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It’s one of the hottest topics in the medical community right now, but also one of the most controversial. So what exactly is CBD, and is it really a medical breakthrough, or just another bad habit? In this special series on CBD and medical marijuana, Dr. Daniel Amen and Tana Amen are joined by Dr. Rebecca Siegel for a discussion on the many pros and cons of using CBD as a treatment option.
Dr. Daniel Amen: Welcome to the Brain Warrior's Way Podcast. I'm Dr. Daniel Amen.
Tana Amen: And I'm Tana Amen. In our podcast, we provide you with the tools you need to become a warrior for the health of your brain and body.
Dr. Daniel Amen: The Brain Warrior's Way Podcast is brought to you by Amen Clinics, where we have been transforming lives for 30 years using tools like brain SPECT imaging to personalize treatment to your brain. For more information, visit amenclinics.com.
Tana Amen: The Brain Warrior's Way Podcast is also brought to you by BrainMD, where we produce the highest quality nutraceuticals to support the health of your brain and body. To learn more, go to brainmd.com.
Dr. Daniel Amen: Welcome, everybody, to CBD week. This is going to be an interesting week. Every conference you and I are at, people have that question.
Tana Amen: And all over Facebook, all over social media-
Dr. Daniel Amen: "Is CBD good for myself, my mother-in-law, my dog is taking-"
Tana Amen: Dog.
Dr. Daniel Amen: It's just one of the most common questions people ask us. With us to discuss it is Dr. Rebecca Siegel, who works in our New York City clinic. Rebecca is a child, adolescent, and adult psychiatrist. She joined us recently, but had been in private practice in New York for 13 years. She's a graduate of the Albert Einstein Medical School, where her father also attended. He was a neurologist. She completed her psychiatric residency and child fellowship at Mt. Sinai Hospital in New York. She specializes in the assessment and treatment of anxiety, mood disorders, ADHD, with a special focus on issues confronting adolescent and young women. She's also a mother of young girls, and she's licensed in the state of New York to use marijuana. It actually requires a special license. Rebecca and I have had lots of interesting talks about both the therapeutic uses of marijuana and the potential harm that it can bring. So welcome, Rebecca.
Dr Rebecca Siegel: Thank you very much, Daniel and Tana. I'm happy to be here.
Tana Amen: Welcome. This is going to be interesting. Yeah. I have a lot of questions, actually.
Dr. Daniel Amen: Let's start with your interest. Why did you decide to get a license to prescribe marijuana in the state of New York? Let's start there.
Dr Rebecca Siegel: It is a very, very interesting question that has pretty much changed my career in less than a year. I had a patient come to me and say that she no longer needed a pharmaceutical medication for insomnia. I said, "What did you do?" She said she found CBD. She went and tried an edible, actually, with CBD, and it changed her life. She didn't need this particular pharmaceutical medication for sleep. She asked me, could I help her do this? Was I a prescriber of medical marijuana? I said I was not, but that I probably could be.
So I found out what the requirements were to get certified in New York State. The rest is my story. I've certified about 150 people now in the state of New York for medical marijuana. I've seen both the pros and the cons. It's a very balanced view I have. I see it as an option for people.
Tana Amen: We have patients where we know that it clearly is something that we would use. But we have a lot of patients where we believe it makes them worse. So how do you determine?
Dr Rebecca Siegel: First of all, as a certified prescriber in New York State, I am bound to follow 12 diagnoses that a patient ... A patient must have one of 12 diagnoses in order for me to say they should be certified for marijuana. The two major diagnoses that I use are chronic pain and PTSD. In fact, there was research done that said that chronic pain is now the largest diagnosis for why people are getting medical marijuana. That could mean CBD. That could mean THC. That's part of our conversation, is what's the difference between CBD and THC? Many, many people don't understand that.
Dr. Daniel Amen: Let's talk about that, but before we do, let's go through those 12 diagnoses that are approved in the state of New York. Do you know them off the top of your head?
Dr Rebecca Siegel: I can give you quite a few. Certainly chronic pain and PTSD are two of the most common that I use. There's ALS and cancer pain, nausea due to chemo, HIV/AIDS, Huntington's, ALS, things like that.
Dr. Daniel Amen: Okay. So mostly they're medical diagnoses as opposed to psychiatric diagnoses, but PTSD obviously is a psychiatric diagnosis. I know it's approved in 10 states for dementia, which worries me, because what we've seen is marijuana causes overall decreased blood flow. But is the decreased blood flow worse than Xanax-
Tana Amen: Right. That was my question.
Dr. Daniel Amen: -or worse than opiates? Probably not.
Tana Amen: So CBD, you're saying, decreases blood flow.
Dr. Daniel Amen: Actually, that's the question we don't know. We know that marijuana users-
Tana Amen: So marijuana does.
Dr. Daniel Amen: -overall have lower blood flow compared to non-users.
Tana Amen: But we're not sure about CBD.
Dr. Daniel Amen: Correct. Rebecca, talk about the difference between CBD and THC.
Dr Rebecca Siegel: Right. CBD and THC are found ... Let's start at the beginning. We have the cannabis plant. The cannabis plant consists of marijuana and hemp, right? Marijuana is where you can have THC as well as CBD, and all the other compounds that make up marijuana. Hemp is a whole 'nother thing. Hemp is mostly CBD-
Tana Amen: Oh, so I'm getting CBD. Interesting.
Dr Rebecca Siegel: -and now allowed in ... That's the Farm Bill that was passed in December. It is only allowed to have less than 0.03% THC. It is a majority of CBD in hemp. That is now why hemp products are considered legal.
Tana Amen: So those of us that put hemp in a lot of different recipes ...
Dr Rebecca Siegel: Exactly.
Tana Amen: You're saying I've been getting CBD for a long time.
Dr Rebecca Siegel: It's more complicated. Now the FDA has not allowed hemp or hemp oil to be put into food and drinks. They will be holding hearings in May to discuss whether it will be allowed. That should be a very interesting time, for sure. I will definitely be listening to those hearings if they're broadcast.
Tana Amen: That's wild. I had no idea that ...
Dr. Daniel Amen: So the cannabis plant has THC, which is the psychoactive ingredient in marijuana, and it also has CBD, which they say has no psychoactive effects. I don't believe that at all. I've actually never done marijuana, but I was at a conference and I tried CBD, and it made me feel spacey. I did not like how it made me feel. 'Cause my brain's busy and I like it being busy. It sorta felt like I had a couple of drinks. I didn't really like how it made me feel.
The lore, or most people think, that THC in fact can be addictive, and people do have withdrawal, where CBD is not. What else can you say about the science about the difference between those two?
Dr Rebecca Siegel: CBD, they're putting it out there as going to help everything in every way, which is not necessarily true. That is why so much research needs to be done. But what is now approved by the FDA is a medical [inaudible 00:09:56] called Epidiolex. That is solely CBD in a special preparation, a liquid form, for children with severe forms of seizure disorders, Dravet syndrome and Lennox-Gastaut. That has been passed through the FDA. It is an approved medication. It reduces the seizure frequency in children. It doesn't take the seizures away entirely. But that is huge. That's huge. That is the only actual reason why CBD has been approved by the FDA. For no other actual reason.
Tana Amen: Interesting. I have a question, 'cause you mentioned it with marijuana, like is it worse than having a drink? But one of my questions is, like you're saying, we don't have that much information yet long-term on the use of CBD. But is it worse than having a drink because you're stressed out, or taking sleeping pills, or taking pain pills because of pain? Because people swear it helps them with pain, it helps them with so many different issues. What's worse?
Dr. Daniel Amen: The question is, we actually don't know, because it's only so recently been legal that my thought is, let's do the other things first. If they don't work, then this becomes an option.
All right. Stay with us. We have lots more to talk about in the issue of CBD, THC, and are they a panacea to get you to heaven early?
Tana Amen: If you are enjoying the Brain Warrior's Way Podcast, please don't forget to subscribe so you'll always know when there's a new episode. While you're at it, feel free to give us a review or five-star rating, as that helps others find the podcast.
Dr. Daniel Amen: For more information, give us a call at (855) 978-1363.