Friday, November 16, 2018

Most Medical Schools Don’t Cover the Endocannabinoid System, They All Should


The endocannabinoid system is the second largest neurotransmitting system in the body, so why aren’t medical schools teaching it?

When will more medical schools include the second largest neurotransmitter system, the endocannabinoid system (ECS), into medical school curriculum? In 2013, Cardiologist Dr. David Allen did a preliminary survey to determine which schools teach the ECS and found that only a total of 13 percent of U.S. medical schools even mentioned it. Now, we’re not talking about cannabis here, but a neurotransmitter system that was discovered in the late 1980s, almost 30 years ago. We know that it is critical for homeostasis, yet few medical schools have seen fit to train medical students about it.

If a physician is unaware of the ECS, its constituents such as the neurotransmitters anandamide, 2AG and dopamine and/or the role of dopamine in retrograde inhibition, how will doctors ever understand how and why cannabis treats migraines, seizure disorder, Crohn’s Disease, arthritis, and the myriad of other conditions cannabis has been shown to treat?

The federal government has gone out of its way to discourage the discussion of even the neuroanatomy and neurophysiology of the ECS. Strangely, the government has been particularly active in its efforts to falsely debunk the medical utility of cannabis and cannabinoids— even though the Department of Health and Human Services has a patent on the popular cannabinoid Cannabidiol (CBD). The U.S. government has known since 1974 that cannabis kills cancer cells. 

A case that illustrates this point is the way the federal government dealt with important research done by the distinguished University of California at Los Angeles (UCLA) pulmonologist and frequent recipient of National Institute of Drug Abuse (NIDA) grants, Dr. Donald Tashkin. Tashkin was tasked with proving the link between smoking cannabis and lung cancer; his study proved the opposite. What Tashkin found amazed him and dismayed the feds.

Tashkin’s team interviewed 1,212 cancer patients from the Los Angeles County Cancer Registry. His control group was 1,040 cancer-free citizens matched for age, gender, and neighborhood. Smoked cannabis use was measured in “joint years” (number of years smoked times number of joints per day). Tashkin found that increased use of smoked marijuana did not result in higher rates of lung and pharyngeal cancer. In fact, they had a lower risk than those who smoked nothing at all. Tobacco smokers, of course, were at greater risk the more they smoked. Tobacco smokers who also smoked marijuana were at slightly lower risk of getting lung cancer than tobacco-only smokers.

Ever since his results were reported the government has been very quiet on Dr. Tashkin’ s findings . They have dissembled and tried to undermine his credibility. Rather than publicize his findings the government seized on a much smaller study done in New Zealand. The NZ study had exactly the same findings as the Tashkin study except for a handful of very heavy users. However, there were so few in this category that the cohort was not statistically significant. The federal government seized on this statistically insignificant outlier and gave it widespread publicity. They misrepresented the findings of the NZ study saying it contradicted Tashkin’s. This was a complete misreading of the results. “Heavy cannabis users may be at greater risk of chronic lung disease - including cancer - compared to tobacco smokers,” is how BBC News summed up the New Zealanders’ findings .

The New Zealand study looked at use levels of cannabis and all but the statistically insignificant heavy user cohort had similar results to Tashkin. The media ignored the very small size of the entire study - 79 smokers took part, 21 of whom smoked cannabis only. According to the mainstream media, the New Zealand study represented the latest word on this subject.

Talk about fake news! In a talk he gave at Asilomar in 2008, Tashkin criticized the New Zealanders’ methodology. According to O’Shaugnessy’s Fred Gardner, Dr. Tashkin said, “There’s some cognitive dissonance associated with the interpretation of their findings. I think this has to do with the belief model among the investigators and - I wish they were here to defend themselves - the integrity of the investigators.”

We need to have science dictate policy, not people like former Attorney General Jeff Sessions who clearly lied under oath before Congress. One can only ask what other lies have we been fed to justify avoiding using cannabis as medicine. Medicine needs to be directed by intellectual curiosity, a thirst for knowledge and truth and science. I urge medical school faculty who share these values to give your students the tools they need to survive in the twenty-first century medical environment.

11/28/2017
By Dr. David Bearman,  HuffPost Contributor
Dr. Bearman is a California M.D. who specializes in pain management, harm reduction and medical cannabis.

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