Episode Transcript

Trevor:  Kirk, we're back.

Kirk:  Hey,.

Trevor:  So I've got Gill Gil Luxenbourg.

Kirk:  Yeah, where did you find this guy? This is an amazing interview.

Trevor: Like everywhere else just you know stumbling through the LinkedIn and he looked interesting he said sure I'll talk to you and you know he ends up you know with not giving too many things away. Medical cannabis patient number seven in Israel amongst a bazillion other things

Kirk:  Yeah, no, your conversation with him is great. And for the listeners of Reefer Medness The podcast, I am Kirk Nyquist. I'm the registered nurse.

Trevor: I'm Trevor Shewfelt. I'm the pharmacist.

Kirk:  And you, and you've brought a guy that we're going to make three episodes out of this out of this conversation, right?

Trevor: So this is part one of three.

Kirk:  Yeah, okay. So we'll give a little bit of an origin story in each of the starting episodes. But so just so that our listeners know, there are three episodes. Quick introduction to the fella.

Trevor: Sure so in this one we're going to sort of talk about his origin story you know from you know his mandatory military service in in Israel where he sort of stumbled across cannabis medically to him starting to figure out cannabis advocacy and cannabis education that's sort of what we'll cover this time around.

Kirk:  Yeah. And again, to listeners, know that this is the first of three we're doing. So, yeah, let's just get right into it, Trevor. And at the end, we can sort of sum it what we heard.

Trevor: Sounds good. Let's listen to Gil. Gil Luxemburg, welcome to Reefer Madness. You have a, we are just talking off camera, a really long and interesting trip through the cannabis world. Let us take you back to I guess the late 90s, early 2000s and you were sort of in compulsory military service for Israel. What sort of happened?

Gil Luxenbourg: Well, everybody joins the army. I just happened to get Crohn's during the army, so my first introduction to cannabis and as the first experience was after being diagnosed with Crohn disease in the army losing 37 kilos, which is about 80 pounds within just three months. Hospitalized in a military hospital. No medicine they gave me worked. I don't remember all the names, but they tried a lot of different things. And at some point one of the military doctors who was an active reserves military doctor and he's a gastroenterologist he came once every two weeks to meet with me and he took a second shift that day and he gave me five roll joints and told me try this it might work. Now with those five words try this, it might, work he changed my life. Everybody that says that, you know, cannabis doesn't work for the first time or whatever, didn't try the right thing or didn't write when they really needed it. I was so relieved. It's, it's unbelievable. I could eat for the first time and digest and hold it in. And two weeks later, I could actually go home for the first time in three and a half months, which was amazing.

Trevor: That is and like you said you you've been through all the biologics and all the high-powered things had you ever was cannabis something that you had used recreationally before or were you surprised that he recommended it?

Gil Luxenbourg: Surprised! I went to my GP and told him about it back home, even though I wasn't supposed to, I wasn't in contact with him for a while because I was in the army, just to consult because I was so surprised. I didn't know anything about it. And he told me, listen, it's illegal, but if it works, I'm not opposing. Went back to the army for the military hospital, just got ready for my Monday morning session with my gastroenterologist who, when I told him that I told my GP about it, turned two shades paler than the white wall behind him. Picked me up in there, he's a huge guy, he picked me in the air like a leaf to his face. And he's like, I'm trying to save your life. Why are you trying to destroy mine? I was so, I was naive. I didn't get it then. It took me a moment or two to understand what's going on in his mind because he was seen 20 years imprisonment. Mandatory. As a doctor who gave drugs to a patient in the military hospital for saving my life. That's the risk he saw in front of him. So my angel. Saved me and changed the course of my life because I realized that if I made him an outlaw and now if I'm now an out law that's you know you can live in the shade as an out law or you can change the law.

Trevor: And that segues nicely to you, you did that, didn't you?

Gil Luxenbourg: I started out with having six patients before me who were licensed by the courts. The court actually meant to license them just because they were caught so many times and it disturbed the court's time because they came every time with the doctor's note saying that this is for medicinal purposes. So they were licensed this way. And I went into the Ministry of Health and told them, no, that's not the path for me. I want to get a license because it's really medically helping me. How do we do that? Took four and a half years, 400 medical documents and 600 pages of my own journaling of my own path with cannabis just to prove to myself and to them that this is a real medicine. And back then, we're not talking about email like today. We're talking about snail mail of waiting three months every time until you get the reply and then you need to answer and to, to search for materials and to send back and to wait for three months to get a reply and so on and so forth. But eventually in 2004, I was licensed for medical cannabis. Now we're talking a time before YouTube, there wasn't no, there wasn't any available source of information to learn from. So we had to self-educate. But when I opened the door, I kind of pushed and, you know, I nudged a wedge under the door and founded the Israel Medical Cannabis Association in order to help patients pass through this open door that we just created.

Trevor: Right, and so this was like a patient advocacy group. It's like you said there, the how to do, what to do where to do for patients just wasn't available.

Gil Luxenbourg: Exactly. Like in the beginning, it started with how to grow your weed and how to use it for medical purposes or at all, because nobody knew anything. We didn't have sources for nothing. And then it moved on and transitioned into a joint cultivation that then transitioned on to become later on, a part of it split off to Tikun Olam  the first medical cannabis company in Israel, officially. But I took on the other path of the page of leading the patients through the journey and learning how to actually, you know, treat cannabis as medicine, because it's very different for everybody and everybody reacted differently. And in the beginning we had like 50% of patients that went through all the ordeal to get their medical cannabis license because they thought this was going to be their savior. After everything else failed. Stopped using it within the first four months. And it took us a while to kind of understand why and how to fix it.

Trevor: And I want to get to that because that's a lot of your story, but just to keep everyone on the right timeline. So you first got your license in 2004, it wasn't easy. When did medicinal cannabis become, we'll call it, relatively easily available in Israel? Ballpark, what year did that happen?

Gil Luxenbourg: Well, relatively easy is a relative term, but let's say that from 2005 that I helped founded the association and help started helping the patients through until 2008, we got to around 3000 patients, maybe 2011, maybe we had five, maybe 6000 active patients. It took 11 years to get to 10,000 active patients But then over the next 11 years, we got 140,000 patients. So it's just a matter of momentum and getting to the right elevation and enough doctors and nurses and pharmacists and people into motion and aware and informed in doing it to kind of make it happen for the patients because every doctor that we bring along brings about 10 new patients and the outlines bring like 200, 300 new patients a year. The extreme outliers bring like a thousand, but we're not talking about those extremes right now. An average doctor just comes across, you know, a GP that just has his own small clinic comes across about 10 patients a year that need medical cannabis that you can just direct to that direction. And it takes time for them to understand how to even want to participate in this, not to mention how to do it.

Trevor: Back to your dropping off in four months.

Gil Luxenbourg: Yeah, I'm saying like 2008, I was licensed by the Ministry of Health. Finally, after doing it with the patients for a while and showing them the results and changing it from, you know, it took a bit longer to show all the results. But in 2008, they licensed me for a medical cannabis coaching and education license, which was a unique new license that they kind of invented. And I could then both coach new patients and actually administer them the medicine for the testing, for the test trial period and trying with them and their physicians to get to the point that we know it's kind of going to help them out before they get the full prescription and licensing, because it was dual prescription and license at the time. Very long process and in order to save them from that. The Ministry of Health kind of helped with this path of the coaching, but mostly for the education for doctors, nurses, and otherwise, which led on to in 2011 that I actually coached the first medical cannabis nurses class in Israel. And that was a game changer in the atmosphere of the country because we finally had nurses, in the elders homes, in the hospitals, in child care, actually knowing what they're doing with medical cannabis. So there could be clinical trials because there was somebody to administer and that they were knowing what their doing. And that helped all of the research and science progress a lot. And I've got a lot, I think that goes a long way, the science and research when you actually have it with live patients, real clinical trials, and you have real results and you can show it. And those people speak on the news, then it attracts a lot of attention and a lot of diffusion of the stigmas around cannabis. And we had to diffuse a lot of stigma's before we got it to really be accepted.

Trevor: And I don't know if I'm jumping the gun, but one of the interesting things you're talking about with your cannabis education is a lot of people drop out relatively quickly. And as a pharmacist, I can relate to that. I'm just thinking people using eye drops for glaucoma, they get annoyed after a few months and they stop. You know, people stop using their asthma inhaler and then they don't come back until they can't breathe again. That people sort of, people drop out, or we call it become non-adherent, pretty commonly in sort of pharmacy world. What were you finding about why people were dropping out of being a medical cannabis patient?

Gil Luxenbourg: Well, we see that it splits in the middle. We have patients that kind of went through the period of needing it enough and now they just want to lay off and they kind of come out of it on the other side not needing it. So a lot of chronic patients come onto it just at the peak of their real needs for rescue at some point after they balance the endocannabinoid system. This is why. Today we know why but back then we just knew what. We saw that they're stopping the use and we asked them why and they're like i don't know i feel good enough i don't need it anymore so why continue but at the beginning it didn't even get there i mean most patients use because of one wrong dose because of a one bad experience because of one very shaky friend that told them to do the whole thing instead of just two puffs as they were instructed, even if they were instructive, like. A lot of times, especially in the beginning, we were getting the elder population and we were getting that population that was going to the hospices and kind of palliative care. Then we got the cancer patients, which were going through so much with their chemo and radiation therapy and otherwise, that we kind of tried to help. There was the second tier, the first tier were just those very hard patients and a lot of them realistically just died. So that was another kind of thing for the statistics of why people stopped within the first four months, we had 50% drop off rate. But taking all of this into account when we started the education program and actually ran people through it with all of the different companies that were providing medical cannabis at the time. All the big first aid that provided cannabis in Israel. We had this shift of four months of 50% drop off to 34 months for a 50% drop off. Now it doesn't mean that people didn't stop using cannabis. Some people kept, you know, some people keep going for life. Some people stop, but if the 50% off rate moves from four months to 34 months, you can actually get data from what's going on even during this short period of, of usage. And we saw that these were mostly cancer patients that their cancer stopped and they were, they recovered and they did just, you know, kind of didn't want to get a habit of cannabis. Didn't want to dent their life apart for medical use. So they stopped. We saw different patients that were ongoing through real peaks of their inflammation and different inflammatory diseases. And when it kind of subdued and went back into submission or remission. Then they kind of laid off either stopped or really reduce their doses. But those are the most cases that stop after a period of time and not in the beginning, the beginning it's the grandma that goes to the hospital with a elevated heart rate and thinks that she's going to have a heart attack. She took too much THC.

Trevor: Yes, of course we hear that here too, yeah.

Gil Luxenbourg: But even worse, like I had a case of a patient that went through open heart surgery for nothing because he had a birth defect in the heart that was treated at nine with surgery, but not 100%. So he had some form of arrhythmia. And when he took medical cannabis, he actually was instructed to take two puffs at night with a joint before he goes to bed, like 30 minutes before he goes to be in no more. But he met his neighbor who told him, come on, smoke the whole thing. What's two puffs? And he smoked the whole. And the next thing, and you know what? That's a story I'm telling about shame because this guy went through open heart surgery for shame, not anything else. It wasn't because of cannabis. It was because of shame of telling his doctors that he took cannabis. So next thing he knows, the room turns black. He wakes up in the hospital in the ambulance on the way to the hospital, ashamed, afraid, not sure what to say because it was his first time. It wasn't yet on his medical records that he was licensed for medical cannabis. So it wasn't on the medical record at the hospital. But what was on the record was the previous surgery and the fact that the defect wasn't completely resolved. So they did one plus one is equals two and immediately went directly into the OR because of his complete fluctuations of, of, uh, arrhythmia, arrhythmi and the heart and the heart rate and whatnot. And somehow they opened them up, they stitched them up and they kind of, he went through a long recovery, but. That's a story that we keep telling the patients to not be ashamed to tell the medical professionals about their cannabis use, whatever it is. The police is the police, but your doctor needs to know. Your anesthesiologist needs to know. Your physician needs to know like everybody within, like their pharmacist needs to know and your nurse needs to know, it's very simple.

Trevor: No, that's an eye-opening and sobering story that, yeah, I hope everyone keeps in the back of their mind. So Kirk, one of my favorite little bits from that was during his sort of origin story. The military gastroenterologist saved his life with cannabis and things were much better but he he went and told his family doctor and then came back and told the gastroenterologist and said the guy went three shades whiter than the wall behind him and physically picked him up you're going to ruin my career. I like the visual on that one.

Kirk:  Yeah, and how many times have we heard that, right? I mean, Dr. Jennifer Anderson in our episode that we did with her becoming the doctor that you need, she also was confronted by that, you know? Cannabis works, but you can't talk about it. So what I inferred from that story is this physician knew something about cannabis, but westernized allopathic medicine doesn't so he suggested his patient uses it and huh guess what it worked.

Trevor: Well and but before when he used it it was not legal at all in in israel and that's how we sort of got into you know patient number number seven you know he he yeah so yeah no i i really like that and then all the stuff he started doing with with education uh doctors pharmacists nurses uh he he did a lot and you know accomplished a lot. And this is just our first episode we got some more interesting stuff coming up shortly.

Kirk:  The other thing I want to reinforce in this episode is how he basically reminds people to tell your doctors that you use cannabis. I've been confronted by this, and recently I was confronted by going to one of my fee for service medical practitioners in town, now I'm not going to say which one, because there's all sorts of fee for services, your eyes, your dentist, your medical doctor, but I went to one of them. And they asked me to bring a pharmaceutical list with me. And of course, I don't have any pharmaceuticals in my medicine cabinet, on my side of the cabinet. I use cannabis. So should I be telling my allopathic practitioners that I use Cannabis?

Trevor: As a pharmacist, I want you to tell us everything, from the vitamins you take to the cannabis you smoke. Yes, I do.

Kirk:  I completely agree. Regardless if that individual knows anything about the endocannabinoid system, I believe as soon as I come into the appointment, as soon as it's a confirmed appointment, if I miss it, I have a sneaky feeling I'm going to be responsible for paying for the appointment. So I see us having a contract. So if my practitioner's asked for my pharmaceutical list, should they not understand what's on that list. And we know the answer is they don't understand. We know that the majority of allopathic practitioners don't know the endocannabinoid system, right? And they should, but they don t, which is a whole different podcast. The reason I bring it up is because, you know, he has an acquaintance that went through open heart surgery because he didn't inform the physicians he used the cannabis.

Trevor: Yeah that that that was that was quite the story wasn't it yeah like we've we've talked about that we had a little old lady who basically got the wrong cannabis from her bud tender we're not really blaming the bud tender but you know got the long cannabis thought that she was having a heart attack and ended up in the emergency room but at least there they discovered what had happened you're right this one went way farther than that

Kirk:  Well, and this goes back to, you know, Daniel Bear, and again, this is a series of three, but to give people a little foreshadowing here, people need to be educated, right? We need to teach people to mindfully use cannabis so that these kind of situations don't occur for the patient nor the practitioners that are waiting in the emergency department that have ignored the endocannabinoid system. So this is a good story. I enjoyed this conversation and I'm pleased that we're breaking it up into three.

Trevor: Yeah, hopefully it makes it more bite-sized, so I'm going to do the comeback. We've got more Gill, and he's going abroad. He's going to Czechoslovakia and Bulgaria, and things smell good over there because he's also talking terpenes.

Kirk:  So we're Reefer Medness the Podcast. Don't forget to go to our web page, reefermed.ca. It's a completely searchable web page. And as you all know, Meta and most social media do not support a cannabis based project. And the only way we can get our word out is through word of mouth. So please, if you like our episodes, if your like our podcast, please tell a friend and like us on the platform that you use.

Trevor: Sounds good. All right, we'll talk to everybody soon with more Gil