Podcasts featuring Dr. Sherry Yafai

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UCSD's Conference from the Center for Medical Cannabis Research.   

  How each panelist came to cannabis

• You:     An ER physician for 20 years.  Your practice is now about 80% cannabis patients, ranging from 8 months to 99 years old. You also      mentioned your DCC-funded study, presented at the poster session, and      argued that pediatric and dementia patients are being left out of      research.

Where they get information

• You:described three prongs: PubMed, what's actually on the market (which      changes fast), and your own patients' outcomes. Your examples were THCV,  where all three line up for appetite suppression, and CBN, where they      don't, although THC+CBN for sleep works for many patients. You warned against relying on ChatGPT or UpToDate for cannabis.

Promising areas for cannabis treatment 

• You:     Neurologic and neuropathic conditions (Parkinson's, autism, PTSD, CRPS),      and opioid tapering, which you said has to be clinician-led rather than      patients figuring it out alone. You also mentioned the inflammation data      in people with HIV on antiretrovirals. Cannabis enables opioid tapering, where her chart      

Does cannabis relieve pain or just change the relationship to it? This was the liveliest exchange.

• You : disagreed with the "only perception" view. For neuropathic pain,      you've seen true resolution over 3–6 months, often with tapering use. Your examples were a 90-year-old with rib pain who is now off opioids and patches, and a post-op knee patient whose swelling resolved on CBD with a little THC.

Research they'd like to see

• You:     Topicals for skin disorders, absorption through G/NG/GJ tubes, and putting      cannabis clinicians on research teams. You criticized trials that use      250–500 mg CBD per day, calling those doses unrealistic and a likely cause      of the side effects and dropouts researchers then report.

Views on CBD

• You:     You'd rather the public use CBD than overuse THC, and you like CBD-dominant ratio products for working patients. You also said the hemp industry has corrupted it, citing delta-8 made from CBD and endometriosis suppositories that had      their THC removed after acquisition.

Drug interactions

• The real ones are tacrolimus, and high-dose CBD with valproate. An overlooked one is THC amplifying anticholinergic side effects in older adults. CBD with psychiatric drugs and mood stabilizers, and THC stacked with sedatives, hypnotics, and benzodiazepines.

The video accompaniment to the podcast

Keynote Speaker in Minnesota 2017 - Spring into Cannabis. 

Discussion about Cannabinoids, Hemp and the Emergency Department