Can medical cannabis save your life?

Transcript:

Interviewer:                Hello everyone and welcome to The End with Dr. Tim. It’s been some time since we’ve gotten back together. There’s been this thing going on called the pandemic, the COVID-19 pandemic. And also, we moved our facility, the Positional Release Therapy Institute to a new location so we’ve been pretty preoccupied with that. But we are super psyched today to have Dr. Corey Anden back with us as a follow up to our last podcast where we had medical cannabis 1-0-1.

 

                                    And so, in a way today is kind of like the 1-0-2 piece to that talk. So, thanks Dr. Anden for agreeing to be with us today and we sure appreciate your, your expertise in this area.

 

Interviewee:                Thank you for having me Tim.

 

Interviewer:                Sure thing. And for those of you that didn’t catch Dr. Anden’s podcast last time let me give you a little background about Dr. Anden. So, Dr. Anden is a board-certified physician that’s been practicing medicine in northern Utah for over the past thirty-two years using a whole person approach in a non-surgical treatment options.

 

She now runs a new company Human + Nature Medical. And we’ll give you some links to that so that you can connect with her. And also, you can find her on social media and also the internet via CoreyAndenMd.com.

 

Now Dr. Anden’s mission has been to heal and cope with their chronic injuries, pain, and musculoskeletal disorders by really combining education, lifestyle strategies. She’s been a trailblazer particularly for female physicians in Utah and also medical cannabis.

 

Dr. Anden grew up outside Pittsburg, PA. She graduated from Pittsburgh school of medicine in 1984 with her medical degree and honors in orthopedic surgery, neurology, and psychology. She moved to Utah in 1988 for the greatest snow on earth. And we hope it stays that way with the new season coming up here.

 

Interviewee:                I hope so.

 

Interviewer:                And started her own private practice.

 

In March 2019 Dr. Anden was the first physician in Utah to open her doors to a new and hopeful medical cannabis patients and she has been advocate through her career and was actually awaiting the fay when medical cannabis has come to Utah.

 

So, it has now arrived here in Utah and also really across the nation and world and is being more readily recognized and widely accepted as a medical alternative for many patients. In fact, she’s such an advocate and eager to learn more that she recently has been involved in a program at the University of Maryland and has gained a great deal of knowledge from their program and that’s in cannabis and therapeutics.

 

Dr. Anden, however, is very knowledgeable in the dosing parameters and the entourage system and is very comfortable in recommending medical cannabis for patients of all ages, demographics, and levels of experience.

 

So, where we take off today is really, we talked about, you know, how medical cannabis came out, how it went form the marijuana days way back when and we made it illegal, and it started to become legal, and all the benefits that we’ve observed and seen both in research and also clinical practice for medical cannabis. But the question was, and I think we ended with we just didn’t have time, to say well how does it do that?

 

How does medical cannabis decrease pain, inflammation and all these wonderful things that we know medical cannabis does for patients. And so today we’re going to dive in a bit to what’s known as the endocannabinoid system or what’s abbreviated often as ECS. So, you’ll hear us talking ECS, if we’re talking about ECS we’re talking about that system.

 

And just so you have a sense, this system was discovered over thirty years ago. I mean this is not actually new knowledge. It’s often not been talked about. But it’s, it’s quite often new knowledge to many practitioners and it really became new to me as I got into researching medical cannabis and got into conversations with Dr. Anden that this system is, is pretty amazing and it’s sort of on part with our central nervous system, our peripheral nervous system, other systems we have that we study in medicine and we utilize in medicine. But let’s talk about it, I guess. I guess maybe, maybe you can just explain to us Dr. Anden. And what is the endocannabinoid system or the ECS system?

 

Interviewee:                Yes. Thank you, Tim., so the endocannabinoid system was discovered as you said in the late 1980s, early 1990s. So, that was about he time I was actually finishing my residence training so it wasn’t known for me during medical school that subsequent physicians maybe could be aware of it.

 

Most of the research was done in Israel because you, the way it was discovered was studying the plant chemicals from the cannabis plant. And wanting to understand how they interacted in the human body. So, where that research was primarily being done was in Israel because it was still illegal pretty much for research to study in the United Sates other than plants grown at the University of Mississippi. So that was the, those were the scientists as the forefront of this.

 

Interviewer:                Okay.

 

Interviewee:                So, it, studying the plant chemicals was found that they bound to receptors in the human body. They expected I believe to find those receptors in the brain because of the associated major cannabis effect, thinking that it was the psychoactive or the intoxicating effect. But as they discovered more chemicals in the cannabis plant, they found that they linked to lots of different receptors all over the human body.

 

                                    So, then this was determined, this was named the endocannabinoid system, meaning endo in the body as opposed to, and then those chemicals were called endocannabinoids as opposed to the plant chemicals which are called phytocannabinoids, P-H-Y-T-O.

 

                                    So, they’re chemically very similar and interact in the body and facilitate that research. So —

 

Interviewer:                So, cannabis helped really to identify as I’m hearing, it helped identify that we have this system. Like it was innate in our body already, like, we don’t need, we don’t need medical cannabis to have this system or activate it, but it’s already there. Is that correct?

 

Interviewee:                Correct. But they wouldn’t’ have discovered it without the plant chemicals, because it’s a system different from the nervous system or the cardiovascular system where you have large organs and identifiable without microscopes.

 

                                    You know, you’d identify it with the naked eye, we have these symptoms, these, these systems. Here are nerves, here’s a heart, here is lungs.

 

                                    So, then the endocannabinoid system is really at the cellular level. So, these are receptors on actual cells. So, these cells are the building blocks of those organs. So, not really visible to the naked eye but more to be studied on a chemical and microscopic level.

 

Interviewer:                To be, I guess would it be similar, I guess the analog could be our opiate system or dodginess opiate system where we have these receptions that sort of, you know, take up our pain-relieving chemicals known as opiated and dodge these opiates. Would that be kind of a similar system?

 

Interviewee:                Sure. But I don’t think we call it an opioid system. We just call it, we have opioid receptors.

 

Interviewer:                Opioid receptors, yeah. Okay. So, we have cannabinoid receptors too?

 

Interviewee:                Cannabinoid receptors. But the endocannabinoid system is more than the receptors. So, there’s really described three components. So, we have the receptors, we have the chemicals that bind to those receptors called the endocannabinoids, or the plant chemicals also bind in them, so the phytocannabinoids. And then we have the enzymes that manufacture those chemicals and also break them down when they are no longer necessary.

 

Interviewer:                So, I guess in your opinion, what do we need this system for? How is it helpful to us to have?

 

Interviewee:                Yeah, it’s very important, it’s really the system that oversees all of the other systems to create balance and the term we use, homeostasis, which is balance. So, the endocannabinoid system is really the central mechanism that modulates the function of all of the other systems.

 

                                    So, basically if something’s out of sync, something’s too high or something’s too low, say hormones or just the way the body’s working, the physiology of the gastrointestinal track isn’t quite doing what it’s supposed to do, or immune system is being barraged or we have overactive immune systems or underactive immune systems, which is a topic of consideration these days with the COVID-19. And the endocannabinoid system works to modulate and regulate those systems to bring them back into proper function.

 

Interviewer:                Okay. So, sort of like if you had a big stereo system, you had a volume knob, the ECS system is sort of the volume knob turning the volume up or down of these different systems —

 

Interviewee:                Yeah.

 

Interviewer:                And kind of modulating them, I guess?

 

Interviewee:                Sure, sure, volume as well as bass and treble and all of those other things. Yeah.

 

Interviewer:                Yeah. Makes them all play like an orchestra. I guess, basically all those instruments — 

 

Interviewee:                Yes.

 

Interviewer:                Coming through our stereo. So —

 

Interviewee:                That would be nice.

 

Interviewer:                Is there, are there certain things that we know that regu — that are primary to the ECS system, like what are the things that maybe the ECS system that our listeners would recognize that it regulates? Things that it does? Does it regular sleep or mood or pain and things of that nature?

 

Interviewee:                So, there are receptors distributed widely through the body, many are in the central nervous system, so the brain and spinal cord. And that’s what we most associate the endocannabinoid system but of course it’s more than that. So, in the way the receptors and the chemicals interact in the brain, it influences mood, and memory, cognition. So, it can be very helpful in modulating symptoms of anxiety, depression, PTSD, also seizure disorders, Alzheimer’s, cognitive decline.

 

Interviewer:                It sounds like, it sounds like a miracle system. It sounds pretty wild. And, now you had shared some research articles with me, and also, I looked at some little pictures and things of that nature. So, it might be a good time to share this with our listeners. Now those that are just listening of course you might not be able to see these, but what I’ll try to do it we’ll try to put these up as resources for you that you can link to and take a peek at them.

 

                                    So, one of the things we were talking about before was this receptor system and that they’re, these receptors are located in different areas of the body. Can you explain the CB1, CB2 thing that people are gonna see and maybe hear about with this system?

 

Interviewee:                Sure. If people are interested and they started googling the ECS. It will definitely come up with slides that talk about CB1 and CB2 receptors. So, these are the receptor part of the three-part endocannabinoid system. So, CB stands for Cannabinoid-1 and Cannabinoid-2 receptions. These are considered part of the classical endocannabinoid system. Because these were first discovered, but since then we now know that there’s quite an expanded endocannabinoid system with many receptors involved directly and indirectly in the system. So, the CB1 receptors are located primarily in the brain and central nervous system but as you can see, they are also in the cardiovascular, pulmonary, musculoskeletal, gastrointestinal system, even the reproductive organs and in the bone marrow.

 

                                    So, that means that when the endocannabinoids are reacting with CB1 receptors, there’s going to be influence on many of those different systems and they sort of seem totally unrelated, but as we know our body is very complicated. And these systems do interact and influence each other. So, for example, I alluded to the, or discussed the brain and central nervous system that as far as the gastrointestinal track goes, the endocannabinoid system can regular abdominal and treat, influence systems, such as abdominal pain, irritable bowel system, autoimmune disorders of the GI tract, nausea, vomiting, etc.

 

                                    It can regulate reproductive function, fertility, infertility, bone marrow, meaning helps our bones to store calcium and also to make bone marrow products for the immune system.

                                   

Interviewer:                Well, you know, to me, I’m looking at this and I’m like, it seems like our entire body that we have these receptors in and I’m just thinking because we’re in sort of a crazy land about inflammation, and viruses and things of that nature and impacting our immune systems. I would imagine that if something goes a little awry with this system, it’s really impacting our entire body and maybe our ability to fight you know, illness.

 

Interviewee:                Yes. That is correct. So, the, it’s now thought that many disorders, aside from the current virus, infections, that autoimmune disorders or people that are more susceptible to infections, may have disfunction in their endocannabinoid system which makes them more vulnerable.

 

                                    So, we talk about autoimmune disorders like rheumatoid arthritis, lupus —

 

Interviewer:                Mm-hmm.

 

Interviewee:                It’s now being thought of as a disfunction in that system.

 

Interviewer:                Okay.

 

Interviewee:                So, right now we’re talking about with the virus, the inflammation that occurs. Of course, we want our body to mount an inflammatory response to the virus, but we don’t want a magnified inflammatory response.

 

                                    So, the endocannabinoid system helps to regulate that. You know, we talk about the cytokine storm that people have. And recent research is talking about the endocannabinoid system, having a pivotal role in modulating the amount of response, the actual immune response. That it’s on target, not too little, not too much.

 

Interviewer:                Right. And so, I, as you’ve seen, I just put up an image. Sort of a neuron and its role with the immune system and as we can see here. The CB2 receptors kind of take up some of those, I’m sorry, the cannaboids, cannabinoids. And I’m just curious, when they do that Dr. Anden. When the immune cells receive that cannabinoid, how does, I mean, how does it theorize? I guess talked about in research and others, how does it impact that immune cell? I mean how does it really help us in regard to maybe our immune response? I’m just curious.

 

Interviewee:                Well, the body perceives a threat as a virus or an autoimmune disfunction. And then it regulates the function of the immune cells to cause more of certain cells to be produced or stop the production of certain cells and their reaction on the target tissues.

 

Interviewer:                And I would imagine, you know, because their immune system it sort of responds to a threat, whether that be COVID-19, bronchitis, you’ve broken your leg, you have a systemic sepsis infection, you know, with the immune process, and my understanding is that it’s really meant to sort of create an environment where it’s going to fight that attacker I guess you would say? Or that issue that is causing inflammation, and really kind of engulf it.

 

                                    For those who have maybe heard this term, often when we have an infection, we release what’s known as macrophages. They’re like little Pac Mans that go around and eat up things that should not be there. And so, I would imagine and what we’ve seen in research that if we have a pretty robust attack on our systems or system. That we want a really strong immune response.

 

                                    And my sense of it is that if our ECS system’s working well, then we can mount a stronger immune response. Is that really a fair assumption would you say?

 

Interviewee:                Yes, that is correct. We talk about having good endocannabinoid system tone just like when you work out and you want to have a fit body and you exercise your brain and you have good cognitive powers. We want to have a very strong endocannabinoid system. However, our modern society and our lifestyles tend to keep our endocannabinoid system not functioning the best.

 

Interviewer:                Hmm.

 

Interviewee:                So, there may be people who are more susceptible to infections because they’re just generally not healthy. And that means their endocannabinoid system isn’t healthy. So, we see with certain infections there are people that are more vulnerable to that. People who have diabetes for example, diabetes is thought of as a chronic inflammatory process. So, they’re body is 24-7 fighting inflammation throughout the body. So, that’s depleting the reserves of the immune system. So, you know the endocannabinoid system, the immune system, are already at kind of you know.

 

Interviewer:                Yeah.

 

Interviewee:                No frontline defense mechanism.

 

Interviewer:                They sound pretty overwhelmed. And I would imagine chronic pain is similar in the sense that chronic pain kind of overwhelms the system and creates you know this chronic inflammatory response. And so, I know that that’s an area of your expertise, chronic pain, and obviously it is mine as well, but more in a therapeutic and therapy side of things.

 

                                    So, can you kind of discuss a little bit for our listeners and viewers, like how it is that we can leverage? How it is that we can leverage? How can we maximize our ECS system to really help us fight pain, chronic inflammation? And maybe where does cannabis come into that process? I’m just curious your opinion on that.

 

Interviewee:                So, when we talk about chronic pain, we don’t necessarily have to have inflammation. So at some, the definition of pain is a physical as well as psychological perception of something that hurts. Right? That we perceive as discomfort and undesirable.

 

Interviewer:                Mm-hmm.                  

 

Interviewee:                Inflammation is something we can measure.

 

Interviewer:                Mm-hmm.

 

Interviewee:                We can see that a tissue is inflamed. Red hot swollen, or there, at a microscopic level there’s inflammation. So, people can have pain without inflammation. I supposed people can even have inflammation without pain, right?

 

Interviewer:                Now, would that be —

 

Interviewee:                Why’d it be the chronic inflammatory process if people aren’t necessarily complaining about the pain?

 

Interviewer:                And I seem to remember to just to piggyback off your comment there, that even those who have type II diabetes or those you know, for example, those who are really overweight or obese, that they are actually producing inflammatory cells. But they’re not necessarily feeling pain, pain, but because they are overweight and sort of the in balance in their systems, they’re really just producing inflammatory cells.  Is that correct?

 

Interviewee:                Correct.

 

Interviewer:                Am I thinking correct in that?

 

Interviewee:                Well, there’s chronic inflammation just feeding on itself.

 

Interviewer:                Mm-hmm.

 

Interviewee:                With, yeah.

 

Interviewer:                Okay. So, so, you’ve got chronic inflammation possibly with or without pain. We know it’s taxing our ECS system. Probably not making us very healthy and not really setting up us to fight inflammation, to fight viruses and bacteria and all kinds of things. How does, where does the THC piece or the medical cannabis piece come in to the ECS system? Because it seems to be inherently tied to that system.

 

Interviewee:                So, the plant phytochemicals are very similar to the body phytochemicals or the body endocannabinoids. So, the THC which is technically delta-9. THC is very similar to the endocannabinoid anandamide which prefers to bind to the CB1 receptors, which is the central nervous system, brain, spinal cord. But we saw all those other systems.

 

Interviewer:                Yeah, yeah.

 

Interviewee:                So.

 

Interviewer:                I think I have a picture of this system or what you’re talking about. So, you keep chatting and I’m gonna see if I can pull that up for people.

 

Interviewee:                Okay, okay. So, when the body produces endocannabinoids, they are produced on demand and transiently. So, they don’t circulate through the body per say. They stay in the organ system in which they have been stimulated to eb produced. So, they’re produced as what we call the presynaptic and interact at the post synaptic, and they go back and forth membranes there.  But they are only present for a period of time as needed.

 

                                    So, when we have the plan cannabinoids, delta 9-THC, it comes and it binds, it gets into the body by some mechanism, then gets it into the blood stream. So, it’s being taken all over the body to multiple different organ systems simultaneously to have effects.

 

Interviewer:                Yeah, and I put up a little picture here, compliments of a research study that we were looking at and I’ll provide the source here at the end of the show. But as you see the present term, that’s kind of like a neuron that lets little neurotransmitters out. Kind of like gasolines to fire up the other transmitter that receives it. So, it kind of goes in there. But from my understanding, this ENS system is super unique that is has kind of what is retrograde signaling so that, just so that our viewers can understand this. So, it’s very analogous to, if you have your leaky pipe. You want to actually stop the water before it hits the sink or hits the floor, that’d be better said. So, we’re going to turn off the faucet to keep it from letting out the water onto the floor, which could be analogous to this post-synaptic neuron that we see here that’s gonna receive it. So, my understanding is that THC really kind of binds into that receptor, CB1, CB2, and really inhibits the release. You know, for example, this glutamate here that we see, that’s like the gas, the water that essentially fuels pain. Gabba being more in the brain, so, would that be, I guess to expand off your explanation, is that what we’re seeing here in this sort of diagram?

 

Interviewee:                Yes, that’s a good explanation.

 

Interviewer:                Mm-hmm.

 

Interviewee:                But it becomes more complicated because it can turn on and also turn off because we’re trying to create that balance, that homeostasis.

 

Interviewer:                Mm-hmm.

 

Interviewee:                So, depending on the perceived needs or threat, it modulates.

 

Interviewer:                Okay.

 

Interviewee:                THC modulates that.

 

Interviewer:                Now.

 

Interviewee:                Go ahead.

 

Interviewer:                I was just, that just kind of brought up a question in my mind. If we’re putting a lot of THC into the system. Are we, I’m gonna play devil’s advocate here, are we sort of disabling the system to function normally? Kind of limiting its ability to react normally? Kind of like in a way we’ve heard about steroids or hormones. If you take them, if you take them, if you take them, then your body loses that natural ability. Does that occur at all? Is that a problem or something we should be concerned about with the use of say medical cannabis for this function?

 

Interviewee:                Well, it’s dose dependent. So, this is plant-based medicine. And when we’re talking about the cannabis plant, we’re not just talking about THC. So, I’m a fan of whole plant medicine. So, meaning that there are more than five hundred chemicals and delta-9, THC, and CBD cannabidiol are just two of those. So, we’re sort of switching over from the endocannabinoid system to other chemicals that react with it.

 

Interviewer:                Yeah.

 

Interviewee:                So, then it becomes dose dependent. So, what I’m finding is people who have a really good functioning endocannabinoid system, they have good endocannabinoid system tone, they really benefit from micro dosing. Very low doses of THC. That’s the main one that we measure but very low doses of whole plant cannabinoids, terpenes, etc.

 

                                    So, it appears that people that have an endocannabinoid disfunction, now that could be a deficiency or that could be an overstimulated endocannabinoid system, may require different doses of certain of the plant chemicals.

 

                                    So, one interesting thing is people who have PTSD seem to require very high doses of THC relative to someone who just has nausea per say. So, what that means is the endocannabinoid system in the brain, particularly the amygdala, hippocampus area where memories are stored, is not working very well at all due to, for whatever reason, physical, psychological trauma, there’s a dysfunction.            

 

Interviewer:                Right.

 

Interviewee:                So, higher levels of THC seem to be what they require. That’s what I’ve read in literature. And I have seen that in my clinical practice as I query people about their preferences with the cannabis. So, that’s very interesting and the way that works in that area is that it, that amount of THC actually helps people to forget.

 

                                    You know, we talk about loss of short-term memory or long-term memory related to cannabis as a bad thing. Btu when you have a condition when you have too many memories then it actually helps to decrease that for example.

 

                                    Now, other people do better with very small doses of THC and higher doses of other plant cannabinoids, depending on how it works in the system. So as with plant based, with plant-based medicine different from pharmaceutical medicine, it’s very personalized and it takes some experimentation. Hopefully with someone who has some clinical understanding of the endocannabinoid system and how it works. You know, a clinician trained in that area to help sort through the details because the way our culture is right now. People think it’s always about high THC. And it’s, that’s not true at all.

 

Interviewer:                I think you know in our last talk you had mentioned something very profound to me. So, as a physician who evaluates patients and prescribes THC or for for THC administration or medical cannabis. The dosages, the dosage, getting the dosage just right or the strain just right and coupled with that is pretty darn important, and that one of the things you said to me kind of struck home is if you are getting high, you’re probably, all the time, if you’re getting high on the medical cannabis it’s probably not the right dosage. And if you feel nothing and you don’t have any improvement in your condition, your dosage probably is not correct either. That’s probably a really gross paraphrase of what you said.

 

Interviewee:                Well, that’s, that’s simplifying it you know.

 

Interviewer:                Yeah, yeah. But essentially it —

 

Interviewee:                It’s simplifying it quite a bit because you have to know what the underlying condition is. What is it that we want to treat? What does clinical research suggest as a good combination of those chemicals?

 

Interviewer:                Mm-hmm.

 

Interviewee:                And tailoring the medicine to the condition.

 

Interviewer:                Right.

 

Interviewee:                So, I wouldn’t say getting high, getting high isn’t bad. Getting high all the time is bad. That might imply too much THC.

 

Interviewer:                Okay.

 

Interviewee:                And when you overwhelm the endocannabinoid system with too much THC then all those little receptors that we were talking about, respond in a way such that they decrease the quantity of them that there are.

 

Interviewer:                Okay, so there’s less receptors.

 

Interviewee:                So, we call that down regulation.

 

Interviewer:                Okay.

 

Interviewee:                So, I describe it like this. So, we have a nice, beautiful day, we have lots of windows and the windows and doors are open, and we have a light breeze coming, it’s all very pleasant. But when you overwhelm too much wind like a hurricane coming through those windows and doors. What do we do? We board up those windows and doors. So, that’s what the endocannabinoid system does. So, it actually decreases the number of receptors —

 

Interviewer:                Mm-hmm.

 

Interviewee:                That are available. So that also is an endocannabinoid dysfunction because now we don’t have enough receptors to handle other stressors.

 

Interviewer:                Well, and what strikes home to me now is the awareness that going to just get your medical card and have no direction, no evaluation, no dosage sort of modification based on your symptoms and how you’re doing and your condition. It sounds like it could be hit or miss, and you could potentially overwhelm you ECS system and really maybe not be as effective in the use of that system, but also in the use of medical cannabis. Is that a fair I guess statement?

 

Interviewee:                Well, that’s a fair assumption. This is what I see with patients. So, we have our people who are long term cannabis users, and they think that they’re very knowledgeable about cannabis and using cannabis. And seem to perceive that it is all about getting high and it is all about the THC content. Okay?

 

Interviewer:                Mm-hmm.

 

Interviewee:                So, those people require a different sort of education but again, they already think they know what they know. And do now we have to undo some perceptions and learning. Now, people who’ve never used cannabis before who were beginners, that’s lovely. Because I present —

 

Interviewer:                Yeah.

 

Interviewee:                This sort of education about it and then they understand from the get-go, that we’re gonna start low and go slow and use some combination of chemicals and bring that in. Because a lot of new people, their, their understanding is they don’t want to get high. They don’t want to have the intoxicating. That’s the fear factor.

 

                                    Although it’s really not that type, it’s not like an alcohol intoxication, it’s not a psychedelic experience. It’s just a thoughtfulness, different way of thinking. So, it’s easier when people understand how it works and the difference between plant-based medicine and pharmaceutical medicine and that there is an endocannabinoid system, and this is how these chemicals influence and work in it. And then people are like, oh, okay. So, then I can give them direction on what products to purchase, stay away from the very high THC products.

 

Interviewer:                Mm-hmm.

 

Interviewee:                But there is a market for that, based on the common knowledge which isn’t really the correct perception as we know it. Now, scientifically more about eh endocannabinoid system and the plant chemicals.

 

Interviewer:                Well, you know with that, that fear that patients have, and for many it’s a real fear based on their job. They’re, it happened yesterday, I had said to a patient, hey, I really think you should maybe go talk to Dr. Corey Anden. And I think medical marijuana might be a really good option for you based on their symptoms and chronic pain and so forth. And they said, well I can’t do that. I’ll get fired. I’ll get fired if I get a positive drug test. And this was a contractor for the U.S. Government, which I found out later. And I said well what about CBD and he said oh no, we’re not permitted to take CBD either. Because I believe based on some fear, a lot of people end upgoing the route of just CBD that’s pretty commonly sold now in most health avenues and markets.

 

                                    So, is there a different maybe you can explain you know, how potentially the ECS system could be impacted with CBD, maybe not? Why some individuals might be beneficial to go a certain way? To combine? Is there a magic potion between CBD and THC for a ECS system? I mean I don’t know. I’ve seen some different opinions on that, and I’m curious about yours.

 

Interviewee:                So, there’s more than five hundred chemicals in the cannabis plant. So, we’re talking about, you’re talking about THC and CBD. So, my other analogy for that is that’s like talking about Tom Brady and Rob Gronkowski. That’s two chemicals or two players in the whole NFL. So, if we just had the two of them or just one of them, we’d be very bored looking at them playing football. Right?

 

Interviewer:                Mm-hmm. Yeah.

 

Interviewee:                We just don’t have THC and CBD. We have the whole AFC, NFC, the whole NFL. And that’s what makes it —

 

Interviewer:                Right.

 

Interviewee:                Interesting. All those players interacting together.

 

Interviewer:                Right.

 

Interviewee:                So, we only target THC because the government decided to regulate that and that of course increases the interest in that chemical. So that chemical at very low doses is anti-inflammatory, analgesic, antipain, treats nausea, vomiting, it’s relaxing, calming, all of those sorts of things. As you get to a higher dose or a dose that overwhelms a particular personalized endocannabinoid system, then we can have more intoxicating effects. But people need to understanding, you can take THC in certain doses and it’s not intoxicating. You know –

 

Interviewer:                Mm-hmm.

 

Interviewee:                It’s like ibuprofen.

 

Interviewer:                Mmm.

 

Interviewee:                So, CBD interacts with the endocannabinoid system different than the Delta-9 THC. So, we’re still studying CBD. CBD interacts with a lot of different receptors. But it doesn’t directly bind to CB-1 or CB-2 receptors. It more acts on the enzymes that degrigate our, in our endocannabinoids, like the anandamide, for example.

 

Interviewer:                Oh okay.

 

Interviewee:                It interacts with the enzyme that degrigates anandamide, so it increases anandamide levels, but it also interacts with other receptors that are involved in pain modulation and such.

 

Interviewer:                Mm-hmm.

 

Interviewee:                So, when we talk about a product, we’re not talking about just THC or just CBD. You can have products that are an isolate. They’re just THC or they’re just CBD.

 

Interviewer:                Mm-hmm.

 

Interviewee:                Without, so they’re just Tom Brady and just Rob Gronkowski. Okay?

 

Interviewer:                Mm-hmm.

 

Interviewee:                You don’t have the whole system. And what we know when you have an isolate, you require ten times the dosing.

 

Interviewer:                Oh, okay.

 

Interviewee:                And any time you have more dosing of one chemical, what do we have? Side effect.

 

Interviewer:                Toxicity I would imagine.

 

Interviewee:                Toxicity. So, there are studies on epidialects for example, people will say, oh you can’t take CBD, it elevates liver enzymes. Well, we’re talking about epidialects that is basically a CBD isolate. It’s plant derived but it’s only CBD. And the doses that they talk about are 300 to 600 mg once or twice a day. So, people take whole plant cannabis that has a CBD product and is called whole plant or full spectrum and the dose is more like 30 mg. Right? So, we’re not gonna have elevated liver enzymes.

 

Interviewer:                Okay.

 

Interviewee:                So, we have to be careful what we’re talking about.

 

Interviewer:                Okay.

 

Interviewee:                Now, with the whole plant products. So, CBD that I carry and recommend to patients, is whole plant. Which means by regulation under the farm bill, it can have less than 0.3 percent THC. So, it still has some THC because you still need a little bit of Tom Brady in there.

 

Interviewer:                Right, right.

 

Interviewee:                So, it has a little bit. So, and of obviously THC products that have full spectrum have more than 0.3 percent THC. More like 20 percent THC. So, on a drug test, because that was your original question and a person who is employed. So, depending on the sensitivity of the drug test, even if they’re taking CBD that has less than 0.3 percent THC which I can guarantee has no impairing effects, they could test positive.

 

                                    So, it begets the question, what are we checking? Are we checking that someone’s taking cannabis or not taking cannabis? Or they’re impaired or non-impaired? The question should be impairment. The question shouldn’t be are they taking this medicine or that medicine, just as if people have a glass of wine at dinner or they take Ambien at night. Okay, that’s okay. As long as they’re competent at work the next day.

 

                                    So, a lot of companies that have federal contracts are still, because it’s still federally illegal, they’re not letting their people use cannabis. Now, how can they get around that. Well, they can decide what they want to test for on a drug test. They don’t have to test for the metabolites of THC.  If I was having a company I would rather want to check and see if they have alcohol in their system. Right?

 

Interviewer:                Or they’re impaired in some way?

 

Interviewee:                (Inaudible — crosstalk) (00:41:17) Right? So, the thing is a lot of those chemicals that you you test for, they, when you take them, they’re in your system for twenty-four hours or forty-eight hours or even less. Our body holds on to the phytocannabinoids. The phytocannabinoids are stored in our fat. Now, we can decide why that is. It sounds like our body really lies that and it’s keeping it for a rainy day.

 

Interviewer:                Yeah.

 

Interviewee:                So, it stores it. So, one may excrete the metabolites of THC for two weeks, three weeks, depending on your metabolism. If a person is more heavy and has more body fat, they may store more and therefore they may excrete more. So, it really doesn’t have to do with when you took the THC. Like, I could have taken CBD you know a week ago and I could still test positive for it. So, first of all the substance is not impairing. There’s a tiny amount of THC. Your body stores it and now you have this test. So, we are definitely not testing impairment. So, it’s just illogical as to why this is an issue. We should be testing competency not whether you test positive for a metabolite of cannabis.

 

Interviewer:                Well, it kind of goes part and parcel with our culture or our society here in the U.S. Sort of pharmacological lens and perspective that anything is a bad thing, no matter how much it is. And we see that you know, playing out today a little bit even in our approach to this pandemic in these different viruses that are impacting our society. Kind of an all or nothing kind of thing. And I maybe that’s the same thing when it comes to testing, it’s an all or nothing thing. You could have very, very miniscule amounts that happened weeks ago and you’re not impaired but still, you’re held liable for being impaired but you’re really not impaired. It’s kind of like the testing thing with COVID. You know, you may have it, but we’re not going to test you for it. We don’t know if you’re impaired in this sense of — 

 

Interviewee:                Right, right.

 

Interviewer:                Infected, but —

 

Interviewee:                It’s the, it’s kind of — 

 

Interviewer:                Assuming you are.

 

Interviewee:                We’re making a lot of assumptions.

 

Interviewer:                Assumptions.

 

Interviewee:                The thing is based on the current and the science that we’ve had really for twenty years or more, these drug laws should have been you know, changed. So many states have legalized cannabis.

 

Interviewer:                Yeah.

 

Interviewee:                Why the federal government doesn’t, if they just legalize it, all of this layer of complexity would go away.

 

Interviewer:                Well, yeah.

 

Interviewee:                So, in Utah for example, because cannabis is legal by the state, if you work for the state of Utah, you’re allowed to be using cannabis.

 

Interviewer:                Oh really, okay.

 

Interviewee:                If you’re a schoolteacher. Maybe not a bus driver because you have a CDL license issues there. But if you work for the city of South Ogden, you know, you are allowed to use cannabis as medicine.

 

Interviewer:                Well, you know, that’s a big discussion that I think we’re opening a door to is the politics potentially behind you know, not really paying attention to the research, you know.

 

Interviewee:                Well, it becomes discriminatory then.

 

Interviewer:                But what do you mean by that?

 

Interviewee:                Meaning that your wife as a schoolteacher you could use cannabis, but you’re a subcontractor at Hill Air Force Base and you can’t use Air Force base and you can’t use cannabis.

 

Interviewer:                Hmm, or –

 

Interviewee:                Because of federal.

 

Interviewer:                Right.

 

Interviewee:                So, so, it’s discriminatory on your ability to use the medicine based on your employer.

 

Interviewer:                Right.

 

Interviewee:                It’s been in the news now, Amazon and Google are not testing people for you know cannabis anymore.

 

Interviewer:                Well, you know, you brought forth an analogy with the football piece and I’ll just kind of recircle back to that because I think it’s an important point.  That we need to be careful of looking at these compounds in isolation. Particularly in their ability to affect the ECS system. Very I guess analogous again that we don’t want Tom Brady trying to win against the entire Raven football team on the field. Right?

 

Interviewee:                Right..

 

Interviewer:                He has to work a lot harder cause of it.

 

Interviewee:                Yes.

 

Interviewer:                And more than likely he’s not gonna be as successful, right, if he had had his entire team with him kind of working against or trying to overcome the Ravens you know, and so.

 

Interviewee:                Right.             

 

Interviewer:                As you can tell Ravens are my home team.

 

Interviewee:                Okay, yes.

 

Interviewer:                So, I gotta throw that out there.

 

Interviewee:                Yes, yes, yes.

 

Interviewer:                But so, with that I mean there’s, you’ve brough forth a couple really key primary messages here. One, we really should be utilizing whole plant medicine. Not just one little isolate. Second, there’s a lot we don’t know. We don’t know yet how CBD is really interacting fully, but it appears to be working and helping our ECS system. And finally, there might be dysregulation. There might be problems with our ECS system.

 

And so, with that I have seen some literature, and there was some, there was an editorial in Nature I believe it was, regarding maybe those who are susceptible to infection or illness, their ECS system is not in good shape. It’s something wrong with it. So, as a physician yourself and you know when I have patients come in as a therapist. It just seems like sometimes people are all out of whack. I mean I know that’s a very broad and general term.

 

Interviewee:                No, it’s true.

 

Interviewer:                A lot of their stuff I just can’t explain because all their systems just seem to be like out of balance. And so, as a physician when you’re kind of evaluating, is someone maybe their system, their ECS system is not working well, how do you, I’m just curious how do you come about maybe that assessment? Because I see it being talked about a fair amount in the literature now.

 

Interviewee:                Well, we don’t have a blood test for that, because as we said the little, the endocannabinoids that are produced or transiently produced in that synaptic system. So, they’re not really flowing through the blood that we can check on a blood test or a urine test and they react depending on the stressors. So, its really more of a clinical assessment. I’ve gotten to this point in my thirty-two years of medicine that I respect my talents as a physician as a healer to make a global perception.

 

Interviewer:                Sure.

 

Interviewee:                When everything’s hurting or every joint has degenerative changes, there’s something not quite right as a systems level. Probably at a lifestyle level and that sort of thing. So, in so far as cannabis has been used as medicine for six thousand years safely. There’s no lethal doses of it. And based on my understanding and knowledge. I’m going to conclude that there is definitely a problem with the endocannabinoid system in those people.

 

Interviewer:                Right, right. Sure.

 

Interviewee:                There’s also a problem with the musculoskeletal system, the neurological system.

 

Interviewer:                Mm-hmm.

 

Interviewee:                The cardiovascular system, but the endocannabinoid system oversees all of that.

 

Interviewer:                Well in fact —

 

Interviewee:                In the six thousand years of medicine says that before we had pharmaceuticals developed in like the 1930s, plant-based medicine was good at treating a lot of those things.

 

Interviewer:                Well, if —

 

Interviewee:                So, let’s just try to some cannabis because we really don’t have anything to lose.

 

Interviewer:                Right, well, you know, it brings up, and we have limited time here to kind of get into this, but it just makes me wonder why aren’t we talking about the utilization of plant-based medicine. And I’m not just saying cannabis because there are other plants that treat illnesses. You know there’s this whole COVID-19 thing going on and my, my and I guess my gut kind of tells me like we should have strong immune systems, right?

 

Interviewee:                Right.

 

Interviewer:                We should try to be building our immune systems to be as strong as it can, have them to fight COVID-19, to fight the next pandemic, to find the next illness, to fight whatever.

 

                                    So, I’m just perplexed a little bit, why is there really no talk about the immune system?

 

Interviewee:                Well –

 

Interviewer:                There’s no talk about building our immune system and what we can do to do that. I know that we can do it through vaccines and it’s super, vaccines are super helpful for those who are at risk, they really need it. But for all the rest of us who are just trying to kind of like, make sure that we have the best defenses. Um, how would you say we boost our ECS system or boost our immune system? I mean, makes recommendations from you who’s really been in this field for years —

 

Interviewee:                First —

 

Interviewer:                Recommendations from you who’s really been in this field for years.

 

Interviewee:                Well, your first part. I also question why we are not being bombarded with information on how to improve our natural immunity. It’s as if we’ve given up on our bodies. That our bodies cannot fight infection. That everything has to be technologically engineered to fight immunity.

 

                                    No, we definitely should be talking about enhancing our natural immunity. So, that would include enhancing our endocannabinoid system. But there are also other supplements. You know vitamin D and zinc has been linked to improved immunity. And there are research papers that will say that most of the people, high number, more than eighty, ninety, of people who are critically ill and likely to not survive — 

 

Interviewer:                Mm-hmm.

 

Interviewee:                A COVID infection are vitamin D deficient.

                                   

Interviewer:                That’s amazing.

 

Interviewee:                There are quite a bit of studies on that. I would say that it’s possible that regular cannabis users if used properly, medicinally, would have an enhances natural immunity.

 

Interviewer:                Possibly even maybe to COVID who knows.

 

Interviewee:                Well, I mean, to, well cannabis has antibacterial, antifungal, and antivirus effects.

 

Interviewer:                And, and —

 

Interviewee:                And antitumor effect.

 

Interviewer:                Right, right, and I think — 

 

Interviewee:                You know it, it, causes cancer cells, can’t tumors to implode.

 

Interviewer:                Sure, sure.

 

Interviewee:                You know apoptosis. So maybe it does the same thing.

 

Interviewer:                Mm-hmm.

 

Interviewee:                With other types of overwhelming overgrowth type of processes in the body. So, how can we enhance the endocannabinoid system?

 

Interviewer:                Right. How can we boost it?

 

Interviewee:                So, well, you know it’s the usual suspects. We need to have a natural plant based healthy diet.

 

Interviewer:                Okay.

 

Interviewee:                You know, not artificial foods. We should surround ourselves with things of nature. So fresh air, getting outside in the outdoors. We should engage in pleasurable healthy activities like yoga, dancing, singing, just you know, feel good using our body.

 

                                    So, it doesn’t necessarily need to be working out at a gym, but just staying active and staying present.

 

Interviewer:                Mm-hmm.

 

Interviewee:                There are some studies that suggest that cold immersion can stimulate the endocannabinoid system. So, I personally have been, I’m not a fan of cold water but I’ve sort of been making myself go into cold water.

 

Interviewer:                Yeah.

 

Interviewee:                And you have some cryotherapy —

 

Interviewer:                Yeah.

 

Interviewee:                Equipment in your facility.

 

Interviewer:                Mm-hmm.

 

Interviewee:                So that stimulates it. And then you know, then it goes full circle. We need good sleep but often time in our society people don’t sleep very well. It’s like everyone has insomnia. So, cannabis can help promote sleep.

 

Interviewer:                Right.

 

Interviewee:                Which then promotes the endocannabinoid system.

 

Interviewer:                Right.

 

Interviewee:                So, that would be a better chemical —

 

Interviewer:                Mm-hmm.

 

Interviewee:                To use other than you know synthetic pharmaceuticals which don’t really produce the right kind of sleep quality.

 

Interviewer:                Right. Well, you know, because we are in this phase of not talking about natural immunity and possibly even discounting it and also possibly even our immune system itself. I do think our ECS system is somewhat under attack by outside forces in a way.

 

                                    I would like to see more research on this. I believe it’s really needed. You and I talked about maybe doing a research study on users and see you know how they do. It is happening though. Nature just published a piece about sort of a test tube study where they introduce sort of this mix of cannabinoids and CBD. And they put it in a test tube with COVID and it completely obliterated it.

 

                                    Like, cyto-kind of production, increased the macrophages. It was a really interesting study.

 

Interviewee:                I’m not surprised.

 

Interviewer:                We don’t have any. I haven’t seen any human studies yet. But I think that’s the precursor possibly to a human study. Which it would be super exciting guys to see that come out and I think that we are on the frontier of really digging into what the ECS system, the endocannabinoid system can do for us and really how best to conjure that system so that we have natural defenses. So, we don’t always have to rely on biotech. We can build our natural defenses. So essentially, we are making biotech for ourselves but internally. And obviously what we heard today was that medical cannabis could be a, a helper in that process. Particularly if you’re having issues, it’s dysregulated, you need help, you need a supplement in the essence of your natural cannabinoids. And maybe — 

 

Interviewee:                Who —

 

Interviewer:                We’ll see research prove that out in time.

 

Interviewee:                Right. I agree.

                                                                                    

Interviewer:                Yeah.

 

Interviewee:                So, it becomes full circle. You have those people who we talked about the healthy lifestyle that they just can’t get the motivation to do that. So, let’s start with the cannabis end, for whatever reason, people feel better. So, then they will get out and go for a walk.

 

Interviewer:                Right.

 

Interviewee:                Then again.

 

Interviewer:                Sure.

 

Interviewee:                We create this healthy circle lifestyle. You know, gives you that little extra burst of feeling better so now you choose better fruits and vegetables to eat and not at a fast-food place, you know.

 

Interviewer:                Or you know, you go out for a walk because now you have less pain.

 

Interviewee:                Right.

 

Interviewer:                And you’re able to move which then produces less pain and decreases —

 

Interviewee:                Right.

 

Interviewer:                Your inflammation and so forth.

 

Interviewee:                Right, it feeds on itself.

 

Interviewer:                Yeah.

 

Interviewee:                Right. So, I would —

 

Interviewer:                Well –

 

Interviewee:                I would love there to be more research on natural immunity, you know. I just —

 

Interviewer:                Mm-hmm.                                    

 

Interviewee:                It just amazes me with the healthcare system that why aren’t we talking more about just healthy bodies and how to keep our bodies healthy.

 

Interviewer:                Well, that’s a whole other podcast.

 

Interviewee:                We’ve given up on the ability of the person to make good choices.

 

Interviewer:                Yeah, yeah that’s —.

 

Interviewee:                You know, and that’s sad.

 

Interviewer:                Right. Well maybe for the future that, I think that’s worth, a worthwhile scientific debate, that’s a worthwhile investigation, discussion that I believe we should be having and also should be probably at the forefront of our medical and scientific community.

 

                                    I don’t think the immune system’s changed since we’ve been here. I mean it’s changed in the sense you know we’ve evolved, but I don’t think it’s going away and hopefully we’re not trying to replace it.

 

Interviewee:                Right, right.

 

Interviewer:                So possibly a definite, awesome scientific discussion for the future and debate and one I think a lot of medical practitioners and scientists would be really interested in having. So, I really appreciate having this discussion with you today Dr. Anden. It’s been super enlightening, always super informative. And as always, we’re gonna end with just curious, what impact you like to have on humanity with the work that you’re doing?

 

Interviewee:                I like working with people one-on-one. I would like there to be more global education. So, when I teach a patient and I am instructing them on how their endocannabinoid system works and how they’re using cannabis. I ask them to share that with their family members or friends who are also using cannabis.

 

                                    There’s lots of information on the internet you know google, anyone can google things and learn more about the endocannabinoid system but for some reason they don’t. Maybe they’re afraid of it, they don’t know, but even experienced cannabis users, they don’t know these words that we’re saying.

 

Interviewer:                Right.

 

Interviewee:                And there’s so much more to learn about it. So, I’m trying to impact sort of on a pyramid scheme.

 

Interviewer:                Right.

 

Interviewee:                Where I see a certain number of people and then they spread the information in their method of communication because other people are most likely to get information from their friends and family.

 

Interviewer:                Right.

 

Interviewee:                And so, I feel like spreading it that way you know where the person says hey, I think you’re taking too much THC. This is what I learned, we should back it down and maybe try some different types of products.

 

Interviewer:                Right. Well, I’m all in, pun intended. I’m all in to help you spread that word. I think it’s essential of humanity to know about this system, to utilize it, to capitalize it, even more important for medical sciences and researchers to really continue to kind of dig into this system and help us to leverage it for the protection of humanity. So, thank you very much and we really appreciate your time. And hopefully we’ll see you next time on The End.

 

And we will be posting up some of those articles we talked about both on the COVID front, the ECS system and other ones that may be very pertinent and important for you to gain some knowledge and continue to spread the word. So, thanks very much and we’ll see you next time on The End.

 

 

[End of Audio]

 

Duration: 61 minutes

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