In week 13 we sat with Dr Stephen Chalk GP and Medical Director of Cannaponics.  In this episode, we discuss how they have begun building their cannabis company in WA as well as patient outcomes with a focus on pain and dependency between medications versus cannabis.  We also discuss cannabis efficacy in terms of clinical evidence vs. reported quality of life, tolerance, titration and dosing especially in the case of treating pain and sleep disorders. We deep dive into the pros and cons of opiates and other pain/sleep medications versus cannabis and the surrounding concerns from efficacy to price.

Key Points

0:59 – Dr. Stephen studied pre-clinical medicine in Oxford and then went to King’s college London for clinical medicine. He has been working in various emergency departments around London. He moved to Australia so as to change the hectic working environment about 9 years ago and has been settled here ever since.

2:31 – Dr. Stephen agreed that Australia has a very relaxed and supportive environment for doctors as compared to UK.

3:00 – Dr. Stephen asserted that after a few years of working in busiest emergency department across Australia, he completed his GP training from south of the state. On his patient’s insistence, he felt drawn towards medicinal cannabis while working as a GP. He explained that he always felt like decisions were not made strategically in this field, therefore, he joined Cannaponics as a medical director to improve the said situation.

7:20 – Dr. Stephen described the growth site in Collie along with the concept of supporting local community by setting up the industry in a fast deserting land.

8:24 – Dr. Stephen spelled out the desire to give patients access to low priced locally produced medicines.

9:25 – Dr. Stephen clarified that the most common problem which required prescription of medicinal CBD was chronic pain as there was no effective traditional medicine available. He also explained that doctors were gradually moving away from opioid prescription as it led to long term dependence and addiction.

12:35 – Dr. Stephen was of the view that apart from medicinal cannabis, there was a lot of talk about not using opioids or anti-inflammatory medicines thereby limiting choices for chronic pain management. He asserted that the improvement seen in patient’s sense of well-being and quality of life was all the evidence required to believe in the healing power of medicinal cannabis.

15:58 – Dr. Stephen believed that there was an overwhelming evidence that medicinal cannabis has a positive impact on one’s health.

16:34 – Dr. Stephen demonstrated that due to subtle improvement, the majority of people failed to notice any effect altogether. However, he illustrated that the same people accepted some positive outcomes on insistence.

18:48 – Dr. Stephen shared a tragic story of a patient whose respiratory system collapsed due to opioid abuse.

20:40 – Dr. Stephen expressed that abundant evidence of recreational and illegal use clearly demonstrates the safety limit of intakes of traditional medications versus cannabis, therefore, it has better safety profile than other traditional medicines.

22:19 – Dr. Stephen narrated a situation where patient accidently received about 10 times more cannabis oil than prescribed but still had no major side effect. He clarified that this trait was not possible with any other medicine.

25:17 – Dr. Stephen agreed that TGA regulations specify clearly that it cannot be used as a first line of defense against diseases. However, he narrated that he always desired to immediately prescribe medicinal cannabis for anxiety, sleep disorders and stress.

27:19 – Dr. Stephen believed that counter access for wellness is not the right way to go as there would be no quality control. He elucidated that over the counter CBD medicines would be available within a few years.

29:50 – Dr. Stephen spelled out that CBD is really safe unless anyone has liver impairment or interactions with rare medicines.

30:26 – Dr. Stephen explained that he was not strictly against the recreational usage of cannabis as it allowed individuals to release their daily stress in a healthy way. However, he expressed that he is not too crazy about recreational legalization as it could take patients towards self-prescriptions. He cleared up that he smoothed the things out for patients by treating any possible side effects.

34:58 – Dr. Stephen explained that usually when patients are at the end of line, they are already on a cocktail of traditional medicines.

35:47 – Dr. Stephen iterated that it was best for patients to make a market survey and compare medicines before buying any PBS medicines.

36:43 – Dr. Stephen clarified that the medicinal cannabis is usually added in small amount before amplifying its dosage. He was of the view that the symptoms must be viewed carefully before increasing the dosage to view their overall impact. He insisted that doctors should not try to get rid of all the symptoms at once so they need to opt for start slow and then medium pace.

40:05 – Dr. Stephen explained different types of pains. Among them, he was of the view that osteoarthritis is the most common chronic pain which was very difficult to manage even with medicinal cannabis. However, overall response of medicine depends largely varies from patient to patient. He also expounded upon Fibromyalgia and its treatment through medicinal cannabis.

42:42 – Dr. Stephen explained that due to hyperactive pain nerves in Fibromyalgia, the patient had a package of sleep deprivation and widespread pain symptoms. However, he also explained that all these symptoms can be easily fixed through THC.

45:31 – Dr. Stephen elucidated that all symptoms could be easily managed through medications versus cannabis

47:36 – Dr. Stephen expressed that no professional body stood for medicinal cannabis despite of PBS approved medicine available in Australia owing to the stigma amongst the medical community. However, he believed that the situation was changing as a growing number of GPs were opting for medicinal cannabis. He asserted that a number of qualifications and courses were available for doctors to educate themselves about medicinal cannabis.

49:55 – Dr. Stephen clarified that due to lack of knowledge among patients, most recurring question is relevant to the legal status of medicinal cannabis.

50:31 – Dr. Stephen notified that the doctors could suggest medicinal cannabis as a therapy but could not publicly advertise it.

51:44 – Dr. Stephen affirmed of the unpredictable status of medicinal cannabis and asserted that tolerance can be built up by gradually increasing the dosage.

55:14 – Dr. Stephen believed that it was very hard to balance the dosage of medicinal cannabis.

Links:

Cannaponics: https://cannaponics.com.au/