Interview with Dr. David Bearman, American Academy of Cannabinoid Medicine
Could you give our readers a little background on your professional life? When did you start to become interested in practising cannabis medicine, and why?
My career is split almost equally between clinical and administrative medicine. I have worked at all levels of government: United States Public Health Service (USPHS), San Diego State University (SDSU), Sutter, Ventura and Santa Barbara Counties. I have over 50 years’ experience providing drug abuse treatment and prevention and helped start the Seattle Open Door Clinic, the third free clinic in the county, and was Co-Director of the Haight Ashbury Drug Treatment Program.
I have been in the practice of cannabinoid medicine for 20 years. I started practicing cannabis medicine in 2000, after retiring as Deputy Director from the oldest County Organized Health System (COHS) Medicaid Managed Care Program in the county, The Santa Barbara Regional Health Authority (now CenCal). I worked there for 17 years, first as its Medical Director and Director of the Health Services Department and later as a Deputy Director.
My first introduction to cannabis as medicine was in 1959 from my father, a pharmacist. He often discussed alcohol prohibition. He told me that when he was a pharmacy student at the University of Minnesota (UM) School of Pharmacy in 1928, that one of their assignments was to make a tincture of cannabis. He said that they had to be very careful because the alcohol was illegal’. I still have his 1927 Edition of Remington’s Textbook of Pharmacy. On page 999-1000 it tells you how to prepare tinctures of cannabis and that this is recommended for treating pain and anxiety.
I have learned an enormous amount by listening to my patients. I have treated a wide range of conditions and symptoms that have responded favourably to cannabis including Cohn’s Disease, Autism Spectrum Disorder, Parkinson’s Disease, fibromyalgia, migraines, seizure disorder, auto immune diseases, ADD, PTSD, analgesia. The list is almost too good to be true, but it’s true.
I am also an expert witness, author and public speaker. I have testified in court over 500 times, written 5 books and spoken throughout the U.S. and around the world on cannabis, cannabinoids, and the endocannabinoid system.
From your experience, what type of patients can particularly benefit from cannabis medicines? Are some patients better suited to cannabinoid therapy than others?
The American Academy of Cannabinoid Medicine (AACM), of which I am executive VP, did a study of 300 patients, 100 patients from each of three Cannabinoid Medicine Specialist. We found that analgesia was far and away the number one reason for which these doctors recommended cannabis. Anxiety was the second most common reason. In my experience, bed time is the most common time to take cannabis. This is likely because there are so many things that cannabis is relevant for but treats conditions that can interfere with sleep: not only pain and anxiety but ADD, PTSD, RLS and stress.
Patients who have done some reading about cannabis, cannabinoids, and the ECS, and have informed questions about cannabis, cannabinoids, and the ECS, make good patients. That said, the ideal patient is a person with an open mind, who approaches cannabis as the medicine it is and has been for over 4,000 years. It helps if they understand that therapeutic responses and side effects are dose-related. The better informed they are, the more likely the patient is to follow the universal cannabis dosage advice to start with a low dose and slowly increase the dose until either therapeutic effects are achieved or in the alternative the side effects are unacceptable.
Medicine is always a balance between therapeutic effects and new effects. The DEA’s Chief Administrative Law Judge in his finding of fact after a two year rescheduling hearing (1986-1988) found that cannabis was “one of the safest therapeutic constituents known to man”.
I spend about one hour with each new patient. Much of the time is educational, teaching them about the Endocannabinoid System (ECS) and the therapeutic attributes of cannabinoids and terpenes, discussing possible side effects and how to treat them, should they occur. I advise naïve patients to either call or make a follow-up visit to provide feedback on if or how the therapy is meeting their medical needs to discuss and any side effects they may have. We can use this commendation to discuss what dose adjustments, if any, need to be made.
You’ve written a number of books which provide much education for clinicians (and other interested parties) around cannabis medicine – from dosing to administration and beyond. Cannabis education shouldn’t just be left to pioneers like yourself though! What needs to change systemically, to ensure clinicians – and perhaps the wider public – are being sufficiently educated around cannabis?
Thank you for mentioning my books. I wrote them in an effort to put cannabis into a factual, historical perspective, to demystify and destigmatize this amazing therapeutic plant. CANNABIS MEDICINE: A Guide to the Practice of Cannabinoid Medicine’ is a good introduction for doctors, nurses, and the discerning patient.
Education and understanding the science are key to a clearer, more realistic view of the medicinal potential of cannabis. I have worked with various organizations including the American Society of Cannabis Physicians, Society of Cannabis Clinician, the Advent Academy, the American Academy of Cannabinoid Medicine (AACM) and The Compound. In an effort to educate the public, healthcare providers and medical cannabis patients.
We need to get this ECS education into the medical school curriculum. We are beginning to see several medical schools do research and/or teach about cannabis, cannabinoids, terpenes and the ECS. These schools include Washington State University, University of Colorado, and Thomas Jefferson University The University of California has cannabis research centers at four medical schools, UCSD, UCLA, UCI, and UC Davis.
Probably the most important thing that would highlight the research and contribute to the de-stigmatization of cannabis as medicine is for Dr. Mechoulam to receive the Nobel Prize for science or medicine. Other beneficial steps would be to put a couple of questions on the National Board Exams on the ECS. Lastly, Cannabinoid Medicine should become a recognized subspecialty.
You’ve previously held positions at various levels of government and have also testified as an expert witness on countless occasions. Could you tell us a little more about your experiences here? In your opinion, what needs to happen for widespread changes to oppressive drug policy?
You are correct that I have worked at all levels of Government. This includes federal: the USPHS; Counties: Santa Barbara, Ventura, Sutter; State: California State University (SDSU), Federal and local: Santa Barbara Regional Health Authority, a quasi-government Medicaid managed care program. I have served in local elective offices for 36 years.
There are several actions that can help move the ball forward to get cannabis more and more into the medical mainstream.
(A) Have WHO support rescheduling and/or more clinical research on cannabis
(B) Make rescheduling cannabis part of a major political party platform
(C) Have a prominent moderate support the rescheduling of cannabis. There currently are several conservatives and a few liberals on board
(D) Include teaching about the ECS in medical school curriculum
(E) Have more people of color serve in elective office
(F) Have either President Obama or Trump or both come out for rescheduling
(G) Have a famous person use cannabis to send their cancer into remission and let the world know about it
In addition to your domestic influence with regard to drug policy, you have previously travelled to New Zealand to provide expert insights on cannabis and cannabis medicine. Later this year, they will be holding a Cannabis Referendum. To what extent do you think you influenced the debate around cannabis in NZ to become more mainstream back in 2017? Do you think other countries should be taking policy decisions around cannabis to the public, and why?
I enjoyed both my trips to New Zealand and found the activists there to be smart and sophisticated. When I was in New Zealand, I said that the NZ Government, like the US Government, was lying to their citizens about cannabis. I said that Deputy Minister of Health, Peter Dunn, was speaking out of both sides of his mouth. This is because Sativex (a tincture of cannabis) was legal and available in NZ, but Mr. Dunn said cannabis had no medical value. It was clear that there two facts were incompatible. I understand Mr. Dunn now has ties to the cannabis industry.
Initiatives cut both ways and are never perfect. I voted for Prop 64 even though it was not perfect or what I really wanted in my heart of hearts. I voted for it because it was important for this initiation to pass; it let people out of jail and it was important to send a message that the largest state in the U.S. wanted to liberalize its drug laws.
A referendum offers a great opportunity for education. Even if it fails the first time, the referendum can help clear the air. It requires knowledgeable spokespeople to address the issues of science, to explain the therapeutic constituents of the plant and the human physiology of the endocannabinoid system. The campaign can speak to the unfairness of the laws and the way they are enforced against minorities and the poor. It’s an opportunity to decrease the stigma of cannabis. It should expose people to its history in New Zealand such as its medical use by Sister Mary Aubrey in the nineteenth century. She is on the way to being canonized.
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To hear more from Dr. David Bearman, check out the GCI Virtual Summit.