06/05/19 Ethan Russo

Doctor Ethan Russo re CBD, hemp, vape pens, dabbing & more, Dr. Carl Hart dispels "radical" label & Dan Linn of Illinois NORML & legal weed

Program: 
Cultural Baggage Radio Show
Date: 
Wednesday, June 5, 2019
Guest: 
Ethan Russo
Organization: 
Doctor
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CULTURAL BAGGAGE

JUNE 5, 2019

TRANSCRIPT

DEAN BECKER: I am Dean Becker, your host. Our goal for this program is to expose the fraud, misdirection, and the liars whose support for drug war empowers our terrorist enemies, enriches barbarous cartels, and gives reason for existence to tens of thousands of violent US gangs who profit by selling contaminated drugs to our children. This is Cultural Baggage.

Hi folks, I am Dean Becker, the Reverend Most High. You are listening to Cultural Baggage on Pacifica Radio and the Drug Truth Network.

A little bit later we'll hear some thoughts of Doctor Carl Hart, perhaps a little editorial from yours truly, and some great news out of Illinois, but first up, we'll hear from Doctor Ethan Russo.

ETHAN RUSSO, MD: Currently, the director of research and development for the International Cannabis and Cannabinoids Institute. That's based in Prague, but I still live in Washington state.

DEAN BECKER: With that, we've begun the introduction of today's guest, Doctor Ethan Russo. He's an MD, he has a lot of credentials, a board certified neurologist, psychopharmocology researcher, and former senior medical adviser to GW Pharmaceuticals, which is perhaps the top dog of the medical marijuana industry.

With that, I want to welcome our guest, Doctor Ethan Russo. How are you, sir?

ETHAN RUSSO, MD: I'm fine, thank you.

DEAN BECKER: Doctor Russo, I wanted to put forward your credentials because you have worked with, and I hate to use the phrase, but the top dog of the industry, GW Pharmaceuticals. They've been headlong at this for over a decade now, have they not?

ETHAN RUSSO, MD: Well, yeah, actually, the company started in 1998, and I was a scientific adviser with them, starting that year, and came on full time in 2003 for the next eleven years.

DEAN BECKER: And they have put forward, I always try to pronounce this, Epidiolex?

ETHAN RUSSO, MD: Close. Epidiolex. So that was actually their second product. The first, called Sativex, was a spray in the mouth combining extracts of a high THC chemovar, chemical variety of cannabis, and a high CBD chemovar of cannabis.

Sativex is approved in thirty countries outside the US for treatment of spasticity in multiple sclerosis. Epidiolex is almost a pure cannabidiol product, and in 2018 it was approved by the Food and Drug Administration for treatment of two severe kinds of epilepsy, Lennox-Gastaut syndrom and Dravet syndrome.

DEAN BECKER: Well, you know, Doctor Russo, I think I knew that, that Sativex was the precursor, if you will, and had been available. I was lucky enough, and gosh, it's been fourteen, fifteen years ago, I interviewed Doctor Geoffrey Guy, who I think was then the chairman or head scientist or something at GW, and they put him on the airways back then, and we talked about Sativex, and how it's a two-pronged approach. Right?

ETHAN RUSSO, MD: Correct. Sure. So, again, GW was really instrumental in bringing cannabidiol back to the fore. Most people around the world had sort of forgotten about it since it was positively identified in 1963. It really lacked the excitement, if you will, of THC, which is obviously the main psychoactive ingredient in cannabis.

Along the way there were individuals, particular Raphael Mechoulam in Israel and the team headed by Elisaldo Carlini in Brazil that continued to look at cannabidiol for its anti-inflammatory and anti-convulsant properties. An anti-convulsant is a drug for seizures.

DEAN BECKER: Well, Doctor Russo, I, again, I wanted to bring you on today's show because there's an important issue that really needs addressed, it's kind of multi-faceted, and I'm going to try to jump into it here, but I was wanting to bring forward your credentials, your, you know, expertise, if you will, for the listeners out there, because there's a lot of discussion and a lot of, I don't know, opinions being put forward, but some of them I don't think are to be trusted.

Doctor Russo is author of Handbook of Psychotropic Herbs, he's co-editor of Cannabis and Cannabinoids: Pharmacology, Toxicology, and Therapeutic Potential. He's a man with those credentials, and with that, I want to jump right into it.

There is, even in Texas now, an approval or a forthcoming approval for CBD medicines, the federal government has been talking of, you know, allowing for CBD medicine, or the use of CBD, I'm not sure, they talk about, you can't say it's good for medicine, that kind of thing, and I just wanted to ask you, Doctor Russo, there's so many types of CBD, they're selling it in head shops and at gas stations and all kinds of places. Are they to be trusted, I guess is the first question?

ETHAN RUSSO, MD: Well, I think that consumers are probably going to be pretty confused by this situation, and for good reason, because this is a highly unregulated industry at this point.

I think that it's clear we're going to always have three echelons of products. There are going to be the rare pharmaceuticals, prescription medicines, like Sativex and Epidiolex, that have gone through the FDA approval process.

Then we're going to have supplements that are made by reputable companies that have some level of quality control that they can identify and provide to consumers.

And then there's just going to be the other products, which could be herbal cannabis, or something that your neighbor makes. Right now, with all the online commerce and everything else, we've got a lot of products that don't necessarily have the quality control behind them.

They may or may not have the CBD concentration that they purport to have. Some of them are going to have THC in them, even though they claim that they may not. A lot of these products are going to be produced abroad and they're going to be made from hemp refuse. What I mean by that is, the stuff that's left over once they've used the other materials, say for building or whatever else, and they're left with this mass of stuff that either would have gone to landfill or gotten composted, but they'll chemically extract it to get the CBD as a value added product.

But in the course of that, in order to concentrate the material to get the CBD, they're also concentrating pesticides, heavy metals, or anything else that might be contaminating that material.

But, you know, I personally would like to see some regulation of the industry so that the consumer can, number one, know exactly what they're getting, in other words have access to a certification of analysis to accompany the product that also would include safety data, something that would indicate that this material is free of pesticides, heavy metals, or bacteria for that matter that would pose a public health risk.

DEAN BECKER: Okeh. I appreciate that thought. It brings to mind that, you know, you talk about this refuse, the leftovers, being used. It seems like the less effective way to do it, and I guess my first question, or next question, would be, is the best CBD extract to come from the flowers, the leaves, -

ETHAN RUSSO, MD: Absolutely.

DEAN BECKER: - the seeds, are the seeds of use? How do those come in -

ETHAN RUSSO, MD: Well, yeah, let's look at the plant. The highest concentration of cannabinoids, including cannabidiol, is absolutely going to come from the unfertilized female flowering tops. That's the quality area for this kind of material.

The amounts in the fan leaves below the flowers are going to have about one percent. The trichomes - the place where these are made have about one percent of the content as compared to the trichomes that come from the flowers.

So, immediately, you've got a lower quality product, and it's not the same kind of profile, either. If we're talking stems, you get this down to a minute amount, and the seeds, if they're washed, although they can produce a high quality protein and essential fatty acids that are good in the diet, they have no cannabinoids at all.

Similarly the roots are devoid of cannabinoids, but have other products that have medicinal value. So there are many parts of the plants, and they have uses of their own, but, best medicine is going to come from the flowering tops.

While we're at it, we have to make a distinction between what's called a cannabidiol or CBD isolate, that would be some kind of concentrated form of CBD that supposedly excludes the other material, versus what's called a whole-plant extract.

An extract, medically, is almost always going to be more effective in that it would contain other ingredients, at least trace amounts of other cannabinoids and also the terpinoids, the essential oil components that contribute to the medical effect of cannabis.

DEAN BECKER: That brings to mind, we have had over the years the Marinol, which was a synthetic THC, which I guess -

ETHAN RUSSO, MD: Right.

DEAN BECKER: - had no CBD contained therein, and it didn't work because, as you're talking about, it's compounding, the multiplicity of the molecules, enhances its effectiveness. Right?

ETHAN RUSSO, MD: Quite true. Yeah. THC as a synthetic isolated drug has had very little uptake in the medical field because it's been poorly tolerated, it tends to produce dysphoria, an unhappy mood rather than euphoria. It's poorly tolerated even by people who may have been accustomed to using cannabis in the past.

So it's had limited use in treating vomiting associated with chemotherapy and previously in patients with AIDS wasting syndrome, but it's had very small sales in the industry because of these problems. So it's very different to THC that would come from a whole plant extract, directly from cannabis, which is a much more versatile and better tolerated medicine.

DEAN BECKER: All right, my friends, once again we are speaking with Doctor Ethan Russo, a very learned man, very learned doctor, and we're seeking his opinions about marijuana products.

Doctor Russo, I'm not going to ask you for a legal opinion, there are different laws. Texas is saying they're going to legalize hemp, they're saying they're going to legalize CBD, and yet it is the dispensary, the Texas dispensary, only makes CBD oils, they can't even sell the flowers here, and I guess what I'm leading up to is that, we have to be demanding, I guess, there are these stores even here in Houston that are selling CBD, but there's nobody who's really knowing what is going on.

And I guess what I'm really going to point to is that they're selling a one eighth ounce of CBD flowers, hemp flowers, for fifty bucks, whereas if you go on the web you can buy a full ounce for thirty bucks. It's - there's a lot of shenanigans going on. Your thought there, Doctor Russo.

ETHAN RUSSO, MD: Well, I have to agree. Again, I will go out on a limb and say I think that we have to have a descheduling of cannabis so that research can proceed unencumbered, and that patients in need can have access.

By the same token, I'd like to see regulatory oversight on all these products so the consumer doesn't have to regard it as a crap shoot when they go to a make a purchase of a cannabis product.

So I'd like to see those two things happen. But it's a big ask, because there's a tremendous amount of ignorance out there, and a tremendous amount of prejudice attached to this medicinal plant.

DEAN BECKER: No, I agree with you. There's even a different extreme, if I can explain it properly, and that deals with folks, and again, I love marijuana, I smoke it every day, I think it's the best thing, you know, medicine there is, but there are those who, you know, go a little too far, I think, calling it a sacred plant, it's not a medicine, it's, leave us well enough alone, et cetera.

There's a middle ground there where rationality comes in. Your thought there, Doctor Russo.

ETHAN RUSSO, MD: Yeah, I agree. I think anytime you go to extremes, one way or another, it's not necessarily going to be the best policy.

But, prohibition has never worked, it certainly hasn't with respect to cannabis, and we need a situation where people can have access to the medicine they need and have confidence in its quality and safety.

DEAN BECKER: Okeh. One more point hinging on that thought about the sacred plant and everything. We have to also maybe back the truck up a bit. Take a look at this. I smoked Marlboro's for fifty years. I have COPD, I regret every damn cigarette I smoked.

But the point I'm looking at now is I see these kids with these rigs they've got, and the anvil and a blowtorch, and they're doing these dabs and they're taking these massive choking hits. Maybe that's good for youngsters, maybe that's good for a little while. Is it good for a lifetime? Your thought, Doctor Russo.

ETHAN RUSSO, MD: Well, I don't think it's good, even on a temporary basis. Quite frankly, a lot of this behavior is a byproduct of prohibition. What I mean is, in prohibition, yeah, there was some beer, but the prevalent item was bathtub gin. And that was a high potency material.

If you're going to have to lug around a product that you've got to hide from the police, it's better if it's high potency, and the same applies to cannabis.

So what we had the last several decades is selective breeding for high THC cannabis to the exclusion of cannabidiol or other components. So the popularity currently of these concentrates and dabs is just running that kind of trend to an extreme.

So you've got materials now, some of these concentrates can have seventy-five to ninety percent THC, to the exclusion of CBD. Generally they're devoid or have minimal terpinoid content.

What's going to happen with that is, you'll have all of the possible side effects attached to THC without benefit of the other components that will temper the experience and increase the safety factor.

So, when someone uses this kind of material, there is a risk that they're going to have a condition called orthostatic hypotension. This basically is a faint. The sudden release of high content of THC slows down the heart enough, what's called vasovagal reaction, that it causes the person to faint. They basically have inadequate blood flow to the brain and they pass out.

In the meantime, they may fall, hit their head, end up in the emergency room at the hospital, having incurred huge expense, and scared a bunch of people. The condition will pass, but it's totally unnecessary.

The other problem with these concentrates is they provoke the rapid development of tolerance. Tolerance means that, if somebody uses this kind of material regularly they're going to have to use more and more to attain their desired level of high.

In use of cannabis, whether it's recreational or for medical purposes, the smallest dose that does the job is the correct dose. And that is best achieved with a whole cannabis product, preferably in a small dose.

With that, particularly if CBD is aboard, there's little risk of developing tolerance and these other side effects. That would be the proper way to use cannabis.

DEAN BECKER: All right, thank you, Doctor Russo. I've got one more question for you, sir. I see the ads, people trying to sell the vape cartridges, the little, you know, for your pen vaporizer. And, I see the warnings, there's a lot of them that are found to contain high levels of lead and other toxins. We - you talked about it, prohibition is just not the way to control or prevent these problems.

ETHAN RUSSO, MD: That's true.

DEAN BECKER: Go ahead, sir.

ETHAN RUSSO, MD: Sure. So, yeah, it is true to say that these vape pens can't be beat in terms of convenience and how rapidly somebody can get high and how easy it is to hide.

So, it's very attractive, particularly to young people. But, it just is not necessarily the best way to use cannabis, and certainly isn't recommended for medical use.

Most medical conditions are going to be chronic, where cannabis is used, and under those conditions it's best to use an oral preparation that's going to have a longer onset of activity, and is less likely to produce an overt high. The idea is to treat the symptoms, not to alter one's consciousness in medical applications.

So, in order to have best practices, we have to buck this trend of higher potency THC to the exclusion of other things, and this particularly attractive and simple delivery device is a very insidious proposition. So, again, improvements are going to come through education, but also regulation.

So that is what I'd like to see happen.

DEAN BECKER: I'm with you, sir. You know, I talk about it's time for us to finally control our supposed controlled substances. Would you agree with that thought?

ETHAN RUSSO, MD: Right. Prohibition is the worst method of control.

DEAN BECKER: Well, it certainly is. Well friends, once again we've been speaking with Doctor Ethan Russo, a medical doctor, written several great books. Doctor Russo, some closing thoughts, a website you might want to share.

ETHAN RUSSO, MD: Well, further information would be available on the International Cannabis and Cannabinoids Institute website, which is ICCI.science.

DEAN BECKER: It's time to play Name That Drug By Its Side Effects! Rash, hives, difficulty breathing, tightness in the chest, yellow eyes, swelling of the tongue, hoarseness, dark urine, fainting,, fever, irregular heart beat, mental or mood changes, seizure, and death. Time's up! The answer, from the UCB Group: Xyzal, for asthma.

DAN LINN: My name is Dan Linn, and I'm the executive director of the Illinois chapter of NORML, which is the National Organization to [sic: for the] Reform [of] Marijuana Laws.

DEAN BECKER: Well, the news is that Illinois is to become the eleventh state to legalize marijuana. Tell us what that means for your state.

DAN LINN: Well, we will be taking this market that already exists in the illegal sector and bringing it above the table to the legal sector. We will be able to create jobs with this, increase tax revenues, as well as expunge a lot of criminal records for folks who were caught with low level amounts of cannabis.

We're talking about 800,000 people with those arrests records in Illinois that will be getting wiped clean.

DEAN BECKER: Now, when will this take effect? And who will be able to buy?

DAN LINN: Adults over 21 will be able to purchase up to about an ounce of cannabis on January First, 2020.

DEAN BECKER: Will folks be able to grow their own at home or not?

DAN LINN: Only patients that are registered in the medical cannabis program will be able to grow up to five plants, but out of state residents would be able to purchase about half of the amount that an instate resident would be able to buy, so you're looking at about a half ounce with a little bit smaller amounts of edibles and concentrates that out of state residents could buy in Illinois.

DEAN BECKER: Now, I'm aware that in several of the states that have legalized there's big discussion, brouhaha if you will, to make allowances for legal places where people could smoke, in essence like a bar, so to speak. How is that going to align in Illinois?

DAN LINN: Yeah, the state didn't carve out a specific license for those types of social consumption facilities, but they do allow local municipalities and regulating bodies to create, well, it would be kind of like a hookah lounge or a cigar shop or a private club where you're, at least in theory right now, people could publicly consume cannabis at those facilities.

DEAN BECKER: Now, this will allow for growth of marijuana flowers then to be sold, but will it also allow for extracts and any of these other derivatives?

DAN LINN: Absolutely, and it does have a specific license for the processing or production of those products.

DEAN BECKER: Okeh. Now, I know the law enforcement community is striving desperately to find a means to determine those who are incapacitated while out driving on the roads. What is that situation in Illinois?

DAN LINN: There's some language in the law about a validated sobriety test. Right now, what we're advocating for is a standardized field sobriety test, similar to the one that most people are familiar with, with walking the line, standing on one foot for thirty seconds, saying the ABCs backwards. We feel that that, coupled with a dashcam video, will be able to keep our roads safe and still allow prosecutors to prosecute somebody who's impaired behind the wheel.

DEAN BECKER: Let's talk about what it took to get to this point for Illinois. You know, I share my show with stations around the country, heck, up into Canada, and I'm in Texas, but we're - we're F'd. We can't do a thing here until these politicians get off their butts.

But what did it take to get this done in Illinois?

DAN LINN: We were in a similar situation. We couldn't put it to the ballot and the voters, we had to go through the legislature. This was the product of close to twenty years of lobbying at the capitol, holding educational and informational meetings, seminars throughout the state.

But really it was about having lobby days at the capitol, getting voters and constituents to meet with their elected officials, talking to them about the need for change. We were able to get a medical cannabis law passed, after that we were able to get a decriminalization law passed so that people would no longer be arrested for these low level possession amounts but just be issued a ticket.

And then ultimately we were able to make it where people were able to purchase this at a legal storefront, and consume it in certain places.

DEAN BECKER: All right. Well, Dan, I want to thank you. Once again folks, we've been speaking with Mister Dan Linn, he's the executive director of Illinois NORML, that's NORML, out there on the web. Thank you, Dan.

DAN LINN: No problems, it's a pleasure talking with you.

DEAN BECKER: Major media does not treat the drug war fairly. Doctor Carl Hart doesn't like that attitude, and the way it tries to dismiss the credentials or credibility of drug reform. The following is part of a recent interview he did with Global Health.

INTERVIEWER: He has a different and what some would say radical and controversial approach to drug policy. He is joining us now to explain what that is. Carl, thank you so much for joining us.

CARL HART, PHD: Thank you for having me.

INTERVIEWER: Yeah. We've been chatting during commercial break about some of your views, but to include everyone else in on the conversation, what are some of the myths, the commonly held myths that people have about drugs and drug addiction?

CARL HART, PHD: Before dealing with the myths, I'd just like to say something about the introduction. So, like, when people introduce me as radical or controversial, that kind of sets the frame for the audience to see me in a certain light, and we must understand that I'm the chair of my department at Columbia University. I'm a scientist who's published hundreds of papers in the scientific literature.

So, that's not radical. My perspective is evidence driven.

INTERVIEWER: Okeh.

CARL HART, PHD: And so, because the perspective is not held by most people doesn't mean that it's radical. It means that those people are ignorant.

INTERVIEWER: Okeh. Fair enough.

DEAN BECKER: Just a few seconds left for this Drug Truth Network editorial.

These politicians, nearly all of them, know the truth about the drug war. They made their bones through this policy. It's hard for them to back down now. But I know if you, their constituents, go before them with the evidence, the truth, the scientific papers, and the ability to show they are immoral, they are off base, they are allies of terrorists, cartels, and gangs, and they are ensuring more overdose deaths of our children, eventually they will come around.

I remind you, once again, because of prohibition you don't know what's in that bag. Please, be careful.

To the Drug Truth Network listeners around the world, this is Dean Becker for Cultural Baggage and the unvarnished truth. Cultural Baggage is a production of the Pacifica Radio Network. Archives are permanently stored at the James A. Baker III Institute for Public Policy. And we are all still tap dancing on the edge of an abyss.