Episode Transcript

Trevor:   Kirk, we're back.

Kirk:  Hey, Trevor. How's it going?

Trevor: Good. And now, are you ready for some big news? Big news? Huge news? I'm Trevor Shewfield. I'm the pharmacist. I remember to introduce myself at the beginning of the podcast.

Kirk:  Yeah, I'm Kirk Nyquist. I'm the registered nurse and we are ReeferMedness The Podcast found at ReeferMed.ca. All Things Cannabis. We have a webpage for all types of learners. And this is the second episode for Lauren E. Kelly, PhD, Masters in Science, Bachelor's Med Science, very knowledgeable cannabis researcher, probably one of the top Canadian cannabis researchers?

Trevor: Yeah, associate professor. She'll do her thing. Pharmacology, University of Manitoba. She's a principal investigator in cannabis. At the moment, she is the president of CCIC, the Canadian Consortium on the Investigation of Cannabinoids. I got that right on my first try. Some other things like the Canadian Medical Cannabis Trial Network, CMCN. She's the co-lead. She has many many hats and I can't believe we got her on the line twice because she is a very busy person.

Kirk:  Very busy person. And also, I said up front in the first episode that we talked to in the intro, I said that there was an irony about us finding her and she addresses that irony in this episode.

Trevor: We should let Dr. Kelly introduce herself and hand us some knowledge and then we'll do what we do with knowledge at the end.

Lauren E. Kelly, PhD: So hi everyone, thanks Trevor and Kirk for having me. So my name's Lauren, I'm an Associate Professor here at the University of Manitoba in Pharmacology and Therapeutics. And I wear a couple of hats in the cannabis research space. So I'm a principal investigator, someone who runs my own cannabis research. I'm also the president of our National Society of Cannabis Researchers, the Canadian Consortium for the Investigation of Cannabinoids or CCIC. And I also co-lead a network of folks who are trying to do medical cannabis clinical trials called the Canadian Medical Cannabis Trial Network or CMCN. So here with a few hats on today.

Trevor: Know and that's perfect that segues nicely into so we have a whole bunch of different listeners you know we have lay people who have heard of a clinical trial all the way up to researchers who have run a clinical try but everyone in the news has at least heard of a clinical trail a drug trial you know these things that are reported on the news that you know, Metformin helps with COVID, and does it, does it not. Can you just start with how is a quote-unquote regular drug trial, regular clinical trial done? And then we'll go into what's a little different about cannabis.

Lauren E. Kelly, PhD: Yeah. So clinical trials are different than other kinds of research studies. They're basically a methodology, but they require a specific study protocol. So you're going to tell the people in the study how they're going do something, whether that's take a drug or how they are going to learn a new math program or whatever it is that you're evaluating. And we call that the intervention. So in clinical trials, you know, there's different approval processes that are necessary. So all clinical trials in Canada have to be reviewed by a research ethics board. You need to declare how this trial is going to be funded. So clinical trials can be funded by a variety of different groups. Maybe that's a grant or from the government or from a company. They all have to go through a research ethics board process. And then wherever the research is going to happen, so typically that happens where the patients are. Or maybe it's even happening, if it's happening in their home, that's a little bit different. But any institution that's going to be a part also has to be approve it, and then if you're studying a drug, Health Canada gets involved. So Health Canada get involved in clinical trials when you're studying something that is not going to be used according to the label. So, you know, we're talking cannabis today, but there's other things that fall in that category as well. So if you are studying a drug the way that it's intended, so if you are studying morphine for pain in adults, you don't necessarily need Health Canada to approve that trial because you're using the product according to its.

Trevor: According to its indication.

Lauren E. Kelly, PhD: Exactly, according to it's indication, but of course we know medical cannabis doesn't have this, so that's a whole different question, but if you're studying something new or in a different population, so for someone like me who studies children, many things are off-label, even the things that get used every single day, and so most of my clinical to all of them have to go through a Health Canada approval process as well. So there's several layers of complexity to how these clinical research studies happen. And then they, you know, once they have all their approvals, they can start and collect data and then they have to, you know, keep their data and they have to commit to reporting the data as well. So that's something that's really important because those of us who work in an academic environment, like at the universities, when we get money from the government or from an organization to run a clinical research study, we also agree when we accept that money that we're going to share the research findings. So we're gonna publish it, we're going to write infographics or share it in a podcast or whatever that may be, we're going to have a mechanism to make sure that the results get out there and that's a little bit different than studies that get run by industry because they're not, if they're funded by industry, they're necessarily bound to the same reporting requirement as though the research that gets done funded by government. So.

Trevor: Without going too much into the weeds, that was an interesting point because in pharmacy world, most of the studies I look on were originally funded by industry because they try to sell the drug, which is fine. I assume a cholesterol drug trial that was done 30 years ago, still need Health Canada approval, but right, but then they're not bound to release the results. That's interesting.

Lauren E. Kelly, PhD: Yeah, it just depends on who funds the study. It's actually a funder requirement, it's not a Health Canada requirement. Health Canada requires you register the study, which means before you start you say you're gonna do it, but not necessarily do they have a mechanism. They're not, they don't have a lot of sticks, right? So they don't have a lot of mechanisms in Canada to say, pharmaceutical company, you must report these cholesterol study drug results. Whereas our funders can say, hey, Lauren, you did a cholesterol study and we're not giving you any more money until you report the results. So it's just, they don't have the same kind of, you know, carrot and stick model.

Trevor: Okay, no, that's really interesting. Now, cannabis is different in everything, you know, from, you know, there's a bazillion different active ingredients in it to how people are using it, or the fact people can use it without going to see a medical professional at all, which, you know is interesting. It makes cannabis endlessly interesting. How is cannabis research different than than a quote-unquote regular drug trial.

Lauren E. Kelly, PhD: Yeah, it's a great question. I think endlessly interesting is a great way to describe working in cannabis research, I think, Trevor, because I would say it's endlessly interesting and a new roadblock every day. So when the Cannabis Act came into place, so before 2018, cannabis in research was just treated like an opioid, like a controlled substance. So pharmacies knew how to handle that. They have a special, you know, walk safe where controlled substances go. They have dispensing protocols. They know how to do that. The cannabis act came in place it made a specific cannabis license required for research. So our institute all the universities then had to apply for a cannabis research license so that process has taken a while but a few most of the universe many of the universities i won't say most, have these in place now um but they basically mean that our cannabis products for research can't be stored in the same pharmacy that the rest of the medications are so Yes, it's very a complicated storage procedure, so it has to be, you know, behind two, there's, it depends on where you are, your institution basically sets the rules for how these products will be stored and dispensed. And so again, one difference is that you require a specific license to do cannabis research now, whereas before you would do your health application and you would just follow the controlled drug substances part. So that was a whole new process for us. So when we got funded to do our first clinical trial, we didn't have, we had to wait and get our license in place. And that's one big thing. But I would say one of the biggest differences is that medical cannabis products and recreational cannabis products are made to Good Production Practices. They meet a quality standard that is not pharmaceutical grade or what we call Good Manufacturing Practice. So we're not allowed to study non-GMP products in a clinical trial. So as clinical trialists.

Trevor: And sorry, just a definition thing again, because this has come up before, make sure I have all my terms straight. Recreational cannabis is what level and research is GPP?

Lauren E. Kelly, PhD: Yes, Good Production Practices and medical cannabis, like if you go through the medical cannabis streams, those products are also GPP.

Trevor: So GPP is what I could go down to my my license shop and buy tomorrow. But GMP is what you need as another step up is what you need for research. Okay.

Lauren E. Kelly, PhD: Correct! And the problem is that in Canada, there's like two companies that can even make GMP products. So the reality is we can't study the products people are actually using in a clinical trial. We're not allowed. And that's because the Food and Drug Act govern how we study drugs, and the Cannabis Act governs how we studied cannabis. And these two were never designed to integrate in any way, Trevor. And so things, for example. We send our product centrally. So in our clinical trials, our participants see the doctors, their own doctors, but we centrally mail them their cannabis through Canada Post, same way medical cannabis does. But they can't send us the bottles back for us to do accountability like we would in a normal clinical trial because if they give a bottle to Canada Post they're dispensing cannabis according to the Cannabis Act. I kid you not, I kid do not. And so... We have to, we're in a space where we're trying to balance these two governing documents, like body documents that don't align and are often contradictory. And so it's a big difference compared to opioids because again, there was one process for controlled substances, you know, opioids are one thing, you can make it consistently and make a placebo for it and comparing it to other drugs where you have also data. So another big thing is, you know, the people say, well, why is a clinical trial needed? Well, I can't just pull from the health system how many people are using medical cannabis and how they're doing, right? That data doesn't exist the same way it does for a cholesterol drug, right. In the provincial registries, you could go and say, how many use this cholesterol drug? And how many of them came to hospital or how many have them didn't come to hospital? And so that kind of information that we really need to identify is a trial even feasible? Like how many people could be eligible? It's a big challenge for us because medical cannabis, even in pediatric patients, is still just that authorization process. So that authorization form goes to the LP and they get their medical cannabis product, but there's not a standard way that it integrates with the clinical records. And I think that makes it a bit different than really all of the other prescription medications, if you will.

Trevor: Yeah, no that and so how about because we hear this a lot you know if half a dozen clinicians you know all notice you know strain X works really well for autism and so you know not surprisingly they all keep telling their patients keep using strain X for autism. Does that anecdote, even if you know it's an anecdote from, you know, 10 different clinicians across Canada, how can something like that, can something that ever be turned into a clinical trial or is that just making hypotheses or how does, how do even really good anecdotes work their way into research?

Lauren E. Kelly, PhD: That's such a great question because we often say our motto is turning anecdotes to evidence because it's such an essential first part of a clinical trial. I mean, unless a bunch of people think your idea is good, you don't want to do a clinical trial because they're a lot of work and they take a lot of time. So you kind of want that first step of 10 people to say this is something we all think is a good idea. With regards to the strain, that's where we won't be able to study the strains that are using. So we have to work with a manufacturer to create something similar. So that's what we do now. And what I will say is our first trial started because three doctors were in the same room and they all mentioned they were sort of using different cannabis products for headaches and people seem to be doing better. People who were refractory adolescents who were missing school. And so I think a lot of these conversations is actually how clinical trials should start is with some consensus among, you know, we see benefit but for who and is this real or is it some sort of placebo? Those conversations are critical and the challenge is in the pediatric space we kind of all, I don't want to say we all know each other, but lots of us are connected because there's, you know, only 16 children's hospitals, so the oncology teams kind of know each, other the neurology teams kind, of know, each other and so they get to kind of collaborate on those spaces. In the adult world where care is just so much more distributed, I think it's a kind of a bit of a different ball game, but. Yeah, in pediatrics, I would say that's really an important first step for research, for sure, because you're going to need people who are going to recruit for your studies, right? So you need people, who think this study is important to do. Otherwise, there's no point in doing it.

Trevor: And I'm guessing I know the answer, but maybe I'm off, and that's why we ask questions. Can you do retrospective studies? Like again, let's go back to a cholesterol drug. It's relatively easy to go to a provincial health system or to an insurance company and go, all right, we can look back over your records and this many thousand people took this cholesterol drug and this may thousand of them had heart attacks. So thus we think this, you know, this dose is good at preventing heart attacks. Is there any big batch of data like that in cannabis that you can look back at to even sort of do a retrospective study or get ideas or anything along those lines?

Lauren E. Kelly, PhD: Yeah, it's a great point, and there are ways, sort of, but what I will say is that the biggest challenge with that is the exposure, right? Because cannabis, as we know, is not just cannabis is cannabis, you know, oral CBD oil is not the same as, you know, smoked high THC cannabis. These are very different exposures, and there's not a data set that links good exposure data with those clinical outcomes, right? So you can't do that at a provincial level. At an insurance, I never thought about looking from an insurance perspective. That may be interesting. I'm not sure how well claims data really reflects quality of life for many of the patient and family-oriented outcomes, but it is potentially an option, although obviously you're gonna miss folks who are not gonna be submitting and insurance claims for that. But... What I would say is that it's very different than a cholesterol drug because you can't just get from a hospital, how everyone codes the statin drug is that same DIN, right? One DIN is one DIN. Everyone uses the same one in Canada. Cannabis, people write it in a note somewhere. Some people write in different places in a file that doesn't speak to each other. It's written on paper somewhere. And so it's a lot harder to actually quantify those exposures. So we end up with these kind of research studies that say like, cannabis use, yes, no. And it's like, well, what is, like, does that mean CBD oils? Does that mean smoking one time in your whole life? Does that like, that kind of exposure data is really important if we're actually gonna learn about safety and efficacy. So I think using retrospective studies, we can get what we kind of call signals, right? We can look and say in one clinic where we, there's like one doctor who's maybe seeing 50 patients, 25 using cannabis, 25 not. We can look at small studies like that and those do exist in the pediatric spaces, like in palliative care is a great example where they're not ready or interested in doing clinical trials, but they have lots of kids they're collecting their own data on. And I think the problem in Canada is right now it's up to the clinics kind of to do that. There's not like an integrated strategy on sort of overall how do we learn from all this work that's happening in the clinics and not making it into the research realm.

Trevor: I'm hoping this isn't a different tack but a few years ago I was at a cannabis conference in the US and everyone was, oh you're Canadian, and so almost everybody there said, oh it was fantastic that you guys legalized but then you kind of dropped the ball. You didn't really do anything with that. I'm I think I know the answer, but we'll ask anyway. We were ahead of everybody else when we legalized in 2018. Did Canada kind of drop the ball on research too?

Lauren E. Kelly, PhD: Big time. I mean I can't pretend to think otherwise. I think the Cannabis Act was written about like product quality and you know restricting an illicit market. It never considered medical patients or cannabis research in general. Like I do not think that they really considered that much at all and I do think that we have fallen. I will say as someone who is in this space pre-legalization the companies that were interested in funding research and wanting to make medical products. But Canada didn't require them to be medical grade. And so in Europe, Australia, other regions, their medical cannabis products have to be GMP. And there's no reason why Health Canada didn’t create a strategy where medical grade cannabis products were available for medical patients. I mean, I think we can all agree that patients deserve a consistent and quality product for their health needs. And I think they dropped the bar on research around clinical trials completely. I mean initially they funded a few. Cannabis team grants and that funding has all expired. They haven't had any new initiatives around studying cannabis and health and clinical trials specifically, even though the public has so many questions. And so I think that if I was to go back and redesign it, if you will. I mean they need some kind of medical cannabis advisory board, some kind of medical cannabis strategy, they need to be thinking about how are we going to connect all of the dots on this sort of floodgate because they open the gates and you know without really a plan for well how are you going to learn and you know make sure that we can create evidence that guides safe use and helps people to get the answers that they want about these products.

Trevor: So I can see Kirk furiously writing notes, so I better let him throw in a few questions before he explodes. Kirk, any questions?

Kirk:  Oh man, yes. This has been fascinating, eavesdropping and just making little notes. A couple of things. You mentioned good manufacturing is medical grade.

Lauren E. Kelly, PhD: Yes, pharmaceuticals grade. That's what all the drugs get made to.

Kirk:  So you said two LPs in Canada are doing that. Now without naming them, do their medical program patients get that grade?

Lauren E. Kelly PhD: No

Kirk: So that grade is only for research.

Lauren E. Kelly, PhD: Correct.

Kirk:  That's too bad.

Lauren E. Kelly, PhD: Whereas in Australia, all the medical cannabis patients get medical grade, like pharmaceutical grade. And it's not that it's, that GPP is always bad, but it's an extra layer of quality that is there for a reason to ensure that people who have access to a consistent product. And it also, you know, another problem is when they run out of products, they don't have to notify patients. So when, you now, Trevor, your example of like, if 10 clinicians notice there's really one great strain and all their kids with dravet are doing great on one product. They don't have to notify those kids when they can't carry that product anymore. If the next batch of it isn't the same exact composition, because of course, we know batch to batch things change, there's no notification process. So they could go to fill it and they could be like, sorry, we don't have that.

Kirk:  But it gets deeper than that, you know, I just learned this past weekend, the government in British Columbia and Alberta actually delete skews. So you can be an LP and you can have a skew that has a specific strain, and you consistently grow and build your market, the government can choose to just drop the skew. Like, so even the LPs don't have the ability to capture their market with their products. So it can't be consistent. That was gonna be my next question. When you're doing your clinical trials, how are you ensuring the manufacturers, the LP is giving you consistent product?

Lauren E. Kelly, PhD: We actually do external check, so great question, Kirk. And I actually send it to my good buddy, Robert LaPrairie. Shout out to Robert, because I know he's been on your podcast before.

Kirk:  Friend of the Show.

Lauren E. Kelly, PhD: I do independent testing on it to make sure what's in there is actually what's there. So I will say that has all come back fine. We haven't had any concerns. And we also, so I will see that for our products, we know what's it there, but we also order one complete batch and it's good for two years. So for example, we have a batch in manufacturing now because our sites are all almost ready to start. So we basically order a big batch. And then use it until it expires, so that all the people in the clinical trial at least get the same batch of product. And then of course, we have the certificates of analysis and all that. So we do know what's in there from their end, but we also independently test it so that we are very sure that what is in there is what is there.

Kirk:  And Trevor, just one other observation, and this goes to a previous episode that we did, and that's where we did the National Cannabis Registry that's happening out of America, John Hopkins. They came up with some standard cannabis questions, and you made a comment earlier about how it's so difficult to ensure that research matches. So, is the Canadian Cannabinoid group that you're chairing, are they working with John Hopkins, you guys have back and forth?

Lauren E. Kelly, PhD: Yeah, so I actually work with Ryan and Johannes pretty closely. So we also have a pediatric study that's observational, and there is an adult one in Canada as well, run by my colleague Hans Clark out of UHM in Toronto. So there are similar initiatives to what Ryan and Johannes the Hopkins team are up to. I will say our data is similar. In the pediatric space, we use different scales, of course, but what we're collecting is similar, and so we've been in discussions with them. The issue becomes sharing our data across the border. So like they're looking to have like a big repository where we would send data and that part has not been consented to and is not something that we can do at this point. But in terms of like a meta-analysis, like they don't have any kids in theirs. So for us, it's a little bit of a mixed bag, but we've been trying to convince some of our pediatric colleagues in the U.S. to join in and push them for a pediatric group. So. I will say all that to say is that, yes, they're reasonably aligned in terms of what we're collecting here in Canada. That cannabis exposure questionnaire that they're using is reasonably similar to what we have been using here as well. But lots of discussion between the groups for sure because, you know, what they learn and we learn is all part of the same, you know, public duty to get some answers on these things.

Kirk:  Right on. Thank you.

Trevor: No, thank you, Kirk. Those were great. If we put on our magic hats, where, you know, people listen to Canadians, the U.S. is struggling to do legalization properly down there. Hodgepodge and everybody hates national control of anything. But if I can give you the magic queen of cannabis hat, and they will let you...

Lauren E. Kelly, PhD: I would like a wand.

Trevor: And a wand.

Kirk:  And a unicorn. You need your unicorn.

Trevor: And a Unicorn. Why do you need a unicorn? Because why not? If you could make, especially on the medical side, if they could legalize quote-unquote properly using sort of the things that we have done here, maybe not quite so well, especially in the medical space, what kind of advice would you give to the U.S. About how to legalize properly and help medical patients?

Lauren E. Kelly, PhD: Well, I would say for the first thing is whatever medical cannabis stream should have pharmaceutical-grade products that we can actually study the things that people are using. And secondly, a national system should be able to push research out to folks as well. And so our system is hodgepodge. The LPs get things they can't push research because they're not allowed to share about research with people who are accessing products. There's all this space around people can get products, but they don't know what research is happening. But if they were getting products and they knew where they could find more information or become involved with research or like about the Hopkins study, right? And why is every medical cannabis patient not given a pamphlet that says, hey, there's this research that's available. Here's how to join it or here's their website. And so I think another thing that we did here wrong was this whole labeling and like what information goes out, like, the restrictions around research. And like how we push, you know, videos. We made a video about how to report adverse events to cannabis. Well, why can't we play that in every LP store? Like, I mean, there's not a mechanism right now for integrated knowledge sharing. And I would say that those are my two like medical cannabis grade products and a knowledge sharing, some sort of integration or strategy would be my top two wishes as my unicorn waves its wand.

Trevor: I love both of those. Kirk, before I ask if there's anything we missed, did we miss anything from you with your furious note-taking?

Kirk:  Well, just to promote our videos that we also made and the goal was to help the rec market sort of advertise in education. So we have six videos we did where we showcase we're in a room of a of a dispensary, who's not allowed to advertise or promote cannabis, talking about mindful cannabis consumption. So we're basically trying to teach mindful cannabis consumption and help. And it's cricket, so we're not getting any recognition from government at all. So I mean, you've presented a really cool picture. Well, unfortunate picture, but a cool way of showing us how cannabis isn't happening in Canada. We've got this Cannabis Act that has stopped everything. And you talk about the green culture, and the green culture often says the Cannabis Act with legislation, we've got more laws than we ever had for a plant. And it's frustrating. And it's interesting in the last, what, 10 episodes, Trevor, we have come across industry marketing are thwarted in cannabis, research thwarted cannabis, LPs with dropping skews thwarted with cannabis. It just seems every level of the cannabis culture is blocked.

Lauren E. Kelly, PhD: And I will say the staff at Health Canada and the cannabis branches is scheduled to be decreased to seven people. That was like a preplanned funding cut, right, because they had a big department while they were onboarding all the LPs. And I'm not sure if that's going to be a good thing or a bad thing.

Kirk:   bureaucracy.

Trevor: So we'll end how we usually do. Was there anything else? This was a fantastic discussion. We really appreciate your time. We could talk to you for hours, but was there anything else I guess specifically on cannabis research or anything cannabis related we missed or you wish we had gotten to for our listeners?

Lauren E. Kelly, PhD: Yeah You know, I often think of like the example of like how it feels to study cannabis right now is like if we were studying wine, but every bottle had like a different amount of alcohol and some people drank it, some people bathed in it, some people inhaled it, some people rubbed it on their skin and it had no label. And so, you know, we really are kind of in the wild west. And so I feel awful for health care providers who are getting these questions and really saying, you know, I am uncertain and they genuinely mean it. They're not lying. This is a health systems failure to really account for how we can learn and, and, you know, increase and ensure there's better care. And so I think sort of that's really the last thing I just want to highlight is that, you know, there's so many questions about cannabis, and so little infrastructure to answer that.

Trevor: Kirk, I want to hand this to you because I think the first time I heard that the cannabis in cannabis research is different than the cannabis in, like I'd buy at a rec store or I'd be sent in the mail if I was a medical patient, I think that first time was from you, and it was when you were talking to a previous guest.

Kirk:  Yeah, we talked to Dr. Balneaves, who is also affiliated with the CCIC, the Canadian Consortium for Investigation. She was also involved with that group, and she informed us how different ways cannabis is grown. But we also heard this when we went into Europe and talked to Peter Vermeul about Good Manufacturing Products and also with our Moroccan stories. And the big thing about international cannabis is ensuring that our cannabis is growing using Good Manufacturing Procedures and we discovered in Canada that that doesn't have to happen.

Trevor: Yeah so and i'll keep trying to keep my acronyms right so if you go to a rec and none of this says it's bad it's just a different series of checklists you have to go through but uh in a rec store or what you would get mailed medically is GPP Good Production Practice but if it was for research or this is the apparently the standard that if you were making a cholesterol pill. It would be to GMP Good Manufacturing Practice. And like you said, when you were in Morocco and talking to Peter in Spain, everyone there seemed to be aiming for GMP to get their stuff into the European market. So again, just another interesting difference between, you know, the Canadian market, the European Market, the rec market, the research market, it would. And Dr. Kelly mentions, too, it would kind of be nice if everyone was on the same page with what standards we have to get to.

Kirk:  Well, it goes back to how the government created the Cannabis Act with no real forethought how it was going to affect an industry and communities. My understanding is in Australia, Dr. Kelly touched on this, in Australia all the legal cannabis that you can obtain is grown to GMP standards.

Trevor: The medical stuff for sure. I don't know about rec. In fact, I'm not sure if Australia has rec but she definitely said the medical stuff in Australia was that GMP level.

Kirk:  So why not start at that as the common denominator, right? And so that, so you know, I've ranted before about how every time, and it seems like this has been the last six or seven months where we talk to our guests and we've gone to returning guests. And what they've told us is how cannabis is thwarted everywhere. So now the irony that I talked about is how, the reason why we can't find lot of cannabis researchers in Canada is because cannabis research in Canada is prohibited by the Cannabis Act and government's ignorance? You know? So, it's just every way you turn...

Trevor: And and and just It's prohibited no, difficult yes, but I really liked your story right at the beginning. So pre legalization pre 2018 It was quote-unquote easy to do cannabis research in Canada because it was just treated like an opioid like a narcotic. My pharmacy has opioids in it, you know we have to keep in a safe and do read about a paperwork at it. But we know how to do it. The hospital pharmacies and research facilities and universities they know how do that. They do research with opioids, you know you keep it stored this way, you look after it that way, there's a checklist, you follow it, everyone's good. But post 2018, suddenly they needed a completely different license and keep it in a completely place. And as we were talking about earlier, now the cannabis you can do research on is different than the cannabis that you would buy in a rec store. And it's so different that if they mail out, you know, X cannabis to a research subject and they take it, they can't ask them to mail back the cannabis bottle or the remains of the cannabis bottle for you know like this accountability to see how much you used because now the patient would be dispensing cannabis because this isn't quote unquote regular cannabis. It's, I don't think there's a conspiracy but it sure looks like you know if we got people to sit into a room we could clean up some of this bureaucracy and make it worth better.

Kirk:  Yeah, you know, I rant about this, but I can't imagine the frustration that researchers have. I mean, when you consider how the Canadian Collaborative, no, that's the Collaborative Childhood Cannabinoid Therapy she belongs to, but also the Consortium for the Investigation of Cannabinoids, how those members of that group must be frustrated, because I mean we talk to these people, you know, we're more sharing stories and trying to apply it to our practice. Where their practice is to study cannabis and how they're completely handcuffed by rudimentary regulations that have nothing to do with plant but was made with the stigma of cannabis. And I'll say that. I think a lot of this is through stigma and, you know, I put on my tinfoil hat. I can't help but think that someplace, somewhere, someone's playing with the marionettes because quite frankly, Trevor, I mean, come on in the last six, seven months, where have we had a story where cannabis, it's been easy to work with cannabis?

Trevor: Well, yeah, and I'll declare my bias. I know you like your tinfoil hats and conspiracies. I, as usual, I lean towards, and I'm not really trying to insult people, but maybe a little bit, incompetence, poor planning, and not just going back. Everything needs iteration. You make a set of cannabis laws, you throw them out to the world, you see what happens. There's gonna be some stuff that, now go iterate, go back and fix. So you know.

Kirk:  Well, but they've done that. They've reviewed the Cannabis Act.

Trevor: that didn't go particularly well. So we need another round. So again, back to, you know, incompetence, poor planning, and you know need to iterate. Make, do, try again. Back to the drawing board. Let's one more time and I love this quote that she's Dr. Kelly used to sort of sum up cannabis research and if I remember it maybe we should put this one in a t-shirt. Cannabis research is if we were studying wine but each bottle had a different amount of alcohol. Some people drank it, some people bathed in it, some people rubbed it on their skin and it had no label.

Kirk:  Cannabis research

Trevor: That could be a t-shirt.

Kirk:  Yeah, yeah. Well, man, this was a good one. I enjoyed these conversations. I'm so pleased I made it for this conversation. It was odd to be sitting there listening to your interviewer thinking, hmm, hmm. I look like I'm just a talking head on YouTube.

Trevor: I could see you vibrating. I want to ask this, why isn't he asking this?

Kirk:  Yeah, but

Trevor: But you know, I think we got all the questions in there eventually.

Kirk:  It was a good discussion and she was a good sport and she's another researcher that we need to keep in touch with.

Trevor: Absolutely.

Kirk:  All right, man.

Trevor: There's another good one. Go to ReeferMed, the podcast. So that's not where we are. We're at reefermed.ca.

Kirk:  Yeah, yeah, yeah. Give us a rating. Tell a friend. This whole podcast, this whole passion project of Trevor and mine, it truly is a word of mouth thing. And in the last several months, we've seen a bump. So people are telling friends. So please tell a friend, you tell two people, you tell two people.

Trevor: And so on and so on.

Kirk:  And soon they'll be inviting us to come to conferences, and we can stand on stage and spout off our knowledge.

Trevor: Sure.

Kirk:  Or at least help somebody out somewhere.

Trevor: Sounds good. All right. Talk to everybody later. This was another good one.