Dec. 5, 2018
Seneca News
The cannabis doc is in
Q&A with a Seneca health physician about marijuana
Dr. Michael Verbora doesn’t just talk a lot about cannabis. As a cannabinoid expert and a member of the Canadian Consortium for the Investigation of Cannabinoids, he has completed more than 2,000 cannabinoid therapy consultations and presented many talks in community and hospital settings.
Verbora is also a health physician at the Seneca Health Centre at Newnham Campus, Chief Medical Officer at Aleafia Health and Medical Director at the Canabo Medical Clinic.
Since cannabis became legal in Canada two months ago, Seneca has sent out emails to employees and students about what is and is not permitted on campus under the new legislation. This week, SeneNews sat down with Verbora to talk about cannabis, its use and how the human body can make its own cannabis molecules and help with healing.
SN: What can doctors prescribe cannabis to patients for? What are the side effects?
MV: Chronic pain, severe insomnia, nausea and vomiting with chemotherapy and severe epilepsy. Different forms of cannabis have different side effects. High cannabidiol (CBD) — a cannabis compound with significant medical benefits — is well tolerated with minimal side effects. Tetrahydrocannabinol (THC) — the main psychoactive compound in marijuana — can cause cognitive impairment, motor slowing and rebound anxiety/paranoia. In rare circumstances, it can cause psychosis. Higher dosages pose higher risks.
SN: Is it the same to just smoke cannabis at home when you feel pain?
MV: Maybe! Depends on what the physician would prescribe you. Most physicians don’t recommend smoking, which is a harmful method of consumption. Also, higher CBD with lower THC has less side effects and is often used for some forms of pain while higher THC is used for other forms of pain. Pain is complicated as it involves biochemical and cognitive experiences unique to each individual. There’s no one size fits all for chronic pain.
SN: How does cannabis make people feel?
MV: Relaxed, calm, happy and hungry. If too much is taken, you can get the opposite effects of anxious, worried, paranoid and scared.
SN: What is the endocannabinoid system and how does it relate to cannabis use?
MV: It’s a fascinating system that regulates our entire system of homeostasis — the state we heal in. We all make cannabis molecules in our body, and activities like singing, yoga and exercise boost cannabinoid levels in our bloodstream.
Endocannabinoid receptors are all over the body but found predominately in the brain and the immune system. This makes brain and immune diseases both potential targets with the cannabis plant. Some research suggests people suffer from headaches, chronic pain or irritable bowel symptoms because their endocannabinoid system is not well balanced (e.g. deficient).
SN: Why is cannabis so stigmatized and what are some of the misconceptions?
MV: We’ve been misled for many years about the truth on cannabis. We’ve been told it’s a bad drug that causes harm and all sorts of dangers to individuals and society. The next 20 years will be exciting to get contrary data on what cannabis can do for many people’s health and wellness.
SN: If you don’t need cannabis for medical reasons, are there any health benefits to using it recreationally?
MV: That’s a tough question! There isn’t enough science yet to say, “a puff a day keeps the doctor away,” but there are many researchers and scientists who have strong beliefs that cannabis, when taken in moderate dosages, not smoked, might be protective to our overall health and well-being.
It’s important to note, many people turn to cannabis to help with stress, anxiety and insomnia. There are better, safer and more natural options than cannabis, such as mindfulness, meditation, sleep hygiene, yoga, exercise and singing, all of which help optimize our body’s ability to make its own cannabis molecules and help us heal.
SN: What are the different ways in which people can and/or should consume cannabis?
MV: Most people either inhale or ingest cannabis. Inhaling is best used with a vaporizer to avoid toxic byproducts of smoke, such as benzene, which is a carcinogen. Smoking has been associated with higher incidences of bronchitis. Vaporizing appears to be safer based on recent data. Ingesting is a smokeless way of getting the effects of cannabis and can last a lot longer than inhaling — six to eight hours compared to two to four hours with inhaling. When ingesting, it’s important to start at low doses and don’t take extra doses until another day. The side effects of too much orally ingested cannabis can be very unpleasant. It’s a rookie mistake to take a second edible/capsule/oil dose while the first has not kicked in yet.
If you inhale cannabis, don’t drive for four to six hours. If you are pregnant, breastfeeding or have unstable mental health, it’s recommended that you don’t inhale cannabis at all.
SN: Can you develop cannabis addiction from medical use?
MV: True cannabis addiction is very rare. What we see is cannabis use disorder, a slightly milder form, but nonetheless, it can have detrimental impacts to an individual’s health.
Cannabis use disorder can occur in about nine to 11 per cent of the population. If you start to use cannabis daily to cope with stress, you begin to forget the proper coping mechanisms. It might also make people lack motivation over periods of chronic use. If you are worried about this, you should check in with your doctor to discuss safer use patterns.
Cannabis can mask a lot of symptoms, which can help temporarily, but it’s important when it comes to chronic issues that we get to the root cause and deal with the issue through exercise, nutrition, cognitive therapy and other modalities.
SN: How has the medical cannabis industry changed since the legalization of cannabis, if anything?
MV: It’s still too early to comment on this, but so far, we’ve seen more patients asking for medical cannabis. As the stigma decreases and this becomes more “mainstream” over time, people will feel more comfortable talking about medical cannabis and how it helps them with their health. We expect the medical use of cannabis to increase immensely over the years, especially as new ingredients are discovered and tested for a host of conditions. We are in a renaissance of cannabinoid research and that’s exciting.