S3E7 - Cannabis is for Kids

You don't give cannabis products to children, right?  Or what about that Charolette's Web stuff for seizures? Dr. Robert Sealey is a physician from Victoria with extensive cannabis experience.  He see children and has recommended cannabis for some of them.  From ADHD, to childhood schizophrenia, to Dravet syndrome this wide ranging conversation covers many pediatric cannabis topics.  Come learn with Kirk and Trevor about kids and cannabis.  Are three year olds different from thirteen year olds? And don't forget the chocolate milk!  It's all about the chocolate milk.

 

 

This Episode is sponsored by Strainprint

Episode Transcript

Trevor:  We're back.

Kirk:  We're back. Reefer Medness.

Trevor:  Reefer Medness, I'm Trevor Shewfelt the nurse, No I am not. You are Kirk Nyquist the nurse.

Kirk:  I am Kirk Nyquist the nurse.

Trevor:  I'm Trevor Shewfelt, the pharmacist.

Kirk:  The Pharmacist. And we have just talked to a Dr. Rob Sealey.

Trevor:  Yeah, he is a cannabis specialist without a specialty.

Kirk:  Yes. Yes. Well, I'm finding this fascinating. We are we're meeting people who are specialists in cannabis who have never taken post-doctoral schooling. They've self-taught and become specialists.

Trevor:  Because there is no school of cannabis medicine out there.

Kirk:  No, we've been we've been legal in this country for.

Trevor:  Eight, nine months.

Kirk:  18 years. No, no medically.

Trevor:  Medically close to two decades.

Kirk:  This has been a fascinating process, this podcast that we've done here and learning how Canada is really not... Well we are medicinally and recreational legal, but we don't have the right systems, it seems, in place. We're learning all these nooks and crannies of people that use cannabis as medicine that they have to fight uphill to get their rights.

Trevor:  And I really liked how the idea for this this episode came. So, I was at the pharmacy because that's where I am most of the time. And, you know, "Trevor, Line One," pick up line one. "Hi. I listen to your podcast and I didn't really know you well enough to come in and talk to you, but I think I've got an idea for an episode."  Sure. What's your idea for an episode? Well, why haven't you done cannabis and kids yet? I got people who are talking about using cannabis and autism and ADHD and I don't know because, you know, I don't know anything about cannabis and kids and autism and ADHD. Let's do some reading and see if we can find a yes. I we have.

Kirk:  And we did, I got, an email and as we sat down today, I got an email from a friend of mine from Vancouver last week suggesting, "Kirk, you should interview Dr. Rob Sealey.".

Trevor:  Well, there we go.

Kirk:  And here we go. I'm sitting in the chair and you say we're interviewing Dr. Rob Sealey. Well, look at that. I got the guy. I've been reading about him myself. So, kudos. We've just spoke to a doctor about cannabis and children.

Trevor:  And probably more importantly, good ideas for this podcast come from you guys. So, email us, call us, call us at the pharmacy.

Kirk:  Yeah. Actually, our person that's helping us with advertising, our advertising expert has said that she's never seen such networking on social media before because we are finding many of our stories in social media and phone calls to the pharmacy.

Trevor:  So, hit us up on the social media.  Email us. Find us on our website at Reefermed.ca. That'll be the best place to find all the ways to contact us.

Kirk:  I'm sorry I interrupted you, but I wanted to find out about the specialty. And later in the interview, you'll hear how I interrupt Trevor.  Not that I do that often, but we never asked him if he if he uses Strainprint. Our sponsor,.

Trevor:  Strainprint. Strainprint is really into research too.

Kirk:  Right. I know I've been reading about the ongoing endometriosis trial that I'm working on, but yeah, they're into all sorts of good research and personal research that you can do yourself on what's Strain works for you.

Kirk:  And Strainprint.ca. They are the sponsor Reefer Medness and we thank them for that. And you can become a community member. They have a Strainprint community. You can get involved in their question/answers.  Again, it's very peer driven. It's another thing that I've discovered in this project, this Reefer Medness podcast that we're doing Trevor, is that everything seems to be peer driven. People are learning and doing and helping each other. It's a very collaborative environment.

Trevor:  If I know something, I pass it on to you and then you pass it on to your neighbor and a away goes.

Kirk:  And it's very grassroots. It's been a pleasure doing this podcast so back.

Trevor:  But back to Dr. Rob Sealey. We had a nice chat about pediatrics and cannabis.

Kirk:  We should get into his interview.

Trevor:  Let's listen to Dr. Rob Sealey.

Trevor:  Actually, I never asked you, Dr. Sealey, where are you on the West Coast right now?

Dr. Sealey:  I have no idea. No, I'm actually on Vancouver Island. I'm in Victoria right now, but I travel around quite a bit. But my home base is Victorian now.

Trevor:  And could you give a bit of your back your background to the listeners?

Dr. Sealey:  Well, OK, well, I'm a medical doctor. I actually graduated from the University of Saskatchewan back in 1990. And then I went down to the States and did some internship and I made my way back to Victoria and decided to plant my roots here since, ever since 91. So, I've been a general practitioner. But it was in 2001 that I got interested in the medical cannabis world, basically pushed that way by one of my patients when it was legalized for the first time. She wanted to be the initial patient in British Columbia, and I believe she was patient number one. And at that time, of course, I had no no idea what she was talking about, telling me all these different strains and cannabinoids and this and that. So, she reassured me, and said she would teach me as we went, all I had to do is fill out the Illuminists papers and we went on that journey and she managed to go back to work. She had been on disability because of chronic pain and arthritis. And we got her off of her opiates and she survived and did extremely well. And so she taught me to venture that way and maybe try treating other patients. The other part of my life actually is similar to your life, is I used to do co-host of a radio show across Canada called Wisequacks, and it was what we called medutainment. We would have fun trying to answer people's questions and they'd call in with a problem. And it was actually, you know, it was diabetes or hypertension or asthma, we had the answers pretty quickly, but of course, we'd kind of tantalize them along the way until we eventually gave them the answer. But it was the questions when people were asking us about medical cannabis that we were getting stomped on. And so that got me even more interested. You know, you just don't want to have that dead air space when people are asking you a serious question and you just kind of laugh it off. So that got me started into different organizations like the International Cannabinoid Research Society and all these other organizations looking at the science behind cannabis. Because that's a real myth, that people stand behind and say there's no evidence that cannabis works. And that's actually not true. There is evidence out there. And so I delved into that and through that, I've done a number of referrals from other physicians, both GPs and also specialists right across the spectrum, taking on their most difficult cases where patients aren't responding to the usual medications or there's intolerable side effects. So that's how my background got started. And I'm full on with medical cannabis patients now 100 percent of the time.

Trevor:  Well, that's fascinating. And lots of those, tie in just the fact you're pushed in by a patient. I think I've lost count of the number of physicians and nurse practitioners and naturopathic doctors we've talked to along the way, who, you know, said I didn't know anything about cannabis. I didn't want to know anything about cannabis, but I had a patient insist I learn. So, you know, you seem to be following the pattern there.

Dr. Sealey:  There's this thing called Internet now and people have this Googling capacity. It's embarrassing as a physician or a health care professional to have the patient sitting across from, you know, more about the subject than you do. And so doctors usually will have that quick answer back and say, well, I don't believe in it because there's not enough evidence when indeed a lot of times the physicians don't have the comfortable feeling of knowing or having the knowledge because it's not taught in medical school still.  It's not taught in standard, you know, continuing medical education. So, there's a real gap and patients are way ahead when it comes to this subject than most physicians are.

Trevor:  And as usual, the patients are ahead on this one, too. So, the idea for this episode is I literally had a patient call me up at the pharmacy and say I listen to your podcast, but you haven't done anything about cannabis in kids yet. When are you going to do that? So I guess I better learn something about cannabis and kids. So, a few emails later, we got in touch with you and I think that segues nicely. So, do you treat any kids with cannabis right now? And what sort of issues are they having?

Dr. Sealey:  Well, I'd like to thank you for throwing me such a hard curveball. I mean, this is probably the most difficult subject when you're treating patients with medical cannabis, right. Kids or are a different lot. I mean, in Victoria, we think of a kid as anybody under the age of 65. I mean, most of our patients I see out here, the demographics are the seniors with arthritis. And they're pretty straightforward, believe it or not, because they've tried so many different medications. But as you can predict, I mean, kids, we don't have a lot of double blinded, placebo controlled randomized clinical trials in pediatrics, mostly because of ethics. It's been, you know, illegal to study the cannabis for, you know, decades. But how do you, you know, even go forth and test that on kids when there's all this fear of, you know, what THC does to the brain, potentially cetera? Well, the interesting thing is we know, you know, again, the old word anecdotal. Right. And that's it's funny because people dismiss anecdotal, but, boy, it's hard to dismiss, you know, thousands, if not millions of patients that are using cannabis. And just to say, well, you know, it's nice that you tell me it works for you or for your child, but because there's no evidence. I don't believe you like that. I don't think we can do that anymore. We can't dismiss the anecdotal. But for children where we have more evidence that that is Western based clinical evidence are in things, of course, like epilepsy. I mean, that's what you were hearing about the drug treatment with resistant epilepsy. We know that, you know, of all types of epilepsy, especially the severe, intractable epilepsy in kids, that 30 percent of all seizure disorders do not respond to any pharmaceutical that is presently available. And there's probably 30 different pharmaceutical meds that are being used for seizures. So there's a large group of people, especially children with very severe seizures, Lennox-Gastaut, Dravet Syndrome, where these kids, you hear about them, they have these seizures multiple times a day and they're high risk of morbidity and mortality. So, some of the studies have been done on children in epilepsy. And, of course, some pretty exciting news coming out. And there was one just last year out of Sick Kids Hospital in Toronto looking at a preparation for the first time that had both THC and CBD in it.  A lot of times we say, well, CBD is what you should use in children because it's potentially safer. And we don't know exactly, again, what THC does to the brain long term for sure. But this was a study that said, you know what, we've had some older studies, small studies looking at CBD and its effectiveness. But wouldn't it be something if THC actually makes CBD work better? And that's one of the theories that we've thought about in a number of conditions, that CBD, the safe guy, if you're lucky, it'll work. But if you want to really bring in Big Brother, THC seems to be like lighting a match. It's like lighting a fuse to make CBD work better. And this study and Sick Kids Hospital last year did exactly that. They used a little bit of THC and a large amount of CBD on children. And the results were quite remarkable in that these were kids. There was only 20 of them, but they were the toughest kids to treat. And in the fact that no other treatment worked for them. And two out of the 20 became completely seizure free, which is unheard of, and about 70 percent had a reduction in their seizures, like quite a significant reduction in seizures. And again, these were children that had no other effective treatment. And there's a few other 3 other, 4 other studies, that look more again at CBD and one that looks at adults. But in pediatrics, we know that CBD seems to be the main player and you just have to titrate the dose. They say kind of is if a child completely resistant to CBD is if you push the dose of CBD up to 20 milligrams per kilogram and try that for three months, and if they don't have a significant decrease in their seizures, then it probably won't work for them. The rate limiting factor is, actually the oil, the carrier that it comes in; too much oil is upsetting to the stomach of a of a child and they can get diarrhea and a high dose CBD actually can be sedating, which is interesting. We always think of CBD as not being psychoactive in that, but at very high doses it could be sedating. But for most children, the average dose probably be 10 to 15 milligrams per kilogram is we would see a response in most kids for treatment resistant epilepsy. But I certainly have seen in my practice when I get kids referred from the pediatricians, that a lot of them respond at even lower doses than that. But the real resistance is if you had 20 milligrams per kilogram for three months.

Trevor:  OK, so the pharmacist in me is going to jump in because I get enough adults complaining about the taste of the CBD or any of the cannabinoid oils. How are you, how are you getting bad tasting oil into kids. The pharmacist in me, wants to start making suppositories, but I'm not allowed to. That's a whole different story.

Dr. Sealey:  Well, let's not go there. Believe it or not, what I usually recommend is chocolate milk. And there's not too many kids that will pass that up if they hear a doctor saying, well, just mix in chocolate milk. But I'm part of a group of physicians that are called Practitioners for Medical Cannabis and we share different tidbits. And there's physicians scattered around the world. There's probably about 150 of us now. And it's just all sort of little neat tidbits of what works best. And one of the topics one day was exactly on tolerability of the taste. And it turns out that the chocolate, the Terpenes, they work better with chocolate and the fattiness of the milk helps the absorption. So chocolate milk works for taste and actually probably makes the oil work better as well.

Trevor:  Well, that's a good tip. It probably even from some of the adults out there.

Dr. Sealey:  It is, yeah.

Trevor:  So, seizures. I agree. I've heard.  And Kirk and I are even just flipping through the Sick Kids Study, so we'll call that, quote unquote accepted now. But I've I've been reading slash hearing some more unusual things for cannabinoids and kids.  Things like autism, ADHD and something I didn't know existed Pediatric Schizophrenia, do we know... What do we know about some of these, we'll call them more off label or more unusual uses in children.

Dr. Sealey:  Well, it's interesting because that, again, I see a lot of referrals for behavioral disorders related to any of the above. And you're right, there's nothing really on label anyways. But what's interesting is we know in autism, where, again, parents and caregivers are really desperate to try just about anything because the treatments are not very effective that we have. So, we know that a lot of people are using cannabis substances, usually CBD in Autism Spectrum Disorder. What's interesting is a study just came out of Israel, only a few months ago and it was looking specifically at children with autism and it was about 200 patients and it wasn't double blinded. These were these were parents and caregivers that came forward and said, listen, we're treating our child with autism, with cannabis. We will agree to be in this study. And it was a study that looked at the vast majority of these patients were using a very high CBD, like a 30:1 or a 25:1 parts CBD to THC. And there was out of this, almost 200 patients, 30% had a significant improvement to the use of cannabis over a six-month period. Another 55% had a moderate. So that's about 85% of these patients had either a moderate or a significant improvement. And there was only, you know, less than 8% that didn't have any improvement. So that's pretty remarkable.

Trevor:  Absolutely.

Dr. Sealey:  I think that's the first study that's actually shown numbers of what kind of improvement has happened in these kids.

Trevor:  OK, so it's not completely outside the ballpark to use it for, we'll call it, quote unquote, behavioral issues.

Dr. Sealey:  Not at all.

Trevor:  How about something that I assume has less controversy about it.  Pediatric cancer, pediatric oncology. Oncologists that I met are usually pretty willing to try unusual things any way. You know, when we've run out of all the stuff in the in the regular basket, I think oncologists are generally known as, yeah, sure we'll give something and go. What have you seen with our pediatric oncology, pediatric cancer and cannabis.

Dr. Sealey:  Yeah, exactly. And before we jump there, I don't know if you even saw the news yesterday talking about, again, behavioral disorders. There is a licensed producer in Canada that just got approval to do a study in Australia looking at individuals with intellectual disability, with severe behavior disorders and using cannabis for them with CBD. So that's just being launched. And that was just announced yesterday. So we are going to see more studies coming out. We know, again, anecdotally, and I've certainly seen in my practice a number of people, the testimonials that I get from parents and caregivers of the huge difference that their children have with using cannabis, especially CBD, is quite remarkable. Now, as far as the pediatric cancers, I think is exactly the same as we see in adult cancers. When I see patients referred to me by oncologists, it's usually because either "A" a person is on a chemotherapy that they're having difficulty tolerating. And we know that chemotherapy induced nausea and vomiting, appetite, stimulation, these are things that cannabis can be useful for us is to treat the symptoms of the adverse effects of chemo, standard chemotherapy. And I always encourage patients to continue on with whatever the oncologist prescribes as standard therapy. When I see patients that are grasping at straws because there is no other treatment available or they're resistant to the standard oncological care, then yes, we would introduce cannabis. The oncologist would quite often say, I cannot actually authorizes for you, but I will certainly make a referral to Dr. Seeley, who's familiar with the process. We used to think that CBD was the mainstay of help in cancer. If it was going to do anything that's kind of shifted over more to THC. So, then you have the controversy as well. What is THC do in children? Is it an adverse or not? Now, when you weigh the benefits versus risks, again, it's pretty obvious if you've got no other choices, you're going to probably take that risk or the parents will take that risk of using THC. What's interesting in small children, they seem to tolerate THC very well. We don't think that it does anything to the developing brain, really, until the age of 12 to 18. It is the teenagers that deal with THC differently because of the neural maturation of the endocannabinoid system. So, the adolescents, that's a whole, another ball game. But again, when your backs up against the wall, you may even introduce THC in that group. But the little kids, they tolerate THC, even the psycho activity, they don't seem to be impaired with THC. But the limiting factor of THC, is by getting enough dose in that it might make a difference in things like cancer, is the impairment. So that's when you can look at possibly your suppositories or other ways to administer without having that impairment factor.

Trevor:  That's fantastic. Now, again, I wouldn't be a responsible pharmacist if I didn't talk about accidental poisoning. So it makes the news here in Manitoba, month, month and a half ago, my mom had an edible a chocolate bar and didn't store it properly, like didn't didn't treat it like medications. Her kids got into it and ended up in the pediatric ICU.  Got two cents to put in on what adults do, with their with their especially edibles coming up for being legalized, around children.

Dr. Sealey:  Yeah. I mean, that is that is a concern. And children and animals. Right. Dogs. And they get into this these products. I mean, the good news is we don't have the receptors in the brain stem, nowhere near the abundance that we have for opiates. So, it would take a pretty large dose, in fact, almost impossible for somebody to die from an overdose of cannabis. But it can be really, you know, frightening for individuals to have too much dose. That's it's I hate to use the word overdose. It's excessive dose. Now, here I talk to you about chocolate milk for tolerability. Part of the group discussion that we had is what do you do with those individuals that take too much as an edible? And that happens quite often because people, you know, it tastes great and they don't respect the fact that it takes 60 to 90 minutes to kick in the system. And they don't respect the fact that the liver metabolizes the THC into a stronger THC. So, they get whacked hard if they've taken too much of a dose. And then they have to kind of hang on for eight to 10 hours. So they end up in emergency. And the emergency room doctor, for the most part, just pats them on the head and says, don't worry and reassures them and sends them home. But what you could do is use cold lemonade. So cold lemonade, again, looking at the Terpenes and how it effects can help reverse some of the effects of too much THC. And of course, if you have some, adding some CBD to the mix will also be helpful for a person that's having a bad, quote unquote, trip from excessive THC.

Trevor:  Oh, that's cool. So, I've recently learned what Terpenes are and I like to attribute everything to Terpenes. Do we think it's things like the limonene in the lemonade that's doing good or do we know.

Dr. Sealey:  Exactly? I think that's exactly what it is. So, there's something to that that that kind of helps to reverse and settle down the excessive THC. And then the other thing that we run into is in emergency. We're seeing more with the recreational use is people that are getting into these, you know, high dose THC, the Shatters and the Dabs and these sort-of-things is hyperemesis.  Cannabis hyperemesis syndrome. And this is where people end up with emergency because they keep throwing up and throwing up. And when it's when they start to get this problem, it's because of excessive THC. It floods the receptors in their brain and it makes them sick. Well, individuals start thinking they go, wait a minute, THC stops nausea and vomiting. So they end up taking more to think that that'll help them.

Trevor:  The patient themselves takes more.

Dr. Sealey:  The patient takes more. And so, they get more and more and they get in, they start to throw up. And the emergency rooms are seeing this intractable vomiting is just over and over. And the treatment for that, believe it or not, and almost it makes the diagnosis not that they do this in emergency, but is a hot shower. Patients will tell you the only thing that gets them to stop throwing up is to go into a hot shower. And that resets for some reason, the receptors, what the emergency room doctors are starting to stock is topical Zostrix or capsaicin. Rubbed on the belly for some reason reverses the vomit. And then you get a person to start, you know, titrating down their dose of THC, starting adding in more CBD. And that's what will reverse this syndrome. But it's a really quirky syndrome that. Has just come into existence in the last couple of years with this excessive THC.

Trevor:  Well, thank you for that little sidetrack because, yeah, Kirk and I stumbled, stumbled across stuff about cannabis, hyperemesis syndrome. And honestly, you know, the little you know, you read a paragraph here or there, but you don't get a whole lot of info. So, no, that was that was really helpful. So last, because we sort of touched on it earlier. So you're talking about, you know, THC doesn't seem to do much in toddlers, but can affect the brains of the 12 to 18 year olds. So there's, of course, lots of public health information and good public health information that we should not have teenagers, adolescents using cannabis recreationally. Any thoughts on that? And, you know, or what do we do if we have a teenager with a medical condition that, you know, THC might be good for them? What sort of concerns we have?

Dr. Sealey:  Yeah, those are great questions. And when we say, you know, adolescents shouldn't use cannabis, I think we have to make sure we say, OK, let's define that. Are you talking THC or CBD? Adolescents shouldn't use THC unless they have a condition where the benefits of THC might outweigh the risks. The THC, the neuro maturation of the endocannabinoid system seems to take place around, like I mentioned, age 12 to 18. Some researchers think even up to the age of 21, which is an issue because we've just legalized cannabis for recreational purposes, depending on the province, anywhere from age 18 to 19, which is a little bit less than what some of the science is saying.

Trevor:  Yeah, Kirk keeps going on a rampage that he wants to move cannabis and alcohol legalization up to 25, which might be a really good idea medically, but politically, I don't think that fly.

Dr. Sealey:  Well, this is the problem where we're struggling with the actual science and medical. You're right. Versus, you know, trying to get rid of a black market. So it just happens to coincide with the age of alcohol. But it doesn't really fit with the science from that perspective because of our endocannabinoid system maturation. But I will see kids quite often come in with their parents and they ask for my help in getting their child off of cannabis. You know, they're starting to get this cannabis use disorder where, you know, they're using it over and over again with their friends and they say they're using it for anxiety. They're trying to calm down, to focus, et cetera, et cetera, all these different reasons why they're using cannabis. But quite often they're using a THC dominant cannabis that at the moment kind of checks them out of their you know, anxiety and don't feel anxious at the moment. But in essence, it's probably making their anxiety disorder worse. So my input is usually getting these kids off of the THC by introducing more CBD products. The kids, of course, don't like it because they're like, well, this is no good. There's I don't get that high feeling, but it's you've got to, I think, get these kids off of the THC when they're in their, you know, 15, 16 year olds. It's really important. There's also the issue of what about psychosis, right. What about schizophrenia? Well, again, jury's out on this. But the consensus seems to be that if you have a genetic predisposition, if you've got a gene in your body, that your family history of schizophrenia and you load up with THC as an adolescent under the age of probably 19 or 18, there's maybe a two and a half times increased risk of having your first break of psychosis or schizophrenia. And you say, well, you've already got the gene, you know, they're going to eventually get it anyways. But if they if they get psychosis or schizophrenia earlier on, it's typically a more difficult to treat schizophrenia lifelong. We know that adults and some of the psychiatrists are using cannabis for their established schizophrenia patients where the, you know, novel antipsychotics are not working. They're introducing cannabis for, but for the adolescents you don't want to be that person that prescribes cannabis and they end up having their first break of psychosis or schizophrenia.

Trevor:  Oh, I think that's an important point for everybody out there. Now, we could keep talking for hours, but unfortunately, we're going to run out of time. So, before I babble on, anything that I've anything that I've missed, anything that you think the listeners should know about. With cannabis in particular, but I guess cannabis and cannabis and kids that we haven't touched on yet.

Dr. Sealey:  Well, I guess, you know, let's stick with the kids, because that's a very unique population for a number of reasons. And I guess sometimes parents will contact me directly and say, "listen when you see one of my kids, for this issue, their behavior, etc. I'm not comfortable talking to my own doctor about it or my doctor doesn't support it," and I'm very firm in saying, no, I will not do that. I don't think it's appropriate to treat a patient without their doctor or their pediatrician. Everybody needs to be on the same team. And if there's good reasons why that patient shouldn't be on cannabis, then we can discuss that. But certainly, and I say this with parents as well, they shouldn't go to the recreational store and just try these products out for their kids. You just, it's just dangerous territory. And the recreational stores are not allowed legally to counsel patients or caregivers, obviously not about anything for medical purposes. It's a recreational store for recreational purposes. So you parents speak to a physician that's comfortable talking about cannabis, but make sure everybody's on board. You shouldn't do this behind the backs of anybody.

Trevor:  So, Dr. Sealy, actually, my co-host Kirk, has a question or two. We're just going to quickly switch mikes and he is going. I think he's got his mic. So I'm going to shut up. And this is Kirk, Nyquist, our nurse.

Kirk:  Good morning. You're in Victoria. I just left there a couple of weeks ago. It's my hometown. I'm a Mount Doug grad, and a Camosun grad, and a UVic grad and also a Royal Roads grad.

Dr. Sealey:  You've done a lot of gradding.

Kirk:  I did a lot of gradding. You know, just this is a new form of medicine. You are a general practitioner, a family doctor.

Dr. Sealey:  Yeah, I did. I did family practice for 28 years. And in my last since 2001, I started to see cannabis patients at the end of my day and then I started to get referrals on top of that.

Kirk:  So you have you gone out and learned this by observation in your own research as being a doctor, or have you gone out to that post-doctoral training in cannabis because you've made a couple of comments about being referred? You get referrals from some specialists. So are you now a specialist in cannabis? And did you do that Anecdotally.

Dr. Sealey:  I'm considered anecdotally a specialist in cannabis. That's my full-time practice now. So I take referrals from all specialists, whether it be pain specialist, nephrologist, oncologist. But there is no specialty in cannabinoid medicine that doesn't even exist officially. But I take referrals for that reason. But there is no such thing as that specialty.

Kirk:  So where do you get your research from? You getting any research from Israel?

Dr. Sealey:  I research every day. I do research through all sorts of sources. Like I say, I'm a member of five different societies and I get journal articles on a daily basis and I travel a lot. I've traveled around the world at various conferences and I've also taught. I've given probably over 500 lectures now to other physicians and the public business organizations, universities, medical schools. So I that's what I do for a living full time is a cannabis specialist that doesn't really exist as a specialist.

Kirk:  That's fascinating to me. I'm wondering what other parts of medicine is like that. I think it's fascinating. Congratulations to doing this. I'm one of the earliest docs.

Dr. Sealey:  Thank you very much. I appreciate it.

Trevor:  So, Kirk, that that was great. I wish we could have talked. I think we could have four or five Dr. Rob Sealy episodes. And apparently, he's done the whole radio thing before.

Kirk:  Yeah. Yeah. He's got more experience than we do, but it was nice. It was also nice to hear how he applies his practice in comparing it to Doctor Shelly Turner out of Gimli as well, and how she's doing hers.

Trevor:  And how many doctors and nurses and naturopathic doctors have we heard now say I got into this because my patients made me.

Kirk:  My patients made me. That's old-fashion medicine. I think that's wonderful. So that was a good interview, Trevor. It's another good one.

Trevor:  It was another good one. Kirk, I hear you want to talk a little bit about the price of weed.

Kirk:  Well, you know, traveling across this great country, as I have done in the last year and a half, there's no weed anywhere, no commercial weed. We would get lots of new stores coming up.

Trevor:  Ontario just got bricks and mortar store within a week of us recording this.

Kirk:  Right. And we know and we know that there's not enough commercial weed.

Trevor:   A Shortage.

Kirk:  A shortage of weed out there. So now I hear that there's weed that is $16 a gram.

Trevor:  Maybe it's really, really good.

Kirk:  Maybe it's really, really good, but I'm not sure how $16 a gram is going to break the black market because there's some really good craft growers out there that haven't been recognized yet that could probably help with the shortage of recreational weed. So I don't know $16 a gram seems an awful lot of money.

Trevor:  Or you could go back to one of our previous episodes with The Economist and Addiction's where we had an economist say, you know, politically unpopular, but if you really want to break the black market, we could have the government subsidize legal weed to help break the black market.

Kirk:  Well, there's nothing wrong with that. However, that's a good debate to have. But I know that craft growers are the silver market, the black market. They're still growing their weed. Some of them grow some astounding weed. And I'm not encouraging this, but I know that if a guy's got 16 bucks in his pocket, is he going to spend it on a gram of legal readers are going to buy two grams of a black market weed. I don't know of $16 a gram is going to cut the black-market man.

Trevor:  No, no... And again, in our previous episode with The Economist, that that's exactly the dilemma when you tax, there's other things going on, too, but when weed is heavily taxed and one of the stated goals of the government of Canada bringing this out is to break the black market. If you add a bunch of taxes to it, you're not really going towards that stated goal of breaking the black mark.

Kirk:  Now, there's so many ethical issues about this. The more the deeper we get into it. And when you start concentrating indoor farming and the phosphorus and all the hydroponics, you know, cannabis is such a natural thing. We titled our very first episode Back to Dirt, but yet how much of our weed is grown in dirt? And I guess there's another issue out there is all that hydroponics, where does the waste go? I'd like to I'd like to figure that out. There's just so many questions, so many episodes Trevor.

Trevor:  We said this before. We need a botanist. If there's a botanist out there who wants to talk to us about this, we need to talk to someone, some bright gal out there who's good with the dirt and the growing of the cannabis.

Kirk:  Yeah, I'd like to talk to a botanist. There's so many more stories out there and they're coming people. We've interviewed, we've interviewed lots of people. Thank you for the stories. We have a contest, the My Cannabis Story contest that we're running.

Trevor:  Yeah. So, my cannabis story is simply pick up your phone, find the voice memo app and record a minute to three about, you know, what cannabis means to you. So, is this a medical condition? Is this a recreational use? We had someone who said they really didn't enjoy being on cannabis and being at a concert. So even if you don't like cannabis, tell us why. We just want to hear we on the street literally Kirk and I are stop, if not every day, every week by people who just tell us, you know, their story to deal with cannabis. We want to share those stories with you.

Kirk:  So our listeners, you all know that we all play local music and we've been doing 100 km, 100 mile diet of music and the Parkland region. And we have we have so much talent in Manitoba and so much talent in the Parkland. We have another original and we're going to break the third wall and let our producer introduce them.

Rene:  Thanks, guys. Yeah. So sticking with the radius thing, Jerry Sereda from Ethelbert, Manitoba, not too far from Dauphin. This guy is really good. He's played with Dirks Bentley, Shane Yellowbird, Jason Blain, Donny Paronto. And today's song is Jerry Sereda. And Morning After the Night Before.

Trevor:  Kirk another good one,.

Kirk:  Another good one. We're got to get T-shirts.

Trevor:  We will definitely get T-shirts. So stick around. We've got lots of good interviews coming up. And I guess we're out of here.

 

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