Sawbones: A Marital Tour of Misguided Medicine - Sawbones: CBD Oil

Episode Date: August 4, 2018

CBD oil is collecting a lot of adherents and getting a lot of buzz due to, in part, it being derived from cannabis. It won't get you high, but is CBD oil the panacea many are promoting it as? Let's discuss on this week's Sawbones! Music: "Medicines" by The Taxpayers

Saubones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, what's wrong with these about? Some books. One, two, one, two, three, four. I'm your co-host Justin MacCaroid.

And I'm Sydney MacCaroid. I'm your co-host Justin Macaroid. I'm your co-host Justin Macaroid. I'm your co-host Justin Macaroid. I'm your co-host Justin Macaroid. I'm your co-host Justin Macaroid. I'm your co-host Justin Macaroid. For the mouth. Hello, everybody and welcome to Salt Bones, and we're able to wear a misguided medicine. I'm your co-host Justin McElroy.

And I'm Sydney McElroy. Been like three weeks, Sid, since we've been recorded in this fashion. I mean, we missed week last week. We've heard that we recorded across from each other. It was kind of strange. Across the states, I should say. That's true.

That was unusual. I was unusual. Hey, Sid, have you ever recorded an episode of Salt Bones before? the states, I should say. That's true. Yeah. That was unusual. I was unusual. Hey, Sid, have you ever recorded an episode of Sawmands before? Um, what? Just answer. Yes. Hey, Sid, have you ever, you know, it's just always, always got to get in.

Hey, Sid, have you ever recorded an episode of Sawmands before? Yes. Hey, Sid, have you ever recorded an episode of Sabas before on weed? Is that really, is that gonna be the, can we not? John Stewart half bait, amazing. Amazing performances. This has been great performances from PBS, starting John Stewart as the, what guy from half bait to ask if you did everything on weed.

We've already done a whole episode on medical marijuana. So you may be confusing some of our listeners. Well, it's because I'm on weed said you're not. I'm on a lot of weed. No. And so I'm a little mixed up a little loopy go kuku in the head. You say, do you want to share what you, so Justin is prone to self experimentation. He likes to try new things. You got to try new things because they might help you are anxiety. That's what Daniel Tiger says. So what have you been, what have you been dabbling in?

So the thing that I've been sort of messing around with is CBD oil, which stands for cannabis buds, do it oil. Cannabis oil, nope. And we're at the health food store, and I guess this should have been a tip off because we were at this new health food store in Huntington, and we're like making fun of like all kinds of whack stuff

that was in there that we'd seen on saw bones. Like this is whack, this is made up, this is stupid, this is wax, and then as we were checking out, I got something at the counter. What is it that I had to get? It was like, Charlie wanted something. She saw something and pink there. And so I was buying it and then I saw CBD oil at the counter

and I'd heard that that was like good for anxiety. So I was like, for some reason I forgot that everything else in the store was made it and then I saw CBD oil at the counter and I heard that that was like good for anxiety. So I was like, for some reason I forgot that everything else in the store was made up and thought like, maybe this will do it. So I bought this drop of CBD oil and I asked I said, can I have some CBD oil please? He had this whole display and he was like, which one? And I was like, I actually don't have any. The one everybody likes. I put no thought in this.

What's the, they just opened, so they don't even know what the pop is or what is. So I just like got one at random that was peppermint and looked like regular. I thought I was playing with some pretty strong forces and I didn't want to get into like the deep stuff because it was weed and I was afraid. Was the one that was called the deep stuff? No, it's called the, I think it was weed and I was afraid that I was the one that was called the deep stuff.

No, it's called the, I think there was a maximum strength if you remember a service and I did not want to get into that stuff. The deep stuff, the dank stuff, the double, the double strength stuff. The good stuff. Can I have the double stuff? I thought I was going to get arrested. So I was trying to be quick. And also I didn't talk about it. Actually, I was afraid I was going to get arrested by the wife, Dr. Police, because you didn't know that I was buying it. I was afraid you'd make fun of me. I didn't. I was looking at the, I was like, well, this is, it's unfortunate that we have this store that has so many fake products in it, but then they also had some good vegan foods for when my sister comes into town. So I was perusing. You're perusing those while I was getting hooked on, hooked on weed, hooked on the good dank stuff.

Justin, do you know what you bought? I, okay, kidding aside. You know what it is. So not that much of a dense. As I understand it is a oil that is made as a byproduct of cannabis that in and of itself has no psychotropic qualities. That is correct.

It is one of, there are like 113 cannabinoids in hemp in marijuana, and it's one of them. And it's not THC. THC is what makes you high. And it's been cannabidiol does not. So, it's not, I don't, do you, have you thought you've been high on it? That's a great question. Let's start with that. Do you think, were you thinking you were high? No.

Because you're not. No, I don't think I, I didn't think it was high. All right. Well, we will eliminate it. And we're having a little bit of fun. All right. We'll just making sure. To the show.

No, I mean, you let me know when you're ready for me to talk about my, my experiences with it. Do you want me to go through the evidence first or do you want to talk about your experience? It might be easier for me. Actually, you know what? It might be better for me if I talk about sort of my perspective on it

because I feel like I might be too embarrassed to actually use that way. Okay. I did a curse show. It's not as bad as you think, but go ahead. I did a cursory Google and what I did find was, I think I found like a study, I thought I found a study that it was helpful with anxiety

I saw and then I saw a lot of anecdotal evidence which I know I know I'm not saying that I was that's like Be all-end all but I saw a lot of it. They're loved and it's from people who are like Whatever and the thing that I do believe about like cannabis and hemp and anything like that is an offshoot of that a lot of things There's one not going to be a ton of research done into it because there's not a lot of money in it. And two, there is going to be all research is going to be sort of hampered even in this case by the connection with marijuana. And I think that I've even seen some states that are like making it illegal. And I don't know why you would do that if there wasn't something to it.

But anyway, I've been kind of experimenting, like I said, kind of doing the standard dose, whatever they said to do on the bottle. I dropped like 15 drops out of an eye dropper under my tongue of this peppermint flavored oil. And I would say like once a day, and I would say that it is not extremely pronounced, but and again, and maybe placebo. But I do feel like I have a slight mellowing of my mood when I have taken it. And I felt I forgot it when we went on our book tour and I felt like I was a little More stressed out now that it was very stressful kind of whirlwind travel experience so that could be Stressful and then after that we were on vacation, which was

Well, it's less stressful than the bacteria was um So there's obviously some some mitigating factors there, but that has been my experience with it. It is not so pronounced where like, if I haven't taken it in the morning, and I've been doing it, I think like three weeks or so. And it's not so like, if I haven't taken it in the morning, I suddenly am like, oh my god, I'm freaking out why. So it's like, that has not been my experience. But I think there is a, it feels like there is a slight difference and I may be wrong. Do you think there is enough that if,

that it would like keep you from seeking out prescription drugs now? Like if you were thinking I might need a medication for my anxiety because it's not well controlled, that it has enough of an effect that you would no longer seek out a medication. Because you are. I mean, only if, only if, and this is, we've been talking a lot about this lately,

I feel like the difference of, like, different perspectives on science. But if and only if my anxiety was very well controlled by the real or placebo effect that this oil was having, if it was doing the job, where I didn't feel like I needed to seek out more stuff than I probably wouldn't, I have used, like, I mean, I still have, like my medication

that I have taken for it. So I would, if it was, you know, severe enough, like, you know, I think so. You're taking the pragmatist approach. Yes, I take the... It works, it works. It works, it works. Okay. But I'm not saying that it does work. I'm taking the pragmatist approach. Yes, it works. It works. It works. Okay.

But I'm not saying that it does work. I'm taking the Justin approach. It seems to have worked a little bit. Maybe we'll see what effect. I'm not aligned to myself. So, I don't think you're aligned to yourself. That's right. When I start with that.

But I think that we've done a whole lot of... It would be, I'm very easy to fold. So I would know if I was lying to myself. No, we've done a whole episode on medical marijuana, and I think a lot of the points that we made on that episode are gonna be repeated in this context. So, canada dial was discovered at first in 1940, and it was originally thought to be inactive.

It was just, here's another component of marijuana. We found weird, huh? We found a lot of these, they're not the THC one, 40 and it was originally thought to be an active. It was just, here's another component of marijuana. We found weird, huh? We found a lot of these, they're not the THC one, they don't matter. That was the original thought. As you said, it does not have a psychotropic effect. You don't get high from it, which is why it's kind of odd.

You're right, a lot of states have banned any derivative of hemp. So. They don't want to get into the research and do the research. So, which is odd in the sense that if it truly is just the can of a dial, it doesn't, it's not a drug, it's not psychoactive. So I'm not sure the purpose. But I'd say is more related to the fact that this is not well regulated, you don't know what you're getting. I don't know. This episode would be even better if I could say

at the end of it that I took your bottle to a lab and had it analyzed to see if there actually is CBD in it, if so, how much. And some actually have been found to contain THC, but that I'm getting. Well, that was gonna say that that's probably easier. It probably wouldn't be no great shakes to be like, to slip some THC in there and just kind of,

but use that as a distribution system, I guess. Or to not have it have CBD at all. Oh, really? Yes. So it's been proposed as a medication for anxiety. It's also been investigated for pain, for multiple sclerosis, for cancer, for epilepsy, which we're gonna get into, which is very interesting.

And there are some now like FDA approved uses for it. So very, very recently, if we'd done this episode six months ago, I wouldn't be able to say that. Oh, interesting. Okay. So when we get into like the history, there's not a lot of history of CBD because that's independent from the history of marijuana. And we've done a whole episode on that.

So I don't want to belabor that point. But marijuana compounds, whether they contain THC or not, have been used as medications for thousands of years. Right? We accept that. That that, like it dates back to an ancient Samarian text from 2900 BCE that people were using marijuana. It's introduction in the West is probably from the early 1800s. That's when we started seeing marijuana use for various purposes in the West. And you could go into the different strains of marijuana that we used. What's their more THC in those was their more CBD. That's a lot of the talk now.

You can breed it so that there's higher proportions of CBD to THC. You know what I mean? Right. But it's been used for a very long time for things like pain and appetite, stimulation and nausea. And even in the 1840s, you started seeing it mentioned as something for anxiety and other psychiatric disorders and also for seizures and that kind of thing.

and other psychiatric disorders, and also for seizures and that kind of thing. It was part of the United, like, the US pharmacopia, like the list of accepted medications to treat everything from psychiatric things, like depression, to insomnia, to tetanus, to muscle spasms, to all kinds of different things. And that was all the way up until the Pure Food and Drug Act of 1906. And that was all the way up until the pure

food and drug act of 1906. And that's when you start to see like the decline of the use of marijuana. And at that point, it was being prescribed for many different things. But that started to regulate it. And then finally, in 1970, it was made a schedule one narcotic in the United States. And at that point, of course, the Schedule One drugs are drugs that supposedly have no medical, accepted medical uses. Yeah. And so if something is a Schedule One, that prevents us from, you know, using it as a medication. What it also does is prevent us from, know doing experiments with it on people. Oh weird isn't it because it's like it doesn't have any but if it does

We will never find out it's kind of silly in order to put something as a schedule one It really should mean I mean it really should be something that we know it's miss labeled It's miss labeled and we talked about that on the medical marijuana episode I really feel like CBD and medical marijuana in general, marijuana has no business as a schedule one. I mean, it's listed as the same as heroin or cocaine. I mean, it's not the same thing. And I think we all know that whatever your feelings are on recreational use of marijuana,

I think we can all agree that it's mischeduled. You just said that on a podcast now, you're gonna have to resign as surgeon general because in Barlett won't let you, because you do a good job. That was a great episode. Now, I'm not gonna get into the recreational use of marijuana, because I think there are a lot of,

I mean, that's a lot more, that's not medicine, and I'm a doctor. I get into it on my show Weedsum, where I talk about all the recreational times I've had on marijuana. You can talk about it as much as you want, but I'm just gonna get into the medical stuff. I'm actually out of stories now. I will leave it a mystery whether I am pro or con,

although most people could probably figure that out. Much has been made of the medical potential of marijuana. And this was usually linked to THC, but we have over time begun to engineer strains of, like I said, marijuana that have more CBD. And so we're investigating the potential of just the CBD because the thought is, maybe you're somebody who has any one of the disorders

I've named and you are interested in marijuana because other conventional therapies haven't worked for you, but you don't want to get high. Right. You don't like the feeling of being high. You're not interested in the psychotropic effects, but if there are some sort of medicinal properties, you are interested in that. And then CBD comes in because there has been some evidence that perhaps CBD alone Could help us or things right right?

Products that contain CBD can range from like actual strains of marijuana that just have more CBD But it's still marijuana. So you're still going to get all the psychoactive effects right Two things that are like one-to-one like compounds that are one-to-one THC and CBD, two pure CBD oil products, which should not make you high. How does it work is a big question. So we've removed the THC, so you're not just getting high. And that was the thought for a lot of people, right? Like, does marijuana just help with pain or anxiety or whatever because you're high?

Right. And so now you don't care. Well, obviously not if CBD helps, because CBD doesn't get you high. So how would that work? There are certain receptors in your brain that are actually like, we've labeled them as cannabinoid except, or receptors, CB1, CB2, different receptors. And would those be even being there if we weren't supposed to be doing? one CB2 different receptors. And would those even be in there if we weren't supposed to be doing, I wanna think about it. Why would the Lord and all those infinite wisdom

have put receptors in there for weed if we're not supposed to do weed? Certainly, other things could bind and do bind to these receptors, but also this. It's stumped. At the centrally located CB1 receptors, the way that CBD works is to delay the breakdown of something called a nanda-mide. And that is a substance that acts at these receptors to like comb your brain.

It calms down neuronal activity in your brain. It can also help to reduce pain and inflammation. And as a result of it calming that, or as a result of delaying the breakdown of the substance that causes, it calms your brain, then you have a longer calming effect. Does that make sense? This is similar to how, sort of how like an SSRI, a selective serotonin reuptake inhibitor, that's like prozac, or another antidepressant. It's similar to the way, a selective serotonin reuptake inhibitor, that's like prozac or another antidepressant. It's similar to the way they work on serotonin. They keep the serotonin around longer. Think about it that way. This keeps the anandamide around longer.

The CBD is indirectly keeping this calming effect in your brain longer. Okay. That's one way we think it works. It also acts on CB2 receptors, which helped to reduce pain and inflammation. Help you enjoy the movie CB2 starring Chris Rock. Maybe is that CB2. No, sorry, CB4. We're not there yet. Oh, no, I don't know about those receptors.

In addition, high amounts of CBD have been found. I have a lot of CB4 receptors. Let me just put it that way. It's a good flick. In addition, high amounts of CBD have been found to bind to serotonin receptors. And we know that serotonin is the, that is how we have chosen to address a lot of anxiety and depression through medications already, right? Yes.

So we have a lot more literature on CBD in like the last 10 years. So a lot of the stuff, a lot of our solblins episodes are old stuff. Well, the history is kind of being written on CBD right now. We're in the midst of this is the history has a sigh on our CBD. Well, it's true. We had, you know, some thoughts that maybe it would help with, like I've said, anxiety, depression, with sleep, with nausea. At the 2015 International Cannabinoid Research Society, 25th Annual Symposium, they reported that the use of CBD can be beneficial for a whole bunch of different things. Kidney fibrosis, inflammation, metabolic syndrome, overweight and obesity, anorexia,

osteoarthritis, all kinds of musculoskeletal conditions. And again, this is all like preliminary evidence that people are suggesting. Some of this is in vitro, some of this is in vivo. And that's kind of where I would start to get a little, I don't wanna say suspicious, I'm not skeptical of it, I'm just not as excited, maybe as some people are. A lot of this is in vitro,

which means we are watching the way CBD interacts with different parts of your body under a microscope, like in a lab. Here's how it bound to these receptors. But what does that mean clinically? What will that do in a lab. Here's how it bound to these receptors. But what does that mean clinically? What will that do in a human, in a living, breathing human body? What will it do?

Are you asking me, or is that rhetorical? Cause I don't, you don't know. I don't know. Yeah, well, they don't either. I mean, that's the problem. And that's the thing, like in vitro study is great. It's a first step, but then until you put it in humans,

you can't draw conclusions. You can say that things that compelling, there's a correlation, this is interesting, this deserves for the research, absolutely. But so far, clinical data that actually proves this stuff is still lacking. We just haven't done it yet. So, and I'm gonna say this a lot in this episode

so that I try to avoid a lot of angry emails. I'm just saying we need more research. Right. Not saying that the answer is no, but I'm not saying the answer is yes, either for a lot of these claims. I'm not saying it's no. I'm not saying it's no.

But, you're not saying it's yes. But, the excitement about the possibility of CBD, the excitement about the possibility of CBD, I think has far outstripped the evidence for its efficacy at this point. Right. It got, let's say, let's say, I think it's fair to say that CBD has gotten a pretty good bump from its cousin THC.

Yeah. In like building buzz. Writing the co-tails of THC. And there are products that contain CBD all over the US, not just oils like UBOT, but they're like energy drinks and energy bars and coffee that also has CBD and tea made out of CBD. I mean, like there's all kinds of different ways to consume CBD. And the problem with that is that right now,

nobody's quite sure how to regulate this stuff. And so you don't know what you're getting. Some of them might actually contain any at all. And even if they do, the bioavailability, which means the amount that you can actually absorb after you eat it, after you take it in your mouth, is only like depending on the preparation, somewhere from 13 to 19%.

Ideally, it can be quite, it can be much less in some preparations. So if you're only getting that much, is there enough in your energy drink to even do anything? Oh, maybe not. A study from the Netherlands collected homemade and store bought CBD products and then just analyze them to see what was in them. And they found that they didn't consistently contain any CBD nor did the amounts present coincide with what was printed on the label, which what they said was supposed to be present in them.

And what's even more concerning is that there were reports last year in Utah of a CBD oil, or of an oil compound that was being marketed as CBD that was actually a synthetic cannabinoid. And we have talked about the dangers of synthetic marijuana on the show before. And it was resulting in seizures and hallucinations. And a lot of patients were being hospitalized because the stuff they were getting wasn't CBD at all. So this is why I think some of this excitement is dangerous is because there are all these products to, you know, to try to make money off of this excitement, but.

It kind of looks like a baby a little bit. Yeah. Like this thing popped up and it's kind of a miracle and everybody lets all just get like waist deep in it without really knowing. And because like, one, there's a lot of positive feedback and two, like, we don't know what it does. Yes. We have no idea.

No, we don't know what it does. And as again, as I've mentioned, we mentioned, we are federally prohibited from doing a lot of studies to find out more. So what does it work for? Well, I'm going to tell you what it does work for, but first Justin, let's go to the billing department. Let's go. The medicines, the medicines that ask you let my God before the mouth. All right, Sim.

All right. You ready? You want me to tell you what it's good for? Justify my preconceived notions. Well, I'm not going to justify it, but I'm going to tell you some things that are interesting. There are at least some studies that have suggested that perhaps it can be helpful for some of the pain that can

be related to multiple sclerosis. I at least, they believe that in Canada and Sweden where a medication to T-Vex, which also contains THC, is prescribed for this reason. So there is at least enough evidence that they're willing to prescribe it. Notably in the US, and this is probably where most people have heard of it recently, epilepsy. So as of June, the FDA approved a CBD, a CBD-based drug for epilepsy. That's, that's kind of huge. Is that saying that it's like, does that say it works? I mean, if the, yeah, I mean the FDA believes it said the FDA is part of the federal government

in 2018. I do not think it's a buck wild question for me to ask does that mean it works? Uh, okay. Do you want me to get into like politics in the FDA? Not really. I mean, like yes, the FDA, the FDA is a government organization and there, there's lobbying. And then if you want to get into the power of the pharmaceutical industry and their ability to lobby drugs and get them through faster that maybe there are not, there's not great studies

for, I mean, like, yes, obviously all this exists. I'm not going to sit here and say, if the FDA believes in it, it must definitely work. But there's got to be at least they have standards. There has to be some evidence that it does something. Okay. It can't be some evidence that it does something. It can't be totally fake and make it through the FDA. Theoretically, it's helpful, correct? Yes. Theoretically, yes. This was big news. This new medication, EpidialX, is what it's called. It's CBD and it has been approved for specifically two syndromes, two epilepsy syndromes,

Linux, Gesto, and Dervet syndrome, which are, and it's important to know that they're approved for these syndromes. These are usually diagnosed in children. I mean, they're always diagnosed in children, I should say. They're pediatric epilepsy syndromes that are very refractory to treatment. These are traditionally very difficult disorders to treat. Patients who have these syndromes may suffer from 50 or more seizures a day. So these are what we kind of consider intractable epilepsy syndromes. And so this

isn't being used as like a drug of first choice among everyone who's ever had a seizure. They're using it for patients who have probably tried and failed many, many other medications. And maybe that ketogenic diet we talked about on our keto episode. So but that is that is a FDA approved usage now. So there are at least some studies that were compelling enough that the FDA said, okay, let's give it a go for this. Okay. And as far as anxiety, there was a meta analysis in 2016, which is a big study of studies,

it's big like compilation of a bunch of studies. Sounds like the best you could do, really. Which showed that some animal studies suggest it might help with anxiety. I'm an animal. And humans there, I found case reports, I found very small trials. Some of them were indeed double blind trials. Like specifically, there were some things for like give a give a speech something you could control very easily something that like you have to give a speech in public and you

either do it with CBD or without CBD and whether there was like a placebo that had like corn oil in it or something. Anyway, I found studies that were small but did show some of them some statistically significant results. I know I shouldn't get you out by that one. But like, it really helps me out this idea. Like, I got a big speech coming up. Glad I just ate a whole syringe of corn oil. Anyway, I didn't, I didn't blow them all away. I got amped up with my not at all baffling, pre-sher ritual. And I'm ready to go.

And everything else, we're not really sure yet. All the other things that it's claimed to be good for, we don't know, and it's hard. Yeah, okay, Dr. McAroy, I'm gonna need you to like couch that anxiety effect efficacy a little bit more. You, I met a study of animals, that's fine. I need you to like be judgy about it. What does that mean to you?

I know, because people are gonna go off and they're gonna be like, I gotta get CBD oil. Dr. McAurray said it totally works for anxiety. I would say what I say about a lot of things, and this isn't just the party line. This is what I truly believe. If you have untreated psychiatric disease, I would seek help from a professional. I wouldn't, I wouldn't self-treat. I would go ask for help

from a, from a psychiatrist or a family doctor or a psychologist or therapist or counselor. None of them will have a guts to give me the CBD oil. Like, crave. I would go talk to somebody. I would. They don't want to be put out of business. I think that yes, it is important. And I'm not saying that that's the only thing to do. And this is true, not just for things like anxiety and depression.

This is true for hypertension or diabetes. It's true for everything. You've got to find your own coping skills and mechanisms for managing your disease yourself. Absolutely. Which is why we've talked before about things like yoga or meditation or some of the different techniques you've learned to help you cope with your anxiety that I think are very important. I don't always have the time for this.

Sometimes I just want to score some wool in my mouth and get on with my day. I accept that CBD could be part of that for some people, but the problem, and I guess this depends on, Justin and you and I have been talking a lot about if you're a pragmatist or an empiricist. I guess it depends on if it matters to you, if something really, really works and can be proven in a lab to work, or if it seems to work, and so that's good enough for you. Success is that it appears to work and you don't need to know the truth.

I guess that's what it matters. So far, I will tell you this, it does not, if it is in fact CBD, which you can't guarantee if you're buying a supplement, what you're taking might not be CBD. Okay, the guy behind the camera seems pretty good. What you're taking might not be CBD. Okay, the guy behind the camera. What you're taking may contain zero CBD. Okay. So if we theorize that what you're taking and anybody else is getting is actually CBD, it's probably a low risk thing to do.

Yes. I found a study actually that specifically said that like they were trying to out for Crohn's disease to see if it would help with Crohn's and they said no, it doesn't help, but it didn't harm anyone. It seemed to be a safe but not effective thing. Safe ineffective treatment for Crohn's. There are side effects to it. You can have some stomach upset, you can have some sedation, and especially if it also is found to contain some THC, but you can be drowsy. But generally speaking, the side effects are fairly minimal, so it's usually tolerated really well.

It's fairly safe to try most of the time. But again, I can't tell you what you're taking. Like I can't tell you what you're getting if you're buying it from a supplement place. And this is concerning because it is marketed to at-risk population, kids, kids with these intractable epilepsy syndromes are being marketed this product that is not well controlled and may work some people.

You can also rape it. It's very speaking of. Yeah, we had. I didn't get into that. Yeah, you can consume it in oil, you can inhale it, they're different preparations of can be dialed that are available.

It's being marketed to the elderly for things like Parkinson's or dementia or Alzheimer's. And then all of the complex fatal diseases, always like anything that's new, I feel like gets proposed for things like cancer cancer. You know things that can be terminal things like multiple sclerosis People who feel like well may feel like at some point that they're out of options And so they are more likely to to be desperate and turn to these things and that always makes I think any of us a little skeptical a little suspicious The regulation is a big problem because of conflicting federal and state laws, right?

Right. Mara Watt has a schedule one drug. But there are states where it's legal. Right. So it, so this gets into really murky, like legal waters as to who is in charge of this, who's going to make sure that what you're buying is what you think it is. The federal government says it's all legal. So what the heck, the FDA just approved a CBD. Right. So also, is it a food supplement or is it a medicine? Oh, no. If you're buying it over

the counter and it's a food supplement, then it can be safe until proven otherwise. If it's a medicine, we go the opposite route. It's unsafe until we can prove otherwise. So this really matters. And you just don't know what you're getting when you buy it over the counter. I should know, we kind of talked about this for Linux Gesto and like the use of it for epilepsy syndromes. The study that I got into like the study that the FDA used to approve this and I would not say it was a slam dunk for efficacy. I would not say that it was like the miracle drug. Why is that?

There were a couple of things. One, it was absolutely funded by the drug company, which I mean to be fair, most of the big giant double blind studies that prove a medication work are. So that's, I mean, full disclosure, it is. Um, at, but they made the only available like CBD preparation so far for this, the only like FDA regulated CBD thing. So they are, they are providing a drug in a market where there is no competition. Right. When you make an orphan drug, so the, or a drug for an orphan disease, so something that there's nothing else for, you can keep it on patent longer.

Mm. It's more lucrative. I'm just, I'm not saying that that means it doesn't work. I'm just saying these are things you should, oh, you, you, you deserve to know the whole story, I think. And when you get into like the politics of the FDA, this stuff comes in to play. And it's important to note too, in that same study, 23% of the patients that receive CBD had side effects significant enough that they dropped out of it. And I don't mean, yeah, I don't mean that anything bad necessarily happened to them. Like, I don't, I don't mean to say it's dangerous, but at least

made them uncomfortable enough. What's the strength for the isn't? You know, you know, I have to look at the strong dose. They think it was probably not the dose alone. It was in the study. Nobody was using it as a as monotherapy. Nobody was using it as a single agent. They were using it in combination with other epilepsy drugs. And that's one of the ways they think it might work actually. I was going to get into that is that it prevents the breakdown of other, it works on certain enzymes that break down other epileptic drugs. And so by preventing the breakdown of these anti-epileptic drugs, it actually lets them last in your system longer, which might one make them more effective, but two make you drowsier. And so that's why a lot of people dropped out is because the kids who were on the medication

were really drowsy. And so they took them out of the study. Some of the results, while they looked very promising, didn't actually ever reach statistical significance, which means even though it's it trended towards working, you couldn't actually say scientifically speaking that the differences weren't just from chance. Do you know what I'm saying? Yeah, I don't. So there is a follow-up study to this to try to kind of refine, because that's what you

always do. If you have a study that suggests something, you want to do more studies to try to see if it's true, you know, to reproduce the results, that kind of thing. And this one was a little concerning to me because there was a mention that there were certain patients that were handpicked and referred by one neurologist who was very convinced that CBD was the best way to go. And so he was finding patients whose like parents were gonna go like move to Colorado and get CBD oil no matter what. And so he was putting them in this study instead. So you're taking people who already believe CBD works and then giving them CBD and asking them if it works. You could kind of buy us your sample slice. It does. It does. There's a and I mean,

these are these this isn't a random sample. These are selected specifically. Right. But people who, yeah, and they're, they're seeing high placebo response in these studies. From people who think they've got the real stuff and they, because they believe in them, because they already were going to use CBD even before they got into the study. So they believe they've bought the hype. They believe it worked even before we saw why they're not dead. They might. The other thing, and I was reading some neurologist critiquing this, and I think that's the thing you need to know, like as doctors, I don't have a horse

in this race. I don't make money off CBD, and I don't make money off anti-liplactic drugs, so I am not in camp and a lot of neurologists their responses. I thought we're very That it was kind of moderate like well if this is a medication that works great if it doesn't work Let's not use it But we got to take the emotion out of it the all this passion for it really has no place in science. You just, you'd study it. Let's study it and see if it works. And we have some evidence that says, you know what, this might actually be helpful for patients with these very severe

chronic, can be very debilitating, you know, epileptic disorders. So let's try it. But let's, let's not get carried away, you know. carried away. And I think that's what we would say about literally any other medication, right? There might be better ways to target these receptors. We found them. We know CBD works. Maybe there's something we can make that works even better. Why are we settling for this if it works a little? Yeah.

Just because it's marijuana and that makes us excited. And if the government doesn't want us to have it. It's buzzy. Yeah, I mean, that's something to ask about. And it's also, you know, it's important to remember that like a lot of these, a lot of the people who are using this medication

are just, they're desperate, they're desperate for anything. Right. And so that's gonna, that might change the results a little bit, which I guess it doesn't matter if the patient is doing better from the perspective of the caregiver, does it matter whether it's true or not?

You know what I'm saying? This is not a cure all. It might help some patients, it won't help all of them. There are some who might be harmed by it. Again, I think minimally harmed, but might be harmed. This is true of every medicine. The CVD is not unique. I could have said that about literally any medicine I prescribed ever in my career.

But that just means that it doesn't make it something special. And I think that's probably like the end of this conversation. The point is there is no place for zealotry in science. It either works or it doesn't. And if it works, we should use it. And if it doesn't, we shouldn't. We should be able to study it. And again, I returned to if marijuana was not a schedule and drug, we would know a lot more about what it does and doesn't do.

And we wouldn't have to have, but when you try to research CBD, you have to sort through just pages and pages of people who are advocates for it without any evidence. Right, right, right. When you said anecdotal evidence, I was thinking about the idea of that term. Why is it, why is anecdote ever evidence? It's anecdote. It's not, yeah, it, why is anecdote ever evidence? It's anecdote. It's all, yeah, it's sort of like a paradoxical. I mean, like it can't, yeah.

Yeah, to my mind, evidence is evidence. And if this stuff works, we should make it available. It should be regulated so that you get what you think you're getting. So that we know that what's in that dropper that you're using is in fact, CBD. That is troubling for sure. And no matter where you stand on it, you should want this to be, you know, whatever. You should at least want to know that you're getting where you're getting. We should have endless room for evidence within the within the world of science. We should always be willing to explore and search. And if marijuana and CBD specifically have these great therapeutic possibilities, then let's

study them, let's figure out what they are, and let's find a safe, effective way to give them to people. If they don't, though, then we, I think you got to give it up and move on. And I think that's where I think that's where we're running into a wall is that, you know, I found people who are advocating its use to cure cancer. Exactly. You've lost me too, because, you know, if you're telling me there's some great studies that suggest maybe for epilepsy and for anxiety, and I saw some things for PTSD and for insomnia, again, for maybe pain and for nausea, I think all that stuff merits further study. Let's do some good studies and see if it works or not.

But once you start making claims that it is the miracle cure all that will fix all of your problems, well, we all know how that shakes out. You're standing with every other charlatan in history who's just been trying to make money off of the desperate. Folks, that's gonna do it for us this week on Sobans. We got some affiliate links on our website

where you can order CBD oil. Let us get a cut of the product. And we ask, well, it's a side bids. I'm looking into. No, we don't. I don't got a lot of great flavors. Vapet, don't vapet, it's up to you. Everything we have can be vaped and not vaped.

So I won't take this. Thank you, the taxpayers, for letting us use the song Medicines, this is the Interunaway Entrepreneur for our program. We got a book coming out in October, October 9, specifically. We've actually had the first common advanced reader copy of that book, and it is so neat, and we're so excited about it.

A city sister Taylor Smirrell did the illustrations and they're beautiful and you can get pre-order that right now. It is such a big help. Pre-orders are huge because they're counted in the first week book sales and that is a huge determining factor as to whether or not you get to make more books. So please, please take a moment and preorder go to bit.ly forward slash the solbona's book and preorder right now. I really, really appreciate it. I think we're really proud of this book. And I think you'll really like it. I think you'll like it if you like our show. And honestly, you know, it's made it into the like our show, but like it's like medical trivia. And and we're doing old medical stuff., it doesn't like our show, but it likes like medical trivia and weird old medical stuff get it form

because there's a lot of... Or just trivia. I think I always think this is a kind of book like for that person who just likes to know things that nobody else knows. Yeah, I learned a lot writing it. I think we both did. So, but folks, that is going to do it for us right now.

So, until next time, my name is Justin McAroy. I'm Sydney Mack. And as always always don't drill a hole in your head Alright! Maximumfund.org Comedy and Culture, Artistone. Listener supported.