drive change in America and around the world

Dr. Frank D'Ambrosio speaks to Health Europa about how he became not only a lawyer but also a counselor on cannabis policy reform.

For 20 years, Dr. Frank D'Ambrosio was an orthopedic surgeon. Why in recent years, has it completely changed course and created a clinic in California to prescribe cannabis as a drug? Dr. D'Ambrosio is now a strong advocate and advocate for cannabis policy reform. Cannabis must be recognized for its therapeutic benefits.

Health Europa told D'Ambrosio that his experience had been one of the first to recognize the medicinal benefits of cannabis and, in particular, its potential as a potential alternative to opioid for the treatment of chronic pain. often leads to addiction. Here he tells us his inspiring story, explaining how he came to the discovery of the potential of cannabis, tackling the problem of persistent stigma and why he often advises incorporating it into the kitchen.

When and how did you become aware of the benefits of cannabis as a medicine?

I did not learn anything about cannabis or the endocannabinoid system at the medical school, so it was something I found alone in the 1990s after graduating. I've always known that people used cannabis to relieve their stress and sleep problems, but I really did not start making it a medicine until there are probably five or five Six years ago, when as a spine surgeon, I had an office filled with patients who were addicted to opioids. I was looking for a way to prevent people from consuming opioids, but there were really not many options.

During my research, I started reading more and more about cannabis as a safe alternative to opioids and so I experimented with some of my patients. I was able to see incredible results, just incredible and the rest was part of the story. It was even before anyone realized that we actually had an opioid epidemic in the United States and that no one was talking about it. It was an easy and accepted thing to do when a patient came to the emergency room with a fracture: squeeze it with the appropriate opioid and wait for it to heal. I did not know that it only took a prescription for a 10-day opioid stock – which was the usual response to which we adhered if any one showed up at the showroom. urgency with a fracture or painful injury. It only takes a 10 day prescription for someone to develop an opioid problem.

From there, it became a question of transforming my practicing orthopedic surgeon into an opioid treatment operation. From there, it became heroin and then alcohol; we started to intervene. The more I saw and the more I saw, the more I discovered how important cannabis can be for many problems. to suffer in an acute and chronic way. That's how things really started and they just grew up and grew up.

We find here in Europe that it is the patients themselves who bring this information

to their doctors and therefore drive the change. Does this match your experience as a doctor?

I would like to think that I have been proactive in what has been done. Patients did not ask me any questions about cannabis until I openly established myself as a health professional openly in favor of cannabis as a medicine. When I established my practice, it was one of those situations where "if you build it, they will come" – so I built it. The situation in Europe is a little different because at least in the UK, what I've seen is that it's a country that produces as much cannabis as possible to meet the needs of Europe. Export and medicinal uses across Europe and around the world, and yet they have won. ' Nor do they allow their own patients and citizens to use. It's almost beyond hypocrisy. It seems to me so unpleasant that it is acceptable for everyone to use cannabis as a medicine, but that the citizens of your country can not.

During my visit to the United Kingdom, I spoke in Parliament and last November the law was amended to allow people to have access to cannabis to treat health problems. Unfortunately, they set up obstacles to interfere in the whole situation. GPs are not allowed to recommend cannabis to their patients. They are not allowed to ask them about cannabis. They must consult a medical specialist for advice and a prescription. The governing bodies order him not to prescribe it.

Doctors authorized to prescribe cannabis are in a difficult situation because they believe that they can not prescribe cannabis because of the risk of losing their ability to practice the profession of doctor. The other problem is that patients do not have the opportunity to try cannabis before having exhausted all other traditional means of treatment. It seems absurd to force people to endure all this suffering simply to gain access to something that you can cultivate naturally and that will help treat a tremendous amount of problems. I find it incredibly counterintuitive. The updated guidelines that will come out later this year may be helpful, but in the end, if doctors are still afraid to write prescriptions, nothing will change. I hope that education is the solution and that there is nothing more insidious or monetary.

Last November, you asked the World Health Organization's Expert Committee on Drug Abuse about the potential of cannabis to save more addictive pharmaceuticals. What reception has been received and has this changed so far?

Well, first of all, it was an amazing experience with so many people from all over the world, cannabis was just one of the drugs we talked about that day to be reclbadified. In 1961, at the first meeting of the Expert Committee on Drug Addiction, this drug was considered one of the most dangerous among all available drugs and had been clbadified in Category 1, at the time of the first meeting. like heroin and LSD.

The members of the committee had not addressed this issue until last November, which took 50 years. I had the chance to go and shared with them my experience with my practice and what I am doing with opioids and how it is incredibly beneficial for many patients. Following this, the committee then votes on the opportunity to submit its findings and recommendations regarding potential changes and reclbadification to the World Health Organization.

This happened in November and they announced in January of this year that they recommended reprogramming cannabis accordingly. I would like to think that it was partly because of what I had to say. Moreover, with all the literature available to date, there was really no reason for the Expert Committee on Drug Addiction to accept that it be removed from Schedule 1 and postponed to a later date. .

We will now share it with the entire electorate of the World Health Organization. I understand it will be in the fall. I hope that the entire organization follows the recommendation of the Expert Committee on Substance Abuse and promulgates the declbadification or reclbadification of cannabis.

What can you tell us about the benefits of using cannabis in the kitchen, does this have any advantages over other methods of consumption?

Cooking with cannabis is simply an alternative way of introducing cannabinoids into the system. There are people who have lung problems and who should not smoke as well as those who can not breathe, or even those who simply want a more enjoyable way of using cannabis. This applies particularly to some of my older patients who had never used it before, because there was misinformation about cannabis as early as the 1930s.

Many people do not smoke cannabis, they are not interested in these methods of delivery. So it's another way for them to introduce cannabinoids by incorporating them into the cooking and eating they already do. It offers the opportunity to treat more people by showing them an alternative method of administering cannabinoids in their system.

The other thing to mention is that when you introduce cannabis into a food or into an edible form, cannabis takes longer to start functioning and it also takes longer to leave your system. When you inhale cannabis in the form of steam, the onset of action is immediate as it is directly absorbed into the blood by the lungs. When it is introduced into the gastrointestinal tract, it must instead be digested, navigate throughout the system and circulate in the intestines for a while before it can actually act. There are various advantages and disadvantages to using cannabis and introducing it into the system via different methods of distribution – as long as people understand the risks and benefits of the beginning and are aware of the potency, then this does not happen. is not a problem. This is simply another avenue for people who wish to consume cannabis without involving the lungs.

You have been described as a "myth of cannabis for medical purposes". Do you always meet resistance when you try to educate them, and if so, is it as prevalent today as it has always been?

I really think it's better than that, people are a little more receptive. It's like physics, the first rule of physics that an object at rest tends to rest. You have to overcome this by pushing this rock to make it move before it starts to progress. You have to push rock with cannabis, but it's not as difficult to push now as it did. It's easier with younger patients, but when you look at the older generation, it's a bit harder to lobby for people to understand that cannabis is not everything you've been taught. . Bad things will not happen to you if you use cannabis, not all things have been said to you. We just have to keep pushing the rock now.

Unfortunately, doctors are among the most difficult people to educate because they have already learned everything they thought they needed to learn and resisted change. They are also reluctant to have other doctors tell them something that goes against what they have learned and who have very strong opinions. I often find that, with respect to other physicians, the basics of my knowledge of cannabis fail to take root in the rocky soil of their minds. There is still a lot to do.

What advice would you give to Europe's health professionals about the benefits of cannabis for medical purposes in setting up the legal and regulatory framework? What can they learn from your experiences in the United States?

What I hope is that they are able to keep an open mind and not to have such a rigid thought simply because they learned things from the outside world. 39 a certain way. I would advise them to open their mind to opportunities and innovation.

Big innovations are constantly happening and people are resisting them. Some people have resisted the fact that we are a heliocentric universe and insisted that the Earth was the center of the universe and that to think otherwise was heresy. And finally, it became admitted that it was the truth. Personally, I feel like I'm on the right side of history, and I think in 100 years we'll come back to that time and ask, what's the question?

People will believe what they want to believe, but I would simply ask that they open their minds. There are endless possibilities and many ways to change. Just consider cannabis as one of the arrows in your quiver to try to eradicate the disease.

Dr. Frank D'Ambrosio
Orthopedic surgeon
Activist and lawyer
Tweet @DrFrankLive
https://www.doctorfranklive.com/

Please note that this article will appear in Issue 10 of Health Europa Quarterly, which will be available in July 2019.