The Dime Episode 60 Transcript: Deciding on a Dose: Medical Cannabis Research with Dr. Jean Talleryand of MediCann

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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!

Bryan Fields (Twitter: @bryanfields24) and Kellan Finney (Twitter: @Kellan_Finney) broke down the Medical Cannabis Industry with Dr. Jean Talleryand of MediCann.

Dr Talleryand’s 20 years in the medical field make him an expert when it comes to Cannabis as a form of medicine. Listen now to hear Bryan, Kellan and Dr. Talleryand discuss the following:

  • What is The Dosing Project™?
  • Why is the medical industry slow to adapt to new changes?
  • How does one decide if medical marijuana is a good fit?
  • How are providers being educated on what products to pick?
  • What are the most common uses for Medical Cannabis?

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[00:00:00] Bryan Fields: This is the dime, dive into the cannabis and hemp industry through trends, insights, predictions, and tangents. What’s up guys. Welcome back to the episode of the dime as always. I’ve got my right-hand man Kellen Finney here with me. And this week we’ve got a very special guest back the T in the building back to tea.

[00:00:21] Thanks for taking the time. How are you doing today?

[00:00:23] Dr. Jean: Doing well. Thanks for asking me to be alive.

[00:00:29] Knowing how you doing,

[00:00:30] Kellan: doing well, just a Scott down and joined the 4th of July out here in Colorado. So it’s another sunny day. Just looking forward to the rest of the week

[00:00:39] Bryan Fields: for sure.

[00:00:40] Dr. T it’d be great to kind of get into your background and how you got into the

[00:00:44] Dr. Jean: space.

[00:00:44] So I first heard about cannabis in California during my residency, so that’s more than 20 years ago. I finished residency. I started in 1995 and finished in 92. Toward the end of my residency, I had a patient come to me and asked me to sign this form. And I guess I had known cannabis in college and pretty much dropped it from there.

[00:01:07] You know, medical school training is pretty rigorous and it’s tough to keep yourself together and be using regularly. So the patient really struck me because. Was not asking for opiates for his chronic pain. In fact, he was handing them over to me and asking me to sign this paper and said, that’s just fascinating as well.

[00:01:29] I, you know, I I’m trained in family medicine and was specifically looking at complimentary and alternative. Medicines. So things like traditional Chinese medicine puncture, so Canada’s fit right into the herbalism paradigm. And so really worked with what I was interested in. And here I was in Northern California watching the community using cannabis.

[00:01:53] It was perfect to learn more about it. So I signed a paper and the patient was pretty happy. Pain under control. And I said, wow, this big, you know people handing out, usually they come into your office and they’re asking for pain medicines or for hope prescriptions. And so this was before the whole crackdown on opiates.

[00:02:12] But to see this was really looking into the future and going, wow, this is going to change the medical industry as it’s still doing that.

[00:02:21] What year was that?

[00:02:22] That was 98. So my last year of residency, and then back then, there were some clubs in, that’s what they call them in San Francisco, Dennis Perone clubs.

[00:02:35] There’s a club called champs. And, you know, once they heard that, that I was a doctor willing to entertain their use of cannabis, that they. Budding to me. So I began to learn more from my patients and more about the plan and how it works. See that it had many benefits, including treating chronic pain,

[00:02:55] Now,

[00:02:56] Bryan Fields: let’s kind of dive into that.

[00:02:57] Obviously 98 was a very different time than we are now. Were you hesitant at the time to kind of sign off on that because you took a very different route than many of your peers would have taken. And some might’ve been very hesitant to kind of sign off on that. That would be the road less traveled. So can you kind of hear how you thought about that decision?

[00:03:18] That’s a tough one.

[00:03:18] Dr. Jean: Absolutely.

[00:03:19] Well, you know, complimentary and alternative medicine is also a bit less travel than surgeries, traditional pharmaceutical. Medicine. So I was already putting myself from their friend. Yeah. At first I kind of laughed at it cause I didn’t know the science behind cannabis.

[00:03:35] And I just saw you ask them folks just trying to get hot. But as I learned the science side, you know, and learn the impact. Wow. It really changed my spine. It was good to get introduced to, you know, some physicians that had been doing this for awhile, you know, since the seventies trying to advocate for patients like that.

[00:03:56] Yeah, I’ve heard and rattler Todd Mikuriya, who were really pioneers in California in being advocates for patients. But yeah, I definitely put me in the fringe of the medical world. It’s something I was probably born to be anyway. I’m third generation physician. So I came in. Medical school was a little bit of a chip on my shoulder and having grown up with dinnertime conversations on the medical industry anyway.

[00:04:24] So it fit me pretty well

[00:04:27] Bryan Fields: after that first patient did a second patient come with a similar request, because like you were saying, others kind of flooded towards you. You know, if you’re interested in kind of taking a different route than the opioids, and you’re looking for a doctor to prescribe medical marijuana, that likely could have been one where either it took a little while, or it could have been quickly after.

[00:04:46] So how long roughly.

[00:04:48] Dr. Jean: Well, you know what one friend tells two friends and then so on, and then pretty soon the dispatch history or the club gets to know your name and what wasn’t long. I took a, a break, you know, after residency, wasn’t long, probably around 2000, 2001. I was seeing more patients than I could handle.

[00:05:08] And I took a little break and eventually realized that, Hey, this could be a business, you know, of course. Training as a physician doesn’t necessarily make you a good businessman. So it took a little while for it to distract me. Oh yeah. I guess this could be a business. So we started medic Canon in 2004 and Medi-Cal essentially was the Referral service that said patients interested in medical cannabis to two physicians to evaluate

[00:05:38] them.

[00:05:40] Bryan Fields: Some of those other physicians that kind of joined the network were, were there some that were hesitant to kind of be a part of it, obviously from a research standpoint, there might’ve been not as abundant of information back then. So like how did you communicate to them? All these opportunities and upsides, because one of the area to we’re looking to expand on is kind of the educational gap and communicating all the possible values.

[00:06:02] But where did you go there?

[00:06:04] Dr. Jean: It’s still a work in progress 20 years later, just to, you know, heads up the medical industries, just getting around to this idea of computers are a good thing. We’re really slow and conservative in regards to adopting new ideas. And cannabis is definitely one. At first, it wasn’t great.

[00:06:23] You know, I definitely would run into the fringe physicians, you know, who were just doing it to make money or, or do something out of different rebellious and sort of trying to train them to apply the science was a little hard, but over time I developed. A method. And now it’s interesting because what my goal is is to train physicians, to be, you know, a little bit researcher, a little bit prescriber, you know, using the idea of an equals one, you know, a case to look at the patient that way, rather than me telling them how to use the cannabis and what mostly it’s about education, rather than talking to the patient rather than.

[00:07:07] Dictating what they’re going to do. And that’s a little hard for physicians. We’re so used to knowing all the answers, you know, so teaching them to sort of regain their scientific explorative training and really be, you know, a research scientist rather than. Prescribers in the field, that’s really the goal.

[00:07:25] So it’s still hard to burden physicians because relinquishing that powerful position is part of the, how you become a medical cannabis physician. But it’s a very interesting, and you learn from the patients and you end up. Sharing that educational approach, educating, educating patients in your interaction.

[00:07:47] So, yeah, I don’t know if your experiences, when you seen physicians, is that was what the approach they had or just kind of find the paper and see you later. But really that’s what I’m trying to get docs to do is document what the use patterns are, understand the dosage and get specific about what you’re treating.

[00:08:07] And really worked with an experiment patients with new products, burying products, too. I have, for an example, I did. And you can stop talking, but I will talk forever. That’s for an example, I have one of my early patients was a four year old girl, a little girl. Who had that Mannix Gusto syndrome that was made popular or famous with Dr.

[00:08:33] Gupta’s using Charlotte’s web, but I had that patient also, or, and and we did also notice how CBD was really stop her seizures. But the problem of course, with the industry is that the plant is married. And so we would get great results for several months. And then when the batch change and here comes the seizures again, and we didn’t know what the, what was wrong.

[00:08:59] Well, it is different where we, you know, what had changed in the batch and I’d ask the growers. Did you change? Are the turpines changing? Well, of course they’re changing. Yeah. Probably causing her to have her seizures come back. So that really highlights the biggest issue with the industry now is how to take a variable plan, multiple chemicals, energy, and getting it to something predictable where we dose it and where we can understand exactly what combination of active ingredients are affecting the outcome.

[00:09:34] Right now, she is 13 and Using Epidiolex. So she’s come full circle on it. And it’s working by the way, trying to convince her neurologist to use Epidiolex years ago. It was a no go. We’ve actually, they’ve come around and now she’s successfully being treated with.

[00:09:58] Bryan Fields: It’s an amazing story. And Kellen, I want to go to you because I got a question about the variability of the, and then the PR person response is hear you’re building up the product and the variability of the individual.

[00:10:08] Are those going to be counterintuitive when approaching the success of a product?

[00:10:13] Kellan: Yeah, I

[00:10:13] mean, at the end of the day, I think this is why a lot of people nowadays, especially myself, Kind of criticized big pharma for only using like a one chemical approach for treating illnesses. But at the end of the day, it’s the most sound scientific approach in terms of trying to get results.

[00:10:35] Right. Just change one variable at a time. With cannabis there’s instances where you will create a product. And just like Dr. T was saying in terms of the variability from a terpene perspective, but there’s a bunch of other final chemicals that are present in an extract from cannabis. And when you start changing 8, 10, 12, 20 different chemicals in a quote-unquote medicine.

[00:10:59] It really, really makes it challenging to have reproducible results from a treatment

[00:11:04] Dr. Jean: perspective. Yeah, absolutely. I think it’s going to be a challenging for pharmacology and pharmacology is not developed with that in mind. So it really is sort of breaking new ground in pharmacology, but very exciting because it could really produce a whole group of new medicines.

[00:11:26] With multiple active ingredients that are acting synergistically. So yeah, very exciting to, you know, grab a cannabis, maybe an old plant, but it’s really pushing our, our methods to newer methods. So excellent. Direction thickness. I think

[00:11:42] Bryan Fields: sometimes those newer methods are challenging for people and for older generations, particular to kind of adjust to the possibilities.

[00:11:51] Maybe I haven’t prescribed cannabis before medically for these patients, but who am I to kind of pull this option off the table for some of these individuals and these poor children that are suffering from some of these upper, from some of these diseases, because there is that challenge, like you were saying, Dr.

[00:12:06] T of like, understanding that true nuances of the plan and then prescribing it sometimes is looked at as like a last resort when unfortunately. It’s too far down the line. It should be considered as an option upfront in order to help these people, because we’ve seen early signs that are positive. Sure.

[00:12:23] There’s not been an overwhelming amount of evidence early on to kind of give a strong sample size, but the early indications are strong. How do we communicate? It’s small sample sizes as a powerful starting ground to a larger material.

[00:12:38] Dr. Jean: Well, that’s a great question. Yeah. We just have a handful of folks who are well, you know, to bring back my, my example of the little girl who was on multiple medications and the seizures were not going away.

[00:12:52] And as you know, had surgical procedures to try to stop the seizures and they weren’t working completely either. So in, in the end, when you’re out. Options and you sort of brought up you know up against the wall, you know, and there is this one option it’s working, it forces you to go into it.

[00:13:11] So that’s kind of what I think it’s going to do in some ways unfair, you know, it’s pretty safe. I think pretty, because I think often many people say it’s completely safe and, and, you know, there are incidents, instances of folks getting hurt by using cannabis. Now, something as simple as having a fainting episode, as, as you take a to-be for, while you’re driving, you know, things like that.

[00:13:39] That we don’t talk about very much. So there are negatives to it, but overall it’s pretty safe, especially compared to some of the pharmaceuticals

[00:13:48] Bryan Fields: that are out there to push back on Callan’s biggest enemy. And if you’ve listened to a podcast for Kellen versus pharma is a reoccurring theme here. So, I mean, big pharma obviously is not going to want to give up their market share because it is a really in dollar and it might be even understanding the financial impact.

[00:14:05] What role is big form of going to play in the advancements of medical marijuana? Can they be an ally or are they going to be kind of this back and forth enemy? So partner in this, I want

[00:14:17] Kellan: to just take one quick, second. I think they can be an ally, but I think that the benefit of having cannabis not institutionalized within big pharma provides one benefit at this juncture.

[00:14:29] Say there is something really negative that happens. And it happens to an individual who has a very strong legal team from an experience standpoint. They could come after and shut the whole thing down because say it’s a couple big companies doing. The liability aspect and the legal lawsuits and all of that will come in and just crush a lot, a big company because they have the bank account to pay those punitive damages.

[00:14:58] And so if something negative happens, having a fragmented space right now, while we still work out the kinks from a medicinal standpoint, Could potentially help the industry stay afloat and continue to move forward. Because at the end of the day, the reason big pharma focuses on one chemical medicines is because of liability and lawsuits.

[00:15:19] You know what I mean? And, and at the end of the day, they’re trying to develop a medicine to treat a specific illness that is variable within every human, because humans are all different, right? Like personalized medicine is a thing, but it’s gonna take time. And while we work out the kinks of understanding how you put the five keys in the lock, instead of just one key in one lock it’s best to kind of have that on the fringe where some angry person can’t go after all of the capital required to continue that company to continue to work out those kinks.

[00:15:51] So that’s, I’m just going to I’ll end it right there, but that was my one little pro pro thought about the big pharma being involved.

[00:15:59] Dr. Jean: Yeah, I agree with you that Rick farmer can be an ally, but it really is frame shifting. Well, you know, first we all have this sort of enamored vision of the magic bullet, right?

[00:16:12] The magic bullet that can do all, you know, in one. And it’s just not realistic, but it’s great for industry because if you happen to own and produce the magic bullet, then, then it’s very simple. And every time. Add an extra active ingredient. The complexity is exponential, right? And so it’s not just the linear it’s, it’s an exponent.

[00:16:36] So going down that road is, you know, as, as my partner Dr. Abrams say, it’s like going down the rabbit hole, you know, you can get lost very quickly trying to figure out what magic bullets or what active multiple activities. I will do. And then people are very different and that’s something new in the pharma.

[00:16:58] I mean, the whole idea of precision medicine, where we actually will do a genetic swab, figure out what type you are right now. If you’ve got high blood pressure, you know, there are a handful of medicines we might prescribe to you for high blood pressure, but we wouldn’t really swab your cheek and figure out what your genetic makeup is before we prescribe the medicine.

[00:17:20] And that may be the future. So that may be where pharma is going, where we’re, we’re getting more and more precise. We’re dialing in through multivariate analysis and understandings, which group of chemicals may work for your individual position.

[00:17:39] Bryan Fields: Well, I want to agree with both of you. I just don’t think that’s how real life works.

[00:17:44] Big pharma is interested in owning their moat. They’ve got a stranglehold on how it works. They want less variables because they want to control how it works and they want to control the prices because at the end of the day, Kaelin, while I’d love for that to be accurate about fragments in a protected meaning.

[00:18:00] You don’t care about these personal gratitudes for people and actually helping people. In my opinion, they care about dollar signs, right? Like, because the opioid manufacturers didn’t really care that people were having all these issues. They cared about dollar signs. And at the end of the day, my opinion, what motivates big pharma.

[00:18:20] Kellan: I know, but one thing to just remember when you kind of stand that is big pharma cannot own the moat because these are chemicals that nature makes right. They cannot patent chemicals from nature. So that is where the it’s the most challenging aspect. And so with Epidiolex, They own a formulation that includes all of these products from cannabis plant, and then they also own the genetics.

[00:18:44] They keep it under lock and key. There’s a ton more trade secrets involved in how GW does business than most pharma companies. Most pharma companies are like, here’s our patents. Here’s our acts. Here’s our, why it’s out in the open. And there’s more trade secrets in terms of, they only source there, the biomass from one cultivator, right.

[00:19:05] They had to do it this way because they have to control the genetics and it’s under super, super lock and key the exact environment that they are cultivating it because those are dictating the chemical profiles and they can’t own that. And so like, that’s the biggest obstacle. And I know there’s a lot of really smart lawyers involved in big pharma, but at the end of the day, they’re not gonna be able to patent th.

[00:19:28] They’re not going to be able to patent CBD. Right. And so it’s going to have to be this special formulation and they’re going to have to get creative and start adding in synthetic chemicals that are not ubiquitous to nature.

[00:19:38] Dr. Jean: I believe the Epidiolex is just CBD oil,

[00:19:45] Kellan: but it’s a formulation, right? CBD is not schedule one, but it’s what they did.

[00:19:51] And this is just smart lobbyists, right. Is what they did is they formulated a various mixture of CBD and other oils to create Epidiolex. And then the formulation of Epidiolex is what was rescheduled to, to schedule three or whatever. Right.

[00:20:09] Bryan Fields: Is it just CBD? Isolate? I thought there was turpines and some THC in there.

[00:20:14] Dr. Jean: No,

[00:20:14] because every time they thought of leaving those in the complexity, Yeah, so they just ended up now, there is a formulation, how to, how they got to it, how many milligrams per kilogram. And then of course, you know, making it stable, which is what the rest of the non-pharmaceutical companies, manufacturers haven’t quite gotten onto it.

[00:20:40] Make the same thing every time doing that when you’ve got multiple ingredients gets tricky, but yeah, at 10 milligrams to 25 milligrams per kilogram, which is a whopping dose by the way. And not really what’s available out there in the industry in terms of, you know, can you get that by going to start at dispense?

[00:21:00] Very hard to get that dose. It requires you getting, you know, a couple of hundred milligrams per tablet for an adult size. So

[00:21:11] Bryan Fields: did your endocannabinoid system evolve over time? For example, if you’re five years old and then you’re 25 years old, do you need a different sort of formulation in order to kind of still attack that same issue?

[00:21:24] I’m

[00:21:24] Dr. Jean: not sure if the endocannabinoid system changes over time, but your body weight changes and we prescribed medicines based on body weight. It becomes less of an issue as you grow older part, especially for children. You know, as they’re rapidly changing body weight, better adjust the medicines. To that, that’s why I said that, you know, milligrams per kilogram body weight, then that’s what we were using to try to dose the Lennox, Gusto kids who were having those seizures.

[00:21:55] Bryan Fields: Grandmom’s perfectly says that a many to many problems as we just continue down this rabbit holes. Let’s talk about consumers from a medical standpoint, what type of common issues are you seeing directed towards medical marijuana and kind of take us through just everyday conversations that our consumers are having.

[00:22:14] So for example, if someone is dealing with an issue internally, and they’re just not sure if medical marijuana could be a good fit, what sort of everyday things are you hearing that you, you can share with?

[00:22:24] Dr. Jean: So in terms of, you know, what are patients presenting to me with? Yeah. They’re, you know, the, I’d say the top four in the four corners of the yard are, you know, trying to improve pain, this sort of pain, you know trying to get sleep.

[00:22:43] A lot of insomnia up there improve anxiety. Or mood is really, you know, improve mood because, you know, anxiety or depression, improve mood and then appetite, everything to do with your guts. So those are the four corners of the world. You know, I was thinking about the other day, and I don’t know how geeked out you want to get with this, but it’s the autonomic nervous system, you know, if you think about the sympathetic.

[00:23:11] Fight or flight and the parasympathetic really controlling your your Your basic functioning involuntary functioning. There’s, there’s a link between them autonomic nervous system and the endocannabinoid system, which is where cannabis active ingredients are affecting. So it’s going to be interesting to sort of tease those two out, see how they would.

[00:23:34] Bryan Fields: Yeah, and I appreciate you breaking those up into the quadrants. So then I guess my follow-up question would be for someone like myself, who likely has all four of those issues, but would I be picking individual products to kind of suit that? So for example, in the, during the day, if my anxiety is running wild, I would lean towards this recommended product.

[00:23:52] And if I’ve got pain from my anxiety, then you would take this one. So is there kind of like the individual based approach you would take or how would you recommend. I usually

[00:24:01] Dr. Jean: start with the dominant, active ingredients in the products and really sort of trying to you know, present this THC. Or TMCA, you know, versus CBD or CBDA.

[00:24:14] So which one are you going to take one? Are you going to take the other, or you’re going to take a mix of the two and that sort of really helps the simplify because it isn’t experimentation. Right? So by understanding what THC does, what its effects are an advert. Affects it helps the patients, you know, choose one or the other.

[00:24:36] And I like to explain it to the patient this way. I’d like to, I say so the endocannabinoid system, imagine it as, as a car engine and engine is running and you’re going to be adding either fuel THC or oil CBD. So they work differently, but they both helped the engine work a little bit better or help a little bit better.

[00:25:00] So, you know, obviously, you know, a little gap and a little oil in the engine is better than just one or the other alone, you know, is sort of the assumption and probably pretty close to true. And so let’s start with those ingredients and w what you’re feeling and. What what it’s affecting. So it doesn’t have to be just, you know, this product is going to, you’re going to get better with anxiety by taking 10 milligrams of THC.

[00:25:27] That’s what I have to convince other doctors that we can’t be prescriptive prescriptive at this point. It’s going to take us years to really get prescriptive. We’ve got to be experimental and introduced. The players in the game and let them have the patient, understand the players and, and then start experimenting with dosing.

[00:25:47] And of course, starting low and creeping up discussing which modes of administration work for you. It could be that your headache gets better by rubbing a topic. Application on your forehead, or it could be that your headache gets better by taking a tincture or are smoking the flower. So it is not really one way, one path to getting the headache better.

[00:26:11] There are many paths and many active ingredients. So it’s, you know, what’s, what’s going to be your direction. Let’s explore. And that’s really, I think the best approach at this point, and maybe always the best approach with all the complexities of it. Eventually we’re going to get specific formulas, helping a large crowd of people where they’re going to be.

[00:26:33] We’re going to be able to say, okay, you know, five milligrams of THC and 20 milligrams of CBD. Alleviate the 90% of the headaches in this cohort of this core population. But at this point we are not there yet. We’re still trying to figure out I was telling those. We’re still trying to figure out how to categorize the different products out there, where to put one product versus the other.

[00:26:59] Bryan Fields: How did we get there?

[00:27:00] Dr. Jean: Wow. How do you tease apart a tag or math? You know, I think the, I love the crowdsourcing approach. I really love it. I think it’s a stroke of genius too, because we have the ability. To get information from the crowd. And let me explain it a little bit more. So traditional clinical studies follows a very specific route where there are four phases to studies from studying the safety of a particular active ingredient, all the way to producing the active ingredients, figuring out what dose works best for groups of people.

[00:27:36] And then. It works, you know, phase 1, 2, 3, once it goes through the different phases of clinical trial, the last phase is phase four, where it’s now the product is now out in the market and we’re gathering information on the safety. And the efficacy of the product from when it’s out there in the market.

[00:27:58] Well, cannabis really needs skips phase 1, 2, 3, and jumps into phase four. So it almost allows us to get information that feeds back to improving a product and then running it through phase one, two and three. Does that make any sense or am I talking to much. Yeah. So I love this phase four approach.

[00:28:19] People are trying it now. Let’s sort of sample the crowd, see what’s working for who and then sort of zero in on the magic formula up there. And then take that and then go through the traditional approach. Making sure it’s. In, in a group of people, typically phase one studies are just a handful of people.

[00:28:43] Phase two, three. If you’ve got, you know, a couple of hundred people in your study, that’s the large study phase four is sampling the masses and sampling everyone. So you get things like rare adverse events from phase four. That’s why you see certain products get released into the market pharmaceutical products.

[00:29:03] After going through phase one, two and three. They get released into the market. And then you find out years later that it’s being recalled because now that everybody’s got a chance to try it, we’re really seeing what the, what the problems are with it. Rather than that small study studies are models for the environment, but now we don’t need the bottle everyone’s using.

[00:29:24] We’re going to get the data from that and really get a good understanding of how

[00:29:29] Bryan Fields: it’s this, the dosing project. Can you kind of shed some light on how you think yeah. Is this, is this the dosing project? I was hoping you’d say the name, but now I just want to confirm, like, this is, this is the intention.

[00:29:45] Can you shed some light on that?

[00:29:47] Dr. Jean: Right. Right. So the promoting our research started the dosing project. We figured, you know, we, we started a research group thinking, okay, we want to get a lot of different companies collaborating on cannabis research to improve the industry and improve the medicine folks out there.

[00:30:07] The thought, okay. Maybe we’ll go through the traditional route, but it’s a very long and lengthy process and choosing which magic formula to bring through the traditional path is it was starting. I mean, how many different possibilities could be out there? I think people are trying that and they’re running into dead end because it’s like searching for a needle in the haystack with all this.

[00:30:35] So we just decided let’s sift the haystack through our fingers and see have the needle fall out, you know? And so let’s sample the crowds and see what they’re using and see what’s working that really what the dosing project is. So what we’re doing is basically crowdsourcing. We’re getting folks to try different products.

[00:30:54] We’re getting information on the product that they’re trying and how it works. And using that to come up with a good understanding of how many milligrams per kilogram of a magic formula that requires to improve pain and improve sleep. I was just going

[00:31:13] to

[00:31:13] Kellan: say, I think it’s a really cool time to be alive right now because of the infrastructure from a illegal and medicinal market standpoint at this, at this juncture, because this wouldn’t have been possible 10 years ago without the amount of testing and compliance.

[00:31:28] That’s been forced on the industry. Because now individuals can see exactly what the active ingredients are in the product, because they’re required to get a tested before they can sell it to the consumer. So that’s a, I think I just wanted to point that out to the general listeners, because I think that that’s a unique aspect that the dosing project is working with right now that wouldn’t have been possible 10 years ago or

[00:31:49] Dr. Jean: yeah, even 50 years ago, you know, because we can use the.

[00:31:54] And we can crowdsource a lot easier now than we could. 30, 50 years ago. It’s going to really revolutionize, I believe pharmaceutical development to a different paradigm of where, where we can use phase four information, much more rapidly to improve formulations.

[00:32:17] Bryan Fields: Can I be a part of the study. Do I have to buy certain types of products like medical versus black market versus recreational?

[00:32:23] Like if I’m interested in being a part of this study, is there a certain path you are looking to take purchase certain types of products and where I purchased them from?

[00:32:32] Dr. Jean: Well, you know, at first we just decided to just as a proof of concept, we decided to. Study, what most people are using out there, which is the flower smoking, the cannabis flower we’re able to to rapidly, you know, fairly rapidly just after 700 responses, but really after a hundred responses, we were able to see statistical significance and we’re able to see that there’s a group of people that had significant pain relief after.

[00:33:05] Smoking the flower, a high THC flower at an estimated dose of 0.9, four milligrams per kilogram. What does that mean to the it’s about three quarters of one grand joint. So if I talk to patients there, if I said, wow, you know, we’re, most of our patients are getting complete relief with that. A lot of my patients.

[00:33:27] I would have difficulty with that because that’s a lot to consume for some folks who are used to just taking a puffer to, and, and that’s all they can tolerate maybe because it makes them anxious to take more, the smoke bothers them. All sorts of reasons why they can’t take more. So it gets difficult for them, but those who are able to take it or have been reporting significant pain relief at that, at that dose.

[00:33:53] So it starts to put a stake in the sand and lets us know, okay, maybe this is something we can work with and develop, you know, products that are based on that dosage. Hence the name of the project, that dosing project, you know, it was crowdsourcing. Seeing what they’re using and then creating a dose effect relationship that we can communicate to the world so that they can predict what the product is going to do to

[00:34:21] Bryan Fields: them, for people who want to be involved.

[00:34:23] So people, listeners that are hearing this for the first time and being aware, is there, can they contribute? Do you want additional participants share some more information on that? So instead of Kellan and I fielding a hundred questions of people wanting to be connected, We can just send them directly to where it’d be most valuable for you.

[00:34:41] Dr. Jean: Yeah. We’re well, you know, we’re in the second phase of the docent project where now we’re getting, you know, we were sampling for proof of concept. We’re just staring. Cannabis because that’s, what’s available and that’s what most people are doing. But we are transitioning to specific products that are available out there.

[00:35:01] And yeah, we’re looking for sponsors who want to put their product into the dosing project to see. What comes out of it, what dose is really effective. This is a great opportunity for a sponsor to start to make label claims and begin to, you know, help the consumer, understand what the majority of people are experiencing with their product pretty rapidly.

[00:35:28] I mean, we were able to get significances in just six months of work where your traditional study takes years. So it’s a quick, fast way to get to an answer

[00:35:39] somewhere,

[00:35:41] Bryan Fields: but it’s the number one question you get asked when people find out your role in the industry?

[00:35:48] Dr. Jean: The number one question I get asked by my patient?

[00:35:51] Bryan Fields: Just if you’re walking the street, introduce yourself and say, this is who I am. This is what I do. What, what would be kind of like a generalized, common question you get approached with.

[00:36:03] Dr. Jean: Can I have your number and I make an appointment, honestly, that’s probably the, you know, it, it seems, and maybe I’m a little skewed being in California, but it seems that everyone has tried cannabis and understand that.

[00:36:23] Not everyone has looked at it from a, the medicinal viewpoint. And, and so, you know, folks who were struggling with, you know, the four corners, the anxiety, the pain, or they want to find something that’s working for them. And often pharmaceuticals have issues. And so it’s, you know, they’re interested. They want to interest in, and it doesn’t work for everyone for us.

[00:36:49] I mean, that’s, that’s normal, but to explore. And to go through it and see how it might work for you is, is pretty interesting too. And you know, we’re also uncovering old methods of, of using, you know, for example, in Jamaica, the medicinal way to use cannabis. Might be the, take a, the flower and boil it in water and then strain the flower out and drink the water.

[00:37:17] And this is what might be given to kids or elderly, whereas smoking, it may be more considered back. And so taking that medicinal and looking at the active ingredients, and if we saw that. Most of the ingredients were, are acidic cannabinoids, which are not active, but have potential anti-inflammatory anti-anxiety effects.

[00:37:45] So it’s interesting to sort of, you know, take the crowd and help them change the way they’re using cannabis or offer them different options so that you can dress through.

[00:37:57] Bryan Fields: If you could sum up your experience into a main takeaway or lesson learned to pass on to the next generation,

[00:38:04] what would that be?

[00:38:06] Dr. Jean: I really love this crowd sourcing approach.

[00:38:07] I think it’s going to, you know, using technology. Using computation to really dial into precision medicine. It seems very confusing to have all these ingredients, you know, many to many problem, all these ingredients and many different people with different chemistries, but we have. Technology now to sort of match people and create this better effect than the one size fits all approach.

[00:38:37] That has been the dominant way of the pharmaceutical industry. So I think that’s going to really exciting medicine down the road. It’s going to be the future. You know, where you are, personal your medicine is personalized and cannabis is going to be a great candidate for that. That’s what I’m looking for.

[00:38:56] Bryan Fields: Prediction of time, 10 years from now, medical marijuana, will it be accepted as widely as some of the other pharmaceutical ads forward? And if so, which area will be the biggest youth face?

[00:39:15] Dr. Jean: Well, sorry to say. I mean, I thought we would. I, you know, in fact, I, I would talk with the other doctors and we’d put that song on whether it’s going to be 10 or 20 years before things were going to really progressed to, you know, cannabinoids and other active ingredients in the plant being part of medicine.

[00:39:39] And I was on the 10 year side. But it’s been 20 years and we’re not even close. So I say, I don’t know, it’s moving slowly. So in 10 years, I think we’re still going to be trying to figure out the right pattern of, hopefully it moves. But it hasn’t so far, we’re still stuck in, in, you know, the fear of THC, the fear of the psychoactive or the and, and the unknown, you know, as doctors are, you know, conservative generally slow to progress to new things.

[00:40:11] So it’s going to be slow. W we’ll be maybe a little further on as we are now. Turns out science is hard.

[00:40:22] Kellan: I do think that it’ll be more accepted than it is today. And I think that’s just going to be a product of having legal cannabis available. And I think most states at that point. And so I think when. When you legalize it and recreational use becomes standard. I think people then, or who are skeptical about it in general, are going to have at least a curbed opinion related to the medicinal benefits of it.

[00:40:49] Right. And so I think, I think it will be more accepted, but at the end of the day, the complexity of the plant, I mean just the amount of chemicals and natural products within a typical cannabis plant over 400 from an active chemical ingredient standpoint. It’s going to take a lot of not only kind of phase four dosing project kind of trials, but we’re also, we, we forget to mention that there is an entire foundation of the endocannabinoid system that is still currently being built out from an understanding perspective.

[00:41:20] And a lot of this work needs to be done by institutions and universities, and that requires federal support and federal funding. And we’re only starting to barely see. This kind of research being conducted and yeah, there was a record amount of primary literature publications last year associated with an endocannabinoid system in cannabis, but it’s only the tip of the iceberg.

[00:41:41] And I mean, we’re talking like traditional pharmaceuticals had hundreds of years and especially in the last, I would say 75 years from the 1930s on. There has been, there’s been an exponential amount of primary literature associated with the, the human body and our understanding of it. And that’s how we’ve been kind of, we’ve been using all that information to treat individuals and develop new pharmaceuticals in terms of.

[00:42:06] The chemical structure of specific proteins that different chemicals fit into and cause these different reactions within the human body. So, I mean, it’s just, it’s a massive undertaking and it’s a mountain that needs to be climbed and it needs to be climbed in so many different fashions. And there’s just so, so many people that need to get involved to be able to kind of push this forward.

[00:42:29] It’s going to be an army of scientists. Yeah.

[00:42:31] Dr. Jean: That’s a great point, Kelly. And I really think that the collaboration. Is gotta be a big focus if we’re going to move this quickly. And yeah, if we’re going to do this in silos, it’s going to take a lot longer. So a good

[00:42:45] Bryan Fields: point. Yeah. We’re fighting so many battles on, on so many fronts.

[00:42:49] Right. And in addition to all the science and the research, it’s the stigma though, right? Like you can still have the conversation. With your physician about, Hey, like I’m in pain, I need help. And he’s like, here here’s opioids. And I’m like sick, thanks. Or he’s like, Hey, you interested medical marijuana. And even, even me, who’s in the space.

[00:43:07] It kind of feels different where like, it doesn’t feel the same type of conversation I’m having. And I think that starts with it being more widely accepted and more conversations happening in plain sight, more research coming out and more breakthroughs and understanding all these benefits. And over time that stigma will follow.

[00:43:25] We go away in 10 years. Yeah, you’re right. We’ve got a ton we need to accomplish in 10 years for it to be as widely accepted. And in addition, big, pharmacist’s not going to give up their wrong financial decision. Not in a way, man. They’ve got that. They’ve got the pockets of the lobbyists and money talks, right?

[00:43:42] So for them to be open to this, I think it involves them taking a different strategic opinion because obviously we discuss some of their challenges. I think that there’s so many variables, 10 years with all the challenges we have. I don’t think we’ll get there, but I’m also optimistic and hopeful that we can get there.

[00:44:01] They could be the

[00:44:01] Kellan: next Kodak though. Visual camera came. They never saw it. They’re like, no, come on. Hey, this is an optimistic

[00:44:09] Bryan Fields: opinion. We’re going to get a cease and desist letter from big format.

[00:44:19] Dr. Jean: But, you know, from a doctor’s point of view, if you look at the clinical studies that they’re producing on clinical studies.gov clinical trials.gov, you’ll see that most of the studies right now are about cannabis use disorder. You know, they’re not really looking therapeutic, they’re looking into, so it’ll show you that the perspective is still skewed, you know, from, from traditional medical perspective.

[00:44:46] You know, this use disorder, but not, you know, treatment oriented or, or beneficial.

[00:44:53] Bryan Fields: I traveled internationally with my, my medicine.

[00:44:58] Dr. Jean: I don’t think so. You know federally, I don’t, I guess there are some countries that have. Except it cannabis, but typically it requires a doctor’s approval and, and that doctor needs to be from the jurisdiction of where you’re going.

[00:45:19] And so. Try to go to a place and then get a an evaluation there. Even from state to state, you know, technically you can’t travel. There are some states that for example, Maine has a program where if you have your medical cannabis now from New York, you can go to Maine and apply and get that transferred to me.

[00:45:41] And then you can have access to the name that you’re going up there for the summer vacations.

[00:45:46] Bryan Fields: Sure. And I just kind of wondering out loud because my pain and my anxiety, when I get in the car and cross the state line, it doesn’t just go, oh no, this pain anxiety is just stuck in New York. You’re fine, Bri.

[00:45:57] Like you don’t go worry about it here in Maryland and Jersey life is good, but I mean, just traveling, right. If you’re going to go from New York to, let’s say Maryland, you’ve crossed over four states, like I’m just going to leave my medicine at home. I mean, that seems pretty rigid.

[00:46:09] Dr. Jean: It’s a very common problem.

[00:46:12] Yeah. I’m constantly having to coach patients on how they’re going to handle that. They traveled from state to state.

[00:46:19] Bryan Fields: Good thing. Anxiety has boundaries, right?

[00:46:23] Dr. Jean: Not state boundaries.

[00:46:27] Bryan Fields: See, thanks for your time for our listeners that want to get in touch and learn more. Where can they get in touch?

[00:46:31] Dr. Jean: Our research is at www dot the T H E C E S C, Charlie, Edward, Sam, charlie.org.

[00:46:42] So yeah, go to our website and see what fun things we’re doing. If she needed a recommendation go to www dot Metuchen, EDI, C a N n.com. W we’ll see what we can do to help you. Thank

[00:46:55] Bryan Fields: you very much. We’ll link that up all in the show notes. Take care, right.


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