Interview With Dr. Tishler – Harvard Medical School Cannabis Doctor

Interview With Cannabis Specialist Dr. Tishler of InHaleMD

Dr. Tishler. A graduate of Harvard Medical School. His practice focuses on Holistic Care and alternative wellness. He’s spent years working with veterans and gives our readership his thoughts on marijuana. He’s an avid speaker at various cannabis medical events throughout the country and talks regularity about the health benefits of marijuana. His practice is called located in Brookline, Massachusetts.

Please tell my readership about yourself. Your background and how long have you been practicing medicine.

I have a very traditional medical background. I went to Harvard College and Harvard Medical School. I trained in Internal Medicine at the Brigham & Women’s Hospital in Boston. I’ve spent 15 years as a VA ER doc, which leads me to practice cannabis medicine.

When did marijuana become legal in Massachusetts?

Cannabis became legal for medical use in 2012. Of course, we didn’t have any dispensaries until 2015.

Do you believe the Trump Administration will be a positive or negative for the industry?

Well, I doubt they’ll be good for cannabis, but hopefully not negative either. I suspect they have bigger fish to fry, and the industry is large enough now that I think they’d have a hard time stopping it. I think they could stop REC, but not medical.

What ailments or diseases are best fought using the recreational usage of the marijuana?

There are no illnesses that are properly fought with REC cannabis. Cannabis, when used as a medicine, should be done with the guidance of a physician. There’s far more to patient care than just weed. Many patients and more every day are quite sick and have multiple things going on. Cannabis can be very helpful, but with complicated illness, this should be done carefully and safely.

That said, pain is the #1 best use of cannabis medically. Insomnia is #2. Anxiety and depression can be well treated too, but it’s very dose dependent and won’t effectively treat severe cases of either. However, cannabis works well with other anti-anxiety and anti-depression medications. Nausea and vomiting associated with cancer or cancer treatment, poor appetite, and weight loss are also important uses for cannabis.

Is cannabis addictive?

First, we need to note that dependence-forming is not the same as addictive. Cannabis can cause dependence, which is when the removal of a substance causes withdrawal symptoms. Cannabis can do this in about 7-9% of users. This number actually decreases as you get older, and is significantly higher for adolescents and young adults. This is part of the reason we don’t recommend cannabis for teens unless they are very ill. The general dependence rate is about that of caffeine.

Addiction is a maladaptive set of behaviors, like spousal abuse or robbing liquor stores. We don’t generally see this with cannabis.

Is cannabis more addictive than alcohol?

The dependence rate for alcohol is 15%, so roughly double that of cannabis.

Do you believe marijuana is a gateway drug?

I think there’s fairly convincing evidence that any drug can be a gateway to “harder” drugs. Likely this says more about the user than the substance. However, we know that more people go on to other drugs by starting with alcohol and cigarettes than cannabis.

Is marijuana more potent today than in the past?

Clearly, cannabis is more potent now than in the past. In the 1960s average THC levels were about 3% rising to about 8% by the 1980s. Now the average is over 20% with peaks in the mid-30s.

On the whole, I am not overly spooked by rising THC levels. There may be some validity to the concern that this might lead to great dependence, but we haven’t seen it yet.

I would add that there is a theory called the Entourage Effect that says that THC may be the main actor but needs the other cannabinoids like CBD and others to do its job. For medical purposes then, high THC is NOT better because it undoes the proper balance between these cannabinoids. I aim my patients for THC levels as low as we can find which currently is about 20%.

Is marijuana more carcinogenic than cigarettes?

This is a complicated question. The Tashkin study shows that over 25 years heavy cannabis smokers did not get the emphysema or lung cancers that tobacco smokers typically get. However, we know that most cigarette smokes typically get into trouble around 40 years of use, so 25 years of data doesn’t tell the full story.

If someone lives in a state that hasn’t passed the usage of recreational marijuana what advocacy channels do you suggest that person explore?

DPA.

Can cannabis make a person depressed? If so, what remedies do you suggest that patient take to correct their ailment.

There is some evidence that cannabis can make you depressed. There is also evidence that it can help treat depression. It’s pretty clear to me that this is about the dose. A little is good, too much is, well, too much.

Is vaping better than smoking?

We don’t have definitive evidence of this, but the idea is that vaporizing is safer because it doesn’t have all the junk that smoke has. However, not all vaporizing is equal. Vaporizing flower with a quality machine is clearly safest. Bad machines will combust the cannabis, defeating the purpose. Vaporizing concentrates by pen or dabs, or vaporizing oils in a pen is likely pretty unsafe as the non-cannabis ingredients can be dangerous when heated and/or the partial combustion of the concentrates themselves can produce dangerous byproducts.

As time passes do you see more rules and regulations governing marijuana usage becoming more stringent and onerous in Massachusetts?

Massachusetts is in the process of rolling out their REC regulations. I suspect they will be pretty good but will require refinement over time. My major concern is to improve patient access, medication quality, and physician treatment tools – all of which have largely been overlooked while our Department of Public Health has controlled the process, and which may well be overshadowed by REC in the coming year.

On behalf of our readership at Cheap Home Grow we would like to thank you, Dr. Tishler, for contributing your time to answering our questions.

Dr. Tishler is the CEO and founder Inhale MD.

Source: Cheap Home Grow
View Original Post