Untangling Cannabis: History, Perspective, and Benefits for Mental Health with guest Dr. Dustin Sulak
*Please note this episode contains an occurrence of profanity.*
In this bonus episode, Dr. Kimber is joined by special guest Dr. Dustin Sulak for an exploration on the medicinal properties, history, and benefits of cannabis.
An osteopathic physician, Dr. Sulak has become an internationally-renowned expert in medical cannabis, and he shares about the stigmatization of medical cannabis use, perspectives on healing the body organically, and why medicinal cannabis may be worth a try for some patients — with proper guidance and support.
Key moments include:
04:19 – A brief history of medical cannabis and the circumstances that led to it being villainized.
10:10 – How cannabis can be used for treatment, and the difference between hemp, cannabis, and other substances.
15:22 – Dr. Sulak’s thoughts for anyone hesitant about medicinal cannabis.
20:47 – The lack of information regarding medicinal cannabis and its patient benefits.
25:41 – Cannabis, its subspecies, and whether it can help support quality sleep.
More on Dr. Sulak:
Dustin Sulak, D.O., is a traditional osteopathic physician and expert in integrative medicine. His clinical practice in Maine focuses on treating refractory conditions in adults and children. Dr. Sulak is an internationally-renowned expert in medical cannabis, the author of the first foundational text on its clinical use, Handbook of Cannabis for Clinicians: Principles and Practice, and a co-founder of Healer.com, a medical cannabis education resource. He is a passionate educator and leader in the field of medical cannabis, and serves on the board of directors of The Society of Cannabis Clinicians.
Keep in touch with Dr. Sulak:
Instagram: @Healer.com_
Facebook: @Healercom
Website: Healer.com
Clinic Website: integr8health.com
Book: https://wwnorton.com/books/9780393714180?promo=HBCN21
Please remember that this podcast is not a replacement for treatment by a healthcare or mental health professional. This content is created for education and entertainment purposes only.
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This transcript was created by A.I. — please forgive translation mistakes.
[00:00:00] Welcome to I Thought I Was Over This.
[00:00:05] I'm your host, Dr. Kimber, a licensed clinical psychologist, trauma healer, and fellow life journeyer. Every episode we dive into the science of humaning. Whether you find yourself feeling like you've just hit an iceberg and don't know where help is coming from, or you're ready to trade in your raft for something bigger, you aren't alone.
[00:00:27] Grab what you need, get comfortable and let's do this.
[00:00:34] Well, I am so pleased. Today I have Dr. Dustin Sulak with me. I am thrilled because this topic is new to me and it's so interesting to me. I've been following your healer.com. It's just amazing the work that you do. I really see you as like this bridge between the science, the physicians, and the users. I really am excited about the work that you're doing here in the United States, so it's great to be here.
[00:01:10] I would love to have you introduce whatever you would like my audience to know.
[00:01:15] Okay, Sure. So, I'm Dustin Sulak. I'm an osteopathic physician and a general practitioner. I'm in Maine, that’s where I see patients. I've been doing this since 2009 and my interest has been integrative medicine and mind body medicine and spirituality and medicine.
[00:01:34] I work as a traditional osteopath, so a good part of my day, I'm putting my hands on people and quietly listening to their physiology and doing what I can to help remove obstacles from. The process of whatever the health's trying to do and also to support it in doing that. So that's my basic approach to health and medicine, which is, you know, I think similar amongst integrative medicine and maybe functional medicine providers, one of the things that's maybe a little different about me is that back in 2009 when I started my practice, it was the same time when Maine expanded its medical cannabis program.
[00:02:10] And previously they, we had a program here, but most people couldn't have access to it. It wasn't really functional. And suddenly a law passed, a voter referendum actually, and there were thousands of patients that were using cannabis illegally in the state for medicine for valid reasons. And all they needed was a physician's signature in order to do so legally.
[00:02:31] And I was the only one in the state willing to offer that signature. Wow. I had a long personal relationship with cannabis that we can get into later if we want, and some exposure to doing evaluations for cannabis certifications in med school and in residency. And I felt very comfortable offering this to people.
[00:02:48] I didn't know that it was going to take over my career, and literally that's exactly what happened. So, I, you know, I'm still the integrative osteopath. Kind of on the surface, I'm known as this international cannabis expert. Because what I learned was that cannabis is such a versatile medicine, and we'll get into this more deeply.
[00:03:06] Like it, it sounds too good to be true. Often it can help with rare conditions, it can help with common conditions. It can work in the elderly and in pediatrics and all across the spectrum, you know, and it, and it does so by interacting with our healing system, with a very important component of our healing system.
[00:03:24] Understanding of how cannabis works, how to use it as a tool, and how to help patients relate to it, not just in terms of the physical benefits, but also the mental and spiritual. This kind of all worked really well with my background and my passion in medicine already. And so, and so that, that's my story.
[00:03:40] I'm an integrative physician, but also a cannabis expert. I've published, I think, seven or eight papers in the peer review literature. I published a book for clinicians last year on cannabis, and I have a great deal of free patient education on healer.com. As you mentioned,
[00:03:56] it's a great resource.
[00:03:57] Well, I am thrilled. Can you give us, from your perspective, the background of how in the United States we have arrived as what I would say, villainizing cannabis or seeing it as only dangerous, whereas, you know, there's countries around the world that have been doing research with cannabis. For decades now.
[00:04:18] Yeah. Well, so, so very political. I think the first medical conference on cannabis in the United States was in the 1850s. It was popular back then. It, Wow. It was in every pharmacy. Up until around 1920 or so, and then it started becoming a little less popular. And historical accounts suggest that that was due to supply issues, inconsistent potency.
[00:04:43] You know, there's a lot we didn't know about it back then, but it was sometimes called Indian hemp. And sometimes it was just cannabis sativa, and then it would appear in a tincture, it would appear in a powder that could be used to make a decoction like a tea. They sold cannabis cigarettes, which were used for asthma, so it was very well known, very popular.
[00:05:03] I think its most popular use was in a compounded product that included some morphine and some capsaicin. And so, that, that was called chloranidine I think it was like one of the most popular patent drugs that ever sold. Wow. And it was probably better for pain than anything we have currently for treating, you know, in the outpatient setting for, for treating pain because it's, it's doing what us osteopaths talk about and like to do, which is to mimic what the physiology is doing, right?
[00:05:30] So when we have pain, we're addressing it internally with our inner pharmacy using our endorphin system, our endocannabinoid system, and our vanilloid system, which is the target of capsaicin in the component of hot chili peppers. And so, just as an example, like sometimes the wisdom from 19th and 20th century medicine is really.
[00:05:51] Missing from today. And we can learn a lot by going back to it. So what happened was Mexicans were using cannabis, using it to help them like work hard in the fields and recreate afterwards. There wasn't a lot of alcohol use in that patient population and as kind of a way to racially discriminate and control that population in Texas and in some of the other Southern states
[00:06:14] They started having anti-marijuana laws at that point in time. Most people didn't understand that the Mexican word marijuana meant the same thing as cannabis. They didn't really see that farmers were growing hemp. A lot of people don't know that. The same exact species that produces the flowers that can be used as medicine, just a different variety of it produces fiber that can be used for rope and for canvas.
[00:06:38] The word canvas comes from cannabis. I think it was the. Department of Defense or something asked the farmers to grow cannabis for rope and for sales for their ships in World War Two, like, so it's, it's been a major part of our economy actually. Some economists suggest that the whole capacity for the United States to gain independence from Great Britain had to do with the strength of our hemp trade.
[00:07:02] This was a major cash crop for us. Wow. And George Washington grew it. Thomas Jefferson grew it, You know, it was grown all along the East coast, the very beginning of this nation, and we used it. We didn't just grow it and export it, but we exported it and used it. In 1937, there was a bill to make marijuana, not illegal, but legal only
[00:07:22] If it was present with a special stamp, which was like a tax, you know, you could buy this tax. And that's the only way that marijuana could be legal after that. And there's, you know, theories that drive came from actually the timber and the petrochemical industry because they had, you know, they were competing with hemp basically for, for making products from the fiber.
[00:07:43] Uh, that was the timber competition. And then from the oil was the, the petro source of oil. You know, you could have a vegetable source or, or a fossil fuel. And so it's so interesting though because in 1937, the legal counsel of the American Medical Association testified to Congress and basically said, You can't make marijuana illegal.
[00:08:04] This is the same thing that's in all of our pharmacies. This is. Hemp. This is, this is the Indian hemp, this is the cannabis. This is gonna be hard on the patients, hard on the doctors, hard on the pharmacists, and most of all, hard on the farmers. So it's interesting that the American Medical Association was really pro cannabis, anti prohibition.
[00:08:24] You know what was going on at that time also was, you know, the United States had just recently been through making alcohol illegal, and that really didn't work, right? I mean, it just supported underground production of alcohol and crime and overuse and misuse. And so that was like, The first instance of this failed drug war, but now there was this big government organization and funding and employees that needed something else to do.
[00:08:49] And so that eventually led to the Federal Bureau of Narcotics, which is, you know, then morphed into the DEA that we have today. So that's kind of how it changed in this country. We subsequently exported our cannabis policy or our marijuana policy all over the world. And so a lot of countries, there was a, you know, up until recently, kind of a UN agreement, United States has done that a lot with, with our drug policies, which are really destructive.
[00:09:15] I mean, there's absolutely, in my opinion, no academic support for making drugs illegal because people just use them anyway. It works much better to reduce the harm associated with them, educate people how to use them safely and give them opportunities to do so. That, that's kind of where I'm coming from. And that's the background of how, you know, even just the word marijuana has its roots.
[00:09:37] in, uh, racial discrimination. Mm-hmm. And in that speech to Congress, the how did the, the legal counsel from the American Medical Association pointing that out and said, like, this word is a racial word. It's a, I think he called it a mongol term that should not be used. So, you know, we try to use the word cannabis a lot more than marijuana, just outta respect for the history.
[00:09:57] And it's, that's its scientific
[00:09:59] name. I'm so glad to know that. I had no idea. Thank you. Can you talk to us about how the cannabis system works. And is it a little bit different than hemp or is it all
[00:10:10] the same? Yeah, so for years, decades really, cannabis has been used to treat a wide variety of conditions and the, and this is kind of unusual for a single agent to be able to help with like gastrointestinal
[00:10:24] Symptoms and neurological symptoms and psychiatric symptoms and inflammatory symptoms and pain, and you kind of go, you, you name it. And there's some evidence that cannabis or the compounds they're in can provide some help for that condition. So this was like a head scratcher to researchers, you know, figuring out like how to, and in particular, you know, once it was isolated they determined that THC was the main component
[00:10:49] That was responsible for these broad physiologic benefits. And so that led to, in the late 1980s and early 1990s, researchers discovered the target of THC in the body. Well, it has many targets, but the main target, they called it the cannabinoid receptor, and so they named it after cannabis. It was the target of THC in the body.
[00:11:11] Later they discovered that there were two cannabinoid receptors in humans, and that's CB one and CB two. And then they said, Well, if we have these receptors, it's probably not for this plant. You know, maybe we make something in our bodies that targets these receptors also. And so then the endocannabinoids or the endogenously produced cannabinoids were discovered.
[00:11:32] Found to be ubiquitous throughout the body. So basically every tissue, you know, all the, all the connective tissues, the nerves, the capillaries, the, the brain like, like everything in the body has this system of producing endocannabinoids and being sensitive to the signaling of the endocannabinoids.
[00:11:49] And it turns out what we've learned is that this is a kind of a foundational homeostatic system in the body. So it's a regulator of other systems. Mm-hmm. when there's neuro transmission that's out of balance, the body uses the endocannabinoid system to bring it back into balance. When there's immune function that's excessive causing inflammation, it's out of balance.
[00:12:08] Endocannabinoid signaling will bring it back into balance. It, you know, controls the smooth muscles, the skeletal muscles like, so basically, wow. This great capacity to affect anything has been validated. And not only validated that cannabis can do this, but we've gained this enormous body of information about our own health.
[00:12:26] Like how do we prevent disease? How do we respond to illness and injury? We're using cannabinoids all the time to do this, and it's not just humans. So C squirts, which are very primitive type of chordate animal, have a cannabinoid receptor that's almost identical to our CB one receptor. Wow. So this means that animals have been using
[00:12:48] Cannabinoids to regulate their health for about 600 million years. And in comparison, we think the cannabis plant is about 40 million years old. So, Wow. This goes way back before, you know, people say, Oh, humans and cannabis co-evolved, Which, you know, a very small piece of the story might be that, us cultivating it and kind of evolving, you know, maybe societal values and things around it.
[00:13:12] Really, this has been a part of animal physiology for a very long time. A very important part of it. It's
[00:13:17] so cool. As you're talking, it reminds me, I've discovered the polyvagal theory in trauma work. Which opened our eyes into the shut down and the free system, which now like opens our eyes to how we go into working with trauma.
[00:13:35] And it sounds like the discovery of these receptor sites have done the same thing, that it's like, Whoa, this is all over in our bodies.
[00:13:45] Yeah. So. Yeah, so we, we, we learn, you know, we look at these agents and these, or these techniques that are helpful, and that just opens up a whole new perspective on, on what else we can do.
[00:13:55] And so now you'll see there's drugs in the pharmaceutical pipeline that target the endocannabinoid system. You know, there's a lot of work being done. How we can take advantage of the system without the psychoactivity of THC. Right. And so just to get back to your question, like what's cannabis? What's hemp?
[00:14:12] What's medical cannabis? You know, these terms are just completely thrown around in the US the definition of a hemp product is something that has less than 0.3% THC by weight. So like you go to the the grocery store, you can buy Hempseed oil. You can buy hempseed hearts, you can put them in your salad dressing or on your food.
[00:14:30] It's great nutritional product, but there's, there's really no like THC in it and very few of the other cannabinoids or medicinal compounds. Now, you can also get a hemp derived CBD product, for example. Uh, that can have a tiny bit of THC in there, but it's not gonna be enough to cause any impairment unless say you drink the whole bottle, you know?
[00:14:50] So medical cannabis typically describes. The medicinal parts that have higher than 0.3% THC and are therefore regulated by these, this kind of patchwork of state medical cannabis legislation. Right?
[00:15:04] So what's your response to someone who's hesitant and they consider themselves very healthy and they don't equate cannabis use with
[00:15:14] Health and vibrancy, how might you enter in that type of argument?
[00:15:21] It, it's a great question. There's, uh, it's a powerful agent, right? Cannabis can do a lot and so it can do a lot of good and it can do harm as well. But I think, you know, compared to most of the other tools that I've been exposed to in my clinical practice, the balance leans much more towards benefit and away from harm.
[00:15:40] Like for example It's non-lethal. There's no dose that, that you can use to kill yourself. I, if you kind of sidetracking from your question for a minute, but we see cannabis frequently being used to replace other classes of drugs that are much more dangerous. So the opioids, the benzodiazepine, so this is like Oxycodone, Valium, and Xanax and that whole class of
[00:16:01] Drugs and then others like the antipsychotic drugs, the antidepressant drugs, you know, things that still are more likely to cause, uh, dependence and withdrawal that are dangerous to stop abruptly in some cases cause weight gain and metabolic dysfunction. So just from a purely like harm reduction perspective and efficacy, like in clinical medicine, like we're seeing a lot of people that
[00:16:26] Do not fully respond to conventional therapies. Right. like, Yeah. You know, do FDA approved therapies like work for everyone all the time? Like no, rarely. And so we have to like be open to the idea that experimental treatments with things like cannabis might be valuable. And, and what I've seen over more than a decade in the clinic is that it's extremely helpful for patients.
[00:16:47] But now getting back to your question, what does cannabis use look like in the healthy individual, and is there any evidence. That it could be used to promote health and prevent disease. Yeah. Right. This is the question that probably a lot of your listeners are, are wondering if you've got something that can treat some of the most severe, uh, refractory conditions in every discipline of medicine.
[00:17:11] And, and just to really point that out, I get referrals from oncologists, neurologists, psychiatrists, gastroenterologists. Right? Like they send me their toughest cases. So if you can get results like that, and we know that the way we're getting results for those things is by interfacing with a homeostatic system, that's a cornerstone of health.
[00:17:30] Mm-hmm. of course, you have to start asking the question, Well, besides just treating the disease after it occurs, could we use the same tool to prevent the disease from. Like it makes perfect sense based on how we know it works in the body. I believe that's true. So what do we see in cannabis users? Versus non-users, like at the population level, there's trends of less diabetes, quite a bit less diabetes, less metabolic syndrome, lower blood pressure, better rates of satisfaction and life, quality of life, mental health, like a lot of these studies have been done just to look at a cross section of people and divide them into users versus non-users and see how they're different.
[00:18:08] So that's a, that's another clue. But I think, you know, most people have observed the heavy cannabis user. That's kind of doing it illicitly, maybe without any guidance, maybe without a real goal. My perspective on substance abuse or misuse isn't that the substance is the problem. The substance is a solution.
[00:18:26] There's usually some deeper problem and maybe a better solution out there, but because it's been so illegal, what we haven't had much of is this like vertical transmission of here's how to use cannabis in a healthy way. Almost everyone, if you ask them the question, what does alcohol use look like in a healthy way versus an unhealthy way, they can conjure up some images of that.
[00:18:48] Yeah. But when you ask that of cannabis, people usually don't think about like me. So I'm, I'm healthy. I work very hard on my health. I'm very interested in it. I'm exploring ways to optimize it all the time. I've explored lots of ways of using cannabis. Most people might not. Taking a, you know, uh, cannabis, like a tonic in the morning in the form of a, an oil infusion, you know, non impairing dose that helps me feel more clearheaded, more energetic, uh, can help with any minor joint pain.
[00:19:17] They might not imagine me, you know, having a little bit of inhaled cannabis as an adjunct to yoga or Chi Kong or meditation or sexual intimacy. Or using it as a first aid remedy when I get a Bee Sting or a contusion or something like that, you know, using it topically, it works extremely well. Dental pain responds really well to topically applied cannabis.
[00:19:37] Like it has a place in all of our homes. It's safe for kids, it treats fevers. I know some of these statements might make people think like, Wow, you're gonna give your kid a cannabis something instead of a Tylenol. When they have a fever and then you look into Tylenol and see that it's actually a lot more dangerous and toxic than than cannabis.
[00:19:55] So hopefully this is opening some minds to people like imagining what they don't know about healthy cannabis use. But I'm sure that most people at some point in their life could benefit from this incredibly versatile medicine. So important to learn about it now and then when that time comes, you know, hopefully you'll be able to figure out how to, how to do it appropriately.
[00:20:18] And that's been one of my, one of my major missions, is to make that information available freely to people.
[00:20:24] Yeah, I have found that on healer.com you have so many free resources that educate. I'm in California, so we have legalized cannabis use and it seems like It's according to the dispensary person of what kind of information I'm getting.
[00:20:43] How do you find out good information And
[00:20:46] right? It's a big problem. Like every patient that leaves my office gets a printed sheet that says, Here's how I want you to use cannabis. And it's, it's very different than regular pharmaceuticals. It's not like, Oh, take five milligrams three times a day and we'll check in next month.
[00:21:00] It's, Here's how to start. Here's what to look for. Here's how to adjust the dose, depending on how you feel. And so it's quite a process. It requires some introspective, uh, self-awareness. It requires maybe a little journaling or documentation, some feedback. It's, it's part of this individualized medicine patient empowerment model.
[00:21:20] That I'm hoping is taking over medicine right now, like it's desperately needed. And so cannabis really leads the way to that. Now, most people that go to a cannabis doctor will have almost the opposite experience where they leave there with a card or a letter that says you're free to use cannabis legally.
[00:21:37] Um, and the doctor doesn't say anything about how to use it, what to look for, why they're using it. It's just kind of like, You know, we call 'em certification mills. They're out there. You go in, you pay a little money, you get a cannabis certificate, you take it to the dispensary. Now there's someone in the dispensary who has no clinical training.
[00:21:54] Yep. Who's in the unfortunate situation of having to act like a clinician, match a product in a dose to the complaint without even having a full interview or history. So, um, so yeah, that, that's a big problem. And I also have been striving to address that problem. I think successfully for the last four years, we've had an online training program for dispensary agents to help them do their job better and to help them also recognize when it's outside their scope and when they need to, you know, kind of escalate to someone with a little more expertise.
[00:22:25] I love it. Do you have a list of dispensaries that have actually gone through your program? That's
[00:22:32] a really good question. I don't know if there is one. The dispensaries that carry our products in Maine and Maryland, that's where we have medical cannabis products. They all go through it. Okay. Okay. But then we also have, um, we have hemp products that a lot of, you know, dispensaries, cannabis shops, health food stores, et cetera around the country carry those products.
[00:22:51] And I don't know that they've all gone. Training. So maybe a, a training, uh, locator on the website would be a good idea. I would love
[00:22:59] that because, well, again, I'm in California, so my city alone has multiple dispensaries, but it's really hard to know, even if I know what I'm looking for. I don't really know if how good their products are, if they're
[00:23:14] educated.
[00:23:15] You know, it's really hard, really hard. In some states, there's, um, stronger requirements for like double checking, accurate labeling, but in a lot of states, these products are mislabeled. They don't have what they say in them. So you, you need to be able to trust the brand. Um, you know, and then efficacy is a big one.
[00:23:33] Like some of these products are just low potency or not. They're, they're just, What you would want from a medical perspective. Also, many states like California, that have had a medical program for years, like California started this in 1996, you know? Right. Just recently went to kind of legal adult use, and that shifts the, um, kind of supply demand relationship for products that might have more of a medicinal effect to products that might have more of a impairing, psychoactive, intoxicating type of an effect, you know?
[00:24:06] Right. And companies do what makes money and when there's demand for that, they, they shift over to that. And the medical user, uh, sometimes is kind of left hanging and not having access to what would be best for them. So, unfortunate situation. I know a lot of the kind of smaller artisanal producers in California
[00:24:24] That we're working for a long time to serve medical patients are being kind of squeezed out of the market now and having to shut down, being displaced by by big corporations that can, you know, undercut their price and flood the market with low quality products and shut them down. You know, we see it in many industries and it's certainly happening in cannabis as well.
[00:24:44] Exactly. But I don't wanna sound too pessimistic because the other thing is doctors are learning a lot more. So we're talking about dispensary agents and Bud tenderers, like having to step up and do the doctor's job well, how about doctors stepping up and doing it? And I, and I think that that's starting to happen.
[00:25:02] Like we're seeing more of that. So great resource for your listeners is the Society of Cannabis Clinicians. And they do have a physician or a clinician locator, you know, pharmacist, nurse practitioner, nurses, you know, any different people are listed on there. And so if somebody wants an expert with some experience to guide them as they get started, that would be a great thing to look at.
[00:25:24] Go have a visit, give 'em your history, your med list, and so forth, and get some solid recommendations. And then if there's no one in your area, take things into your own hand with the free patient Education. I
[00:25:35] love it. Shifting to the end here, cannabis and sleep, Big need. I don't know if it would be too specific to go into a decision making tree.
[00:25:48] I know certain people have insomnia, others have night terrors. Is there a way to approach it? I know there's so many uses, but
[00:25:57] Yes. Yeah, no, let's, let's talk about that. I think we'll do like a, like a three minute kind of breakdown of some of the different categories of cannabis products. Okay. And then we can segue into sleep.
[00:26:08] And so we can start with, cannabis is a single species, but kind of like tomatoes where there's big ones and little ones and sweet ones, and not, There's way more varieties of cannabis, right? So there's some varieties that are going to be dominant in thc, which is that psychoactive component of cannabis part that gets you high and
[00:26:27] Many therapeutic properties. Mm-hmm. I'll just take a moment to dispel the myth that came from Sanjay Gupta back in 2013 with his first episode of the weed series. He showed a little girl that whose severe seizures got better when she took cbd dominant cannabis, and he. Kind of put this idea out there that CBD is the medicinal part of cannabis and THC is the recreational part of cannabis.
[00:26:51] That's absolutely not true. THC is the compound that mimics our bodies, inner pharmacy, cannabinoids, our endocannabinoids THC acts almost identically to them. So it's, it is the main therapeutic component of cannabis. But we'll have, we'll have some varieties that are dominant in THC and they have trace quantities of these other
[00:27:12] Compounds. And then we have some varieties that are dominant in CBD. So what is cbd? It's like a cousin of thc. It's a lot less potent. Meaning to get similar therapeutic effects. People might need a lot more of it, which could be more expensive. Okay. Um, it's very forgiving though. It's non-toxic. Most doses we could say it's non-toxic.
[00:27:31] There's been some people are maybe a little susceptible to, uh, some of the liver Demands of processing high dose cbd, especially in combination with certain seizure drugs, but for the most part, very safe. CBD tends to help with, um, anxiety, mental focus, and clarity. It can be somewhat helpful for pain, uh, including different types of pain, joint pain, nerve pain, and it does it all without the impairing effects.
[00:27:56] So a lot of people might lean towards like a CBD dominant preparation during the day and a THC dominant preparation. At night. And so this is kind of our segue to night. And, and when I say preparation, what am I talking about you like? Just so people can imagine this could be capsules, this could be drops and a little dropper, bottle of a tincture or an infused oil.
[00:28:17] It could be inhaled. The, the lungs are actually quite a nice route of delivery for medicines in general, but also for cannabis because of its rapid onset. Mm-hmm. Um, and so, you know, selecting the right product and the right delivery method for someone with a sleeping issue. You know, and usually we, we see incredible results.
[00:28:35] So I, I wanna first say that cannabis is not a hypnotic. There is no dose of any cannabis compound that will actually put you to sleep. Mm. What cannabis can do is remove the obstacles to sleep, and those tend to be restlessness, anxiety, pain, or if there's like gastrointestinal symptoms. So for people that have trouble falling asleep but are able to stay asleep, okay.
[00:28:57] We don't need to like treat them with a long duration of action type of cannabis. Sometimes we might just do a very low dose of inhaled like 30 minutes before bed and, um, they get to wind down and have a little like kind of meditation or journaling or something like that. And then that can work really well for falling asleep.
[00:29:14] My, my patients say, When they're lying there, their bodies feel very comfortable and still they don't feel like they need to toss and turn. And their mind, instead of ruminating over and over again about the same stressors or whatever, just kind of drifts off in, in a strange direction. And then it drifts and then it's gone.
[00:29:31] Love it. So that's, that's how I think it helps a lot of people in that way. For people that need more help staying asleep. What we would wanna do is an oral dose, cuz the inhaled cannabis taken before bed is gonna pretty much wear off two or three hours later. But taking it orally, we might get a six to eight hour duration of action.
[00:29:48] And again, this would be a, ideally a THC dominant product. That's made from the types of cannabis that are sedating, and we know this works better. Like for example, you can get a, just a pure pharmaceutical grade synthesized thc. It's actually an FDA-approved drug, right? I can prescribe that. Every pharmacy carries pure THC pills and I've, I had patients that will use herbal cannabis, like artisanal cannabis preparations designed for sleep.
[00:30:15] And then when they go traveling, they just switch over to that THC pill because it's legal to, you know, go into different countries with and cross state lines with. And invariably they say, Well, it kind of worked the same, but not as well. Like, I didn't get as sleepy, I didn't stay asleep as long. I'm telling that story to emphasize that it's not just the thc, right?
[00:30:34] Like the THC is coming. With all of these other trace compounds that kind of modulate its effect. And that's why if you take THC during the day, you might not want that sedating formula, right? You might want a more uplifting, awakening type of formula. So that's, that's the breakdown for sleep. There have been some polysonographs, like sleep studies done.
[00:30:52] With cannabis use, the next question that your listeners should be thinking is, Okay, so it makes you sleep, but what's the quality of sleep like? Right, Right. Like, I can drink myself to sleep or take Valium all night and I might be asleep, but it's not, it's not really good sleep. And so, uh, yeah. Studies have shown that THC can disrupt the sleep architecture at high doses.
[00:31:12] The, the way in which it disrupts, it doesn't seem that bad. Actually. It diminish the REM sleep a little bit. Yeah. And it extends the slow wave sleep a little bit. And I think that slow wave sleep is like the most healing. So that might not be a bad disturbance, but basically the only doses that have been shown to do that are doses that also cause a detriment on cognitive testing the next morning.
[00:31:35] So basically if you're waking, if you took enough that you're waking up stoned right, then it might have disrupted your sleep architecture. But that's too much anyways cuz people don't wanna wake up stoned. They wanna wake up feeling like alive and. Energetic and ready for the day. So if you did take cannabis and get groggy, you would wanna decrease the dose some and get it right, and then you're probably not interrupting the sleep architecture.
[00:31:56] I will say that out of every condition I've treated with cannabis, and you, I've mentioned now, you know, this is a broad range, Probably the most likely to respond are, um, nightmares caused by trauma. Trauma related nightmares. Right. I don't think I've ever seen anyone with trauma related nightmares that has not at least
[00:32:16] Received some benefit from taking THC before bed. And very often it's an incredible benefit, like life changing benefit. Uh, because if you're not, if you're not having that every night and not waking up in that way in the morning, it, it allows people to kind of get on top of their life and, and start their days
[00:32:32] differently.
[00:32:32] Exactly. And that can be stuff that is processed in therapy or with a clinician and it doesn't need to be such an impediment to their Ability to function during the day.
[00:32:49] Absolutely. And I love the way you, you frame that because there is a healing process there, right? They're trying to process it at night. Yes, that's right.
[00:32:56] Trying to deal with that old trauma, but instead, they're just waking up in a panic. It's not happening. Yeah. Maybe if someone was there to hold them at night and talk them through it when they woke up, it could be extremely therapeutic. But a lot of people don't have that and might do better saving it for therapy.
[00:33:11] Exactly. Now you know, one of the things I didn’t Mention about this endocannabinoid system is that it's extremely involved in neuroplasticity, so this is our capacity to learn new things. To acquire different patterns of thought and behavior and you know, also to forget things, right? To, to lose old patterns, right?
[00:33:29] When we think about learning, we usually don't put forgetting in that same basket, but forgetting is actually an incredibly important part of learning. And the cannabinoid system controls all of this. And so not just in animals, but also in human models of trauma. There's been experiments that have shown THC and CBD, either one of them can facilitate what we call fear extinction, which
[00:33:51] Kind of forgetting that fear reaction to a certain stimulus. Right. And that's essential for people that have trauma. And of course just about everyone has trauma, and so Exactly. And so that's essential for all of us to kind of move forward in our lives and get over that old shit that might be holding us back.
[00:34:07] Our brains are doing this anyways with the cannabinoids, and so by supplementing. We see this kind of increased capacity for change
[00:34:15] That is so exciting. Well, this has been delightful. How can my listeners get a hold of you or find more of what you offer?
[00:34:27] Okay. Yeah, so step one is healer.com, and that's where we have our complimentary patient education.
[00:34:34] And if anybody wants to take a deeper dive, there is a paid online training and certification program there. Myself and some of the clinicians I work with here in Maine do offer what we call phone education consults to people. So if you're not in Maine And you wanna get one of us on the phone, you can give us your history,
[00:34:52] We can look over your medications and supplements, and then tell you what we would recommend if you were a patient here in Maine. And we would send a copy of that to your local practitioner to help inform them so that they can kind of take over. And learn something while they're at it and, and manage that cannabis.
[00:35:09] So wow. Educational consults. There'll be a link to that through healer.com as well. And then for people that are looking for quality products, we make products. I haven't done this my whole career. This is new within the last two or three years because. I wanted some products that I could trust for my family and for myself and for my patients, and it's just like the hemp marketplace is so all over the place.
[00:35:32] There's just been a number of investigative reports and peer reviewed journal articles showing that, you know, usually more than half of these products sampled don't have what they say they have in it. Wow. Or they're contaminated with things like pesticides and heavy metals that significant quantities.
[00:35:47] So healercbd.com would be our website where you can purchase HEMP products. Uh, and, and I think we're, we're doing a really good job with those. So you, and I'm not gonna go into it now, but we formulate our products in a different way, and I think we get great results because of that. Oh, that's fantastic.
[00:36:04] And it's all grown here in Maine. I was just at the farm a few days ago. Big organic. beautiful flowers. A farmer that really cares about what he's doing, you know, all organic. Ah,
[00:36:15] that is fantastic. Thank you again for being here, for educating my listeners. It really is a joy to be with you and to learn more about how to heal ourselves, our body.
[00:36:31] And we don't have to be stuck. This is an exciting Yeah. Way to, to find
[00:36:37] healing.
[00:36:38] Thank you. I love the way you said that. Yeah. For, for anyone that's listening that feels like they've tried a lot and that they are stuck, please don't stop until you've tried appropriately used cannabis. Like it is. It is just such a versatile tool.
[00:36:53] Don't, don't even believe that you're stuck. You're not stuck. You know, you don't get that, that qualification until you've tried this because it can just help so many people get over the hump. Where other things can then start helping. You know, if somebody's not sleeping, it's so hard for them to heal in any way, and, and we can, you know, substitute the word sleeping for a number of physiologic functions.
[00:37:15] As well. And, and cannabis can help with so many of those. Yeah. So this is a broadly effective, safe, versatile tool. Uh, but it requires education to get the most out of it.
[00:37:25] Exactly. And I'm so grateful for the work that you're doing on both a policy level and an education level. So thank you for your work in
[00:37:36] the world.
[00:37:37] You're welcome. And one last suggestion to the listeners. If you, um, if you have a doctor that doesn't know about cannabis and you think that they might benefit from that, first of all, your stories, like if you learn how to use it and get better using it, I think that makes the biggest impact on the medical system when providers see that
[00:37:54] But also my book, which I wrote for clinicians, makes a great Gift for your practitioner. So if you have someone that you wanna know, you want them to know more so they can help you, bring them a copy of my gift and you'll probably be helping yourself and many others as well. I love it. And what's the
[00:38:09] name of your book?
[00:38:11] It's called Handbook of Cannabis for Clinicians, Principles and Practice.
[00:38:14] Great. Thank you
[00:38:16] again. You're very welcome. It's been a pleasure.
[00:38:18] Thank you so
[00:38:19] much.