A Holistic Approach to Cannabis

While some doctors are becoming familiar with the use of cannabinoids for medical and recreational benefits, other physicians are reluctant to incorporate cannabis into a general health discussion. Dr. Ryan Zaklin is trying to change that.  He is a Columbia and University of Virginia educated physician who is passionate about the benefits of cannabis.  In addition to his medical practice, Zakin launched Integrated Medicine–a holistic approach to wellness that empowers individuals to explore cannabinoids as an alternative to traditional medicine. We asked Dr. Zaklin some questions to help “clear the air” on the benefits of marijuana for adults 45+.

TB: Most people go to a doctor with an ailment and receive a specific medication.  How is cannabis as a medication different? 

Dr. Z: Many people look to use cannabis for a specific ailment as well. While cannabis may target the physiology behind the ailment, or imbalance rather, there are up to 500 compounds in cannabis that may have therapeutic value. Thus, while most medications are one molecule with one particular target (that may elicit a cascade of physiological events), cannabis has multiple molecules with multiple targets. This is referred to as a “dirty drug” within the pharmaceutical industry as the mechanism is far from “clean”. 

Additionally, cannabis interacts with our physiology largely through the Endocannabinoid System, an elaborate collection of receptors and neurotransmitters that serve to maintain the tempo, or rhythm of the nervous system, keeping the whole system balanced. This system is ubiquitous, touching upon essentially every physiological system in the body. Thus, when patients use cannabis for a specific ailment, they are often inadvertently bringing other systems into balance, thus unintentionally improving aspects of their health. This is one reason cannabis appears to be a panacea.  

TB: How does the use of cannabinoids help to maximize our potential? 

Dr. Z: As related to above, we can then use cannabis as a tonic of sorts. In theory, if we regularly consume cannabis, we are bringing our ECS (Endocannabinoid System) into balance and covering a lot of bases. We may still need targeted therapy. But certainly, a daily tonic may help to fertilize the soil and keep things optimized. 

TB: How specifically can medical marijuana help people in chronic pain?

Dr. Z: There is a physiological connection between the ECS and mechanisms for chronic pain. Studies have also shown that medical cannabis patients are able to either cut their opioid or pain medication dose significantly (i.e. in half) or eliminate it altogether. I have seen similar results within my practice. In addition to the physiological mechanism for pain, there is a calming effect cannabis can have on the nervous system in general. Thus, the mild euphoria can be useful to someone who is used to constantly suffering. It offers them a moment of mental/emotional relief as well. Lastly, cannabis can help improve sleep. It is very difficult to overcome chronic pain without adequate rest and sleep. 

TB: “Oils, tinctures and salves are increasingly common in seniors’ homes. Doctors warn that popularity has outstripped scientific evidence.” NYTimes   What do you say to the skeptics? 

Dr. Z: Come spend a day with me in my office and you will see results that are frankly hard to believe. But there is some validity to the fact that unfortunately in typical fashion, certain companies are trying to take advantage of the green rush and are making swift promises on products that often do not contain what they say is in them. For example, there was a study in the Journal of The American Medical Association (JAMA) that looked at 84 CBD products from 31 different companies online. 21% of them had upwards to 6.43mg/ml of THC. For someone taking this twice daily, that’s about 10 times the amount I recommend anyone who is cannabis naive start with. Thus, there is validity to the major “caveat emptor” factor that we are now seeing in those who are trying to use this to improve their health. 

Salves are a completely different issue. One gets minimal systemic absorption without adding other factors into a topical, and the dosage really needs to be high. Thus, many people are wasting their money on these topical products with many bold claims. There may be benefits from inhaling some of the essential oils present in some of these products. And there is likely a positive effect on certain skin conditions. But, for example, I had a patient with skin lesions from agent orange exposure. CBD did nothing for him topically. Once he added THC in combination, he saw marked improvement. 

TB: How can cannabis help an aging population lead more active lives? (e.g., could cannabis provide support for a person who wants to bike through Provence, or hike in Chile? Check off bucket list items…)

Dr. Z: First, I have to obviously recommend one always follows the legality of cannabis. Thus, often one cannot take cannabis from state to state, however, there is some reciprocity. One must never leave the country with cannabis. 

That being said, when we feel better, overall, we tend to be more active and more adventurous. We are focused on connecting with others and experiencing life to its fullest, rather than our ailment. Thus, if cannabis is helping with any condition that is slowing you down, it may help overcome these obstacles. When used appropriately, cannabis can be quite stimulating and energizing, which goes well with hiking and other outdoor activities. Of course, one must not be intoxicated from a safety standpoint, but the energizing experience often occurs prior to the intoxication. Then, at the end of a long, active day, one can have restful sleep using cannabis. 

Cannabis can also offer different insights both within as well as with others. It can improve sexual activity. It can help you loosen up. Additionally, if we are speaking about bucket lists, well those baby boomers who used to enjoy some cannabis “back in the day” can reignite that spark within them (pun intended) that motivated them to explore their relationship with this plant. Fortunately, now they can do it free of guilt other than association. Unfortunately, if they were using it to be a rebel those days are limited. 

TB: What would you prescribe for: arthritis, anxiety, sleep deprivation, menopause

Dr. Z: Cannabis and Meditation as well as a few other herbs. It really does boil down to the needs of the individual. I would need to see them so that I could understand them from a holistic perspective and tailor a personalized treatment program for optimizing their ECS. 

To further navigate the world of cannabis, please read our companion article, “Wading Through The Weeds —What Can Cannabis Do for You?”