Imagine you have a heart problem and that your doctor has never heard of the cardiovascular system. As crazy as that sounds, a growing number of physicians say that’s pretty much where we’re at with the endocannabinoid system and any number of conditions it affects, notably pain and inflammation. University of British Columbia’s Caroline MacCallum, MD, (photo) reported on this critical lack of knowledge in the European Journal of Internal Medicine:
Physicians of the world remain profoundly uneducated with respect to cannabis and the endocannabinoid system (ECS) that underlies much of its activity. A recent USA study documented that 89.5% of surveyed residents and fellows felt unprepared to prescribe, while only 35.3% even felt ready to answer cannabis questions. Additionally, only 9% of American medical schools documented pertinent clinical cannabis content in their curricula.
So how important is the ECS? David Bearman, MD, appearing on a panel of experts at this years fourth annual CannMed Conference (the first two were held at the Harvard Medical School), put it this way:
It’s arguably the largest neurotransmitter system in the human brain, central to homeostasis, modulates the speed of neural transmission, important in the functioning of the immune system, and it touches on an enormous spectrum of illnesses. And it is frankly criminal that so few medical schools actually discuss the endocannabinoid system let alone talk about the medical utility of cannabis.
Another panelist, Thomas Folan, MD, who’s Board-Certified in Neuroradiology and maintains a clinical practice in cannabis & cannabinoid medicine, agrees: It is absolutely criminal, he says, that we have physicians graduating medical schools as I did in 2007 not learning a single thing about one of the largest systems in our body.
It’s important to understand, says Bearmen, that we’re in this mess because of the fear created by the government’s 70-year history of criminalizing cannabis. The resulting stigma is so strong, he told the audience, that medical schools will neither teach it nor conduct research: “They won’t touch it with a 10-foot pole because because most are reliant on federal funding and they have no idea what the federal government will do,” if they’re involved in any way with plant-based medicine.
The upshot, says MacCallum, is needless patient pain and suffering. Appearing on the panel with Bearman and Folan, she said:
Patients suffer when they don’t get adequate information. For example, they’ll take too much cannabis because they haven’t been taught how to use it. And so their gut reaction is, I’m never going to do that again. Which is really unfortunte because with some education they could have a very different experience. So the patient education is just so key.
Bearman agrees: It’s not just that patients are doing it, he says, they also want to know more. Patients want to know how cannabis works, they want to know why cannabis works, they want to know what it treats, they want to know what dose they should take, they want to know what to do if they get high.
Fortunately, the views of MacCallum and company are becoming mainstream. For example, this summer the Mayo Clinic released a report called Clinicians’ Guide to Cannabidiol and Hemp Oils, in an effort to educate doctors about the ECS and cannabinoids. They also say that because CBD is a hot consumer trend physicians tend to dismiss it, wrongly so. Instead, the Clinic says, doctors need to learn as much as possible and develop an expertise about the ECS and cannabinoids, and take their patients’ interest seriously.