81: Cannabinoid Research, Education and Advocacy ft. Clinical Psychologist Nicolas Schlienz – Transcript

Editors’ Note: This is the transcript version of the podcast. Please note that due to time and audio constraints, transcription may not be perfect. We encourage you to listen to the podcast, embedded below if you need any clarification. We hope you enjoy!

We are starting the year off on a high note! Dive into the world of cannabis research as Bryan and Kellan talk with Nicolas Schlienz Ph.D. about his work with cannabis.

Nicolas Schlienz is passionate about Eliminating health inequities and barriers to healthcare which is why he joined Realm of Caring as their Research Director.

Listen to today’s episode to hear more about:

Cannabis for PTSD

Endocannabinoid Systems

Tobacco vs Cannabis withdrawal

Clinical cannabis trials

Veterans using Cannabis to treat Vietnam and Iraq PTSD

Cannabinoids as a natural means for relief.

Realm of Caring is a 501(c)3 non-profit redefining cannabis through innovative research, revolutionary education, and empowering global community connections.

Visit realmofcaring.org to learn more.

#cannabiscommunity #cannabis #thc #cbd #weed #medicated #sativa #indica #marijuana #cannabisculture

[00:00:00] Bryan Fields: This is the dime, dive into the cannabis and hemp industry through trends, insights, predictions, and tangent.

[00:00:10] What’s up guys. Welcome back to the episode of the dime I’m Brian Fields. And with me as always is my right-hand man Kellen Finney. And this week we’ve got a very special guest Nicolas Schlienz, research director of realm of caring. Nick, thanks for taking the time. How are you doing today?

[00:00:24] Niclas Schlienz: Doing great. Ah, having me on the show, looking forward to talking about anything and everything about cannabis

[00:00:32] Bryan Fields: Kellan, how you doing?

[00:00:33] Kellan Finney: I’m doing well. I’m really excited to talk some science today. So looking forward to the conversation, how are you Brian

[00:00:39] Bryan Fields: doing well and I just want to let the record state in another east coast area in the field.

[00:00:45] Niclas Schlienz: I was going to say that I was like, it’s just been the last, so many episodes have just been me trying to hold down the west coast,

[00:00:51] Bryan Fields: but I need to go with this here. So let the record be stated. So Nick, before we dive in, I’d love to get a little background about.

[00:00:58] Niclas Schlienz: Yeah, sure. [00:01:00] Born and raised in good old Buffalo, New York. So what comes to mind is, as we were just talking about, you know, before this some great for bowls and cold winters, but did all of my education largely at Buffalo. I completed my PhD in clinical psychology in 2015. And during my time in Buffalo, my research was largely focused on drug addicts.

[00:01:22] But not cannabis at that point in time, it was focused on nicotine and tobacco and looking at, you know, what happens when people abstain from smoking for 12 hours or 24 hours on certain, you know, questionnaires and, you know, laboratory tasks. So you can imagine how great it is to come into a laboratory on a Saturday morning, with someone who hasn’t smoked in, you know, about a day, we’re real thrilled to see you.

[00:01:48] So a big contrast between. That work. And then the work that I would go on to do at Hopkins, which I’ll mention in a moment with cannabis. But yeah, so I really, I was formally trained as a clinical [00:02:00] psychologist, but also as a clinical research scientist. So kind of gives me the best of both worlds where working with patients in know in real-world settings gives me ideas for.

[00:02:11] You know, research and grant applications. Whereas just keeping up with the research and, you know, the current literature helps me stay on top of, you know, cutting edge or just the best treatments available for whatever topic it is that I’m looking at. Following my graduation, I got a Buffalo, nowhere warmer, but I spent a year outside of Boston, Massachusetts, where I did a one year clinical fellowship at the Bedford, Massachusetts.

[00:02:38] And that would be where my, my interests in cannabis began to bud pun intended, you know, as the addiction intern there, I was working with a lot of veterans and beyond, you know, men, women returning from Iraq and Afghanistan that had seen a lot of terrible things. And. As, you know, you’d expect that the most common thing you see that is, [00:03:00] is PTSD.

[00:03:01] And a lot of times there’s, co-occurring substance abuse with that. And, you know, still the gold standard for PTSD is exposure therapy where you, you know, it just sounds exactly like it is, you just , you know, you know, re-imagine different degrees of that trauma or that stressor, you know, to the point where you hope that eventually.

[00:03:24] You know, you don’t have that strong visceral response to it, but as you imagine, for a lot of people, they don’t want to know that that treatment isn’t exactly appealing or sexy to come in at the end of the day. Talk about their time in Vietnam or horrible things seen in Iraq or Afghanistan. So naturally cannabis was discussed, you know, you know, near daily while I was there in 2015.

[00:03:50] And. They were just feeling very strongly about this should be legalized. You know, we made sacrifices for our country, but yet this is still [00:04:00] something that, you know, I can’t have prescribed to me. I mean, let alone at a VA a federal institution, but on top of that, you know, another big complaint was just a lot of these veterans.

[00:04:11] And people that were active duty or on, you know, along this medications. And Manny really did not like that. And they were going after the cannabinoids as an all natural means for, for relief from symptoms, which I can completely understand and, and support. So that shift took me to Hopkins where I was privileged to work with Dr.

[00:04:32] Ryan boundary for three years. And he’s been doing cannabis research. No. At the top of his field for over probably 15 years. And I thought. I thought that there’d be a quick, you know, that the learning curve wouldn’t be so steep for cannabis compared to nicotine and tobacco, you know? And so I’m sure Kalyn and I will chat about it.

[00:04:54] Boy, was I wrong? I didn’t know where to start in terms of like learning. I’m like, do I go into the endocannabinoid [00:05:00] systems by looking at them, you know, the city one and CB two receptors? Like what do I do? There’s, you know, different strains, potencies. But at the same point in time that that overwhelming like need to learn was like so exciting because I felt like there was an opening up this box that no one really knows.

[00:05:15] And admittedly, when people ask me what I do, when I would say smoking research, they’re like, okay, well then we’ll just change topics. When you mentioned cannabis research, you know, there’s usually not in the media topic change, which makes sense for a number of reasons. But at Hopkins, I was just exposed to a number of different populations, but also, you know, studies clinical trials.

[00:05:35] Drug self-administration studies with volcano medical vaporizer. There were also, you know, studies, edibles, brownies. I honestly say this to my friends, you know, and this’ll show my age, but I honestly felt like I was, you know, like the scientist and half past. When I was there because my office was directly across the hall from the research pharmacy.

[00:05:59] So during [00:06:00] those brownie studies in the morning, I could smell them baking in the brownies and I’m like, this is surreal. It was. Fascinating. And then sometimes at the end of the day, the pharmacist would say, Hey, do you want one? And they gave me the first time, but not the second. I’m like, I’m like what?

[00:06:16] They’re like, they’re like, no, there’s nothing in these. I’m like, oh, I’m like, sure. So it was just seeing how fascinating that setting. What was phenomenal, but at the same point in time, I saw how challenging it was to get off the ground, to do cannabis research at the behavioral pharmacology research unit at Hopkins, they have a long history trafficker.

[00:06:39] Investigating every drug under the sun. Now cannabis is still a big one. And then, you know, now more recently psilocybin, but other institutions in places don’t have the infrastructure out of the gates to support that research. So it’s a move to a different position. Oh man, I really was preferring. And still, you know, miss [00:07:00] my time there have great colleagues and collaborators, and then to close out this another long-winded response that took me to Rome.

[00:07:07] While I was at Hopkins, I helped to build a patient research registry, which was tracking people’s use of, you know, myriad number of cannabis products in their national environment, across a range of health conditions. And that’s been ongoing since about 2016. So five years of data. And it’s been very humbling, but also very exciting.

[00:07:29] And yeah, I am now talking to you guys and excited to see what else. I appreciate

[00:07:34] Bryan Fields: you taking us through that backstory. And before we dive into realm, I’d love to stay with Hopkins. So when you got started there, was there a certain project that you, you, you got initiated with? I know you said there was a bunch of different directions you could start with, but can you elaborate on the first

[00:07:47] Niclas Schlienz: project and the first undertaking

[00:07:48] Bryan Fields: you went.

[00:07:49] Niclas Schlienz: Sure. You know, I think one thing that Ryan boundary lucked out to have me there was, was it was a clinical trial. That was actually interesting. It was a clinical trial for individuals with [00:08:00] cannabis use disorder, but I mean, there’s currently no FDA approved. Treatments for cannabis use disorder. She didn’t

[00:08:07] Bryan Fields: elaborate what cannabis use disorder is for those who might not know,

[00:08:11] Niclas Schlienz: learn to like, you know, any other problematic, you know, disorder, but it’s just, you know, characterized by problematic use where that the use is very frequent and interferes with your, your, your, your roles and responsibilities.

[00:08:23] You know, you experienced craving withdrawal syndrome, which people are always like really that existed. I’m like, yeah, it’s a real thing. But it varies. And. You know, so people, yeah, the jury is kind of out, I think, in the, in the lay public in terms of does it exist, but, but anyhow, conducts your question.

[00:08:39] Brian, you know, the study that Ryan I’m going was actually quite neat. We gave people either placebo or. Extended release Ambien to see how that would operate on their cannabis use because insomnia among like, you know, heavy users and even frequent users insomnia is one of the most [00:09:00] highly, you know, endorsed withdrawal symptoms from cannabis.

[00:09:03] So that, I mean, know under that logic, if you target the sleep and other things should kind of fall into place. That’s still, you know, an under analysis, but it was really, really interesting. And we also, another part of that treatment was what’s known as MC management, where you basically pay people for like clean urines.

[00:09:22] And that’s been used for a long time now, especially in the stimulant literature like cocaine, but as you both know, it doesn’t work well with a substance that is heavily lipophilic and stays in your body. For, you know, any number of weeks, depending on how, how often you use, how recently you used, or even like your body weight.

[00:09:45] I had one amazing guy who was great during the study who stopped using, but I think out of, out of the 12 weeks of, of, you know, that that was the duration of treatment, I don’t think he had a clean urine for [00:10:00] probably at least six or eight weeks. Which was it, unfortunately, because he wasn’t being, you know, incentivize for that.

[00:10:07] So that’s still an ongoing challenge in the field. So that was the first study. The second study I was a part of was, you know, comparing smoking cannabis via handheld pipe versus the, you know, the Cadillac that stores in vehicle vaporizer. So that was, you know, one of our, probably most highly cited papers.

[00:10:27] But basically people would come in early in the morning, the conditions were counterbalanced and they would smoke and we’d watch them smoke for the volcano medic. It’s a little more challenging to study that because we got these big balloon bags that, you know, fill up with, you know, the vaporized plant material.

[00:10:46] So there can be a little bit of a haze to it based on like the non, like the non components, like the terpenoids. So we could put like garbage bags over there. But, you know, for both, both conditions, pipe and [00:11:00] Deborah riser, I mean, I think they position, they had to come, you know, consume three bags and the pipe, they had to consume all of it.

[00:11:06] So we had a pharmacist would come and check to make sure that everything was consumed and then they would stay there for the, you know, the whole day in our residential unit. I mean, these people are like, sign me up for this. I’m about it. Take out who’ll play pool, you know, sleep, play video games. And then, you know, they get poked and prodded periodically for like blood to look at different blood levels, some cognitive tasks for like an attention working memory.

[00:11:33] Another, just, you know, drug effects, ratings, and That study I think it was one of my ones I probably enjoyed the most because it was so it’s done really impactful in the field because it just really shows how much stronger the drug effects are for vaporization. Compared to combustible, you know, smoking via pipe where it really becomes really, if you want to make the most out of what you have of your cannabis, you go to vaporize throughout, because it doesn’t have all this extra runoff if you were smoking a pipe, but at the same [00:12:00] point in time, you know, with stronger drug effects that, you know, brings concerns about, you know, impairment and intoxication.

[00:12:08] So those were, those were like, you know, a couple of the two that really stopped.

[00:12:12] Bryan Fields: Let’s talk about realm of caring to be, give a little bit background about how the non-profit works.

[00:12:17] Niclas Schlienz: Yeah, sure. You know you know, essentially. Yeah, this was largely founded by two moms, you know other Jackson and page Figgy who had children that were really having, you know, nightmare of a time with very rare seizure disorders and were looking for some kind of treatments, some, some help, some hope.

[00:12:37] And you know, back when they were approached by the Stanleys, the Stanley brothers who farm Charlotte’s web which is named after the late, you know, Charlotte and Vicki of course. You know, you know, both pages, you know, daughters, Charlotte, and how there’s sons, the Chi had fantastic improvements, you know, in terms of like seizure reduction.

[00:12:56] So the point where, you know, each of these two wonderful moms and strong [00:13:00] mounds were finally being able to like, you know, start out a relationship and learn about their child for the first time. And. I can’t imagine what that’s like, you know, as a parent, but I remember a conversation that I haven’t had there in Montreal, and she just stated, you know, when you finally have that experience of something that works, you want to just, you know, scream from the mountaintops.

[00:13:24] We got to put more time and money and effort into, into studying. And I think, you know, both Heather and Paige are trailblazers. But that’s how rum got off the ground. And to this day it has, you know, three main, you know you know, main aims, which are respect. Education and also advocacy. So I’m kind of the, the guy that’s in charge of the research, but importantly, the, the education, we get a lot of people that call in to our care specialists who just don’t know how to, you know, where to start, they’re thinking about using, but it can be very dark.

[00:13:58] So they give a lot [00:14:00] of great recommendations and support, you know, and what I love about it is is that the recommendations are based on, you know, ongoing, you know, drawing literature. They’re not just what your gut feeling is or your intuition. So it sets people up for you know, hopefully a good experience, but then advocacy again, is really focused on, you know, really trying to de-stigmatize cannabis, you know, and it’s, you know, valuable role as a, as a therapeutic, you know, I think the three of us can all agree that.

[00:14:27] There’s been tremendous reform in the U S that there’s still, you know, some, a lot of states that just aren’t budging. So I think, you know, as, as time passes, you know, our initiatives, that realm and other foundations and institutions will just really help to normalize the use of, of this fascinating plan, going dive

[00:14:46] Bryan Fields: in there, explain a little bit more about how important, the value that realms bringing to the end of.

[00:14:52] Kellan Finney: Well, I mean, when I first got in the industry in 2015 or so, honestly it was really, really challenging to find primary literature, [00:15:00] right? Like you can even look up the boiling point of THC and stuff. The fundamental, like scientific knowledge associated with these chemicals just was lacking. Right? And so research is going to be the most important undertaking for the canvas community, just so we can actually tie hard science to a lot of these anecdotal claims that are out there as far as everyone using the cannabis plant to treat a different illness and coming up with kind of different results.

[00:15:29] And that’s where science comes into play. I’m really curious about your transition from. John Hopkins to a realm of caring. What was that transition like? Because I know it can be kind of a unique experience going from a very formalized Institute to almost just a private non-profit organization.

[00:15:48] Can you elaborate on that transition?

[00:15:51] Niclas Schlienz: And before I do, I just want to say like, you know, what, you just, I couldn’t ascend what you just explained, you know, you know, more eloquently. So I really appreciate just how you summarized the [00:16:00] importance of this work, but it was a bit of a, of a shift, you know, from being at an institution where, you know, the name carries so much cloud.

[00:16:09] You also just go into an office you know, where and moving to a realm where I’m. You know, telecommuting, you know, having met any of my coworkers in person. So I think, you know, I think I’ve been accustomed to just being in my office as you know, during graduate school and post-doctoral training. So it’s not really that different in terms of like doing my work or checking things off the list.

[00:16:33] But it does make me urine for like a time when we can all kind of get back to baseline. And I don’t know, just group experiences are just so much different, you know, even in person. I don’t know if you guys, I think you guys would MJ Biscaro we did. I mean, one of our around staff, Adam Young was just really marketing.

[00:16:52] Man networking in person just is so much better than doing it over the phone or versus zoom. And I can, I can’t [00:17:00] even imagine it’s been a pretty good experience. Kaelin, I think been working on this registry for five years. So there was really no anything new, but I will say, and I think you can probably appreciate this and realm.

[00:17:11] I’ve worked more closely with industry, so Charlotte’s web and some of our other sponsors. And that actually required me to really. Learn a new vocabulary, if you will. Because when I have meetings with various associates at any cannabis or company, they’re not scientists, you know, that I can be talking with sales, marketing associates, you know, you know, each time that each meeting there’s usually someone new and the frame has to be adjusted for that.

[00:17:44] And initially. It was, that was the most challenging experience that I had. I’m like, okay. You know, the CEO, that person, you know, I haven’t interacted with them yet, but their time is money. I’m gonna have to condense, you know, my, [00:18:00] my, my, what I wanna say. Into, you know, like, you know, that elevator pitch, the sales and marketing, I’m going to have to just also break down the scientific jargon and, you know, translate to what it means.

[00:18:12] You know, what do you say to a consumer who calls in? So that’s still an ongoing, you know, area of growth for me. Cause it’s, it’s markedly different than academia industry wants, you know, deliverables. When will you have this paper to us by, and as you both know, you know, just, it’s not like you’re putting something together, like physically just a cognitive labor things to come up and LLCs, you know, go and unexpected directions.

[00:18:38] But I do appreciate this experience because I think it, it helps me. Be more sensitive to, I have all these great findings to communicate and I don’t want to have those be lost by not communicating them in the right way to stakeholders and the public. So I’m mindful of that still, when you share one of those [00:19:00] great.

[00:19:00] Of course our recent work without a registry. Basically the people that are completing this registry are people that have registered with realm of caring. And it’s basically an online survey that contains a bunch of different measures that look at quality of life, anxiety, depression, pain, healthcare utilization.

[00:19:18] So that would include like, ER, admissions, outpatient visits, insurance costs, sick days. And we will also ask about specific products that they were using because as, as Kellen, you know, mentioned, you know, a few minutes ago when this first began 2016, you know, it was like the wild west, you know, in the absence of clinical trials where you can really just have tight control over who you’re bringing in and also what you’re studying.

[00:19:44] You know, we don’t have that still for the most part. So this was an excellent opportunity to. just have real people, you know, compared to your typical clinical trial patient that has to meet certain strict criteria that are using a variety of products for a variety of conditions [00:20:00] telling us the dosing. But importantly also letting us know, like the effects that they’re experiencing those conditions.

[00:20:07] Because a lot of you know, again, we don’t know a lot of that information still, and this data, even though it’s not as rigorous as a clinical trial, Can provide really, really strong insights for future clinical trials. Anyhow with that said, you know, our most recent paper focused on the use of people that were using CBD for, you know, either, you know, as a treatment for anxiety or depression.

[00:20:33] And then we had a control group as well, and it was really unique. But I’ll just drop that real quickly. So everyone completes a baseline survey. Then they go on to have complete additional surveys every three months, you know, invites. So it’s some great longitudinal data, but the anxiety and depression paper, it was interesting because there’s been mixed literature on both worlds in terms of CBD.

[00:20:58] But we found that in that [00:21:00] paper, that at baseline individuals that were using she’s no CBD products. Had significantly lower scores on the depression measure, but that finding didn’t carry over to anxiety. So that was really interesting. A unique part of our design is that like, well, what about people that are not using, but at follow-up start using, like, that might be interesting to look at.

[00:21:25] So we call them initiators and we found that people that baseline, but then began using at a follow-up time. Had drastic reductions in both anxiety and depression. So that was really fascinating to see. And among the people that were using it out of the gates and continue to use at follow-up, you know, the effect was still there, but a little bit weaker folks that didn’t use throughout the entire study had much lower, you know scores for Africa, other measure like sleep pain, quality of life.

[00:21:59] So [00:22:00] that was really interesting to, to see that finding, because again, couldn’t eliminate data out there and a lot of it’s preclinical, you know, the rodent data. So it’s different, you know, going from, you know, like a Rodan, you know, paradigm where they stressed out a rat to looking at, you know, how, you know, help someone that’s anxious for whatever reason or you name it.

[00:22:19] So what do you think the mechanism.

[00:22:22] Kellan Finney: Do you have a theory? I mean, I know that there’s nothing concrete right now, but I’m just curious about how you think that CBD is actually causing that biological.

[00:22:33] Niclas Schlienz: My guess is that, I mean, it’s not so much of a, of a big agonist at, at CB one CB one receptors, but you know, I have to imagine that I think there’s a pretty well known potential interaction or cross-reaction with serotonin.

[00:22:48] So that could be it, but at the same point in time, I don’t know, in terms of like the pharmacological economic mechanisms or even just in neuro you know, physiological mechanisms, I’m not quite sure. But once I saw that you had the [00:23:00] chemistry background and like, okay, I’m going to ask Helen. I’m like, what are some of the slots?

[00:23:07] Kellan Finney: I mean, serotonin has to be what’s going on as far as the depression aspect, right? I mean, positive serotonin or serotonin inhibitors. Right? That’s what most antidepressants are. Correct. I didn’t know. I’m not familiar with the link between depression and anxiety, honestly. I mean anxiety would be, the symptoms would be like increased heart rate, lack of focus, maybe.

[00:23:28] Right. Restlessness is that one, right? So I would say that, I mean, there’s gotta be tied to the endocannabinoid system as a whole, because would you think so?

[00:23:40] Niclas Schlienz: I would definitely think so, because I think, you know, kind of, you know, as a clinical psychologist kind of like the difference, you know, between mood and anxiety, you know, that we’re just talking about, I think with anxiety.

[00:23:49] Yeah. You’ve got a different constellation of symptoms, but I think that fear that dread is much different and much more salient. It brings up. Then depression and, you know, there’s [00:24:00] been a number of studies, ongoing studies where they’ve been looking at, you know, cannabis for PTSD, and that, that kind of speaks to can cannabis help with PTSD by helping to extinguish that fear response via interaction with the endocannabinoid system.

[00:24:18] And there’s, I think there’s some great initial data there, but. Anything canvas, there’s still a, you know, a ways to go, but it’s just not your sense. Was this study, did

[00:24:28] Kellan Finney: you guys just use pure CBD?

[00:24:31] Niclas Schlienz: These were just, you know, whatever people were using. Okay. Yeah. So we, we actually excluded people that were, you know, using pharmaceutical CBD.

[00:24:41] So like the dialects, no, in markedly different from the majority of, you know, CBD products, but by and large, you know, a lot of like isolate use, but also full spectrum products that you don’t see with, like the pharmaceutical grade.

[00:24:55] Kellan Finney: Yeah. And that makes it even more challenging from a poly pharmaceutical.

[00:24:59] [00:25:00] Yeah.

[00:25:00] Niclas Schlienz: So

[00:25:00] Bryan Fields: if I have a product that I use for my anxiety, that helps me, is it safe? Which is probably the wrong word to use if I don’t have that product, but still have anxiety and I’m on the road and I grab another CBD based product. Can I feel comfortable that they’re interchangeable to both treat my anxiety or is that one where there’s other components inside of the products that play a vital role?

[00:25:25] In helping my anxiety really, really,

[00:25:27] Niclas Schlienz: really, really great question. Brian I was fortunate enough to dabble in some, some, some pharmacokinetic work while I was at Hopkins, but you know, it’s still like learning about CBD and the onset of therapeutic effects and how long that takes. It’s still not completely, you know, understood, you know, in general realm of caring and even Charlotte’s web tell our clients, you know, start low, go slow.

[00:25:53] And of course, you know, that would be the case for a lot of anxiety medications. Like here, you have your assets arise. So [00:26:00] yeah, it’s, I mean, I would air, I would, I would, I would play the conservative card and say, you know, I don’t know. I don’t think that we don’t have data right now to suggest that you can just swap one out with the other.

[00:26:10] That’d be really interesting if you could, for a number of reasons, especially. You know, given how much, you know, insurance plans costs and prescription medications. I mean, you can really lower the overall healthcare costs, but I had another different interview a while back where a person had asked her, what if I was trying to stop or discontinue taking benzodiazepines for anxiety and I wanted to use CBD or cannabis.

[00:26:34] What would you reckon? And I said, well, as a, kind of, not a real doctor, I would say in the position, because, you know, benzos, benzodiazepine withdrawal can be lethal. And just, I mean, you gotta like follow the current literature. I think people are really excited about this, but it’s also can be challenging to not know how you can actually use it or maximize the use of it for therapeutic [00:27:00] efforts.

[00:27:01] And. I get that. I mean, as human beings, we wants to fast, you know, like here we are 20, 21, you know, Amazon culture, like you get something like a day, sometimes the same, you know, at Baltimore, you know, the same day. But like, I think to make my childhood of like, you know, Saturday morning cartoons and like whatever, like dumb toy was on there and be like, Call us now and shipping and handling, we’ll be like 15 bucks and you’ll see it in like eight to 12 weeks.

[00:27:26] Yeah. So kind of aren’t fond on unweighting and I think a lot of times we do see people discontinue treatment prematurely now, cannabis and CBD, because they’re not like, you know, where where’s the fact,

[00:27:39] Kellan Finney: doesn’t it take. A couple of weeks for even antidepressants to kick into, once you start anti-depression medication, right?

[00:27:47] It’s not like a light switch where they like take the pill the next day. And they’re like, oh, I’m doing good. Like it, it takes a long time to re reregulate those like biochemical pathways in the body.

[00:27:57] Bryan Fields: I wonder though, if, if people associate the [00:28:00] cannabinoids all together, right. Where like, if you take a hit of a ball you’re instantly high.

[00:28:03] So the same concept. If you consume a cannabinoid CBD, maybe you’re instantly feeling or looking for that same. Fact, which is of course not correct, but also off-putting for the person who is like, I took this, this edible CBD edible, and I feel nothing was like, wow.

[00:28:18] Niclas Schlienz: Yeah. I think there’s some really interesting points in there.

[00:28:21] Continue to be really, you know, not having formal training in pharmacology, but. The route of administration, you know, influence on the type of product being used. I think it’s very fascinating. And I think that’s why, when you look at the marketplace for cannabis, you know, you’ve got edibles, you’ve got tinctures, you’ve got vape cartridges and they all have different, you know, you know, durations up of their, you know, the onset of the drug effects.

[00:28:44] You know, I think now, you know, some of the larger companies have pushed out, you know, CBD vape cartridges. I’m curious how people will respond to that, because I think you would imagine with that rather than ministration bypasses, a lot of things and play has less products, you know? [00:29:00] That’s also lost in the process.

[00:29:01] You’d have just in the stomach and tablets. And so I’m really, really curious, honestly

[00:29:07] Kellan Finney: my experience with CBD and the only time I’ve ever felt, something like for sure that something happened was when I, the CBD concentrated CBD oil. Right? Yeah. And it was instant. Like, I literally felt like my shoulders relaxed, wild, and like I’ve taken CBD pills and it’s just like, it’s like nothing, but it’s the only time I’ve actually ever felt an effect from CBD is.

[00:29:29] Smoking it honestly. And so I’m curious, were you able to look at that data from your guys’ recent paper and notice if the majority of consumers were either like ingesting pills with CBD from an edibles perspective, or was it kind of mixed 50 50 even having. And some of that data,

[00:29:46] Niclas Schlienz: you know, as you want expect, just for given like the nature of like how run with Karen start with like the focus on epilepsy we search, you know, for our epilepsy research, almost the majority is people using tinctures because they’re children, adolescents, [00:30:00] and even with anxiety and depression, it’s, it’s similar.

[00:30:04] It’s tinctures. You’re also seeing what you are seeing planets. And kind of, again, some variations in whether or not it’s balanced in terms of its chemo type or like THC dominant or CBD dominant. So there’s some signal in there, but I think it requires some more, more unpacking because just, I think that’s the challenge of cannabis right now is just the product alone, the plant alone is Incredibly complex in our endogenous cannabinoid system. And then you’ve got route of administration and then you have how the drug is you know packaged like in terms of just edibles. I mean, I learned that depending on the fat content in the product might alter, you know, about the time course of that drug effects.

[00:30:46] And I think that’s now where I think I’ve noticed that some, you know, within the industry, there are, there is a greater focus on the, how to. Maximize, you know, the drug, you know, in terms of its, its onset and not having to [00:31:00] wait. So I’m really curious to see where that goes, you know, could that mean you’ll have some that you can adjust that doesn’t take an hour and a half to take again where it could be, you know, 30 minutes who knows, but I think we’ll probably a lot of great stuff.

[00:31:14] We’ll see, probably very soon with that and excited. John,

[00:31:18] Bryan Fields: I’m going to push back on, on you. When, when I consume CBD it’s because my anxiety is running rampant and in those moments, I’m not looking to feel anything except for not have my anxiety run rampant. So for me, when I take those, those edibles or those consumables, I instantly feel better.

[00:31:34] And wonder if it’s placebo effect, if it’s my breathing, whether or not it matters or not, but I start to instantly feel like calmer. And I wonder if it’s my brain’s kind of kicked into gear knowing. Things are gonna slow down or maybe if it’s all just mental and it’s all just one of my own issues, but for me, I’m not taking CBD to feel I’m taking it to kind of slow me down.

[00:31:53] I mean,

[00:31:53] Kellan Finney: I’m not doctor, but I’m say totally, but like my guess would be like, if you [00:32:00] take a pill and instantly. Feel something from it. And then like, it’s

[00:32:03] Bryan Fields: placebo. When I say instantly, I mean like rather like shortly after, right? Like if I consume that and I go to sit down and my breathing starts to slow down and maybe it’s all mental base, but at that point I don’t really care.

[00:32:16] Right. I’m just looking for some sort of relief to slow it down. Yeah. In those moments before it’s not going so well for me. Yeah. Know what

[00:32:24] Kellan Finney: I mean? Everyone’s different. Right. And this is the whole personalized medicine thing, but yeah, for me, for me personally, smoking it like in a vape pen was the only way I’ve actually felt like the, like the body effects of it.

[00:32:36] Does that make sense? I don’t think, I, I don’t know if I have anxiety, to be honest with you. So like, I don’t know if I’ve ever taken CBD to treat anxiety from that perspective, but I mean, if it works, what are your thoughts?

[00:32:48] Niclas Schlienz: I think you’re both right on the money. I think it’s all of the things that, you know, Brian, you mentioned, and I appreciate you sharing your experience.

[00:32:55] I’ve definitely experienced my share of anxiety in life, especially graduate [00:33:00] school. And I think that I really like the thought about, I think there are expectancies of like, When I take this, there’s a thought, okay, I’ll finally have some relief and whatever expect expectancy. You know how that operates.

[00:33:15] I don’t know that they’ve figured that out, but that’s something interesting. There’s this other, you know, there’s this other, you know construct in the field of psychology, that’s called like distress tolerance. Were just like, it sounds like how much distress can you tolerate. But again, knowing that if you have something available to you versus say not having a pill or edible or anything available to you, there’s like some, there’s some decent, you know, calm and, and just design and knowing like, okay, Right here.

[00:33:45] This I’ve got something I can use it whenever I want. And then I do think, you know, people just respond differently in terms of CBD, you know, people have, we’ll talk about, maybe you have to take it longer for certain, you know, conditions. [00:34:00] But also they talk about how well, what if you stop seeing your response, which could be a possibility because of just, you know, tolerability, but I think combination of, of just product administration, expectancies, just pharmacological mechanisms, they’re all at play.

[00:34:14] And I think that’s the beauty of, of what makes the science. So it’s a really interesting. I shouldn’t say that. Who knows, but we wanted to ask it right. Many,

[00:34:24] Bryan Fields: too many problems. So Nick, what’s one area of cannabinoid research that would surprise or shock the average day individual,

[00:34:35] Niclas Schlienz: in terms of

[00:34:37] Bryan Fields: just anything in your research that you’ve come across that you think would shock or surprise, let’s say an every day cannabinoid.

[00:34:45] Niclas Schlienz: That’s a really good question that I haven’t thought about because, you know, it’s a pretty, like relatively like, you know, nuanced state a little bit with, with brown, but I think maybe I’ll just go back to what I briefly spoke about earlier on with withdrawal again. I mean, you [00:35:00] know, the three of us, we are, we’ve all watched like the classic movies, you know, wait, you’re a guest.

[00:35:05] You know, cheating, you know, teaching John, like, you know, half-baked you name it. But when I got to Hopkins and was learning about canvas withdrawal, I don’t know what the current field is like still. But it was very divided earlier on, but that’s like the early to late nineties bowlers have known that it’s not a thing because.

[00:35:28] Put that against tobacco withdrawal. Obviously we would say, you know, nicotine withdrawal is going to be much more severe compared to, you know, cannabis withdrawal. And then we’ll look at other drugs of abuse, like opioids. Now that’s withdrawal. I mean, you’re talking like extreme GI distress, you know, sleep problems, things.

[00:35:46] I mean, think like, you know, like train spotting, you know, and not to like say that that’s the clinical picture or even cocaine. I think cannabis is withdrawal is closest to. Nicotine, but it still is possible. I [00:36:00] think people are probably not are, are reluctant to believe it because I don’t think your average user is probably using it daily, or even if they are using it daily, maybe they might be, it might be, it’s such a small dose.

[00:36:11] There’s any number of reasons, but you know, it, it’s, it’s a thing that’s been replicated time and time again, it’s different in terms of its onset, where with nicotine, if you don’t have, you know, I’m a former smoker, if you know, phonetic cigarette in an hourly, I would, after an hour begin to feel it. But with cannabis it’s, you know, around like two days is where it begins to peak.

[00:36:31] And then it is, you know, it takes about a month or so to resolve. And you can even have like, just residual, like protractive withdrawal. I bring up the withdrawal because. I think You don’t really hear much about that topic withdrawal, you know, in our current climate of, of legalization and reform, we talk about like the therapeutics and I’m not, and I’m not trying to be like, oh, this is like, you know, gray cloud.

[00:36:54] That’s just like, you know, in a room ruin all the fun, but I, you know, it makes me wonder. [00:37:00] In medical patients, you know, is it possible, w w will you see that? Will you see different withdrawal symptoms based on again, like different routes? Like if you’ve got something that’s vaporizing it versus edibles So I think that’s really, really interesting and intriguing. And again, of all the drugs of abuse, I think that one probably has the least street cred but it’s still an area that’s being targeted for, for treatment. Your favorite.

[00:37:26] Bryan Fields: Minor cannabinoids that you don’t think gets enough love in the medical cannabis.

[00:37:32] Niclas Schlienz: That’s a good one, because this is like a point of, I should say confession for me and the folks that wrong. So you have to understand too, that I have this, this research position there at realm. And then a lot of the other on my amazing staff, Tony Sasha, Adam Zerick bell, and our exit executive director, Steve young, they’ve had all these interactions, but with Fox, they do do seminars, webinars about the latest trends in blogs detailing like the latest results, like your CDG, like Delta [00:38:00] eight and.

[00:38:02] I took it at the time, like a deep breath in, and they’re just like, eh, I guess if I wasn’t a scientist, I wouldn’t be, I don’t wanna say like skeptical, but you know, one thing that I try to do is not just me, but even, you know, Ryan boundary at Hopkins. Cause we, we still collaborate with him. Is there any data, you know, like what does the data say?

[00:38:19] And it’s tough because there’s a wealth of data on, especially just now with CBG, but a lot of it’s almost exclusively limited to pre-clinical model. So how do you extrapolate those effects to human use? I don’t have an answer for you, but it’s just, I mean, it’s just, there’s so many out there and

[00:38:38] Bryan Fields: that you’re like a mother who loves all of her kids eat evenly because we all know that everyone has a favorite.

[00:38:45] Your favorite minor cannabinoid, even if it’s not, if it’s not that

[00:38:49] Niclas Schlienz: unpopular, I’m like, you know, I’m, I’m pretty boring in this, in this space with my, my duties at realm. And even at Hopkins, most of my time is with, is with CBD and trying to figure out [00:39:00] what’s going on with CBD. I think to, to kind of like slightly change your question in cheats.

[00:39:05] I think what really intrigues me are the terminal. As I was leaving Hopkins, that was a study that was starting up of looking at some of the more prevalent ones like Lyman, Nene, and pioneer. The things that use you smell and everyday fragrances, fragrances and products. But I quickly learned how to test those in humans, even though they’ve got this, like generally regarded as safe status with the FDA and it changed the, you know, from like just smelling to just ingestion, it’s a whole new ballgame, but I think, you know, they were doing things, but like

[00:39:41] And I think, I mean, again, this goes back to that the entourage effect are these effects independent or interactive or synergistic? I mean, I believe synergistic, but the data hasn’t been conclusive just yet. So I think, yeah, I don’t know. It’s a weird thing about it. I’m an entrepreneur intrepreneur man and not like a they’re

[00:39:58] Kellan Finney: all there altarpiece.

[00:39:59] [00:40:00] Right. And just assessed with terpene versus a monotherapy. And so it counts. Do you think that the entourage effect or minor cannabinoids have a larger purpose?

[00:40:09] Niclas Schlienz: I think there’s things that we already do that are already available to us that are kind of similar to like the therapeutic value of some of the terpenoids.

[00:40:15] I mean, I think I told, you know, someone pretty recently, like when you think of like a Roman therapy and, you know, aromatic oils, I mean, that’s really not that much different from like what a terpene would confer and it sounds. There’s again, great preclinical work with some of the the terpenoids and anxiety and mood, but I can’t wait to see, you know, you know, more like what’s out there because again, just thinking about the complexities of the plant you commonly hear among recreational users.

[00:40:44] Well, you have the CBD that just balances out kind of like. It has like a protective effect against the THC, but in terms of like the, the other terpenoids, I think what makes it complexity is like, how do you study this in like a controlled, rigorous setting [00:41:00] that can give you like confidence that you know, what your conclusion is?

[00:41:03] And I think that’s why all these studies that need to be done are very piecemeal. It’s like step by step, by step, by step, by step. And it goes slow because of just, you know, the current, you know schedule on the status. It makes it really difficult to pretty much do anything at a fast. So, yeah,

[00:41:18] Bryan Fields: since you’ve been in the cannabinoid industry, what has been the biggest misconception of,

[00:41:23] Niclas Schlienz: in terms of just

[00:41:25] Bryan Fields: what has surprised you the most?

[00:41:27] Or what did you come into the cannabis industry thinking one thing and then figure out really quickly that it was slightly or quickly the

[00:41:35] Niclas Schlienz: opposite. I think coming into it, going back to my original experience with nicotine tobacco, I mean, we’re all. Big tobacco and just there’s really no, there’s no good intent behind them.

[00:41:48] I wondered what it was going to be like with some of these different companies that I was working with. Was it going to be bottom line? I mean, if you think about it, you know, bottom line for any, any company, regardless of what [00:42:00] product they’re selling, you need people to keep coming back. And in terms of like cannabis, you know, it could be the symptoms that, you know, are retractable that keep people coming in.

[00:42:11] Or, you know, I’m just speculating or saying a concrete statement, but you know, what if, what if there’s like psychological, psychological dependence on it, the comfort of it or physical? You wonder, but so far of, of my interactions with, you know, our sponsors, I I’ve been really, really impressed with really trying to meet, to do it right.

[00:42:33] There’s already enough stigma. And if we don’t do it right there, won’t be, you know, more progress in this field in the first place versus like fast and loose with what the research. So, you know, seeing that there’s a great push to reduce human suffering and to provide an alternative treatment that is viable and.

[00:42:54] Has a decent, a side effect profile that really doesn’t compare to compare it to more severe, you know, [00:43:00] drugs that are available for various conditions. So I’ve been impressed by that. Will it stay that way? I don’t know. I’d like to hope so, but we’ll see

[00:43:09] Bryan Fields: predictions. We ask all of our guests, if you could sum up your experience in a main takeaway or lesson learned to pass onto the next generation, what

[00:43:17] Niclas Schlienz: would it be?

[00:43:18] I think one thing that I still. Depending on who I’m with that gets me is, you know, asking why or asking a question. I think a lot of times we just accept things based on, you know, who’s talking, but I think being curious and asking, but, but why, why, why does this happen or know telling more about that? I think that’s important.

[00:43:38] I don’t do that enough because you know, I’m not going to stand up in a conference when some prominent speakers is telling the data, you know, presenting this data. I’m like, why should we care, bro? Like, I’m not going to do that, but you know, there’s more tactful ways to do that. But I think asking why, I mean, fosters that, you know, you know, analytical thought that, you know, you know, really [00:44:00] makes you a good consumer of, of knowledge, but also of products and just other, you know, religions, cultures, creeds, sexual orientations, you name it.

[00:44:08] So I think just being open and asking, learning, and it’s learning that.

[00:44:16] Bryan Fields: We’ve had a breakthrough in cannabinoid therapy sometime in the future. This is where we currently operating. Is it a single cannabinoid therapy or is it a entourage or sec with multiple cannabinoids? That is inducing the fact, which one are you most bullish on making the more impactful

[00:44:34] Niclas Schlienz: short-term? I’d say the ladder.

[00:44:35] Yeah. I mean, maybe, maybe there’s no data there right now, strong enough for the entourage, but I just, I mean, I don’t want to have to say, oh my God, but I just, yeah, I, I think it’s going to be some type of combination treatment where there’s like different, you know, different levels of us to the minor, Kevin Owens and, and major and other, I don’t know, like it just really like how would you describe it in terms of like, Because you had to compare it to a drug that’s currently available on the market.[00:45:00]

[00:45:00] I don’t even know what that would even be comparable to in terms of like calibrating the, you know, the candidates plan for therapeutic use. But yeah,

[00:45:12] Kellan Finney: I would say that it is going to be the entourage effect. I think that if I was a betting, man, I mean, I think that cannabis has the opportunity to pioneer the field of like Paul polypharmacy, right.

[00:45:24] Or multiple. Molecules come in to treat one illness and you see this and the antibiotics world right now, right. Instead of using one antibiotic to go kill, like kind of still on episode, right? One molecule to go in and kill all these microbes or bacteria, if you will now. And then of course some live and you have these superbugs, all these other things.

[00:45:46] What they’re doing now is they’re feeding them like multiple molecules. And so like one molecule may just in here. One specific pathway in the organism. Right. And so it doesn’t kill it, just that one molecule, but then with the other molecule as [00:46:00] well, present the like simultaneous inhibiting of two different things.

[00:46:05] Then causes the microbes to die, which then it’s harder for the microbes to like generate immunity to that. But I think that, like you’re seeing that push to utilize multiple molecules to treat one specific problem in other industries as well. So I think that, I mean, personally, I believe the entourage effect is a thing.

[00:46:26] I mean, I’ve consumed pure or like very, very pure. Cannabinoids a single layer, THC versus for

[00:46:33] Niclas Schlienz: science, for science, all for

[00:46:35] Kellan Finney: science, of course. Right. But versus assuming like a full spectrum oil and the experiences drastically. Right. So there’s something going on there from a, an interaction standpoint. So I, I do think the entourage effect is, is the right answer.

[00:46:50] What are you, what are your thoughts,

[00:46:51] Bryan Fields: Brian? I went into this, assuming the, both of you would take the single cannabinoid bear B, just because as we’ve talked about today, there’s so many [00:47:00] variables that are in place. So I’m a little surprised to be arguing. What I thought was a layup on that direction, but that’s kind of a, a thought for another time.

[00:47:08] We’ve talked today about all the complexities and all the challenges with all the variables. And now we’re adding more variables into the small, the small therapy. So I think a single cannabinoid therapy has less variability between all these other predictability measurements that we talked about and think it’s more likely that the pharmaceutical companies can come in.

[00:47:27] I think Kellen you’ve preached those pretty aggressively that they don’t like variability in their effects because there’s lawsuits. So my thought would be single cannabinoid.

[00:47:37] Niclas Schlienz: It makes a lot of sense, because I think starting out to, you know, to isolate, to like, just for, you know, the standpoint of internal validity and being able to be confident that this is, you know, I’m measuring what I think I’m measuring, right.

[00:47:48] One compound that’s, that’s really important. And I think the one thing that I talk about the people with in terms of. You know, with, with CBD and the regulation of it is just, you know, when you [00:48:00] go to your pharmacy, you don’t have to really worry about like prescription medications by enlarge from one month to the next month, like fluctuations in the active ingredient in your medication.

[00:48:09] Whereas if you have like a mom and pop, you know, curated CBD product, you know, from week to week, if you have a condition that’s severe like epilepsy that needs a stable product, you might not actually have. But you know, that’s a different topic from like single versus, you know, entourage, but I think, I don’t know.

[00:48:26] I could go either way with it. I mean, there’s pragmatic to go with like the single sure. Could you imagine like

[00:48:33] Bryan Fields: someone walking in and be like, I know this is 90% CBD, but like last time it was 3% CBC and now it’s six and a half percent. Am I going to feel a different effect? Like those are the types of conversations that most people don’t walk in when they buy a product, they don’t start asking about some of those lower percentages on the back of the label.

[00:48:47] They’re just kind of assuming that everything is within what they expect it to be.

[00:48:52] Niclas Schlienz: Even, you know, in terms of just personalized medicine, I’ve worked on a number of smoking cessation clinical trials that, you know, looked at [00:49:00] like bupropion, which is marketed as Zyban, but also Chantix. And there’s a lot of even just, you know, genetic factors that cause people to respond differently to different people.

[00:49:12] For example, there’s, there’s known differences between how people metabolize the nicotine patch versus Chantix to the point where it almost came down to you’d go into a CVS or Rite aid and you take out the litmus test to see like, which one should I take Chantix for? You know you know, the nicotine patch for, you know, quitting smoking.

[00:49:31] I could see something similar like that too. In terms of like trying to know estimate or kind of like predict, you know, or tremors. In terms of some just crazy cocktail of just varying levels of everything.

[00:49:46] Bryan Fields: So for Nick, for those who want to learn more about your research and they want to donate and get involved, where can they get in touch?

[00:49:53] Niclas Schlienz: Can, you know, go to www realm of caring.org. We’ve got plenty of great information there. Our blog, our folks, [00:50:00] you know, Sasha, she keeps it does a great job. And, you know, have the finger on the pulse of the industry and trends. So the blog is a great place to learn. What’s, you know, what’s new, what’s novel, but also for the, for the person that’s just like, oh, I’m kind of skeptical.

[00:50:14] You know, we have a huge research library and also a bunch of webinars, because another thing that we didn’t really get to talk about is healthcare practitioners also don’t know a lot about, we’re not taught in school.

[00:50:24] Kellan Finney: Yeah. Right. I mean, it’s the craziest thing. I can’t believe that it’s not taught

[00:50:29] Niclas Schlienz: in medical school.

[00:50:32] Our website on a great information there. And I want to say, like, this has been, I think what, you know, I, I don’t want to offend previous, you know, previous interviewers, but this has been like a really phenomenal conversation and just the way it started before we recorded and I’m like, man, like, I can’t wait to talk to these guys, you know, sending me, you know, Opportunity you know, to speak with you, Lindsey for, you know, going out to you guys cause grasslands.

[00:50:57] Awesome. Thanks for sponsoring the podcast. Lindsey.[00:51:00]

[00:51:04] Bryan Fields: We’ll link it all up in the show notes. Thanks so much, Nick.

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