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The Science of Cannabis

An Interview with Dr. Margaret Peterson of the Claudia Jensen MD Center for Integrated Medicine

By David Comden

Photo by T Christian Gapen

Medicinal cannabis has been a controversial subject, both locally and across the nation. While laws may have shifted around its use and legality, some members of the medical community have come down firmly on its side. Margaret Peterson, M.D., a Ventura family doctor for 28 years, is one of them. As the medical director of the Claudia Jensen M.D. Center for Integrated Medicine ó which specializes in holistic care, wellness and alternative medicine ó she has an in-depth understanding of the physiological effects of cannabis in the human body, and its value for the health of her patients.

Dr. Peterson sat down with Ventana Monthly for a discussion about the benefits of CBD and THC, what the science says and the importance of both substances in overall health. The interview has been edited and condensed for space and clarity.

When did you become involved with the Claudia Jensen Center?
I became friends with Claudia Jensen, a pediatrician. In the early 2000s, Dr. Jensen became interested in cannabis as medicine for her adolescent patients. . . . She developed breast cancer and died in 2007, at which time she had two daughters who asked me, as her friend, whether I would kindly take over this practice. So it wasnít my first passion at all, but I do functional [and] integrative medicine, so I looked at this as one additional way that people are helped. So I said yes and I assumed it in 2007. . . . Now [we are] the go-to place for cannabis information and recommendations in this area . . . but I still donít advertise, and keep it fairly separate [from my family practice].

Can you tell us what CBD is and how it works in the body?
There are about 88-plus cannabinoids . . . . [that can influence] the CB1 and CB2 receptors to . . . effect some kind of change. CB1 and CB2 are situated on different parts of the brain which have to do with memory and thinking. CB2 receptors are involved in immunity, the spleen, the skin, and they influence a lot of other systems.

The two basic cannabinoids that we use are THC and CBD. The reason THC still is your master is because it is the most bio-identical to our own [self-produced] cannabis or endocannabinoid, which is anandamide, the molecule made in the brain that is a receptor for CB1 that makes you feel good, takes the pain away. . . . We now have some emerging thought that [the substances responsible for runnerís high] are in fact not endorphins but endocannabinoids.

THC is structurally identical to anandamide. . . . CBD is a secondary cannabinoid, a subject of great excitement. It works indirectly [and] . . . communicates [in the body] with so many things, and itís non-psychoactive so itís become the darling of the press. THC is psychoactive in high doses (greater than 2 mg) so microdosing is the key.

Is CBD effective on its own?
It isnít [just about] CBD, itís the whole variety of things. We know about THC, how it is ďtalkingĒ to things. We have cannabinol or CBN, which has the same properties; youíre going to sleep more using CBN. THCV [tetrahydrocannabivarin] ó [fewer] seizures, Parkinsonís or movement disorders. That is not CBD. There are many different cannabinoids that can be used for different things.

When we talk about the cannabis plant, besides the cannabinoids, what else is in there? There is polyphenol, the No. 1 thing thatís good in chocolate and very important for your body. Terpenes are aromatic oils. Things like pinene, naringin, which is a chemical from grapefruit. . . . What a lot of people like about the purple cannabis strains (Grand Daddy Purple, Purple Kush, Purple Haze) is that they contains linalool, which is the aromatic oil in lavender. . . . To take a CBD isolate from hemp and put it in a pill and take it, doesnít make any medical sense to me.

Where I am completely in agreement with the use and excitement around CBD is as a communicator. We know that [itís effective for treating] chronic illnesses: inflammatory, neurologic, neuropathic. So I agree that we need to keep CBD. If, however, you have cancer ó itís all about THC.

Tell us a little bit about the history of medicinal cannabis.
Prior to 1937, extracted cannabis was widely presecribed ó 7 million prescriptions by various drug companies. They didnít even know what THC or CBD were. [Prescribed] in the form of a tincture [medicine dissolved in alcohol], for asthma, it was the best thing ever ó a tincture of cannabis with white willow for pain. It was medically helpful and recognized. In 1937, the Marijuana Tax Act [was enacted] and all of a sudden, access was denied. Then Reefer Madness. . . . We have 3,000 years of using cannabis as medicine and 70 where itís a crime, an illegal drug with no medical benefit.

What kind of research is being done right now?
In Israel and Spain they are doing fantastic research and it is very much an international consortium. We have for 30-50 years had international cannabinoid research groups, that hold their conferences in Chicago and in Europe (Brussels and Germany), and itís all chemistry, preclinical. Itís all done on molecules, not the whole plant. Thatís how we move science, how we got [breast cancer treatment] herceptin from the Amazon, how we got [cancer-fighting compound] taxol from the jungle. We get the bark, a single molecule trying to effect a single change. Taking these compounds to build the blocks of solid science.

Is this threatening pharmaceutical drugs that are on the market now?
This may affect drugs that are in the pipeline that could be blockbusters, like a migraine one approved recently by Amgen. . . . The problem with Big Pharma is that they are looking for a single bullet that will help the majority of people to solve a problem. When you look at chronic things, you are trying to look at imbalances, to find the imbalances that make the body unhappy. So if you really understand the endocannabinoid receptors, thatís a huge player. And if [your body doesnít] make enough anandamide, then give yourself some plant-based cannabinoid, a little ďdusting,Ē and with time, things are relaxed, stress is down and things work. I donít think that cannabis can pose a threat to big blockbuster drugs in the pipeline to battle cancer.

What are the different ways of ingesting?
There are three basic ways of getting cannabis and cannabinoids in you: Topically through your skin, through your lungs and through your gut. . . . How you ingest or use this as medicine determines what you are using it for. If youíre treating a rash, put it on topically. If you have Parkinsonís or other movement disorders, itís thought that inhaling is the best because it goes right into the nervous system . . . If you want something quick ó say youíve got a panic attack or youíre throwing up from chemo or you have the flu ó why are you taking an oral that takes an hour and half to take effect? Youíre going to inhale it. So if you sense a panic attack or migraine coming on and you find the right thing that helps you, you can take it and in 10 minutes you get the effect, and 3.5 hours later, itís gone. If you need it again, you do it again. But itís not lingering.

Now if you have chronic pain [you need] something more long-lasting ó such as edibles or, my favorite, tinctures under the tongue (as they always seem to be more controlled). [More] products have the high CBD and are very much like the old-school tinctures of cannabis that have been around for years and years. Those take about 30 minutes to work and last 4-5 hours. . . . Because CBD is not psychoactive, you donít know itís working; you might feel a little calm. But for pain, itís like neurontin. Itís not a pain reliever, itís a pain modulator, to change the way your body perceives those impulses.

What are the side effects?
What is commonly known with excessive THC use is hyperemesis ó throwing up when people take hyper doses. . . . When these people come in, itís because of very high doses of recreational use. With CBD, the biggest potential interaction is with medications. THC can trigger anxiety, lower the blood pressure, create a bit of tachycardia (rapid heart rate); it can trigger paranoia. In my experience, Iíve not seen this happen with CBD.

In the future, do you see the prescribing of cannabis as part of a good health regimen?I would hope never to see it as a prescription in the medical term, but absolutely in the prescription as in ďeat well, exercise every day until you sweat and something for cognition.Ē . . . Now there is some evidence that [THC] might in fact be . . . clinically helpful for the brain . . . somehow doing something for reversing the cognitive decline.

Claudia Jensen MD Center for Integrative Medicine
2895 Loma Vista Road, Ventura
648-5683


06-01-2018

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