1 00:00:00,000 --> 00:00:24,560 Welcome back to another episode of Your Mom on Drugs with me, the son. 2 00:00:25,440 --> 00:00:26,480 And me, the mom. 3 00:00:26,480 --> 00:00:32,880 My name is Josh Klaus and this is Jennifer Seltzer, Farm D, and I'm just a guy. 4 00:00:33,520 --> 00:00:38,400 And we're bringing you our actually our 10th episode today, which is crazy to think. 5 00:00:39,120 --> 00:00:43,520 And we're going to do it on a compound called CBD. 6 00:00:44,240 --> 00:00:50,240 Now this compound was brought to us. Mom, you want to tell the story of why we chose to do this? 7 00:00:50,240 --> 00:00:56,400 I would love to. So I had several people telling me, I mean, you know, older people, 8 00:00:56,400 --> 00:01:06,080 my age, telling me that they want 21. That's right. Forever 21. And using CBD and or cannabidiol is the 9 00:01:06,080 --> 00:01:14,160 actual what CBD stands for. And also just extra noticing how many dispensaries of CBD are around 10 00:01:14,160 --> 00:01:20,160 in our cities and towns. And so it just made me think, I want to know more about this. And so 11 00:01:20,160 --> 00:01:24,640 Josh and I talked about it and we thought this sounds like an absolutely perfect podcast. And 12 00:01:24,640 --> 00:01:31,760 so here we are. Yeah, there's a ubiquitous use of it. So we should probably go into what it is and 13 00:01:31,760 --> 00:01:38,800 how it's made and all the distinguish distinguishments behind that. So mom, what is CBD or cannabidiol? 14 00:01:38,800 --> 00:01:48,560 OK, so cannabidiol is actually a part of the whole broader term of cannabis. And cannabis 15 00:01:48,560 --> 00:01:54,240 describes products or compounds that are derived from two types of plants, either the cannabis 16 00:01:54,240 --> 00:02:01,040 sativa or cannabis in indica plants. If you saw these plants, a picture of them, you would say, 17 00:02:01,040 --> 00:02:04,720 oh, that looks like marijuana, because that's actually where marijuana comes from. 18 00:02:05,840 --> 00:02:12,800 The cannabiniol, the cannabinoids are the biologically active naturally occurring 19 00:02:13,680 --> 00:02:20,000 products from cannabis plants. The chemical structure was first determined in the 1960s. 20 00:02:20,000 --> 00:02:27,440 And the most there are several most common forms of the cannabinoids. The first is tetra hydro 21 00:02:27,440 --> 00:02:34,720 cannabinoid cannabinoid. I'm sorry, tetra hydro cannabinol, which is THC, or it's the main 22 00:02:34,720 --> 00:02:40,400 intoxicating component of marijuana. And it's shown also to have analgesic and anti ametic effects. 23 00:02:41,120 --> 00:02:48,800 The next one is cannabidiol or CBD. And it is considered traditionally to be non intoxicating 24 00:02:48,800 --> 00:02:54,960 and not to have the psychoactive effects like marijuana, but it may have some anxiolytic 25 00:02:54,960 --> 00:03:00,400 properties, which means anti anxiety. Can you remind me what any ametic means? 26 00:03:00,400 --> 00:03:06,480 Oh, yes. Anti ametic means to help you not throw up. Okay. So it's against like nausea, 27 00:03:06,480 --> 00:03:14,080 nausea and vomiting. Primarily it's used for cancer patients. Okay. So, and then hemp is, 28 00:03:14,080 --> 00:03:17,920 I'm sure people have heard of that as well too is primarily you'll see hemp and textiles, 29 00:03:17,920 --> 00:03:22,960 but which is like cloths, you know, woven fabric shirt with some hemp in it. Yes. So, 30 00:03:22,960 --> 00:03:28,160 and it's predominantly CBD with a very low concentration of THC. So that's the definition 31 00:03:28,160 --> 00:03:32,320 of hemp. Gotcha. Okay. So the, and these are specifically the cannabinoids, 32 00:03:32,320 --> 00:03:38,400 the most frequently noted cannabinoids that we have available that we're familiar with. 33 00:03:38,400 --> 00:03:42,880 Yeah. I remember reading too, that in each of these plant varieties, there's like 70 different 34 00:03:42,880 --> 00:03:48,240 compounds, but these seem to be the ones that are the most studied or the ones of interest just 35 00:03:48,240 --> 00:03:53,840 because they have the most, well, at least especially with THC, they have the most noticeable effects. 36 00:03:53,840 --> 00:04:02,640 Right. Right. So just a little bit of how did the availability of CBD increase so 37 00:04:02,640 --> 00:04:06,960 rapidly in the last several years? Yeah. Cause I'd never heard of it until recently. I did, 38 00:04:06,960 --> 00:04:11,280 I always thought that it was just marijuana had THC in it. That was basically it. 39 00:04:11,280 --> 00:04:18,240 Right. And so it actually came, I became familiar with it right before I retired from teaching in 40 00:04:18,240 --> 00:04:26,160 2020. I also had a role on what is called the pharmacy and therapeutics committee for a hospital. 41 00:04:26,160 --> 00:04:31,600 All hospitals have that committee and that committee is in place to help determine what 42 00:04:31,600 --> 00:04:38,800 drugs are used in the hospital. And the issue of CBD came up because it's not a drug. We'll get 43 00:04:38,800 --> 00:04:43,280 into this in just a minute, but it was patients were bringing it into the hospital and they didn't 44 00:04:43,280 --> 00:04:50,960 know how to manage it. So, so basically in 2018, there was something called the agricultural 45 00:04:50,960 --> 00:04:57,360 agriculture improvement act, which was also called the farm bill that came into play. 46 00:04:57,360 --> 00:05:05,200 And this bill defined hemp as cannabis and cannabis derivatives that contained little to no 47 00:05:05,200 --> 00:05:11,120 THC. It had to be less than 0.3% THC in those. Cause I think for the longest time, 48 00:05:11,840 --> 00:05:17,120 marijuana is an illegal drug federally. Absolutely. And I think a lot, it was just kind of banned 49 00:05:17,120 --> 00:05:22,240 outright. And I think this was probably a way to say, well, it's not, there's other chemicals 50 00:05:22,240 --> 00:05:28,320 inside of these, you know, the Indica or Sativa variety that might not be as psychotropic as 51 00:05:28,320 --> 00:05:35,440 something like THC. Right. And there are some derivatives of THC that actually have been FDA 52 00:05:35,440 --> 00:05:42,720 approved as medications to be used primarily for nausea and vomiting in cancer patients that is 53 00:05:42,720 --> 00:05:51,120 available. So, but, so when, when this farm bill came out, then hemp and those derivatives that 54 00:05:51,120 --> 00:05:58,320 have very little THC in them became no longer illegal to sell or to market in the United States. 55 00:05:59,120 --> 00:06:04,240 But they are still under the food and drug administration regulatory authority, 56 00:06:04,240 --> 00:06:12,000 primarily subject to under the food, drug and cosmetic act because CBD is not considered a drug, 57 00:06:12,000 --> 00:06:20,080 but it's considered a cosmetic. And I'll get to that in just a minute. Cool. In Texas, CBD, CBD 58 00:06:20,080 --> 00:06:25,440 became legal to purchase in June of 2019. Governor Abbott signed that bill into practice here in 59 00:06:25,440 --> 00:06:31,200 Texas. So let me just tell you a little bit about the food, drug and cosmetic act. The food, drug 60 00:06:31,200 --> 00:06:38,480 and cosmetic act came into play in 1938. And it was due to the fact that there was a drug that was 61 00:06:38,480 --> 00:06:48,400 being used. It was called sulfonylamide and it caused poisoning. It had contained a toxic ingredient 62 00:06:48,400 --> 00:06:54,640 called diethylene glycol and it caused deaths. And so at that point, then the government decided to 63 00:06:54,640 --> 00:07:00,240 create the food, drug and cosmetic act. And in this there's regulations for food, drugs and 64 00:07:00,240 --> 00:07:06,640 cosmetics with the drug part of it. That's when it was just determined that all drugs had to have 65 00:07:06,640 --> 00:07:12,480 safety and effectiveness data with them in order to be able to be approved as an actual drug. 66 00:07:12,480 --> 00:07:19,040 But for our purposes, because CBD is considered a cosmetic, the things in this act that are 67 00:07:19,040 --> 00:07:26,160 relative or that are relevant for CBD are the fact that manufacturing facilities can be inspected 68 00:07:26,160 --> 00:07:40,240 where CBD is manufactured and that it can be that you can do quality standards for a cosmetic, 69 00:07:40,240 --> 00:07:45,920 but it's not going to be like a drug because it's not a drug. So there are a little bit of 70 00:07:45,920 --> 00:07:51,600 regulatory authority, but not like medications. So it's going to be more kind of the lines of like 71 00:07:52,400 --> 00:07:56,960 sunscreen or certain lotions. I don't know if sunscreen maybe considered a... 72 00:07:58,000 --> 00:08:04,080 There are certain types of sunscreens that are FDA approved, but not all of them and stuff. 73 00:08:04,080 --> 00:08:09,920 Okay. Yeah, we should also kind of come into play as like, remember this is the FDA, so it's the 74 00:08:09,920 --> 00:08:14,560 food and drugs. So we're talking about drugs, but also around food. And it's just a funny little 75 00:08:14,560 --> 00:08:21,920 side note. I don't know if it's funny, but it's like there was a time, I think we take for granted 76 00:08:21,920 --> 00:08:31,120 how consistent food has become in terms of shipment and quality. Like back, I believe it's in the 19th 77 00:08:31,120 --> 00:08:38,240 century. There was a time when coffee just kind of became a very predominant beverage in the United 78 00:08:38,240 --> 00:08:45,200 States. And so there was a massive demand for it across the United States. And a lot of suppliers 79 00:08:45,200 --> 00:08:53,840 were saying, well, I only have about 25% of the bean to meet the demand. Basically, I don't have 80 00:08:53,840 --> 00:08:58,720 enough supply. So what they would do is that they would stuff it full of stuff that kind of look 81 00:08:58,720 --> 00:09:04,080 like ground coffee or coffee beans and put it in the mix. So you thought that you were getting 82 00:09:04,800 --> 00:09:09,200 a whole coffee bean or a whole bag of coffee, but really you were only getting 25% with a lot of 83 00:09:09,200 --> 00:09:17,840 other stuff in between. And if suppliers are not required to list the ingredients that they have 84 00:09:17,840 --> 00:09:23,920 out, they will stuff it with other things. We're also seeing this too, currently with the fentanyl 85 00:09:23,920 --> 00:09:32,800 crisis, there's a lot of recreational drugs, things like MDMA or other pill forms that are 86 00:09:32,800 --> 00:09:37,520 actually being laced with fentanyl because fentanyl is really cheap to make. And then they can just 87 00:09:37,520 --> 00:09:42,800 put it in there and it's actually leading to deaths. MDMA or also known as ecstasy is actually not 88 00:09:42,800 --> 00:09:47,440 lethal. It's actually the fentanyl inside of it that actually causes the lethal dose. Anyway, 89 00:09:47,440 --> 00:09:54,880 it's a side tangent to the importance of having when a supplier actually says what is inside of 90 00:09:54,880 --> 00:10:01,120 their product. And so the FDA was created as mom pointed out as a response to say, hey, if you're 91 00:10:01,120 --> 00:10:06,560 selling these products, you have to actually put out what is inside of it. And also we have to 92 00:10:06,560 --> 00:10:13,040 determine if this is actually claiming to do what you say it's doing. And so the FDA is almost kind 93 00:10:13,040 --> 00:10:18,320 of like the police department. They're enforcing the laws that have been set by the government to 94 00:10:18,320 --> 00:10:25,120 actually say, hey, you're actually doing what it's actually doing. Right. And nowadays, I can't 95 00:10:25,120 --> 00:10:32,480 remember now how far back it was when food labels got put on food, but before those labels were not 96 00:10:32,480 --> 00:10:39,440 on food. So you did not know what the content was actually included in your bread or your cereal or 97 00:10:39,440 --> 00:10:43,280 whatever and stuff. And now you do. Right. We still don't even know the dosages of that too, 98 00:10:43,280 --> 00:10:48,160 other than just like the carbohydrates and fats, because they don't want to give away the recipe. 99 00:10:48,160 --> 00:10:53,360 It's competitive edge. Right. But then we have to remember the dose makes the poison. So just like 100 00:10:53,360 --> 00:11:00,080 in, you know, CBD, like it, the THC content is 0.3%. So yes, there is a bit of THC, but you would 101 00:11:00,080 --> 00:11:07,520 have to consume a whole lot of CBD to get that high and probably not enough to actually be cost 102 00:11:07,520 --> 00:11:11,680 effective. Yeah, right. And there's other adverse effects, which we'll get to it momentarily. 103 00:11:12,400 --> 00:11:20,560 So again, as I said, CBD is sold only as a cosmetic except for one medication, which is called 104 00:11:22,560 --> 00:11:29,680 Epidiolex. And it is FDA approved to treat some treatment resistant seizures that are 105 00:11:29,680 --> 00:11:37,040 primarily seen in young infants and small children. And so, like I said, it used to be a 106 00:11:37,040 --> 00:11:41,440 scheduled drug, but it is now no longer a scheduled drug in the in the controlled substance scheduling 107 00:11:42,880 --> 00:11:50,640 system. But anything that has any THC in it that's greater than 0.3%, any cannabis derivatives, 108 00:11:50,640 --> 00:11:56,320 is still considered what is considered a schedule one drug and is illegal things like heroin, 109 00:11:56,320 --> 00:12:02,960 you know, that the marijuana that other than the ones that have been modified and regulated by the 110 00:12:02,960 --> 00:12:12,000 FDA as a drug, you know, they are still considered illegal. And as Josh mentioned, because CBD is a 111 00:12:12,000 --> 00:12:23,200 cosmetic, then there's no regulation as to the quantity in each individual drop gummy tablet. 112 00:12:23,200 --> 00:12:28,240 Yeah, because CBD comes in a lot of different forms. It comes in oils, it comes in gummies, 113 00:12:28,240 --> 00:12:33,760 it comes in a lot of different ways. Right. So there was no standard market manufacturing 114 00:12:33,760 --> 00:12:41,120 process for it. So there was one survey that found that only 30% of products had accurately 115 00:12:41,120 --> 00:12:47,280 labeled content. That's crazy. So like you have a three in 10 chance of a product that you're buying 116 00:12:47,280 --> 00:12:52,640 actually meaning what it says. Right. Having enough CBD in it. So yeah, that you're thinking 117 00:12:52,640 --> 00:13:01,680 it's going to be so anyway, so a couple of fun statistics about CBD. I just found this topic just 118 00:13:01,680 --> 00:13:06,640 really fascinating. I think I don't know why because it's just it's because so many people 119 00:13:06,640 --> 00:13:12,800 are using it. And I'm not sure that it has the effects that people think that does. So anyway, 120 00:13:12,800 --> 00:13:21,600 there was a survey of 2000 United States adults, it found that 60% of respondents had tried CBD, 121 00:13:21,600 --> 00:13:28,880 and they believed in its medicinal benefits. 65% of these US adults pulled believed that CBD was 122 00:13:28,880 --> 00:13:35,440 safer than alcohol. Although only 44% of these people thought that CBD should be legal. 123 00:13:36,640 --> 00:13:46,800 This was very interesting to CBD use broken down by age, 18 to 25 year olds, 32% usage incidents, 124 00:13:46,800 --> 00:13:54,640 there was a 62% incidents and people 26 to 41 years old, 42 to 47 year, I'm sorry, 125 00:13:54,640 --> 00:14:05,120 42 to 57 year olds had a 59% usage, 58 to 76 year olds had a 49% usage, but over 77 year old, 126 00:14:05,120 --> 00:14:10,640 they had an 89% usage. I was like, wow, that's interesting. We'll get to that. Primarily people 127 00:14:10,640 --> 00:14:18,240 who are over 77 years old are using it for sleep for insomnia and for sleep and stuff. So younger 128 00:14:18,240 --> 00:14:23,600 people are using it for that, but they also have a greater usage of it for anxiety and relieving 129 00:14:23,600 --> 00:14:29,120 stress. And this is a mate. I mean, this was a study, or this is a survey that was done by Forbes 130 00:14:30,160 --> 00:14:35,120 in 2024. And they did, I think, with like 2000 participants from people 18 plus and over. 131 00:14:35,120 --> 00:14:42,080 If you go, I went to another survey in 2019 and the attitudes amongst people older than 55 or 65 132 00:14:42,080 --> 00:14:49,520 was vastly different. It was very negative. So it is amazing how in five years, like the perceptions 133 00:14:49,520 --> 00:14:55,440 of CBD have vastly changed to going from like, we think this is kind of like marijuana, we don't 134 00:14:55,440 --> 00:15:00,800 really want to touch it, which is, it is a little bit more hesitant amongst older people to now have 135 00:15:00,800 --> 00:15:06,720 like, oh, this is just an alternative in the non THC version of marijuana and it's safe and it's 136 00:15:06,720 --> 00:15:12,480 natural and it's cheap. So I think the pandemic might've helped out with that. Just people being 137 00:15:12,480 --> 00:15:16,240 at home and probably just going online. I'm like, I'm feeling anxious. I need to help with sleep. 138 00:15:16,240 --> 00:15:24,160 What can I do to do something about it? But I was amazed at looking at a 2019 survey versus a 2024 139 00:15:24,160 --> 00:15:28,960 survey and just seeing how the attitudes, and it's just amazing how information travels so quickly. 140 00:15:28,960 --> 00:15:34,240 Oh, I know. It can change people's perceptions. Oh here, this'll blow your mind. So in 2014, 141 00:15:34,240 --> 00:15:45,440 the sales from CBD was $108 million in 2022. So eight years later, it was $1.9 billion 142 00:15:46,320 --> 00:15:49,920 Oh my gosh. in the United States. That is incredible. Isn't that crazy? That's crazy. 143 00:15:49,920 --> 00:15:54,320 And again, like Josh said, the most common forms are gummies, capsules, oils, and lotions. There 144 00:15:54,320 --> 00:15:57,600 are some other forms that we'll mention in as well, in a little bit as well. 145 00:15:57,600 --> 00:16:07,440 And then I looked too at consumer spending per month on CBD. 29% of the population, this is still 146 00:16:07,440 --> 00:16:17,200 from that same Forbes survey, spent $50 a month. 23% spent 20 to $49 a month. And the 34 to 44 year 147 00:16:17,200 --> 00:16:26,240 old age group spent the highest. They were the highest spenders of buying CBD. So, and then 60% 148 00:16:26,240 --> 00:16:33,520 felt like CBD was safe to consume. Only 45% felt it was socially acceptable. And then there was 149 00:16:33,520 --> 00:16:39,280 also 46% that believed that CBDs would result in a positive drug test. Yeah. Thinking very similar, 150 00:16:39,280 --> 00:16:44,720 it's like, because THC will pop up in the blood. And it will, because there's that small percentage 151 00:16:44,720 --> 00:16:51,120 of THC in it. So it very well can show up on a positive drug test. Yeah. Another thing I want to 152 00:16:51,120 --> 00:16:57,040 mention too is that there was a study done by a branding group. I think they were trying to 153 00:16:57,040 --> 00:17:04,560 actually, they noticed that there were negative associations between consumer usage and marijuana. 154 00:17:04,560 --> 00:17:08,880 And they noticed that people were giving this attribution to CBD as well. And they measured 155 00:17:08,880 --> 00:17:14,640 that four out of 10 people that they surveyed thought that CBD was just another version of 156 00:17:14,640 --> 00:17:18,720 marijuana. They're like, oh, this is just a different variety. Very much like the Indica 157 00:17:18,720 --> 00:17:23,120 versus the Sativa are different varieties. They were thinking it was the same thing. So there's 158 00:17:23,120 --> 00:17:31,200 also this belief that these chemicals will provide similar benefits, but as you know, 159 00:17:31,200 --> 00:17:35,280 the mom on drugs is going to let you know, just because they come from the same plant, 160 00:17:35,280 --> 00:17:39,840 their mechanism of action might be a little bit different. That is a great segue into the next 161 00:17:39,840 --> 00:17:46,160 section, because we are now going to talk about that, that as far as like how CBD works. So, 162 00:17:46,160 --> 00:17:53,520 so like we said, that CBD is derived from the cannabis Sativa plant. And it is distinct from 163 00:17:53,520 --> 00:17:59,360 over 100 other different types of cannabinoid compounds. And I'm going to turn this back over 164 00:17:59,360 --> 00:18:04,320 to Josh, because one of the things that I learned as we were putting this information together was 165 00:18:04,320 --> 00:18:13,360 that we have a system in our body called the endocannabinoid system, which is responsible for, 166 00:18:13,360 --> 00:18:19,760 it's a signaling system that contributes, it's throughout our body, and it contributes to things 167 00:18:19,760 --> 00:18:27,600 like stress response, anxiety, memory, pain, behavior, and it also is important in the 168 00:18:27,600 --> 00:18:35,600 neurosynaptic development of teenagers, adolescents and stuff. And so we're going to see how CBD and 169 00:18:36,320 --> 00:18:40,320 or other cannabinoids affect this system. So Josh, take it away. 170 00:18:40,320 --> 00:18:47,120 Oh, thank you. Yeah, I, my undergrad degree was in neurobiology. So I have a little bit of understanding 171 00:18:48,000 --> 00:18:54,240 of the system upon my reading. So, and as you, if anybody's listened to the show a lot, I love to 172 00:18:54,240 --> 00:18:59,760 give analogies just to modern day life, because, you know, we're made of stuff and other stuff is 173 00:18:59,760 --> 00:19:06,160 also stuff. So I think it's really helpful to really think about, especially your brain 174 00:19:06,160 --> 00:19:14,320 as a collection of musical instruments. And a lot of times you want to figure out how is that symphony 175 00:19:14,320 --> 00:19:21,680 playing. So when I'm talking right now, there's a certain amount of musical instruments playing so 176 00:19:21,680 --> 00:19:28,480 that the muscles in my throat are going at the proper rate. So I'm producing sound that my mom 177 00:19:28,480 --> 00:19:32,800 and y'all listeners will hear and interpret. And when you're interpreting those, your brain is doing 178 00:19:32,800 --> 00:19:38,720 the same thing. If I all of a sudden got hungry or thirsty, there'd be different instruments that 179 00:19:38,720 --> 00:19:43,440 would turn on and would amplify in certain parts of my brain and let me know, oh, you're thirsty, 180 00:19:43,440 --> 00:19:51,040 you're hungry. So in that way, your cannabinoid system or endocannabinoid system 181 00:19:52,160 --> 00:19:58,160 responds to two types of endogenous cannabinoids that you have inside of your body. 182 00:19:58,160 --> 00:20:01,840 They're naturally occurring. These are things that your nervous system actually uses and they 183 00:20:01,840 --> 00:20:08,880 actually use them in really cool ways. You maybe have heard of things like neurotransmitters and 184 00:20:08,880 --> 00:20:18,000 neuromodulators like dopamine, serotonin, GABA, glycine, but this is a, it essentially is a 185 00:20:18,000 --> 00:20:28,640 post-synaptic neuromodulator. What that means most of the time, you're sending neurotransmitters 186 00:20:28,640 --> 00:20:35,920 from one nerve cell to the next nerve cell to make a mechanism of action. So for example, 187 00:20:35,920 --> 00:20:44,080 if you eat something like a cookie, your first neuron or the thing in the brain cell will 188 00:20:44,080 --> 00:20:50,000 basically flood what we call the gap between two brain cells called a synapse with dopamine to 189 00:20:50,000 --> 00:20:54,960 basically say, oh, that was good. This was really rewarding. We should do more of this. Your brain 190 00:20:54,960 --> 00:21:00,880 really likes to reward you for eating food. So the post-synapse is receiving the signal. Now, 191 00:21:00,880 --> 00:21:06,080 what an endocannabinoid is, it is a post-synaptic signal. So it actually sends a signal back to the 192 00:21:06,080 --> 00:21:14,480 first neuron and says, hey, stop, basically stop making more dopamine. It actually is, it basically 193 00:21:14,480 --> 00:21:20,320 is a dampener of these systems because you don't want dopamine just going on forever. You want to 194 00:21:20,320 --> 00:21:24,400 kind of a, you want to close the feedback loop to let you know like, hey, we're good. We're good 195 00:21:24,400 --> 00:21:31,600 here. So essentially you have this natural system inside. So when you take something like THC or 196 00:21:31,600 --> 00:21:38,000 CBD, these molecules fit really, really well because they are cannabinoids. It's almost like 197 00:21:38,000 --> 00:21:43,760 having a parking space that is a certain width. If you have another car that is just that width, 198 00:21:43,760 --> 00:21:48,560 then it's going to fit right directly into that parking space and it's going to mimic that 199 00:21:48,560 --> 00:21:55,280 mechanism of action. And actually in terms of things like THC, it actually out competes your 200 00:21:55,280 --> 00:22:01,760 naturally occurring cannabinoids and it will basically override the system. 201 00:22:02,640 --> 00:22:08,000 And as if anybody's ever smoked marijuana before, you know the feelings that you get 202 00:22:08,000 --> 00:22:13,360 in the symphony that starts to play. And some people really like it depending on the concentrations 203 00:22:13,360 --> 00:22:18,080 that you have. Some people really, they don't, it actually amplifies their anxiety or their paranoia. 204 00:22:18,640 --> 00:22:23,920 Some people, it makes them very creative. It makes them have overarching ideas. It makes them 205 00:22:23,920 --> 00:22:31,600 have overarching ideas because everybody's biology is so different. And so those chemicals are going 206 00:22:31,600 --> 00:22:37,360 to essentially cause different things inside of their body, which makes it so variable. And 207 00:22:37,360 --> 00:22:41,920 everybody's got a different experience. So it's really cool that we have this system and we've 208 00:22:41,920 --> 00:22:50,480 basically found plants that have been able to activate these things. But what we're probably 209 00:22:50,480 --> 00:22:56,880 going to do, do you have anything to add to that system? I would tell you that while THC amplifies 210 00:22:56,880 --> 00:23:02,720 the system because there are cannabinoid receptors, there's a type one and a type two cannabinoid 211 00:23:02,720 --> 00:23:07,840 receptor in that system, in that endocannabinoid system. But what they've found is CBD does not 212 00:23:07,840 --> 00:23:12,560 activate those system, those receptors. It doesn't fit in with those receptors. In fact, what they've 213 00:23:12,560 --> 00:23:18,560 found is that they may antagonize those receptors instead. So dampen down the effect. Not sure 214 00:23:18,560 --> 00:23:23,920 there. They're not exactly sure how CBD works in that whole system. So it may have some effects on 215 00:23:23,920 --> 00:23:32,400 serotonin. It may not. So again, it's just not necessarily the actual mechanism is not 216 00:23:33,600 --> 00:23:40,560 absolutely known. So we just probably why THC will give you that quote unquote high CBD won't, 217 00:23:40,560 --> 00:23:44,160 because it doesn't act on those receptors. Remember these receptors are in your brain. 218 00:23:44,160 --> 00:23:48,320 So anytime that you consume something like THC, it's going to go through your lungs and then it's 219 00:23:48,320 --> 00:23:52,640 going to get into your bloodstream, cross the blood brain barrier because it's very lipophilic, 220 00:23:52,640 --> 00:23:57,200 meaning that it likes fatty things. And if you didn't know, your brain is primarily fat. It's 221 00:23:57,200 --> 00:24:02,960 all fat. So it basically goes in there and then it binds to these receptors. CBD is also lipophilic 222 00:24:02,960 --> 00:24:08,720 as well. But like mom said, it doesn't have the affinity for these receptors. So it's going to 223 00:24:08,720 --> 00:24:14,160 have a different mechanism of action. Right. Like I said, there are some thoughts that maybe the 224 00:24:14,160 --> 00:24:20,880 reason that CBD might have some effect on anxiety would be because it activates serotonin receptors 225 00:24:20,880 --> 00:24:26,800 that has not necessarily been proven, but that's just a thought. And it's anti-seizure activity 226 00:24:26,800 --> 00:24:33,120 is not well known, but it may be that one of our naturally occurring endocannabinoid, 227 00:24:34,160 --> 00:24:39,520 endocannabinoids or cannabinoids inside our body, it may keep it from breaking down, 228 00:24:39,520 --> 00:24:43,600 which may give it some anti-seizure activity. So again, there's just some, these are kind of some 229 00:24:43,600 --> 00:24:51,360 thoughts as far as it's concerned. So one of the, so in addition to being effective for blocking or 230 00:24:51,360 --> 00:24:59,200 reducing seizure activity, that has been proven in some studies in infants and young children, 231 00:25:00,720 --> 00:25:09,280 there are some other potential uses for CBD that have been touted, not with a lot of data 232 00:25:09,280 --> 00:25:15,200 and not with a lot of positive data. That doesn't necessarily mean that maybe in some of these areas, 233 00:25:15,200 --> 00:25:21,120 it might not be effective, but it means that we need larger, more well controlled trials. 234 00:25:21,120 --> 00:25:26,080 So it's randomized controlled trials that Josh and I have talked about. And they're, they're, 235 00:25:26,080 --> 00:25:31,840 they cost a lot of money. And so with something like CBD, you think who's going to fund a study 236 00:25:31,840 --> 00:25:37,840 to show CBD's safety and efficacy in pain, you know, for example, or whatever. So, 237 00:25:37,840 --> 00:25:45,680 yeah, maybe we should take a little bit of a moment to talk about the benefit of why a randomized, 238 00:25:46,400 --> 00:25:51,840 you know, potentially maybe even ideally a double blind randomized control trial would be 239 00:25:51,840 --> 00:25:57,600 a good mechanism for this. Especially just as we highlighted earlier, there's a lot of beliefs 240 00:25:57,600 --> 00:26:04,000 around CBD and its effectiveness and its correlation with something like THC or like 241 00:26:04,000 --> 00:26:09,200 a traditional smoking marijuana. And if anyone's ever done a recreational drug like marijuana, 242 00:26:09,200 --> 00:26:14,560 you do feel something. And sometimes the idea when you feel something, you feel like something's 243 00:26:14,560 --> 00:26:19,760 happening inside of you. And if you take something similar to that, you might think that that thing 244 00:26:19,760 --> 00:26:26,000 is also happening. And that's kind of my guess of why I think a lot of these, a lot of these 245 00:26:26,000 --> 00:26:32,160 treatments or a lot of these symptoms, they feel like will be treated by CBD. But I want to 246 00:26:32,160 --> 00:26:39,440 transition over to you to say like, so why is belief not enough? Why do you need to test and do 247 00:26:39,440 --> 00:26:44,000 a randomized control trial? What's the benefit of that? So that double blind randomized control 248 00:26:44,000 --> 00:26:49,680 trial is the gold standard for a trial. And so basically when you have a randomized double blind 249 00:26:49,680 --> 00:26:55,840 placebo control trial, or even an active control trial, meaning that you're comparing a drug to 250 00:26:55,840 --> 00:27:04,320 another already known established medication, you're, what you're trying to do is eliminate any, 251 00:27:04,320 --> 00:27:12,400 what we call confounding variables. That means any noise that could quote unquote noise that could 252 00:27:13,440 --> 00:27:18,880 make it look like the drug is better than it actually is. So that's why it's very good to have 253 00:27:18,880 --> 00:27:26,880 a placebo arm, as well as the active medication that you're studying compared to one another. 254 00:27:26,880 --> 00:27:38,480 So that all of that noise will hopefully get kind of blocked out or kind of just covered by looking 255 00:27:38,480 --> 00:27:43,200 at that placebo arm. Yeah. What's some of the noise that you would want to remove? I think, 256 00:27:43,200 --> 00:27:50,560 I mean, common ones are like gender or race. It's like you kind of want all of those even 257 00:27:50,560 --> 00:27:55,120 between the two groups. So you, you know, cause if you had like 60 year olds in one group and 20 258 00:27:55,120 --> 00:27:59,040 year olds in the other group, you could say, well, maybe it was due to age, right? Right. 259 00:27:59,760 --> 00:28:04,640 And also the other thing too, with a randomized control trial is that you pick usually one, 260 00:28:04,640 --> 00:28:10,320 maybe two things that you're looking at to look at statistically that you're going to measure data 261 00:28:10,320 --> 00:28:16,400 and show with an objective measurement that something's better than something else. So you, 262 00:28:16,400 --> 00:28:22,880 so if we're looking at CBD versus placebo in pain, for example, we want to look at some pain 263 00:28:22,880 --> 00:28:30,720 measurement score and show that it wasn't just suggestive that CBD was better, but because we've 264 00:28:30,720 --> 00:28:36,480 got that covered with that placebo arm, but that we actually can show by measuring with these tests 265 00:28:36,480 --> 00:28:41,280 that actually it could be better. We don't have that kind of study, but it could be that kind of 266 00:28:41,280 --> 00:28:46,960 study. Right. Cause if a study was also, if it's a, if it's, if it's blinded, meaning that the person 267 00:28:46,960 --> 00:28:52,400 received, let's say we have a person in group A and group and a person in group B, the person is 268 00:28:52,400 --> 00:28:57,520 unaware of which one they're getting. Right. So that's very important. And you tell them like, 269 00:28:57,520 --> 00:29:01,680 Hey, we're actually going to give you some CBD. And then one person, you're actually giving them 270 00:29:01,680 --> 00:29:07,680 the CBD and the other one you're not. So both of them quote unquote believe that they're getting it. 271 00:29:08,240 --> 00:29:13,360 And so you essentially are also controlling for belief. You like, you also, you have belief in 272 00:29:13,360 --> 00:29:17,200 both categories and then one gets the drug and versus the other. And you're seeing if that's, 273 00:29:18,000 --> 00:29:24,640 if that difference is statistically significant to see like this drug actually does something. 274 00:29:24,640 --> 00:29:29,440 Right. Okay. Right. And it'd be great if it was double blinded because then even the researchers 275 00:29:29,440 --> 00:29:34,000 wouldn't know. That's triple blinded. Oh, no, no, you're right. I'm sorry. I've been out of, 276 00:29:34,000 --> 00:29:36,880 yeah, it's double blinded. Yes. I didn't even know there was a triple. There is a triple blind. 277 00:29:36,880 --> 00:29:42,880 That's when the data analysts are also. Wow. Yeah. So, yeah. So yes, if the researchers and 278 00:29:42,880 --> 00:29:47,600 the participants are blinded, there's all, there will always be somebody that knows what medication 279 00:29:47,600 --> 00:29:53,040 somebody's getting in case they had an adverse effect. But yeah. So, but yeah. So that, that 280 00:29:53,040 --> 00:29:58,400 gives you cleaner data. Because everyone has like a bias and an incentive for the study to go a 281 00:29:58,400 --> 00:30:04,160 certain way. And you're just trying to remove as many biases, biases as possible. Yeah. Cause as, 282 00:30:04,880 --> 00:30:10,560 as much as we want to be pure scientists, we have thoughts and opinions about something, you know? 283 00:30:10,560 --> 00:30:18,880 Right. So, so CBD has been looked at in a variety of different areas, including pain, schizophrenia, 284 00:30:19,520 --> 00:30:27,760 social anxiety disorder, anxiety disorder, diabetes, cancer, inflammatory bowel disease, 285 00:30:27,760 --> 00:30:34,640 multiple sclerosis and anti-inflammatory effects. And, and, and it really hasn't been shown to be 286 00:30:38,160 --> 00:30:43,200 statistically better or proven to be effective in any of those areas. Because again, we don't 287 00:30:43,200 --> 00:30:50,080 have large trials. There have been some trials done in anxiety, small ones, the data are not great. 288 00:30:50,880 --> 00:30:56,240 Open label trials. What that means is that people know what they're getting. There's no control 289 00:30:56,240 --> 00:31:03,040 group. There's no placebo group. So they, they, they can say they're better, but you don't know 290 00:31:03,040 --> 00:31:07,040 whether or not that's just like Josh said, their belief, you know, or just they think it's due to 291 00:31:07,040 --> 00:31:10,960 the drug rather than maybe they're having a better day, you know, or whatever, you know, or, you know, 292 00:31:10,960 --> 00:31:16,480 you just don't know that and stuff. So, and we're so good at attributing, you know, whatever we're 293 00:31:16,480 --> 00:31:20,720 feeling to something that we did rather than like, well, maybe it's just cause I'm feeling better. 294 00:31:20,720 --> 00:31:27,840 Right. There were some small studies that showed that CBD might be better, help people be better 295 00:31:28,400 --> 00:31:36,560 at, or feel better with test anxiety or speak public speaking anxiety. But that doesn't, that 296 00:31:36,560 --> 00:31:42,800 doesn't, you can't generalize that to anxiety disorder. There aren't data for that. So it's 297 00:31:42,800 --> 00:31:47,760 more better for short term where there might be some data to suggest like for short term anxiety 298 00:31:47,760 --> 00:31:52,560 versus just generalize anxiety. Like if you're an anxious person, maybe, but again, those studies 299 00:31:52,560 --> 00:31:57,120 were not great, you know, either and stuff. So, and there've been the data are all over the board, 300 00:31:57,120 --> 00:32:00,480 you know, and stuff as far as that's concerned. So we really do need more data. And this makes 301 00:32:00,480 --> 00:32:05,360 a lot of sense because this seems like this industry has, you know, blossomed over the past 302 00:32:05,360 --> 00:32:11,440 decade. So it just seems like that we're playing catch up with the public's opinion and their 303 00:32:11,440 --> 00:32:17,680 consumption of CBD. Right. And remember, because it's a cosmetic and not a drug, so there's 304 00:32:17,680 --> 00:32:23,520 no real regulation over how it gets used. I mean, well, there's, there's some regulation as far as 305 00:32:23,520 --> 00:32:29,680 some of the, like maybe it's manufacturing or processes, but it's not like a drug, a medication 306 00:32:29,680 --> 00:32:33,840 where you have studies that should, that, you know, it has to be safe and effective. And like 307 00:32:33,840 --> 00:32:38,720 you said, it's like if someone says they took CBD and felt better compared to somebody else, as you 308 00:32:38,720 --> 00:32:45,760 said earlier, only 30% of the CBD that gets sold is actually saying how much is in it. So even if 309 00:32:45,760 --> 00:32:51,520 you compared two different people, you don't know how much CBD is actually if two people self 310 00:32:51,520 --> 00:32:57,440 reporting, so they could be taking very different doses. Absolutely. Like when, when, if I told you, 311 00:32:57,440 --> 00:33:03,840 I drank coffee today versus somebody else, their dose is probably much weaker than mine. So it's 312 00:33:03,840 --> 00:33:09,120 like, you have to really measure out the milligrams of caffeine and control that of what's actually 313 00:33:09,120 --> 00:33:16,160 going on. Absolutely. So yeah. So we mentioned earlier that, that CBD comes in a lot of different 314 00:33:16,160 --> 00:33:21,360 form, formulations. So again, we talked about the fact that it was, it became available in Texas in 315 00:33:21,360 --> 00:33:30,080 2019. As long as it has THC concentrations less than 0.3%. I mean, it is available. The only FDA 316 00:33:30,080 --> 00:33:37,680 approved indication is for seizures and a drug called a pidelex. This was so interesting because 317 00:33:37,680 --> 00:33:47,760 CBD comes from a plant that the, the formulation of CBD that you take could be contaminated with 318 00:33:47,760 --> 00:33:54,240 pesticides, heavy metals, or household chemicals because it comes from the ground and stuff. So, 319 00:33:54,240 --> 00:33:59,840 so you again, because it's not standardized and that stuff doesn't get filtered out, you don't 320 00:33:59,840 --> 00:34:05,200 know exactly what you're taking, you know, so that's, that's concerning as well. It does come with a 321 00:34:05,200 --> 00:34:11,440 lot of different doses forms. It's got an oral solution, soft gels, gummies, an oral oil, an oral 322 00:34:11,440 --> 00:34:18,320 tincture spray, a lotion, and it can be vaped as well. So I actually looked up this as well as like, 323 00:34:18,960 --> 00:34:25,680 if you're concerned, if you want to take CBD, it is really good to look up companies that have been 324 00:34:25,680 --> 00:34:32,960 third party tested to actually confirm and do the chemical analysis inside of their batch. Like there 325 00:34:32,960 --> 00:34:38,080 are some people who know, even though they know that the FDA doesn't requirement, they actually do 326 00:34:38,080 --> 00:34:45,760 the FDA analysis or their, their regimen of analysis and, and you can do, you can go to a lab 327 00:34:45,760 --> 00:34:49,920 that will essentially do this analysis and they actually put that on their labels. So, but you 328 00:34:49,920 --> 00:34:54,240 have to do the due diligence of look up where, who these companies are and what they're doing so that 329 00:34:54,240 --> 00:34:58,960 you know what you're getting. So there are some companies out there who are honest, but if you're 330 00:34:58,960 --> 00:35:03,520 just going to the grocery store or your local pharmacy and you get the first thing that you grab, 331 00:35:03,520 --> 00:35:08,240 it might be a good idea to do some research to see what's actually going in there and if they're a 332 00:35:08,240 --> 00:35:17,120 reputable company. Right. So we have to remember that anything we ingest, a alternative medicine 333 00:35:17,120 --> 00:35:24,160 like melatonin, a prescription drug or CBD, they're going to have adverse events associated with it, 334 00:35:24,160 --> 00:35:30,720 or adverse effects associated with them. Everything does. So I wanted to give you the most common 335 00:35:30,720 --> 00:35:37,680 adverse effects or side effects that are associated with CBD. They're mostly dose dependent so that 336 00:35:37,680 --> 00:35:41,840 what that means is the more you take, the more likely you will have that particular side effect 337 00:35:41,840 --> 00:35:48,720 or adverse effect. Somnolence, somnolence, which means like you have a lot of excess of drowsiness, 338 00:35:48,720 --> 00:35:54,080 it can occur in up to 30% of patients and that was determined primarily with the Epidiolex, 339 00:35:54,080 --> 00:36:02,240 which is the FDA approved agent. But because it has CBD in it, we can assume that that will happen in 340 00:36:02,240 --> 00:36:08,400 the non-FDA approved formulations as well too. You can have diarrhea in up to 24% of patients. 341 00:36:08,400 --> 00:36:15,200 You can also have insomnia or difficulty sleeping in about up to 10% of patients. You can have 342 00:36:15,200 --> 00:36:21,760 irritability and agitation, aggression and anger in lower percentages, maybe 5% or so of patients. 343 00:36:21,760 --> 00:36:27,600 You can have a decreased appetite, drowsiness and fatigue, just that as well. A dry mouth, 344 00:36:27,600 --> 00:36:32,800 you could have an increase in body temperature or like a slight fever, nausea and vomiting, 345 00:36:32,800 --> 00:36:41,040 weight loss, anorexia, which means that you've lost your appetite, and hypersensitivity reactions, 346 00:36:41,040 --> 00:36:46,320 such as a rash or itching, especially with the topical formulations. 347 00:36:46,320 --> 00:36:52,480 Did you notice in this study that those percentages that you're noticing, were they compared to people 348 00:36:52,480 --> 00:36:56,880 that didn't take it or was it just a percentage of people like self-reported was in an observational 349 00:36:56,880 --> 00:37:03,760 study? Some of them were compared to placebo and some weren't. I've got the decreased appetite 350 00:37:03,760 --> 00:37:10,400 that I have was 16% in CBD patients versus 5% in placebo. It wasn't statistically, 351 00:37:10,400 --> 00:37:14,400 analyzed, but there were different, that was definitely higher in the CBD patients. 352 00:37:14,400 --> 00:37:20,400 Yes. Also, just like we can't really make claims about its benefits, it might also be good to 353 00:37:20,400 --> 00:37:25,360 notice in people with its side effects, it's like, could have been a bad day, it could have been 354 00:37:25,360 --> 00:37:31,440 something that they've eaten. Also another need to do the randomized control trials, also figure out 355 00:37:31,440 --> 00:37:36,640 the long-term or even short-term side effects as well, and what is actually attributable to CBD. 356 00:37:36,640 --> 00:37:43,680 Probably the most serious side effect or adverse effect that's been associated with CBD is that it 357 00:37:43,680 --> 00:37:51,680 can increase your liver enzymes. Our liver enzymes can go up and the measurements, or the percentages 358 00:37:51,680 --> 00:37:58,800 I saw were eight to 25%. That's like one in four. Elevated liver enzymes is not necessarily bad, 359 00:37:58,800 --> 00:38:02,960 but you just have to watch the person to make sure that they then don't develop liver injury 360 00:38:02,960 --> 00:38:07,520 and things that you would notice in a patient if they had liver injury would be things like 361 00:38:07,520 --> 00:38:14,560 unexplained nausea and vomiting, or if they have some upper right quadrant abdominal pain, fatigue, 362 00:38:14,560 --> 00:38:20,960 they could look kind of yellow and they have dark urine. So that's just things to watch for. 363 00:38:20,960 --> 00:38:28,320 This happens when you take, it's usually when you take higher doses of medications. I know alcohol, 364 00:38:28,320 --> 00:38:33,440 you obviously you get things like cirrhosis of the liver. I don't know if that's because 365 00:38:33,440 --> 00:38:39,440 increased liver enzymes. I also know with acetaminophen, if you take north of certain dose. 366 00:38:39,440 --> 00:38:43,440 You can have liver toxicity. Yeah. You can die from Tylenol overdose. Yeah. 367 00:38:43,440 --> 00:38:45,440 Right. I can't remember how many milligrams you can take. 368 00:38:45,440 --> 00:38:52,080 Yeah. It depends and stuff. So yeah, overdoses for sure. And other prescription medications, 369 00:38:52,080 --> 00:38:56,400 you can have elevated liver enzymes with a variety of medications, but it's just that 370 00:38:56,400 --> 00:39:00,000 watching to see whether there's liver enzymes go really high. 371 00:39:00,000 --> 00:39:06,080 Yeah. I think this is such a good point. I think a lot of times people will see risks like this 372 00:39:06,560 --> 00:39:12,000 and they'll, and not even just with things like CBD, but even medications that have made it through 373 00:39:12,640 --> 00:39:18,960 FDA approval. And I think it's really key to reinforce that the dose makes the poison. So 374 00:39:20,320 --> 00:39:23,360 our- Sometimes, not always, but sometimes. Well, I mean, 375 00:39:23,360 --> 00:39:28,720 I can't think off the top of my head, but it's there. Talk away while I think. So, but it's like, 376 00:39:28,720 --> 00:39:32,640 there are some medications, there are some medications that it doesn't, it's not dose 377 00:39:32,640 --> 00:39:38,480 related. It just may be that your body, for whatever reason is going to be a photosensitive 378 00:39:38,480 --> 00:39:42,720 or there you're sensitive to sunlight. Maybe things like anaphylactic shock when you take- 379 00:39:42,720 --> 00:39:49,840 Right. Or yeah, that, or that you're, if you and I both took tetracycline for acne 380 00:39:49,840 --> 00:39:55,600 or clindamycin for acne that you might get, I might get sunburned, but you might not because 381 00:39:55,600 --> 00:39:57,760 you're, you're just less sensitive or whatever. So- 382 00:39:57,760 --> 00:40:01,600 I guess what I'm asking is like, but if you, let's say you took half the amount, 383 00:40:02,400 --> 00:40:04,800 would you- It might not matter. That might not matter. 384 00:40:04,800 --> 00:40:09,760 Okay. So there are certain drugs that it doesn't matter regardless of the dose. It's just the 385 00:40:09,760 --> 00:40:16,800 mechanism. I guess that would- Okay. This is a good discussion to have. So it's like, 386 00:40:16,800 --> 00:40:26,480 so it's like, so okay. And places like that, it seems to be more of your body's own immune 387 00:40:26,480 --> 00:40:28,240 response to- So it's like- 388 00:40:28,240 --> 00:40:30,480 Or mechanistic response to whatever is going on. 389 00:40:30,480 --> 00:40:34,160 It's a cascade that essentially happens. It's almost kind of like a domino effect. 390 00:40:34,160 --> 00:40:36,880 Right. I guess when I'm talking about with things, 391 00:40:36,880 --> 00:40:42,400 let's just use alcohol as an example, right? Like, so there's an acceptable dose of alcohol, 392 00:40:42,400 --> 00:40:48,320 you're called your blood alcohol content. But if you go over that, obviously more of the functions 393 00:40:48,320 --> 00:40:52,880 inside of your body are going to start becoming impaired. So there's an obviously dose response 394 00:40:52,880 --> 00:40:57,440 to what's happening inside of your body. So maybe I should clarify that. You're right. 395 00:40:57,440 --> 00:41:03,200 So if you take something that essentially triggers biological cascades, things like an allergen or 396 00:41:03,200 --> 00:41:09,040 certain medications, I mean, you can just take a tiny little dose and it's going to put that into 397 00:41:09,040 --> 00:41:15,200 gear, but something where it just is dose dependent, something like alcohol, it's going 398 00:41:15,200 --> 00:41:16,720 to be a different way. Right. 399 00:41:16,720 --> 00:41:19,200 Okay. That's good to distinguish. Yeah. 400 00:41:19,200 --> 00:41:24,160 So whenever I say dose makes the poison, think of the latter. Think of things like alcohol or 401 00:41:24,160 --> 00:41:29,200 things like acetaminophen or Tylenol and the more you take the worse response, aspirin. 402 00:41:30,880 --> 00:41:36,080 And yeah, so to close the loop on that, why I was bringing that up, that's so important to do 403 00:41:36,080 --> 00:41:44,560 the trials because if you get any sense of harm, I think there's kind of this thing in the public 404 00:41:44,560 --> 00:41:48,640 where they think of the pharmaceutical commercial and they hear all of the side effects. 405 00:41:48,640 --> 00:41:49,140 Yes. 406 00:41:49,600 --> 00:41:53,920 And I don't think people really understand it's like, yeah, those side effects are there. 407 00:41:55,040 --> 00:41:59,040 I actually would love to ask you when you see the side effects, are those side effects from 408 00:41:59,040 --> 00:42:04,240 a pharmaceutical commercial from one of the phases of the controlled trial? Because they're 409 00:42:04,240 --> 00:42:06,560 determining toxicity, right? And phase two. 410 00:42:07,680 --> 00:42:14,240 It's not toxicity that they have to, that they are by law when they put those commercials on TV, 411 00:42:14,240 --> 00:42:20,240 they have to cite the most, they have to cite adverse effects associated with that medication. 412 00:42:20,240 --> 00:42:26,480 Now, mostly it, you know how, when you get a prescription drug, sometimes they'll give 413 00:42:26,480 --> 00:42:31,680 you that what they call the package inserts that goes along with the medication. And there is a 414 00:42:31,680 --> 00:42:37,360 adverse effect section in the package insert. And you'll see that usually most package inserts 415 00:42:37,360 --> 00:42:43,120 now have the particular adverse effect of the medication compared to placebo or maybe another 416 00:42:43,120 --> 00:42:48,640 active drug or whatever. So you can see them compared. Sometimes they do the statistics on 417 00:42:48,640 --> 00:42:53,680 adverse effects in drugs and sometimes they don't. And the reason that they don't do the statistics 418 00:42:53,680 --> 00:42:58,800 is because the number of patients that have that particular adverse effects is not high enough to 419 00:42:58,800 --> 00:43:04,720 be able to do legitimate statistics on. So, but you'll get the percentages as far as, and sometimes 420 00:43:04,720 --> 00:43:08,880 they don't do the statistics for whatever reason. I couldn't answer that question. 421 00:43:09,760 --> 00:43:17,920 But they will note those adverse effects, but it could be that it's only happening in 1% of patients, 422 00:43:17,920 --> 00:43:23,040 you know, instead of 25%, but they still list it as part of the adverse effects on that commercial 423 00:43:23,040 --> 00:43:28,720 because that's the top 10 or 20 adverse effects associated with that medication. 424 00:43:28,720 --> 00:43:36,000 And they just have to note it by law. So regardless of the percentage or the relative risk or the risk 425 00:43:36,000 --> 00:43:41,040 that you're associated with it. Right. Yeah. So yeah, a lot of times, yeah, that's a really 426 00:43:41,040 --> 00:43:46,160 good point. So I think it's probably better safe than sorry, just to say, you know, this is the 427 00:43:46,160 --> 00:43:52,400 risk that you might be accruing by taking this thing. Right. Okay. Yeah. And then you and your 428 00:43:52,400 --> 00:43:56,000 healthcare provider can make a decision as to whether or not you take it or not. So yeah, 429 00:43:56,000 --> 00:44:02,080 whether the juice is worth the squeeze and, but so if only like 1% of people get acne from taking 430 00:44:02,080 --> 00:44:05,920 a medication, you're like, okay, I'm going to take that risk. Yeah. I'm going to take the risk 431 00:44:05,920 --> 00:44:12,080 if it's going to help me prevent cancer. Right. Right. Absolutely. Yeah. So we'll move on to 432 00:44:12,080 --> 00:44:16,880 what are some of those common myths or myths under myths. Boy, I'm having a hard time with 433 00:44:16,880 --> 00:44:25,440 words today. Maybe comedy myth, comment. Yeah. It'll like, chill me out. Uh, common myths or 434 00:44:25,440 --> 00:44:32,640 myths, understandings about CBD. First of all, the first one might be that research is researchers 435 00:44:32,640 --> 00:44:39,200 are not studying CBD and they actually are. Um, there are data, there are some trials in progress, 436 00:44:39,200 --> 00:44:45,440 but we just don't have the data yet. So we can just stay tuned as we see whether or not there can be 437 00:44:45,440 --> 00:44:56,320 some more definitive, um, uh, uh, uses identified for CBD. Um, the next one is that it's a proven 438 00:44:56,320 --> 00:45:01,200 treatment for many health conditions. And this is not the case. It's, it's only proven for one 439 00:45:01,200 --> 00:45:06,720 particular indication, but it's used for a lot of stuff that there aren't data to support at this 440 00:45:06,720 --> 00:45:13,600 current time. Uh, the third misunderstanding is that CBD is illegal. It's not illegal. Um, uh, 441 00:45:13,600 --> 00:45:21,920 it is, it was approved or it was made legal to purchase in 2019 in Texas. Uh, different states 442 00:45:21,920 --> 00:45:26,880 have different regulations. I believe what, with what I read was that I think all 50 states allow 443 00:45:26,880 --> 00:45:35,520 CBD to be sold. Now, uh, the fourth myth is that CBD will make you high, high. Um, you say hi, 444 00:45:35,520 --> 00:45:40,960 hi, you gotta pay homage to your Southern roots. That's right. Um, but that is not correct because 445 00:45:40,960 --> 00:45:49,120 remember it does not act, uh, it doesn't, um, uh, amplify or increase the action at those CBD 446 00:45:49,120 --> 00:45:56,560 receptors. Like, uh, like marijuana. Right. Uh, all CBD is the same is not true. We talked about the 447 00:45:56,560 --> 00:46:01,280 fact that it's because it's not regulated, you can have different quantities and different materials 448 00:46:01,280 --> 00:46:10,080 and every CBD, uh, gummy CBD tincture drop because again of that lack of regulation, uh, medical, 449 00:46:10,080 --> 00:46:16,000 uh, medications that are FDA approved are regulated. And while they're not exact milligram 450 00:46:16,000 --> 00:46:22,000 amounts in each one, they've got this small 10% window, uh, plus or minus that. So it makes sure 451 00:46:22,000 --> 00:46:28,560 that you've got the maximum amount. And that's not the case with CBD. Again, CBD and marijuana 452 00:46:28,560 --> 00:46:36,880 are not the same. Uh, so you can't conclude that they are. Um, and that CBD is safe. CBD is, um, 453 00:46:36,880 --> 00:46:42,560 um, it's not without adverse effects. So just remember that, uh, safe and that we can't call 454 00:46:42,560 --> 00:46:47,120 it safe because studies haven't been done. Yeah. It's like safe relative to what? Right. 455 00:46:47,760 --> 00:46:52,480 Saying it could be one of those things where maybe there's just overarching epidemiological data, 456 00:46:52,480 --> 00:46:57,840 you know, just a retro active study to see like, if you just, and you have to do a self report, 457 00:46:57,840 --> 00:47:02,480 be like, how many, you know, milliliters of this tincture do you take a day? And then you just ask 458 00:47:02,480 --> 00:47:07,360 multiple people and you see the dose response and you see how many adverse effects are associated 459 00:47:07,360 --> 00:47:13,520 with that. Um, but I think what, yeah, what would be a lot better is to actually figure out, you 460 00:47:13,520 --> 00:47:18,320 know, what those doses are that are safe. As long as people are going to continue to use it, you 461 00:47:18,320 --> 00:47:22,720 know, it would be good to know whether or not their money that they're spending on this is, 462 00:47:23,280 --> 00:47:29,600 is really worth, worth that, you know? So, so to conclude or to wrap up what we've been talking 463 00:47:29,600 --> 00:47:35,120 about today, as far as CBD is that we have found today or, and Josh and I both looking through the 464 00:47:35,120 --> 00:47:39,920 literature is that it's, it's, it's used as prevalent in the United States and it's got a 465 00:47:39,920 --> 00:47:46,080 variety of reasons. There's a variety of reasons why people use CBD. It is legal to purchase in 466 00:47:46,080 --> 00:47:52,320 Texas. Um, but this is something I didn't mention. If you're going to manufacture CBD, you have to 467 00:47:52,320 --> 00:47:58,160 get a hemp growers license and, uh, there's an application for it. And if you're going to grow 468 00:47:58,160 --> 00:48:04,640 hemp, then you can do that, but you have to be regulated. So, um, it is FDA approved to be 469 00:48:04,640 --> 00:48:10,000 used to treat, uh, uh, treatment resistant epilepsy. Um, it does have some adverse effects 470 00:48:10,000 --> 00:48:16,720 associated with its use and it's not considered a drug in the United States as safety and efficacy 471 00:48:16,720 --> 00:48:22,560 studies haven't been conducted yet. So we do need additional data to determine its efficacy for the 472 00:48:22,560 --> 00:48:29,200 conditions for which it's currently being used. So yeah, it's been really interesting to see a 473 00:48:30,560 --> 00:48:39,840 chemical so widely accepted and not really have too many solid claims on what it's actually doing. 474 00:48:39,840 --> 00:48:47,360 Yes. It just seems like a really interesting time to see, you know, is this just one big placebo 475 00:48:47,360 --> 00:48:53,200 and that people are just getting benefits from it, just from having the agency of taking something 476 00:48:53,200 --> 00:48:57,120 or is there truth in a lot of the claims or some of the claims that we're seeing out there? 477 00:48:57,120 --> 00:49:03,040 And, you know, we talked about the fact at the beginning of this podcast that in 77 year olds, 478 00:49:03,040 --> 00:49:10,640 a lot of the, of the people are using it for sleep. Well, because it has sedation, uh, you know, 479 00:49:10,640 --> 00:49:16,160 or drowsiness associated with it, you know, is it really being used more for an adverse effect 480 00:49:16,160 --> 00:49:21,840 associated with it? Really, really than an indication per se, or should we look at, 481 00:49:21,840 --> 00:49:28,400 should we have clinical trials that actually look at its use in insomnia or sleep difficulties to 482 00:49:28,400 --> 00:49:33,600 see whether or not it's really beneficial there instead of rather than using it for a supposed 483 00:49:33,600 --> 00:49:37,760 adverse effect? That's a good point. I think, I think another comparable example is something 484 00:49:37,760 --> 00:49:41,600 like alcohol, like alcohol can make you kind of drowsy. Right. If you have a couple of glasses of 485 00:49:41,600 --> 00:49:48,000 wine. And if you do that every night to fall asleep, you might fall asleep, but long-term, 486 00:49:48,640 --> 00:49:53,760 like what's it going to do to you? Right. And you might raise the risk of liver damage. 487 00:49:53,760 --> 00:49:58,240 So I think very similar to this, like just because you take something and actually I'm kind of a big 488 00:49:58,240 --> 00:50:03,440 fan of like, if it's not that harmful and you feel like you're getting a perceived benefit of it, 489 00:50:03,440 --> 00:50:08,720 even if it doesn't quote unquote work or it has an evidence, just do it because just the belief that 490 00:50:08,720 --> 00:50:12,880 it kind of works, especially for things like pain, you just want the pain to go away. And so if you 491 00:50:12,880 --> 00:50:19,840 feel like it reduces your pain, that's great. But the big thing is like, what is that doing to you 492 00:50:19,840 --> 00:50:25,760 long-term? Right. You know, smoking can make you, it can reduce your anxiety from your nicotine and 493 00:50:25,760 --> 00:50:31,040 make you more focused, but it can, you know, increase your risk of lung and throat cancer. 494 00:50:31,040 --> 00:50:35,840 So just asking yourself, is the juice worth the squeeze? And that's where something like, 495 00:50:35,840 --> 00:50:40,960 you know, large clinical trials can come into play and do that. So we're just, we're in the middle of 496 00:50:40,960 --> 00:50:47,360 one big natural experiment going on right now. There you go. So, well, thank you again for 497 00:50:48,080 --> 00:50:54,160 a great topic and a good discussion. Oh yeah. This is really fine. I hope that y'all found this useful. 498 00:50:55,200 --> 00:51:00,160 This was for me, it was not just about CBD, but just about manufacturing processes, 499 00:51:00,160 --> 00:51:07,760 how we regulate things in the U S specifically. And, you know, the role of belief and what we 500 00:51:07,760 --> 00:51:13,280 take and what we think is useful, which are all really important things too. I think sometimes we 501 00:51:13,280 --> 00:51:19,520 forget that these things, even things like acetaminophen, when it's generic, has to get made 502 00:51:19,520 --> 00:51:24,880 somewhere and it's getting made in some pharmacy. And sometimes that pharmacy isn't very good. And 503 00:51:24,880 --> 00:51:30,160 you have to really make sure that the stuff that you're getting is actually pure so that it actually 504 00:51:30,160 --> 00:51:35,760 has the effect that we're doing. So until next time, we really thank y'all for listening to this 505 00:51:35,760 --> 00:51:55,680 episode. My name is Josh Klaus and I'm Jennifer Seltzer and we'll see you soon. Thank you. Bye.