”. If, as physicians, we are really frightened to “aid and abet”, why do we even give Recommendations; that has always been odd to me. Every doc that signs a Recommendation is clearly helping/aiding a person/patient obtain cannabis. Although the Recommendation is just a “suggestion”, it does empower the patient to obtain the evil weed. I don’t see the difference and frankly I think most physicians just use this excuse to cover up the fact that in truth, they have no good advise or information and this is where the problem gets tricky.

If we really get true legalization, the social cannabis use will remain social and not involve any physician. Don’t you agree, we can get stoned without a doctor’s note?

But what if the patient is really ill? What if one of these physicians received a referral from another open minded physician to try help out the patient using cannabis as everything else has failed. If this referring physician learns that his/her patient was not helped but just told to go smoke or vape and eat edibles carefully, we have a very significant professional disconnect.

However, what if the referring physician finds out that the cannabis doc was able to explain dosable cannabis medication and all the advantages of both dosing and CBD to his patient. And, what if, the patient, with the help of BOTH DOCTORS finds that Dosable Cannabis workING great and the patient is able to get off 75% of their narcotics in a few weeks? Well, then either the cannabis doc gets a bunch more referrals, or sometimes, the referring doc gets trained by the Cannabis Physician and begins doing the Recommendations on his/her own patients. The referring doc knows that if he/she gets “stuck” that the cannabis specialist is always there to help. Doesn’t this begin to sound like real medicine??? SO:
WHAT SHOULD CANNABIS PHYSICIANS DO ABOUT THIS GROUP OF REAL PATIENTS