Be Informed. Be Well. Episode 40: A Pharmacist Answers Questions About Cannabis with Leah Johnson, PharmD

This week’s podcast as John Malanca interviews Leah Johnson PharmD, RPh, the “Holistic Healer.”  They discuss the impact of Eastern and Western treatments and the pharmacologist’s evolving role in cannabis therapeutics, holistic healing, and health delivery.

John Malanca and Leah Johnson PharmD, RPh, the “Holistic Healer,” discuss cannabis and much, much more.  Her interest in science and how molecules work together in the body earned her a Doctorate in Pharmacology.  In this riveting discussion they talk about everything from drug to herb interactions, the impact federal prohibition has on patient’s healing and symptom management, along with the evolution of synthetic cannabis and big pharma’s attempt to reinvent this remarkable plant.  They also discuss dispensaries and their role in health care, the endocannabinoid system and its regulatory uniqueness, dosing, drug to drug interactions and current trends in cannabis therapeutics.  Her views are fresh and fascinating in this entertaining and information packed interview.  Grab your pen and paper because you will want to remember her lessons.  Leah is an engaging, expert educator. You’ll learn more than you thought in this week’s podcast with John Malanca and his guest, Leah Johnson PharmD, RPh, the “Holistic Healer.”

Be Informed. Be Well.

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Transcript

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John Malanca 0:01
Welcome back John Malanca here with United Patient Group Be Informed. Be Well. and we have a pharmacist on today. Dr. leya has his Princess Leia Johnson. She's also known in the cannabis community as Dr. Leah the holistic healer. She's a trained clinical cannabis pharmacists, psychologist but pharmacist and the owner and CEO of alkemist Consulting. She's an accomplished highly driven, clinical Long Term Care rehab pharmacist with primary focus in pain, mental health, depression, anxiety, insomnia, etc. and sexual health medication management. She also holds three patents which I want to hear hear about, for natural herbal remedy tinctures which she's helped developed as the head of research and development for herbal supplement company. You're based in California here, right?

Leah Johnson, PharmD 0:59
I am, my herbal supplement company was back east in Connecticut.

John Malanca 1:02
Gotcha. Okay, that's right. And we have we have a Brian a center. We're a sensor who's been on the show to a small world so we have mutual friends there but Dr. Lay believes that complete physical and mental health and well being can be influenced by utilization of cannabis as well as other herbal remedies, as well as supplements in conjunction with pharmaceutical magic medications. She believes that most patients are giving way too many inappropriate prescription medications, while not given being given the knowledge for utilizing effective herbal and supplements to reduce the pill burden. She also works in the candidate with cannabis companies to invite them on dosing, which is so important safety interactions, and how to better help their customers see health improvements with their use of their products. She holds a doctorate degree in pharmacy from Massachusetts College of Pharmacy as well as health sciences. Dr. Leah, how are you doing?

Leah Johnson, PharmD 1:56
Thank you so much for having me on your show.

John Malanca 1:58
Thanks for being on. Thanks for being on. And so, you know, I've been in this industry, gosh, coming up 1011 years now. And I've been a fan of pharmacists for years. And we've partnered crinan I had partnered with some pharmacy organizations not only here in California, but nationally. And we've done I want to say eight or nine conferences for pharmacists, and getting them involved. And it's frustrating that California and Colorado, one of the two, you know, front runners, I should say front runners, but people that had been been in this industry for quite some time. pharmacists are not involved and they're starting to come but but in other states. It's required and and so can you share? Well, let's share how you got into this industry. And then in your thought process as well about pharmacists being involved.

Leah Johnson, PharmD 2:54
Sure. So I actually started off my background was actually after undergrad I went to I got a position as the chief chief head of head of research and development for an herbal supplement company in Connecticut. I was there for about three years. And I really enjoyed it just the to learn about my background was in chemistry. So just to learn about the biology of how these herbs work in the system, how they work synergistically together, was just really fascinating. And what I was learning really quickly was how these herbs can be effective without really the need of, of traditional medications. And and these formulations actually came from a doctor over in China who worked with our lead medical director of our lab to set up these remedies. So it was amazing to get to learn about traditional Chinese medicine and how they work. And you know how the different herbs work together. And I thought that was so important. And what actually transitioned me from herbals to pharmacy was I started getting a lot of questions of Oh, I really like your green tea. Can I take it with my warfarin? Can I take it with this med? Is it okay if I take these together? What happens if I take this with it? And just so many interaction questions that I really had a hit a point where I was like, I need to learn more. So I started actually digging and trying to learn about interactions. And then I got fascinated about chemistry and met like just the chemistry behind the chemicals and the medicines and how they work together to benefit people I was like this is really fascinating. So I decided you know what, I'm going to go to pharmacy school so went to pharmacy school on really how to you know really enjoy being a pharmacy school my I had to pick a topic for my senior project and originally my topic was was going to be cannabis, alcohol and tobacco the three that were used and this was back in 2012. The three that we you know, use most commonly for traditional just relaxation, just you know, I'm having a stressful day I want to relax. Oh, I'll have a cigarette. I'll have a glass of wine or Beer oral have you know, oral smoke? So I was curious about that. So I was like, you know, I mean, I, you know, with my herbal research and development, I learned a lot about cannabis, but not as much because because the Chinese it doesn't really is not really utilized too much in Chinese herbs. So I was really it is, but not as much. So I was really kind of curious, a little bit more about it. So I got all the data, I was ready to go, I presented it to my advisor, so excited. And, you know, based on the research, you know, obviously cannabis had the least side effects, and I was so excited. And then the answer was, well, none of these studies are from America. So you can't do this research project in

John Malanca 5:37
Connecticut was illegal than either was it?

Leah Johnson, PharmD 5:39
It wasn't I was actually in Massachusetts at the time. Massachusetts College of Pharmacy, but still, it's it still wasn't I mean, it was I think it was only I think it was decriminalized in California. I mean, it was definitely medicinal California. I think medicinal was in the 1990s

John Malanca 5:54
Yeah, 996. That's what I'm saying.

Leah Johnson, PharmD 5:57
Yeah, those medicinal but like that was about it. But still, research cannot be done in a country unless it's federally legal. So even though it was medicinal in some states, it doesn't or decriminalized. In some states, it still wasn't legalized. And since it wasn't legalized, they can't do Legal Studies, because the only studies you can do when it's not illegal when it's considered an illegal drug is is warnings and side effects studies. You can't do any benefits studies legally. So all the studies that came from America were all side effects studies, but none were were benefit medic medicinal benefits studies. Yeah, were all the ones from Israel and Europe and, and Canada had tons of studies. But at the end of the day, because I was in a an American based school, they needed embarr and American base research. And since that didn't exist yet, I had to drop the project and choose. So but but I have learned so much. And I was just so fascinated about it, you know, again, you know, the background of the herbal supplements, now the cannabis, and you know, in pharmacy school, you know, I'm learning about pharmaceutical meds, supplements as well. So just bringing that all together, which is really fascinating to kind of say, Well, you know, I already knew people weren't using herbal supplements that much, you know, from my time at the herbal supplement company. But then I also realized, well, people are also not really using cannabis or supplements properly, either. They're only going for these prescription meds that their doctor put them on and nothing else has been tried. And I was like, Okay, well, you know, I want to do something with this because this seems kind of silly. So I'm in my wallet was a in the research and why was the research development scientists, the three patents were actually in was in a natural energy drinks, they actually had ribose and certain, certain ingredients in it that actually naturally boosted your energy without any caffeine without any but all just natural Chinese herbs. So my patents are in those and also we did a skincare line with cocoa because cocoa powder, the natural from like the cocoa plant actually is extremely good for your skin when you ingest it. So everybody's like, oh, will chocolate mix, you break out, it's touching things and touching your skin that make you break out but ingesting the cocoa, especially the pure, all of our products were standardized, we made sure I had a certain chemical ingredient in that was, you know, had a certain percentage in it. So it was it was great, because, you know, we adjusted it, the flavor was great. And it really did help like make a very, like smooth kind of look to your skin. So those are my two fun facts.

John Malanca 8:35
I'm a fan. I'm

Unknown Speaker 8:36
a fan.

John Malanca 8:36
That's, I've always I've totally enjoyed that kind of Yeah,

Leah Johnson, PharmD 8:40
so it's and it works great. And it was just it was just so much fun to do. But there's just so much more than but that's just one small segment of medicine. And that people forget that medicine is a lot of things. It's not just one thing. I mean, even even if that's why I usually stick with a holistic approach, because I mean, yoga is medicine for the body, Tai Chi Gong, Tai Chi, you know, any sort of working out in general could be therapeutic to the body, you know, you just as long as you're not overdoing it or hurting yourself just, there's so much more than just medicine because there's medic medicine is such a generalized term for something that just makes you better. So there are a lot of things you can do to make you better and you just need to know how to use them properly. So once I got into the world as a pharmacist, I you know, I started off your retail realize that sadly, as a retail pharmacist, you actually don't have any time to spend with any patients. You think you would because they're right there in front of you, but you literally have no time. It's like, Oh, wait, you don't need a consultation. Great. Let me go over there and feel like you know, let me review 100 more prescriptions ready to go. So I was like nope, I became a pharmacist to educate I became a pharmacist to teach I became a pharmacist so that patients are not on bad regimens anymore. And so then I moved on to long term care which I have a lot more access to the meds a lot more access to the patients and to the prescribers and staff. in long term care, you find the same thing I can, I can have a whole list of, you know, this is not a good medication for this reason, this isn't, you know, we need to switch to this, this would be better there on 10, high blood pressure medicines, let's get them off of all of them and get them on maybe one or two, maybe three if need be. And, you know, I would do all this and I still felt, you know, I worked with some great physician, some great NPS, pas, you know, any provider, I worked with some great ones. But a lot of times I worked mostly with ones that are, well, I don't really understand that medication. And that's what they came into the facility on. So I'm just not going to change it. Which is, in my opinion, bad practice. If you have a medical, if you have some human educational healthcare professional, educating you on what is maybe not recommended, you should listen, because I mean, they usually and if you don't believe them, ask for ask for data, ask for articles. Because the reason why the pharmacists are in these long term care facilities is to get patients off bed read bad regimens. Luckily, with some great prescribers I've worked with, I've been able to get, you know, a lot of the old thought processes, oh, you know, we have patient with dementia, and they're kicking and screaming and throwing things. Well, let's give them an anti psychotic because it will make them quiet. Well, that still happens on a daily basis, and these long term care facilities all over the world or all over the country. But if you actually go into the data long, I mean, if you go into the data about anti psychotics, they cause psychosis if you don't have psychosis, so all you're doing is you're taking these patients, and you can't give this

John Malanca 11:39
No, I'm saying masking it sometimes.

Leah Johnson, PharmD 11:41
Absolutely masking it. And so what you're in the problem is is that before the reason why this was the process was because they could put patients on such a high dosage of, of anti psychotics, it would what's called snowing them, it would knock them out and sedate them. So they would just kind of keep these old adult older adult patients sedated. And now that that and then they realize, Oh no, we can't have these high high doses of anti psychotics anymore. So they started reducing them to proper doses. But now when their proper dose level, now they don't sedate anymore, and now causes psychosis. So I mean, luckily I worked with some, like I said, I worked with some great prescribers and I was able to get patients off of these harmful meds. I woke up a lot of patients from I mean, I have patients were saying my mom's been sedated. He has been like pretty much comatose for about 10 years. How did you wake her up I go, I took her off her anti psychotic, and I put her on something else to help with her mood. Because her mood was why they put her on it to begin with. Yeah, nothing to do with psychosis. So that's, so I was just so upset with that. And just in the fact that if I could help consistently, I think I would have stayed in that field. But learning and seeing that even with the knowledge, even with the data, even with the experience, a lot of providers are still frightful. I'm fearful of doing anything to mid regiments. And if they don't know it, they just leave it alone. And just so it's just bad practices left to be bad practice. And I just didn't want to deal with that anymore. I really want it to be able to make a difference. So what I've been doing out of pharmacy now, still a pharmacist, of course. But I've been working directly with patients and directly with cannabis companies on the proper utilization of medications to get like I said, a holistic approach. You've got the meds, you've got the exercise, you've got the food, you've got the the herbal supplements, the regular supplements, the cannabis meds, just all encompassed. Because if you have everything together, that's when you're going to get your best benefit. You shouldn't if you have a doctor who's giving you a med, and then that didn't work, so they give you another med and then that didn't work. And then they give you another myth, or if you have an ailment that had a side effect. So they said, Oh, we'll stay on your med Well, here's that for that side effect, which then caused another side effects and they give you another med for that side effect. Both are improper ways of prescribing. It's simple. Have you give a med Oh, wait, that medication didn't work for you? Okay, well, here's, let me take you let me wean you off that man and put you on this man and give that a try. And that's the proper way you want people in the pharmacy world, every pharmacist will tell you, you need to be on the lowest dose that's the most effective. And the way to do that is start low and go slow and you'll hear every pharmacist eat and in the cannabis field. You'll hear everybody say the term start low and go slow. And then that's the proper dosing.

John Malanca 14:37
You know, you talk about pills and one pill after another pill, a pill pill and then you remember about to say about six years ago, they had another pharmacy commercial there pharmaceutical commercial, but it was opioid induced constipation. It's like here if you're if you have constipation, opioid induced constipation, here's a pill for it. You know, we've worked with a lot of cancer patients that are in so much pain not because of the cancer became because cancer but but because of the constipation not going to the bathroom for a couple weeks because of the pills are taking them because of the medication. So you know, I think cannabis is not for everybody. And I'm the first to say that it's it's not the, the golden pill, the golden ticket, you know, like Willy Wonka and the Chocolate Factory type of thing. You know, it's it. Combining it, I think education is very important. I'm a big fan of water intake, but exercise, sleep with neck tapping nutritional products and supplements put your body and cannabis in a whole round. It's like, okay, here, go go. Yes to go. Lose weight, you can slow down eating. But I think getting out. And even if you're able just to move a little bit at some exercises important. So it's kind of a full rounded thing. I was asking you to beginning it, you have your bio. A lot of pharmacists that I know got into it because of their mom or dad or brother or sister or a relative or friend, how did you get it? How did you pick this?

Unknown Speaker 16:11
So

Leah Johnson, PharmD 16:14
sorry, mom. Um, so my mom. So my I was dead set, I want to be a trauma surgeon or I want to be an OB GYN dad said no question. You couldn't have talked me out of it. So then my mom goes to talk to my aunt who was an NP and it was like, Oh, well, you really don't want to do then they're both really high malpractice. You know, you should look into being a pharmacist. And then at that point, I was just like, so I'm all you think I'm good about it, I can only count pills. That's all I can do is and this is before I knew pharmacy, you know what, really what it is? And you know, and I've always said to myself, if I could go back and do it again. Would I be a pharmacist? Absolutely. Would I go back and be a retail pharmacist? Probably not, um, except for possibly to get the same learning experience I

John Malanca 17:06
groundwork. Yeah. And learning to where you are now, though.

Leah Johnson, PharmD 17:10
Exactly. But like, so I was actually really not into it. And then I learned a lot more about it. And what people don't really understand is everybody says, oh, a pharmacist is the person who stands behind the counter and counts pills, right? It's like, No, don't do that. They only do that if they're desperately short on help, and they're desperate to get the meds out. And they need, they need an extra set of hands. So they count while they're reviewing, which is not recommended. Because it's always good to have somebody counseling, you do the second double check. So, you know, pharmacists really are so important and effective, what they do is in the retail setting, they check with your insurance, they contact your doctor to when people do not understand how often doctor give doctors give incorrect or, or incorrect medication or medication that interacts with other medications. And it happens all the time. Because most of the time, it's because a there there are a lot of prescribers that actually don't know what interacts with each other. And B, people see many, many doctors and usually go to one pharmacy, so we can see the medication. So when a retail setting, you can see the medication coming in from all sides, which is great. So then you can say, Oh, well, you know, this doctors prescribing this, and this doctors prescribing this and most likely the offices aren't talking to each other or have any idea the patient's going into both of them. So it's really, really helpful. I mean, I've seen patients that go to a general practitioner and use you know, one antidepressant, but go to an answer, but go to a psychologist psychiatrist and use a different antidepressant and the two doctors have no idea they're on two different anti psychotic antidepressants, and they interact with each other. So it's up to the pharmacy and the pharmacist specifically to catch these issues, catch these interactions, and literally to save and help patients so that they don't have medication issues, because the pharmacists are actually literally everybody will say in the medical field. pharmacists are the drug experts. They are the only field known to be the drug experts.

John Malanca 19:06
And as you mentioned and licensed to do that.

Leah Johnson, PharmD 19:10
And licensed Exactly. So when you had mentioned about the California and Colorado and the different locations and pharmacists, I was I have to be honest living in California, I've been kind of appalled that especially when California had medicinal, the fact that there wasn't pharmacists running the dispensaries in every other state besides California, Colorado, a pharmacist and in every state that sells medication in a pharmacy, you need to have a licensed pharmacist, the only person that is legally allowed to dispense medication in the United States is a pharmacist, a licensed pharmacist. So if you're so why is it that a pharmacist has to dispense all these other meds, but they're not required to dispense medicinal cannabis. And that's what really bothers me because people assume Oh, they're just going Oh, it's adult use. No big deal, I'm just gonna go back in and I can just get whatever they're not thinking about the patients that are, why wasn't going to use this bullet was illegal. So I was never going to do it. And you know, and now that's adult use now I can use it and it might be beneficial. So I'm going to go in and ask questions. Oh, I mean, and I'm not saying that the bud tenders aren't helpful. But the bud tenders are most likely and almost 100% not going to ask you for your other meds that you're on, not going to ask you for, you know, what have you tried? You know, what have you tried in the past medication wise, and other benefits and other important information that a pharmacist would ask before they decide what kind of medication puts you on? I mean, it's more than just percentages of, you know, a 20 to one CBD to THC. It's more than just, oh, well, what form is it in, but it's also milligrams, it's also okay, how's your liver function, I mean, there's a big difference. If you're on an edible, it's going to have to go through first pass effect, which is first pass through the liver. If you have a shell, if you have a faulty liver unable to process it, you actually might not get as much. So you might actually have to up the dose. If you have CBD, you actually have to reduce the dose because too much CBD is actually can be, can affect the liver negatively. So there's just so much to understand. And that's why at the end of the day, I always tell people, cannabis is a great medicine. So as a lot of other medicines, there's a lot of supplements and herbals. But unless you talk to a professionally educated person on this stuff, you're most likely not you're only going to get part of the story. And you really need the full story to improve your health.

John Malanca 21:36
You know, we run into that, as you know, there are drug to drug interactions with with, you know, with a lot of over the counter products as well. I mean, we work with a lot of cancer patients a lot A lot, a lot of diabetic patients for neuropathy, and kurenai have presented at their group to sad and other meetings, you know, month after month, and a lot of them are so used to taking you know, five or six oxy a day like you and I would take a breath MIT, and they are introduced to cannabis, two milligrams. And next thing you know, they're climbing the walls because they're so high and they're like, I'm not doing cannabis. I'm like, oh, you're doing six, eight oxy cones with cannabis. And it can double the intensity of the pharmaceutical. You know, and that's why I truly believe, you know, other states, Massachusetts, if they were on the Yes, it's required not it's required. Where's it now in Massachusetts? I have a lot of friends out in Massachusetts.

Unknown Speaker 22:38
I gotta pass I don't know.

John Malanca 22:40
What about Maryland? Because the same thing in Maryland? No, I

Unknown Speaker 22:42
don't, I really only know based on legality. And I just pretty much what I in the infrastructure in every state that I have found the infrastructure has always had a pharmacist except for Colorado and California. And I think he's sure that every state to do specifically medicinal, they have to have a pharmacist. And usually the elements that approved for that medicinal license is very extreme elements like like cancer, terminally ill, and Ms and stuff like that. But it's a shame because a lot of patients who have severe almost, you know, severe anxiety almost to a point where they can't even function could do great on it and really effective without any of these harmful other meds. But they're not considered to be thick enough, I guess, to be able to use the medicinal cannabis, which is really the same.

John Malanca 23:35
Do you see California changing that way? I mean, like when California became so California been legal since 1996. At the medical level, and then they were it was voted in 2000. I'm lost with code right now. 2016. Was that that was that when it was voted in for recreational or?

Unknown Speaker 23:51
I thought it was I think yes, yes. 2016 recreational Yeah, I think I only went through in 17.

John Malanca 23:58
Yeah. And

Unknown Speaker 24:00
for adult use, yeah.

John Malanca 24:01
You know, I voted no on it. And a lot of a lot of our fellow colleagues in this industry got really upset with me. I voted no on it. crin voted yes, on the re and it wasn't that I didn't want everyone to have access to it. The reason I want it, I said it because i don't think i think doctors should be involved and medical professionals should be involved. And what I had seen and what I've seen in Colorado and Washington State and Oregon, when it became recreationally, it pushed out the medical doctor. So everyone's saying I don't need Dr. Sam anymore. Dr. Jones anymore. I go right down to the dispensary because I'm over 21 I get my own stuff. And I work with so many seniors, they're like they have when I say 17 different products. That's no exaggeration. And you know, I'm in nothing gets a bud tenders but the bud tenders don't know. If I'm a diabetic. If I have a heart problem my mind blood thinners Do I have you know harder with you. You know, if you're an alcoholic,

Unknown Speaker 25:02
you take a tincture because the proper term of tincture is it has alcohol in it. Yeah, you're an alcoholic, you would never recommend that to, you would never recommend a tincture to them. That was. Again tincture, by definition is alcohol based, even though I know a lot of people out there have tincture products that are not alcohol, by definition, that's usually alcohol based. So for those patients, you don't want to recommend an alcohol because you're not you're going to trigger their alcoholism. And that's and so there's so much more to it. And I mean, my biggest thing is right now see, I'm 5050 on both. I just think that what should have happened is when it was medicinal, I don't think things can go backwards. I think I very rarely see things get more regulated, I usually see things get less regulated. Yeah. So I wouldn't be so I mean, from what I've seen is it seems like back when it was medicinal is when the pharmacist should have been implemented to begin with it. They talked,

John Malanca 25:55
they talked about it. I mean, we work a lot of pharmacy groups, and they could, we would like to be involved even the county. And you're also in California, the county, you know, crinan I lived in. We did a lot with it with with the county and the mayor and the the the board and they said, they said if you guys really want this medical, put a medical dispensary in your fist in the city in City Hall, which I know you can't, because because of federal but that's if you're really wanting to stay on top. But I do truly believe that you need to have pharmacists involved. And so we've done a lot with pharmacy groups for that. And it's starting to take off in other states, but not here in California. And they're in and I just think if you're already dispensing medicine, why not? Why not this? Brian a center? Yes, he's out in Connecticut, Connecticut. Yes. Great, dude.

Unknown Speaker 26:49
My original mentor, and I love him to pieces.

John Malanca 26:53
Yeah. And he and that was that was I mean, just show you how small world it is. But the cannabis industry is a very small world, but he was sharing pain just recently became a qualified condition back in Connecticut. You know,

Unknown Speaker 27:07
I wouldn't be surprised if the pain was like severe chronic pain as opposed to just pain because, honestly, if based on the opioid epidemic, I I would, I have had many patients that I have actually gotten off of opioids, but I wasn't but not able to do it on their own without the help of cannabis. And it's just pain is just to a point of I mean, pain is what stops people from living their daily lives more than anything else. I mean, people have diabetes, people have high blood pressure, and they still live their lives like normal, but people in chronic pain. It's just I mean, I I know, I actually personally have chronic pain I got into a really bad car accident a few years ago. So my back and neck are always are happy. You know, we're in general, always in chronic pain as well. And, you know, and I've had surgeries and whatnot, and I've been given opioids, and I've actually gotten myself off the opioids because you know, what you should do have an opioid right? Write in a journal while you're while you're literally high on opioids. And see the next day before you take your next one, what you wrote, and that will very quickly make you never take it again, because you're not in you're literally not in your right state of mind. And you can use an almost insignificant amount of THC and CBD in almost an insignificant amount of opioid together. And you can actually treat chronic pain, not just pain, but chronic pain on such small, insignificant doses. And that's and that's how you wean people off of the opioids. And what actually happens as well, which is so fascinating is the combination together gets rid of that extra euphoria. So the reason why people ended up saying as well, I feel so good on this Percocet, you know, I don't feel any pain, and I feel happy. Well, when you mix cannabis with it, it starts getting rid of the drug inducing, you know, dread or addiction inducing effects. And it just makes you feel no pain, but you don't get the euphoria. So then, and the funny thing is, I was like, well, cannabis causes euphoria, or THC specifically causes euphoria and Percocet and opioids cause euphoria, why wouldn't they call it together but they actually cancel each other out for you For you, which is great. And then that way, you just focus on your pain and then you realize, well, okay, I'm a little dizzy. So I'm going to like reduce my dose and Okay, I think that's working and like reduce it and reduce it and what you and like I said, most of my patients I've gotten fully off of, I always say Percocet, but I met I mean opioids in general, but fully off of opioids, because the opioids are. I always refer to opioids as a dirty drug, and an opioid and the reason the biggest difference that people should understand between cannabinoids for chronic pain and opioids for chronic pain is we have an endocannabinoid system. We have the largest system in our bodies, the endocannabinoid system, which is a natural system. Actually in our system that doesn't develop if you use cannaboids we have it there, we make an amide which is a chemical that's similar to THC we make to ag which is a chemical similar to CBD. And we have receptors for these chemicals which THC and CBD will also bind to based on being similar in the chemical structure. And when you have and so when you actually start feeling pain, it sits on the receptor it you know, notices that you feel pain and and it helps cover that response to, you know, suit the pain. So then what ends up happening is cannabis actually has a feature a negative feedback loop, though, if there is if all of a sudden you have a bunch of cannabinoids flying around, your system says, okay, there's too many cannabinoids flying around me they're released because we're saying there's too much pain. So instead of saying to the body, oh, well, you know, we're just gonna stay as we are, it actually down regulates your receptors, so you feel less pain. Because what they what the receptor actually realizes is, oh, we need to down regulate. That's amazing. The body itself is fixing itself. It's healing itself. And that's how it should be. As opposed to opioids, which don't, we don't have an opioid system. So we don't have opioid receptors, we have what's called New receptors. The receptors is another system in the body. And these receptors are not just in areas of pain in your brain. They're also in your GI and in other places, too. So the reason why you get constipated is because these chemicals, the opioids, when they go on the new receptors, they aren't activating them, they aren't talking to them. They're just covering them like a sheet and quieting them. And so that's how it makes me not feel pain is, well, I can't feel pain, because I've quieted my pain. So but the body, the body is really smart, though. And the body's like, I don't care what you I don't care what you've just taken. I'm smarter, I know you're in pain. So I need you to know that so instead of downregulating receptors, they up regulate. So meaning that now when you've taken a Percocet or or Norco or any opioid, and you had maybe five receptors, saying, Oh my god, I'm in pain. Well, now that there was a bit covered, your body maybe makes another five receptors. So when you finally come off of your opioid, instead of five receptors, screaming and pain, you now have 10 receptors screaming and pain, and hence, people have to keep upping the dose and upping the dose to cover the increased receptors. So that's why people would have to have slight pain when you wean them off of it. But with cannabis, you can avoid that because it's working on a completely different system to help the pain sufferers.

John Malanca 32:38
What do you say about the patient that I work with a lot of patients that are finding success, you know, say they're using 25 milligram, like you were talking about? A pharmaceutical they use cannabis in conjunction, but they're able to take the pharmaceutical down to say five milligrams, use the cannabis, five milligrams, and get the same amount of relief as they're taking a 25 milligram pharmaceutical. So they're able to wean off titrate down, I should say, with a medical professional, and have success not having to take the heavier dose. I do a lot with the pain community. Claudia Miranda, who I just had on the show have had her on the show a couple of times, she does a don't punish pain rally for patients. And because a lot of doctors now especially on the East Coast, I do a lot with you know, Connecticut and Massachusetts and Maryland. The doctors now who she fights for are the patients, but also the doctors that are getting their red flags and hand slapped and they're afraid to write a prescription now, knowing that they you know, wreck prescribed it to their patient who has Fibromyalgia or krones, you know, two years, five years prior, whatever. And now the thing I'm sorry, you know, les, I cannot write you a prescription. Right? It's like, What do you mean, you're the one that I'm taking my, you give me 30 a month, I'm not doing 80 a month, I'm doing 30 a month and there's some days that these patients are having some rough days and they take you know, they're out on day 28 in the pharmacy won't fill their prescription magazine, oh, your red flag, you're an addict. And that that's a tough thing because knock on wood, thank goodness, I'm not in pain. I ran into this when my wife was going through this and her doctor prescribed the pharmaceutical and we went back to the doctor and they said, you know, let me give you a higher dose and we went back in CVS wouldn't fill it. And I'm sitting there like, just tears My eyes saying oh my gosh, to see my wife in pain, you know, and so it's it's, you know, so when I it's tough to see that and I'm, you know I've talked to a lot of patients I've talked to a lot of spouses that have gone through this Seeing their loved one. But anyway, you know, but the pharmacist stood up and said, Let me see what I can do. And I remember after Chris passed, I went in there and talk to her. And I just said, I that that day, I'll never forget what you did for me, and I appreciate it. And so she says, you know, so pharmacists are human, too. They're not just going back with a white coat on, say, you know, like, you know, it's coming, it's coming. So the alchemists consulting and I love the name. And, you know, I grew up overseas. I grew up in Asia, my dad was in banking. So we lived over. So I went to school with people from all over the world. But I was introduced in early age to Eastern medicine, Western medicine, you know, alternative medicines, massage, Tai Chi Gong, all that stuff. And so, you sharing this, you're speaking my language. And I just think, you know, to get the whole body in balance, as well. And so our doctors, our naturopath and naturopaths, they can you know, naturopath, when you get a blood test, we'll give you a through WC, we're not normally a doctor will give you A through Z. And so I think it's important to think outside the box. It's not just a one size fits all, here's a pill ticket, you know, and you'll be healed.

Unknown Speaker 36:26
That's what I explained to actually patients all the time is they A lot of times, it's okay, well, and that's why when I give presentations, and when I do speaking events, a lot of times people want to come up to me, and they asked or like, or, you know, if it's on a video, like they'll contact me directly, and they'll say, Okay, I need help. Tell me what dose for anxiety. And it's like, what the issue I have with Western medicine, which is the same thing I have with pretty much anything else is, there is we're all even twins even are different people, like we are all different people. We all have different bodies, we function in different ways. It's never one size fits all. It's I mean, do I think and so even in the pharmaceutical world, you know, okay, well, 2.5 is too low, but five milligrams is too high. But we need to make sure we're treating it. So I guess we'll go slightly higher. And so it's like, well, maybe if there was a one milligram you could give them like, okay, you need three specifically. And then and since we can't do that with Western medicine, it is what we can do with Eastern medicine and cannabis medicine, is make sure we're titrating and using it and, and focusing on it properly. And that's why I mean even with with opioids, I mean, I have no problem with opioids, if they're used properly. And also what the other thing a lot of times for opioids are prescribed to a level of no pain of Oh, are you feeling any pain? No. Okay, you're at a good level. If you're actually slightly less, and you know, yeah, kind of like, I'm good, I'm functional, I might feel slight pain, but I'm functional. That's actually kind of where you need to be because you need your body to understand it's in pain and heal on its own. When you cover all the receptors up with Percocet, oh, with opioids every time you Yeah, Pfizer or Pfizer, whoever the company is gonna come kill me. Yeah, but opioids, the problem with opioids is when you cover those new receptors, you've run into the issue of, you know, of your body going, Oh, yeah, I'm fine. So I don't need to learn to function myself, I don't need to learn to heal myself, you really need to give your body the ability to try its best. And also, a lot of people try to do one thing, it's like, well, this thing, and I just, if this works, I'm just gonna keep increasing it. Maybe instead of using one thing, and using high levels of it, just use a little bit of this. And a little bit of that, it's actually the problem I have with epidiolex as well, which,

John Malanca 38:46
actually, that was, that was my next next topic with you. So let's go right into that

Unknown Speaker 38:50
perfect. So epidiolex is a great drug for seizures and that kind of that kind of thing. The problem with epidiolex though, is it's very high dosing, because it has no THC. And what they've learned over time and studies is that even as small, almost insignificant amount of THC makes the CBD more effective and you can use it at a lower dose due to the entourage effect. And the same thing goes backwards. You know, if you if you want to take THC and you want it to be less psychoactive, add a little CBD to it. So you have too much psychoactive ability as in CBD to lower it. But you can also utilize each to it's interesting, they both lower each other's side effects while increasing each other's effectiveness. It's they're fascinating how they work. And that's like I said, that's called the entourage effect. So when you're using it in that way, you could actually it's such a small, almost insignificant amount of THC was added to epidiolex. You could actually give it to patients at a much lower level. Currently at the higher level you do run into liver problems. It does affect the liver that they found, not to everybody but on very, very high doses it does. So that's definitely an issue but it's There's a way around it, but because THC is not, is not approved, they can't use it. So that's why like I get when I towards the end of working with elderly, older adults, which is the new fun term that we use for elderly it's older adults. So what we're doing with them though is I would utilize the meds because they're all medicare medicaid, you have to do federally approved medications. So with the prescribers that I actually worked really well with, we started playing with, well, they're on epidiolex for seizures, but the dose is really high. And we know that their livers not doing so well. Let's give them a small almost indicate let's just give them one pill once a day of Marinol. Let's see how that works. And the Marinol would then reduce the amount of CBD that was needed. So in and help for the liver stuff. So it was just so fascinating to like, help them and we utilize it with you know, failure to thrive and everything like that. But just in general, they need to be used together and you need to be careful of the some of the medications when you're trying to use one or the other. Everything really needs to be used and to be examined as a whole.

John Malanca 41:09
There's so many topics I want I want to talk about GW Pharmaceuticals as well but also Marin on there. So I have a friend she's 20 years old, functioning autism autistic. And so I introduced cannabis to she in the in her family, her parents and they were having success but the sad thing about cannabis is you know you and I both know it changes it's not like a farmer sort of hopefully we'll get that point where you know you know if I'm if you're filling my prescription here in California or you're filling my prescription in Connecticut, it's going to be the same product and in and you and I could be say try this tincture here in California and go back next month may be completely different because of the grow is different if it's coming from a different lot number of different batch number and so they were doing this they they're down in Southern California and they are I think they go and maybe three times a year to UCLA to get an EKG and just to see and the doctors like I'm seeing this I see this you know I there's not enough study when it comes to cannabis and they said okay, why don't you write me a prescription then? The doctors Oh, it's illegal No. gw pharmaceut came up with epidiolex doctor knew nothing about a UCLA so did research. Anyway, their insurance covers 100% which I know is expensive. It's expensive for most and so they are finding success. They are finding success with this but there are times you still get your your outbursts and then epidemics and the pharmacy will say sorry, you're calling your your prescription to release like, Listen, if you want to see what you know, our daughter's like some days is like this some days it's like this. You know, we have to like it. Not everyone's not everyone's the same. Let me here's my thought process and tell me about you being a pharmacist. Sativex Sativex or Sativex tomato tomahto however you want to call it 2.75 milligrams THC, 2.75 milligrams of CBD not available in the United States, but available I was eight countries around the world. In my thought process, they lost a lot of money because not they have the rights over here to do it. But it wasn't legal yet. So everyone started replicating in a one to one ratio 2.75 2.75 and having success for MS patients. And then fast forward a few years they said okay, we lost so much money, US government help How can we do this? They introduce epidiolex changing the the scheduling of epidiolex to be written by a prescription and so for our listeners, a doctor can recommend medical cannabis a doctor cannot prescribe cannabis. But in this case because it is a pharmaceutical he or she is able to prescribe it.

Unknown Speaker 44:16
And it's CBD specifically there's no THC in it.

John Malanca 44:19
Why do they do strawberry flavor which I just think is it's you know that

Unknown Speaker 44:25
that's that's more of the inner ins and outs of the pharmaceutical company. Yeah, that I that wouldn't have anything to do with the effectiveness.

John Malanca 44:35
Yeah, but no, I just I just think that I don't want to make it look like candy. I remember when I was a little kid. My parents right out of the country. My grandparents are watching me and I had a fever and I ate the whole bottle of St. Joe fish Joseph. Orange. Thanks because it tastes like candy and I mean imagine

Unknown Speaker 44:51
so I think that there will they have to flavor it because CBD is actually quite bitter. Yeah, very, very bitter product when it's when it's full when it's all natural. So it's it's they need to cover that flavor. And also the majority of people that probably that usually use epidiolex are children and many different age groups do but being that it is mostly children, it's hard to get children to take medication anyway. So actually, in most pharmacies, if you do have a liquid medication, you can act in most pharmacies, you they usually have a flavoring thing where they can actually change the flavor, because they know that kids are so picky. So you know, for example, amoxicillin always comes as bubblegum, that's just how the product comes. But there are actually a lot of kids that don't like bubblegum flavor. So what they would do is they can put a flavor muter in so it actually makes it so tastes like nothing, then they put it in, they put this other flavor to then balance out the flavor, so it tastes like cherry or banana or whatever. So the flavor would most likely be just to make sure the kids actually take it and also probably strawberry might have been chosen. Again, this is just hype, just speculation, but cherry strawberry might have been chosen, because maybe it's a stronger flavor to cover that bitter flavor of the CV and you being a pharmacist can't What about the kids that are allergic to strawberries, which a lot of you know

John Malanca 46:03
how to get rashes or anything with that with flavoring in that

Unknown Speaker 46:07
again, you would need to check with that when you need to check with GW Pharmaceuticals to check to see if it is most of the time the flavorings are usually artificial. So if they're artificial, then it's just you don't worry about it. But if they are natural, then yes, that's so you definitely need to if a person has a child who is allergic or anybody who's allergic to strawberries, I would definitely check with GW Pharmaceuticals before you are bio sciences before using it

John Malanca 46:35
well I know a lot of people the cannabis industry would probably get upset with me about this but it's working for her and and meaning epidiolex is working for for for for her

Unknown Speaker 46:47
and the

Unknown Speaker 46:49
problem though is that a slight even almost like I said even even an almost like even if she were to use probably one tablet of Marinol she could probably even bring down her CBD

John Malanca 46:57
what I wrote liver here cuz I'm gonna call them after an ad you might want to take a look at it and then so and

Unknown Speaker 47:03
but the psychoactive The biggest thing other people need to the other especially for the audience's CPD is is C CB two receptors, which are mostly the periphery. So it's mostly like, you know, the reason why high CBD is so effective for agitation and anxiety is because it's anxiety is not usually just I'm an anxious, it's usually like, Oh my god, I'm tense in my body and I can feel the tension everywhere and like my heart's racing and I'm just panicking. So the CBD calms all that down, but it doesn't help with the brain effects. So if you just take CBD for anxiety, it will help you physically not feel anxiety anxious, but your brain still got a flutter so you need just a slight amount of THC to balance it and that's why for most most you usually go 20 to one which is 20 times more CBD than THC but still a slight amount just to trigger that but for pain you want more of a one to one again dosing matters to pick based on the patient and you know, it's like a one to one oh that's a little too sedating and not as effective okay up the CBD lower the THC. It's effective but still sedating. Okay well then we're going to like lower the THC and you just play with it as is you get different ratios and you figure out what works for that specific patient element

John Malanca 48:16
and for cheese like trial and trial and error you know, you find finding that sweet spot and so before we move on to Marinol so is my conspiracy theorists mine is that my honor off on that in the mindset of they they didn't get make the money they want to have Sativex. But they worked with our government to change the scheduling just for that product.

Unknown Speaker 48:37
Well CBD though, as far as I know, for the scheduling, I thought CBD was never a scheduled one. It was never really classified.

John Malanca 48:45
It's still it's funny. I had a lawyer on recently and I said he goes as my father would say it's as clear as mud meaning the CBD, the CBD laws and so it's still quite it's still there. I know the UK is running into this here. It's 0.3% THC over there. They're doing 0.2% and I think now they need to go to full. Straight it's not an isolette but straight crystals but straight. Just Just no TC broad broad spectrum. Yeah, broad spectrum. So okay, so checks out of checks. epidiolex Next, the other end let's go with Marinol. So Marinol, a synthetic form of THC developed, I believe in 1985. legal in all 50 states written by prescription, but not always, not all, it doesn't work. Does it sometimes take about two weeks to get in a system like some pharmaceuticals, it's not instant.

Unknown Speaker 49:44
It depends on the patient. Really. It depends on the patient. I mean, there's a couple different things THC in general, in the most bioavailable form. So like, let's say in the inhaled form, which is usually the fastest, most effective way you can get the most out of it. That still is not I think, I believe Leave, that's about 40% bioavailable in general. So even the plant base alone is only about 40. And Marinol is about half of that. That's about so it's about 20 to 40. inhaled and it's about 10 to 20 for the Marinol. So that's the first thing. Also, the other thing is it's not decarboxylated. So that you what makes cannabis effective is that it's decarboxylated. Because it because otherwise it's THC, a TGA is also effective in the body, but not in the same regards as THC alone.

John Malanca 50:36
Can you talk about that? So I've talked about it many times in the show, but can you use your definition of because when people see all these cannabinoids and what is the cannabinoid and what she see and they say the acid form, they said, Well, I don't want to get high. So it's not like LSD acid, the raw form. So can you share, you being a doctor you want to you want to share,

Unknown Speaker 50:56
so I refer to it was a precursor, okay, it's kind of the best way I can explain it to people, don't, you, I never use the term acid because I know it's gonna confuse patients. So I always use the term precursor. So it's kind of like vitamin D, it's a great example, or a vitamin D, is the non active form of vitamin D, vitamin D, and it's also plant based, and I don't recommend it. So if anybody's on vitamin D out there, take vitamin d3, that's what you want. Vitamin d3 though, is the active is the active form that can that can be utilized properly in the body. So you could still use vitamin D to but it needs to be activated to vitamin d3, which then you can utilize. So why go through all that and make your body do all this work and only, like utilize half of what you're taking or some of what you're taking versus just using the active, it's the same as using, you know, any medication that has a precursor. It's, it's like, do I want to get some of it or all of it. So when I see thca is, okay, your you've got your precursor, that's great. And then when it's decarboxylated, now it's in its active form. So you can definitely have THC a and have some effects from it because your body is going to heat it up. But it's not going to ever hit the same as when it's actually either ignited or when it's actually vaporized, was heating that higher level that your system cannot get to that level. So you might be decarboxylated a small amount in the system if you were to take THC a specifically, but you really want THC, because that's the active form that your body can then utilize. So um, and so it's, that's bad enough. But so when you start with a non decarboxylase, and it's synthetic, and you already have less bioavailability, meaning that it's going to be absorbed less into the system, when you already go down to the synthetic form. And then even more so because it's not the exact form for the decarboxylation, which is what you really, really need to then have the active effect. So it definitely works. But it works differently for different people. So I use it a lot in my practice with the elderly population, especially for their failure, especially for my hospice failure to thrive patients. Yeah, because they would stop eating. And sometimes a lot of people I believe, I think we talked about this a little bit on the phone, john, that, you know, sometimes all you have to do is fix eating and sleeping, and then you can bring somebody back to life. Sometimes just eating and sleeping is enough. You know, and, you know, it's so interesting, because a lot of my patients were near the end on hospice, they're gonna go and then we just gave them some Marinol which also helps with their combativeness and their anxiety and agitation. And we're able to get them to eat again. And then they started becoming more functional, they started waking up, they start getting stronger, they started wanting to do more things. And then they graduated off of hospice, which is something back in the day I never heard of, but now you can absolutely graduate off of hospice. So it's just what you're seeing got as much as it's like, I mean, I will still say that non synthetic is definitely better than synthetic. But the way I would talk to any prescriber out there who's listening to this, who was like, Well, I know CBD works. I know THC works, I can't give them you know, you know, plant based form. So what do I do? utilize these medicines just, you know, speak to an educated clinic, clinical medicinal educator, sorry, clinical cannabis educator, speak to them say hey, what dosage of epidiolex do you recommend what dosage of this and then write it as an actual prescription and monitor your patient? And there's ways around these laws to do things legally, you could just use things off label if you really get stuck.

John Malanca 54:40
You know, I I've spoken to a lot of doctors who've called the saying help I live in this state and I just recently had Dr. Berman, you know, doctor, Dr. Berman, he's down in Santa Barbara. He's no he's one of the pioneers in this industry. But you know, he works with a lot of patients not only here in California, but He works he speaks around the world but talks about with the patients and doctors that are in illegal states and the patients he goes what he's what he's found his like you're saying he's prescribed Marinol and then CBD you know in the in the in clear as mud type of laws are still in the gray area that they're able to purchase CBD legal legally and and work those to get work this together with that because there's there's controversy Do you still get the entourage effect one being synthetic one being not

Unknown Speaker 55:33
you still get the entourage effect but again if it's the same thing as you know, you can still hear somebody if you put barriers in between you and them. Can you hear them as well? No.

John Malanca 55:46
Yeah, you can still hear though what a great visual Yeah, yeah. Before we move on to a cheat sheet for our listeners, not a scientific understood, so THC is in the cannabis in the raw form so you can have a cannabis plant cut it down juice it and that's THC a non psychoactive I'm a fan of it, you know it's great for inflammation you know, the studies show me each contaminant is about 140 different cannabinoids. What do you what do you see in your in your scientific chart, or your on there?

Unknown Speaker 56:20
I'm seeing about the same I mean, I like THC, I don't work with it as much I think my favorite cannabinoid has become CBN I am in love with CBN and is my favorite and for those even in the sciency world or not who don't CBN is actually when THC which as we said is the decarboxylated form of THC a actually gets oxidized so when you use cannabis products, you should always keep them there's light sensitive and they're oxygen sensitive. So you need to keep them sealed tight and you need to keep them in a dark either dark bottle or like in a dark just kind of like medicine you see like the amber bottles to keep it dark. When you keep it open or light or and allow the air to come in it actually oxidizes the THC and makes it into CB n. cb n is specifically for sleep and it is a very very effective cannabinoid, which is very frustrating to me about the regulations and everything because it just seems like you should be able to go to your dispensary and say here I'd like to get a pack of five milligrams CBN to take for bedtime. But you can do that with melatonin but you can't do that with CBN sadly and the CBN doesn't give you the you know you don't feel high you don't have a psychoactive effect you feel sleepy it's bedtime like it literally triggers your your desire to want to sleep and there are plenty of products out there that mix melatonin with CBN and THC with CBN and so on and so forth but CBN is just great so that's like one of my absolute favorites. I'm getting a little bit more into I know CBD is just starting to get big my big my other big one is a CB no THC v yeah which is a little bit more for the like helps with the blood pressure helps with

John Malanca 58:09
that diabetes as well and it's more

Unknown Speaker 58:13
internal like I always consider CB THC v to be more of like the internal organ.

John Malanca 58:18
Yeah. And it's funny you know, people have been talking about a lot of doctors at work have been talking about it for a while but it's not. It's not accessible enough to meet people have it yet and an error. When CBD was just coming on the market, people didn't know what it was and all sudden, it blew up as we sing it's everywhere everywhere you go from your gas station to pharmacies, etc. and thca and now you have the CBN and CBG thcv. And so each and every see

Unknown Speaker 58:48
which is the one that's gonna mess with a lot of doctors because I was like, oh, like CBC Couldn't you call it anybody out anything else? People are gonna think that means complete blood count. That's not what this is.

John Malanca 59:00
What Welcome to the industry. Hi, this is confusing, confusing. A lot of a lot of people say something and i and i spaced out because I was all excited to talk to you about CBN and CBG thcv it'll come to me it'll come to me. Um, maybe not what's good memory? What's good for memory besides coffee I have coffee today. And I was like, oh and tasted good side two cups and I rarely do that but Gosh, I was I was gonna say something here we're gonna talk about

Unknown Speaker 59:35
I will say for memory though. Good. No, absolutely. 150% gingko biloba it's got to be standardized, has to say the word standardized. I will say as much as I don't want to promote any products but nature's bounty. I know how to standardize that's what I use. And what it does is it thins the blood again no cannabis whatsoever. This is just straight. ginkgo biloba, and it, it thins the blood which allows The only way your brain has energy and can function is not with it can't process the glucose or your body breaks down. It has to do for ingested. So what it does is it actually works as a great vehicle to get that glucose from the ingested food up to your brain faster. So again, you guys can Google

John Malanca 1:00:20
standardized, so

Unknown Speaker 1:00:21
standardized ginkgo biloba, yeah. And it's amazing. And the funny thing is, I did it all through pharmacy school, and I found that my retention and what it really helps with more than anything is retention of memory. So what I found is I so then after pharmacy schools, like the amount of pharmacy school now I'm not setting I don't need it stopped using it stopped using it for good two years. And was like getting to a point of, wait, Where was that? Wait, wait, wait, wait, what was I doing? And then I had that and then I said, You know what, why don't I just start taking it again, start taking again, I was able to retain again. And it's it's less about actual memory and more about just retaining that information that you learn. So studying ginkgo biloba is great for studying, because that keeps it in there. It's in the brain?

John Malanca 1:01:08
Well, I'll start taking it and maybe tonight when I'm brushing my teeth, I'm like, Oh, that's a question I was there. It was a it was a perfect question leading into into pharmacists and cannabis and something. So I apologize to you and into our viewers, as well. So with you not working for a brand pharmacy anymore. And I know Brian was the same way. And he you know, he went to his own private practice. And so what you're doing, can you talk about alchemists consulting and what you're doing with with your partner as well. And, and helping?

Unknown Speaker 1:01:45
Yeah, so we're doing so Alchemist because consulting is kind of just my general headline, because I'm like, I need some sort of company to run under. But we I do a couple things under it, I actually do. So the three things I do is i'm a speaker, and educator. So whether that's on the grand scheme of you know, speaking, like like this type of presentation or speaking to a group of people, you know, I do that kind of stuff. I also work directly with patients and I but when I work with patients, it's not as simple as here's a medicinal medical card for cannabis. It's a I can't do that anyway. But be what I do is I go through every single one of their labs over the last year, I go through all of their meds, I go through all of their ailments, I go through absolutely anything possible that they are on, and I review everything together. And then I sit down with them. And I give them depending if it's a patient with like a lot to go through about an one hour review, if it's something like oh, I've already changed my meds I've already worked my doctor I'm on like almost nothing. And I just need a little help with cannabis, we'll usually do a half hour meeting. And this is to go through everything. So we're not missing anything. Like one of my patients, the half of the issue was they were on meds to cause anxiety. So that's why the patient was having anxiety. Plus the cannabis helps to also reduce it. So you know for that. So I do work with patients. I also work with cannabis companies directly also for Hey, you know, I know you're let's say they're working on a product. And you mentioned that the product is for this and it can be used, oh, this is this product is great for everybody with pain. So then I will work with them and say, Okay, well, this is an adjustable product for pain. You know, do you met Do you have any waiver and or disclaimers about other meds that these patients are on? What if they're using things, and these are things that a lot of companies don't think about because most of the time, they don't have a healthcare provider on their team. So I helped to guide and educate these types of companies for for this to work, help them work with patients. And then so as alchemists consulting though, I'm doing two other things. I'm also doing a wellness retreat with a couple of colleagues in there. It's called the Caliph. So you guys can look us up because we do have a website, I think it's up. It's called California wellness retreats. And what these retreats are is actually having it's an overnight it'll be one to two nights depending on the event, you actually go to these farms to an actual cannabis farm. And you're on the premises. So you part of the experience is going to the farm having the farmer explain the different growing and how different growing affects the different flavonoids and how flavor ups are different terpenes and how the terpenes affect the flavor and how they affect that and other health benefits of the terpenes. And how growing causes different abilities and different terpenes and cannabinoids to grow, then we're going to come back we're going to have you know, we'll have an evening yoga session will have an we're gonna have you know, food, you know, food that's, you know, like, you know, as clean as we can, I wouldn't say it's gonna be gluten free and stuff and it's gonna be as clean as possible, you know, not, you know, nothing, just, hey, we're gonna get McDonald's and like, no, it's gonna be like clean, healthy food. And then I also have then I have like a kind of a session with the whole group, which it's usually no more than about 10 people and the whole group the session is okay, so I get all their questionnaires, all of their health ailments, I get all this stuff. I know normally get for consulting beforehand because again, it's still cannabis is a medicine and it will always be a medicine to me I don't care if you're like I had a bad day I'm gonna go use a little bit of cannabis you're using it to get rid of that anxiety so or that stress you know whatever it is it's still being used as medicine in my opinion it's always a medicine yeah so I review it I review all their meds and then we'll sit down say okay, well this group you know, we all have depression issues let's discuss these depression issues. Let's discuss what might work and so on and so forth. And same thing with Oh, for anxiety this anxiety that and then for everybody who don't who attends I give them each a 15 minute free consultation outside you know, to for them specifically to nail down what their therapy should be. And then the last thing we do on the last day is I bring out depending if we go to a dispensary or not I bring out all the different options, the vaporizer, the flour, the the edibles, the liquids, because there's lots of beverages in the market now until I bring everything out and I really kind of hone down on when and why to use each one of them. Because there's I mean, you could I know exactly what milligram dose of THC I need. Okay, do you need that in a gummy form? Do you need in a tincture? Do you need that in a vape I don't know. And it goes through why you need each and when they're beneficial and who should use them and so on and so forth. So the goal of the wellness retreat is to leave the wellness retreat, you know, feeling better about your meds, feeling better about your health, having it all just kind of a just a relaxed feeling. And then also being able to leave with the knowledge of what can I do to keep myself healthy, healthy and how to benefit my meds. So we do that. And then lastly,

Unknown Speaker 1:06:43
lastly, and this one is really really they're all really exciting but this one I really am excited about because this one is to help patients in my opinion the most besides a direct it's the it's how I free how I freely help customers and and patients and, and and companies. I review products for Canada cannabis products for free. And so I focus on the medicinal side a lot. And then my colleague, Rudy Roma, he focuses on the Rudy how

John Malanca 1:07:13
long you've been. Are you guys relationship to or just

Unknown Speaker 1:07:17
the Rudy? Yeah, so Rudy and I met through the cannabis like through the call. Yeah,

John Malanca 1:07:21
I you know, I've spoken to I haven't talked to Rudy and a longtime please show my shirt. Hi,

Unknown Speaker 1:07:26
I will definitely Yeah, so we were actually just talking before you. Um, so we have our own. So we have a podcast. And what we do is we just take a product he so he vets it from ground up, he that's it that the seat see, like the certificate of analysis is there, the ground was tested, the cannabis was tested, GMP certified practices, because we want to make sure that if the product works great, and it makes you better, how do you know that 10 years down the line, it didn't have heavy metals that were going to hurt you. So we we make sure that from ground up, it's healthy, and I make sure on the medicinal level, it's there. And together we talk about the effect. So we call it the good, the bad and the eval. So the good about the product, the bad about the product, and what we think as the evaluation,

John Malanca 1:08:08
and so not to interrupt you and I am interrupt you because it's on my mind is today, I two cups of coffee. So this is me again. You know, it's talking about all the all the pharmacists that we worked with, I brought them in to our office and said, I'm going to show you what it's like to become a Cannabis Patient. This is before 2016. And it was an online. And so I remember Phil was in our office, we were sitting there and he paid is $27 whatever it was, and he's sitting there, getting ready for the screen. And it says we've received your application great. We're reviewing the application. Great. And he's sitting there waiting, you've been approved. And these are the emails that are coming through. He's like, but john, I haven't talked to anybody I go. That's how this industry is. So now you're approved. So he was kind of just blown away. Like, really, they don't even the doctors doesn't come on anymore. So that's the better the good and bad about about California then. And so I would I took a group of pharmacists, and these are all retired pharmacists of 50 years you know, and, and I took them through San Francisco, and I did the good the bad the ugly of farming, excuse me of dispensaries walking in some clean. They know their stuff. Others mispronouncing CBD, I mean, that's one of my biggest pet peeves and when people it's like how do you mispronounce or miss? Or Miss Ryder? What's the word spelling error on that? You know? I mean, I hear that all the time. I see it on magazines I see in an article see BB or C, B D and I'm thinking Come on, CBD. I'm all backwards, right?

Unknown Speaker 1:09:48
Yeah, a lot where the D in the beer flip. That's

John Malanca 1:09:51
I mean, that's I mean, I mean, I've seen marijuana misspelled I see cannabis misspelled on my magazine, my background. I work for magazine publications, you know and travel websites and magazines. So that's my my biggest pet peeve when I see it in this industry is like that. You also talked about working with patients. So I applaud you guys doing that as well, because it's so nice.

Unknown Speaker 1:10:11
That's just that's just me.

John Malanca 1:10:12
Oh, you you okay then you but one of my my thing that which is tough and I and I'll say pet peeves wellness industries when I have patients or seniors that call me and say my doctor just gave me a recommendation. Now what I do, and it's frustrating, I think if a doctor is going to write a recommendation or a prescription for pharmaceuticals, he or she's going to say, here, Bill, this is what you do. These are the side effects.

Unknown Speaker 1:10:37
But they don't not even for pharmaceuticals, to say, here's the med to make you better go fill it by your pharmacist might tell you about it.

John Malanca 1:10:45
And I love it that the farmers say Do you have any questions? Or did your doctor did your doctor go over this? I recently am 53 and I recently and I recently I had to have my first colonoscopy knock on wood I'm everything's healthy. But I remember I went into the doctor, I mean the pharmacist to get my clean out if you want to say and she says, did they tell you? And I said no. And she just shook her head. Like, doesn't surprise me enough.

Unknown Speaker 1:11:15
That's why I get so frustrated as a pharmacist is because we're the drug experts. But you need it. The way I see the the role of a pharmacist as a doctor should diagnose you a doctor has that. And by Doctor, I apologize. I like to use the word prescriber because physicians and pspa is who's specifically talking about prescribers. So if a prescriber prescribers are diagnosticians, they're the best people to diagnose you. So what should happen is, here is your diagnosis, go bring this to your farm, or we have a pharmacist on staff, you know, so Dr. Johnson, this patient is on such as such as such and such, you know, they have this ailment, I want to prescribe them a high blood pressure medication, what do you recommend based on their information, that's how it's supposed to go, then the pharmacist would go in and say, here's the medication, this is how it's gonna affect you. This is what you should expect, you know, here's the medication. That's the proper function of both roles. What's happened is, prescribers have kind of become a jack of all trades, master of none. It's like, Oh, yeah, here's you have high blood pressure. Try that one first. But that didn't work. Okay, try this one to choose this one. And then half the time, the patient goes, Oh, my doctor says it's for my high blood pressure. So I'm sure if anything important needs to be told me to me about it. I mean, you'd be surprised how many people refuse consultations with the pharmacist the first time they're on a med, almost everybody, almost

John Malanca 1:12:38
everybody want to get it and just get out there doctor gave too much. Just take my pill and I'm out again.

Unknown Speaker 1:12:42
My doctor says I need this for my high blood pressure. If anything was going to go wrong with this med, my doctor would have told me and the answer is no, they wouldn't have they assume that if you have questions, you're going to ask the pharmacist they don't know you're not asking these questions they ask. And that's why when I review and when I actually do the full review for patients for the cannabis and everything I always put is a waiver, you need to have a primary care physician I am not your primary care physician is which is why I'm able to work with people outside of the state of California as well as I'm not your primary care physician. First, we need to make sure you have one, as long as you have one you need to understand any advice I give you must be directed to them. First, they need to verify it, then they need and then you can go from there. Because if I say oh well, you're on this medication that's going to cause anxiety, you can't just end You can't just take it off, you can't just stop using it, you have to let the physician know, hey, I spoke to a clinical cannabis pharmacist, you know, who also is very knowledgeable and meds and all these other things. You know, she was looking at this and she saw that this was triggering my you know, this thyroid medication was triggering my anxiety, you know, she recommended and she saw my thyroid levels she saw they were in good range, she recommended we reduce this a little bit. And this is her recommendation for my therapy. And if that doctor says, I don't believe in it, I don't agree with it. I always educate my patients. If you're if you do not feel comfortable talking about this with your physician, or your pa or NP or your prescriber, find a new prescription find one that you trust

John Malanca 1:14:10
all the time. And I remembered See, I was gonna say I thought I was gonna remember I'll brush my teeth tonight. But it was and I know we only have few minutes I can be and I know you have another and I appreciate your time. But it was talking about CBD, which everyone thinks is you know, the the and I never used cure, but everyone thinks Oh, I'm not CBD mo CBD. But there are interactions with hurt medicine and blood pressure medicine. Can you share that in and in a couple

Unknown Speaker 1:14:40
it actually goes a couple ways. So first thing I always recommend is if any patient who is has to be careful their heart rate I actually don't. So in general, anybody who has any heart issues, I usually don't recommend smoking anyway. But I also don't recommend vaping because vaping or smoking any inhaled form of cannabis actually raises your heart. So that's one thing you need to be careful with. Because that will actually make your heart start racing specifically when inhaled. So the other thing is we care about like, as you mentioned, it was about CBD and CBD lowers your blood pressure. So you have to be very careful because it can actually lower it to very low level so, so yeah, so I've noticed that sometimes you've got you know, sometimes you people were like, so sometimes have to worry about that heart racing, especially people who are you know, old fashioned cannabis use patients use the inhalers and stuff like that as

John Malanca 1:15:27
well. Do you? Do you ever see it I know and I want to be courteous of your time as well. Do you ever see CBD inducing anxiety because I am sensitive to to alcohol, butter, salt, and even medications and sometimes lowered I can feel it that it's that it's amping me up and at nighttime I do use CBD for sleep higher doses. And I have I have success that way. And so you see that as a Doctor of Pharmacy that it doesn't do it?

Unknown Speaker 1:16:02
Well so actually most of most CBD most cannabis in general has paradox of reaction so works both ways. So I actually now and everybody's again everybody's different like me, I can't sleep on CBD. I'm one of those weird people that like just if I have CBD, I'm like, like, not not energized

John Malanca 1:16:21
Yeah, I was like that too. And the doctor says, john, trust me on this go higher levels level. Yeah, and so I do that now and it's like, I sleep like a baby.

Unknown Speaker 1:16:30
The problem is for me the the amount of high levels I'd have to take to sleep would be like really I like here's all my CBD, but I find so the CBD I do love it for the energy effect but it is true The more you take of it the more of a calming effect that will cause I caught I and lots of my patients who are cannabis or not cannabis naive who have used in the past are actually getting rebound anxiety from THC is very common. So I I mean most of my patients have rebound from to where they're like it said it's good for anxiety but I swear to god I'm getting more fat it's like low levels like very low levels are good and anxiety the SEC that's why it's high CBD low THC for anxiety as soon as you like and by high I mean like 10 milligrams which is not even considered high but when mixed with the THC it's a good high level. Okay, so anything anything's paradoxical so if you go too much of any too much CBD or THC you'll get the opposite

John Malanca 1:17:32
well I appreciate I know you have another call here it like right now and I appreciate your time and your knowledge and please say hi to Rudy as well it's been a while I mean when I say why I want to say last time I spoke with him was probably about 2013 maybe 2014 so please give him give my best and well Damn. Are you guys

Unknown Speaker 1:17:54
called Canna work showcase? That's the name of

John Malanca 1:17:56
our business partner a couple and I need to get a business cup

Unknown Speaker 1:18:00
business partner business partner Yeah, yeah, we've met straightly through sticking and we both said you know what, we're so sick that sick of the fact that patients can't find good products and half the patients have to go online. Yeah, because you can't they don't have a dispensary or they don't have the license for it. So when they go online, it's like well what's a good product as you know, even regular non cannabis products online can be shoddy. So it's like well what's good product so we said you know, we need to get we need to show patients how to get how to find reputable meds so that they don't need to waste their money because a lot of these cannabis products especially CBD are very expensive.

John Malanca 1:18:33
It is and I think it's a need for patient advocates like like what we're doing and so I applaud you guys for what you're doing as well and even sometimes when you don't when you go into the into the store and I've been in in dispensaries with patients and you know and kind of hand holding them and say you know we'd like you know our doctor recommended tcaa and we don't have TTM like it's right there around Oh, I didn't realize what that was and so you know so ask questions and if that does happen to you and dispensary ask for the manager. You know if you feel rushed by the sales sales clerk asked for the manager say I'm brand new here. You know, I'm a medical patient I'm brand new here the first time I've been in dispensary and it's kind of scary The first time I brought crinan dispensary. She thought What am I doing here? You know? You know it's okay, it's legal. We're not doing anything illegal. So anyway laya Princess Leia laya Johnson I appreciate your help the holistic healer and alchemists consulting we can you find her online we'll put all your information down below as well. And I appreciate you taking time and sharing your knowledge with me as well as our listeners as well and love to be on your podcast when when you guys go live on that as well.

Unknown Speaker 1:19:53
Definitely we'll do well. We'll let you know about while the guest spot be very exciting.

John Malanca 1:19:57
Awesome. Have a blessed day. Yeah, everybody john Malachy united patient group being formed and we will, and we'll see you soon. We'll see you Dr. Johnson. Thanks again.

Unknown Speaker 1:20:07
Bye now. Thank you. Bye