Thursday , September 21
Dr. Rav Ivker, D.O
CANNABIS FOR CHRONIC PAIN
A Proven Prescription for Using Marijuana to Relieve Your Pain & Heal Your Life
Dr. Rav is a respected holistic family physician and cannabis clinician in Boulder, Colo., with a primary focus in the treatment and prevention of chronic pain using a holistic approach that includes medical marijuana.
Complete with success stories from real-life patients, CANNABIS FOR CHRONIC PAIN guides readers through the cannabis and holistic treatment program for specific chronic pain conditions—from arthritis, back pain, migraines, fibromyalgia, neuropathy, shingles, menstrual cramps, IBS, Crohn’s Disease, anxiety, insomnia, depression, and pain from cancer or its treatment. Dr. Rav offers step-by-step instructions on the benefits and appropriate use of medical marijuana and complementary healing therapies and practices. (For example, cannabis does not have to be smoked or ingested to be effective! Transdermal patches, tablets, sublingual and nasal sprays, and drops can achieve the same, if not better, pain relief.) It’s now possible to create a distinct cannabis prescription for varying types of chronic pain. The book also doubles as an instructional manual for industry workers—budtenders and cannabis clinicians—to advise patients on the appropriate use of medical marijuana. CANNABIS FOR CHRONIC PAIN presents cannabis from a scientific, medical, and mystical perspective, making a compelling case for medical marijuana as a safe and effective alternative to opioids.
-Rav is Hebrew for spiritual teacher. He’s a holistic osteopathic doctor in practice for 45 years.
-Had seen tremendous improvements in his patients who used marijuana medicinally, but it was only when he personally had a very severe case of shingles and used medical marijuana that he was inspired to write his book. His pain was 8 to 10 on a 1 to 10 scale, and never went below an 8 unless he used medical marijuana, which reduced the pain to 2-3 in just a few minutes.
-Doesn’t recommend smoking marijuana. Best forms are vaporized, pills, patches, tinctures.
-His book establishes standard of care for integrating cannabis into a holistic treatment program for the most common chronic pain conditions.
-Chronic pain is affecting over 100 million people.
-Is it good to legalize recreational marijuana use? It’s much safer compared to alcohol with fewer traffic deaths. Are some risks for the developing brain, with increases in development of schizophrenia. But it’s only legal for people over 21. Education is the key – let the kids know there is a risk.
-Cannabis is a complex plant, has over 80 different cannabinoids. THC and CBD are the best known of them. CBD is not psychoactive and is quite an amazing medicine. Pain reliever, anti-inflammatory, muscle relaxer, helps with sleep, treats seizures that don’t respond to usual medications, has cancer-killing properties. No pharma drug does all those things.
-CBD oil with < .3% THC is derived from hemp and is legal in all 50 states. Cannabis sativa is the botanical name of the plant. Hemp is the stalk and the seeds of cannabis. Marijuana is the flower of cannabis. In the flower, THC is high. Not all strains of marijuana have high THC. Sativa is high, indica has a lower percent THC.
-Researchers haven’t been able to study cannabis because it’s been illegal. The strains are stronger now. You can pick and choose strains based on the desired effect.
-CBD oil doesn’t provide the pain relief that THC does. Is more effective when combined with THC. THC activates CBD and makes it much stronger. When combined, they give somewhat of a psychoactive effect, but minimal. Products with CBD:THC in a 1:1 ratio provide the most potent pain relief. There are hybrids with 50% sativa and 50% indica in them. Are oil extractions, ingestibles, tablets, patches, and topical oils which can all be 1:1, but are only legal in 29 states.
-Why is it happening that marijuana is still a Schedule 1 drug? Follow the money. The pharmaceutical industry is the one getting hurt by legalization. It’s the number 2 industry in profits.
-Most marijuana patients have been able to stop pharma sleeping and anxiety drugs. CBD products combined with THC 1:1 are comparable in pain-relieving effects to opiods. He’s seen it in his patients. They’re not addictive and you can function quite well. It doesn’t kill. Whereas you can’t function on opiods, with unpleasant side effects including fatigue, constipation, and addiction. Opiod overdoses are killing 150 people a day now, up from only 52 people a day just 3 years ago. The government is cracking down on doctors and, cutting off patients who need pain relief. Cannabis is a viable solution to the opiod crisis.
-7-10% of people who use marijuana regularly do develop dependence. Not as significant as the opiod problems.
-Vicodin, percocet, oxycontin, and oxycodone work for pain, but there’s too much of a downside.
-Some states are suing the pharma companies for making their pain relief products. Pharma hasn’t provided a decent alternative. Cannabis is that alternative. Docs know how addictive pharma is, but they don’t have another option.
-NJ has 10 million people in the state but only has 5 marijuana dispensaries in the whole state. Colorado has 5 million people, 530 medical dispensers. California has plenty of dispensaries. In the majority of states where it’s legal, it’s not easy to gain access. Neither docs nor patients have a clue as to how to use it appropriately.
-Dr. Ivker is doing constant trial and error with his patients. Conscientious dispensary owners interested in providing a high quality medical service get feedback from their customers. Feedback from patients is where practitioners are getting information for providing an effective product.
-California was the first to legalize medical marijuana in 1996.
-Does marijuana have benefits for cancer? Research in Israel show it kills cancer cells. Both THC and CBD have cancer-killing properties. Rick Simpon oil combines THC and CBD. An amount the size of a grain of rice is dispensed in a syringe and you eat it. Lasts 6-8 hours. Recommended to take twice a day.
-If you don’t live in state where it’s legal, you can travel to a legal state and get it from a recreational dispensary. Recreational use is legal in 8 states if you’re over 21. You won’t find highly medicinal cannabis products in those shops, but you can get the hybrid strains that can be vaporized or smoked, or the 1:1 blends of them. Dr. Ivker can’t prescribe for anyone not a Colorado resident.
-A lot of visitors come to Colorado because of marijuana, and a lot of tax revenue is generated from marijuana sales tax.
-Colorado has had recreational marijuana for 3 years. Statistics were inconclusive about the effects on the state. Found there were more traffic fatalities that involved a driver that tested positive for marijuana, but there are more people using it. The number of traffic fatalities with marijuana doesn’t come close to the number of traffic fatalities with alcohol, which is a depressant.
-Listener says CBD is not highly absorbed or utilized by our bodies. Which is more beneficial: water-based CBD vs. oil-based CBD? Dr. Ivker can’t say, although most CBD is in an oil, so it may be better absorbed.
-Hemp paste in coconut oil is a relaxant and reduces anxiety. That is the #1 therapeutic benefit of CBD by itself. Patrick likes the hemp paste from Synergistic Nutrition.
-Does it help with sleep? CBD doesn’t help you to sleep other than it reduces anxiety and helps you to relax. Indica strain can put you to sleep very effectively; it has a lower amount of THC in it. Sativa is higher in THC which makes you high and is desired for recreational use. A 80:20 ratio of indica to sativa is highly effective for sleep, with only a minimal high.
-What’s with vaporizing? Vaporizers are like minature ovens, are hand-held and cigar shaped. Can set the temperature; the ideal temp is 375, which produces no visible vapor and no smoke. You grind the flour, make it into small pieces, pour it into the chamber. Charge the battery -can use 6-7 times with no recharging. In seconds it heats to 375. For every hit of smoke, you need 2 hits on the vaporizer to get an equivalent hit of vapor. Feel the effects within 2-3 minutes. You can smoke or use a vaporizer, but the vaporizer is the healthier option.
-Smoking vs. vaping has same pain reduction. Effect only lasts 2-3 hours.
-How about grinding marijuana, adding to brownie dough, and baking it at 375? It’s too inconsistent for medical use. He doesn’t recommend edibles anymore because the ingredients are not evenly distributed throughout the edible. It’s too uncomfortable if you take too much, like a bad trip, but it’s not a permanent side effect. There are 1:1 tablets available that last 6-8 hours.
-How to know the right dosage for pain relief and anxiety? CBD oil can be in a syringe or tincture or spray bottle. Thicker oils are in a syringe. Dose is the size of 1 grain of rice. With tincture or squirt bottle – you can determine what is the best dose for you. Try 2 or 3 squirts initially under or on tongue, keep in mouth for 5 minutes. Sublingual dosing will start to work within 30 minutes. If ingesting, it takes 1 hour to feel the effects. When the tincture peaks, which will be within an hour to 1 1/2 hours, you’ll be able to determine if it’s helping or not. Take more if you need more relief. Next time, take the combined dose amount.
Any brand recommendations for CBD oil? Can’t say. There are a lot of companies all making claims that they have the best. No studies to determine which is best. All anecdotal, the proof is in the pudding.
-Robert has a 24 y.o. niece with Down’s Syndrome who is getting violent and angry. CBD oil would be good for her. Will help her relax.
-Kira in California wants to know if patients have had an opposite reaction to cannabis. When she takes indica, her pain worsens. Dr. Ivker has never encountered that, but some people, less than 5%, have an opposite reaction to THC. THC can increase anxiety. Try sativa strains.
-Patrick’s experience with marijuana is that it accentuates images and thoughts. If you believe those are real, being high makes it worse. THC is a sensory enhancer and will also heightens awareness of those images and thoughts. Marijuana has been used as a spiritual medicine for nearly 5,000 years. Use it with intention, ask questions as you get high. Being high is a higher level of consciousness. Ask: What is this pain about, what do I have to learn from this pain, why am I here? Journal and record the answers. Can’t divorce the physical pain from the spiritual, mental factors contributing to the pain. Need to address all of the causes. Marijuana can be used to treat physical pain quite well, but if you want more long-lasting relief, use it in all the ways it can be used.
-Part 2 of Cannabis for Chronic Pain presents a holistic treatment program and contributing factors that have caused the chronic condition. Conventional medicine is best at treating acute conditions and usually only treats the symptoms of chronic conditions.
-Pharma wants to turn marijuana into a drug. Marinol, a pharma synthetic marijuana, is just THC only and isn’t as effective. Need the entourage effect. THC is more effective when combined with other cannabinoids and terpenes.
– Are medical marijuana, topical butter, and hemp oil helpful for skin conditions? Yes, and also for musculoskeletal pain. Rub it on. You don’t get high or sleepy. Even melanoma responds to topical CBD oil.
-Mike in Oregon discovered a few drops of pot really helps his erections. Do other people have this experience? Marijuana not only deepened Dr. Ivker’s level of intimacy, it enhances sex. Stronger orgasms, probably stronger erections.
-Kira says cannabis is one of the highest sprayed plants for pesticides. True? In Colorado, pesticides on marijuana are prohibited. He doesn’t recommend any dispensary that uses pesticides. They are so competitive that he doesn’t think anyone is using pesticides.
-Osteopathic medicine teaches body, mind, and spirit from day 1 of medical school.
Dr. Rav Ivker D.O. with great information on Cannabis and High CBD Oil, September 21, 2017