Below is Dr. Mitchell's latest article published in Cannabis Connections of Maine for the November/December issue. ENJOY!
Why is The Cannabinoid Tail-- Wagging the Endocannabinoid Dog
Why, then, is the science behind the ECS not taught to Medical Providers?
As a licensed physician, I must take Continuing Medical Education (CME) courses in order to recertify my license every two years. I did a CME course recently to find out that not one of the 19 hours of lecture dealt with the Endocannabinoid System (ECS). What’s that? And, yes, you have one!
For 50 years, we’ve put politics over science. A political by-line “War on Drugs” forced a number of bad decisions whereby medical schools would lose funding if this ECS was taught to our healthcare professionals.
Cannabis in 1970 was designated as a Schedule I drug. In this category of drugs, they have no medical purpose. For cannabis this has been false by the fact that the United States Government holds a patent on CBD as a treatment for dementia going back to this misplaced decision.
This restriction continued until the most recent past. On December 20 of 2018, the Farm Bill was passed by Congress which made hemp legal for the first time in over 50 years. Research on this age-old botanical was restricted, except by the United States Government and the University of Mississippi, after its misguided placement of cannabis into the Schedule I category. WAKE UP!
Ethan Russo, MD, a world-renowned expert on the ECS, says: “There are more cannabinoid receptors in the brain than there are for all the other neurotransmitters put together. The implication is simple and important. The ECS has the potential to have a powerful impact on the body. It’s a significant part of the makeup of every human being, and it has a substantial effect on our health. There is, therefore, no good medical reason not to teach doctors about its capabilities. And yet most healthcare providers, do not know that this system exists, which is the saddest commentary of it all!
The endocannabinoid system, or ECS, is a signaling system present in all mammalian bodies. It is comprised of two kinds of receptors—CB1 receptors, which are mostly located in the Central Nervous System, and CB2 receptors, which are primarily found in the Peripheral Nervous System. The Endocannabinoid System plays an important role in regulating such things as sleep, mood, appetite, fertility, and memory. It can also be linked to the management of chronic pain and stress. Humans make at least two endogenous cannabinoids (2-AG and ANA) in our body, when necessary, because that is what helps to run the ECS.
“Don’t want to throw the baby out with the bathwater”, because we have kind of walked into this ECS backwards, where THC and CBD are now being commercialized and monetized without the connective science!
If you go to the gas station to get your CBD and to your local cannabis store to get your medical cannabis, you may not be getting what you think you need to get. This is why we need to put the science, the “horse before the cart”.
I have used a number of idioms which are probably familiar to most of you, because I want to bring back a sense of sanity to how we move forward in supporting our ECS education and support the research that needs to get done. The Federal Drug Administration (FDA) continues to hold back and obstruct and ignore the signs that this supplement is critically important as the neurotransmission, balancing system, which controls and affects us in many, many ways.
When are we as healthcare providers going to stop sitting back and start “barking like a big dog” about the ECS and start giving and taking courses on the ECS. We need to get the up-to-date research that’s out there that has been avoided, overlooked, and ignored.
It’s our patients that are at risk. And we have taken a Hippocratic Oath that says we should “Do No Harm.” Silence is complicity! This is neglect of forcing the FDA, forcing medical schools, forcing healthcare providers to learn, and understand this ECS biological system that has theoretically been ignored over the course of the last 50 years. WAKE UP.
WAKE UP to the science that has been ongoing around this Schedule I narcotic for a considerable period under the government’s purview. In 1999, four scientists from the National Institutes of Health (NIH) applied for a patent on CBD! Their research found that this phytocannabinoid known as cannabidiol (CBD) was a great brain antioxidant that helped to protect the brain and was denoted as a neuroprotectant in aging and trauma.
This patent 6630847B1 also stated that this cannabinoid was neuroproliferative. It helps to mend and repair the brain. The patent was granted to Health & Human Services (HHS) in 2003.
Take Traumatic Brain Injuries (TBI) which are more common than you think! More than 10 million people worldwide die or are hospitalized yearly from TBI. It’s alarming how little information exists regarding treatment for TBI because it was considered a concussion for many years and passed on as a minor event.
Military troops often return from combat with TBI and athletes of all ages who participate in contact sports are especially prone to experiencing TBI from pee wee football to the professional ranks of multiple sports. Also, TBI is the leading cause of death for seniors as a result of falls.
What is a TBI exactly? The term in itself is explanatory as a trauma to the skull that is significant enough to cause an injury to the brain. However, its effects are much more complex as the brain is an intricate organ with a vast conglomerate of functions. The long-term sequelae will depend on what part of the brain is injured in this traumatic event.
Bringing it home, TBI accounts for millions of deaths and hospitalizations each year in the US. The majority of them are considered mild and, unfortunately, don’t go on to receive medical treatment or intervention. The intensity of a TBI varies on a scale from mild to severe. The symptoms fluctuate accordingly and are also dependent upon the location of the brain where the injury was sustained. If the brain injury wasn’t severe enough to cause a coma or immediate persistent vegetative state, a TBI can cause eventual cognitive, psychological, and sometimes even physical problems that ultimately impede the quality of life.
The ECS regulates a variety of bodily functions such as mood, memory, fertility, appetite, hormones, and responses to pain or stress. Our receptors are activated by neurotransmitters called endocannabinoids. Our body produces its own, however, we also react to external ones as well.
Phytocannabinoids, Phyto meaning plant-derived cannabinoids, also attach to our receptors that initiate a physiological response. Essentially, our receptors are the lock and cannabinoids are the keys that unlock the neurotransmission feedback.
THC and CBD both possess neuroprotective qualities and have the potential to steer the brain in the right direction amidst the chaos of TBI. Studies are underway that are researching just this and are showing promise that using cannabinoids can alleviate many of the effects of TBI especially when utilized immediately following the TBI injury. Cannabinoids can greatly reduce initial brain swelling and also adjust the ECS enough to compensate for the pain, anxiety, and depression caused by TBI injury.
WAKE UP to this science especially for those who have turned to addictive substances to relieve themselves of the anguish of TBI. Ask your healthcare provider what they know about the ECS system.
Eric I. Mitchell, MD MA FACPE CPE