Medical Cannabis in Sickle Cell Care - Exploring Relief

Episode Transcript

Speaker 1 (00:01):
From the WA and M Studio on the campus of
Florida A and M University. This is Mary Forum Radio,
a weekly conversation on the education and research of the
medical marijuana being conducted to at Bammuti.

Speaker 2 (00:12):
Hi. I'm Heidi Otway, your host for this conversations on
Cannabis virtual form, brought to you by the Medical Marijuana
Education and Research Initiative at Florida and M University. In
this conversation, we're talking about medical cannabis as a treatment
for people living with sickle cell disease. So let's talk

(00:33):
and learn about this subject with our guests. Doctor Alfria
Bakshir is a Board certified in pediatrics and brings more
than thirty years of experience. She is retired and currently
serves as a medical consultant for the Sickle Cell Foundation
in Tallahassee, Florida. The Foundation collaborates with community partners to

(00:54):
educate professionals and the public about sickle cell disease and
the traits. Our other guest is doctor Lynetta Bronte, a
nationally recognized leader in sickle cell disease research, population health,
and health equity. She is the President and CEO of
the Foundation for sickle cell disease research based in South Florida.

(01:17):
In this role, she oversees clinical care, research and outreach
focused on underserved communities and Rounding out our panel is
doctor Anthony James Hall, an accomplished board certified neurosurgeon. As
a matter of fact, doctor Hall was one of the
first five physicians certified to recommend medical cannabis in the

(01:41):
state of Florida. He is a member of several professional
societies and is the current president of the Miami Dade
County chapter of the National Medical Association called the James W.
Bridges Medical Society. I want to thank you all for
participating in this forum and I can't wait to talk
to you shortly. To everyone watching, please share the link

(02:04):
to this forum and on your social media channels so
others can learn about this topic. We also want you
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Your name will be entered into a drawing in August
twenty twenty five to win a one hundred dollars gift

(02:24):
card provided by one of Mary's partners. Now, let's start
this conversation on cannabis doctor Blascher, I'm going to start
with you because you bring decades of experience helping patients
with this disease. So can you set the stage and
tell our audience what is sickle cell disease? Thank you.

Speaker 3 (02:46):
Sickle cell disease is an inherited blood disorder that affects
the hemoglobein within the sickle cell within the red blood cell.
Means that you get the disorder from your parents. One
parent has to donate the s hemoglobin gene and the

(03:14):
other parent may also donate the sthemoglobin or there's some
other abnormal hemoglobins that may be donated. So the most
common type is that each parent donate an s hemoglobin
and the as I'm using this for sickle cell those

(03:36):
who have the trait have an s from one parent
and normal hemoglobin gene from.

Speaker 4 (03:44):
The other parent.

Speaker 3 (03:46):
There's also some other abnormal hemoglobins that are with H
in combination with the schemoglobin also cause some types of
sickle cell disease, and that is the c hemoglobin, dehemoglobin, ohemoglobin,

(04:07):
and ehemoglobin. There's also another which is beta thalasmia, but
it's not an abnormal hemoglobin. It affects how much hemoglobin
you make. In this country, the SS is the most
common hemoglobin that's found, and sickle cell anemia term is

(04:32):
the term that's relegated for those with s S. All
of the others in combination are referred to as sickle
cell disease. Therein degrees of severity. SS is the most
severe form of it. So those who are those in

(04:58):
the United States, there are about one hundred thousand people
by circle cell disease. And the basic problem is that
within a red blood cell, those people on the situations
where oxygen pressure is low, the cell sickle. They stick

(05:20):
to each other, they block the small blood vessels and
so there's no oxygen delivery or poor oxygen delivery. This
causes inflammation and oxygen deprivation and eventually in organ damage. Wow,
we're associated with pain and eventually all the other complications

(05:43):
that come with sickle cell disease.

Speaker 2 (05:45):
Yeah, So, doctor Bronte, can you tell us a little
bit more about the people who are affected by sickle
cell Is it genetic? You know, provides some more context
around that who is most commonly affected by this disease?

Speaker 5 (06:01):
Right, So it's you know, a genetic disorder. As doctor
black Chear stated, you get one gene from each parent
if you have the full blown disease.

Speaker 6 (06:09):
It is a.

Speaker 5 (06:09):
Disease that generated out of sub Saharan Africa as a
response to malarias. So if you're a carrier, you just
have one gene, then you had a good chance of
outliving malaria if you were to become infected. With the
people moving migrating against their will from time to time

(06:32):
to different areas, that's how you have sickle cell disease
throughout the world. It's actually the most common genetic disorder,
not only in the United States but in the world.
And it used to be a disease of childhood, but
because of penicillin prophylaxis, children now live to be adults,

(06:53):
and so it's actually a different disease when we look
at the adults because you have all of that in
organ damage that starts are to set in. So children
have strokes, but then we also have strokes and adults
they obviously suffer from chronic anemia. Pain is sort of
like the cornerstone of their presentation. They get a cute

(07:14):
chest syndrome which carries a high mortality rate. So we're
constantly monitoring for that renal issues, you know, is a challenge.
Some patients will end up being on dialysis and then
they also suffer from blood clots. So it is because
it is a disease of oxygen deprivation.

Speaker 1 (07:33):
You know.

Speaker 5 (07:34):
These individuals just really suffer from those issues that I mentioned,
as well as neurocognitive deficits, so they have sometimes issues
related to time and attention and concentration and sleep, so
many things that really affect these patients along their journey
with sickle cell disease.

Speaker 2 (07:53):
Okay, so I'm curious to what are the common treatments
for individuals who are living with this disease, Doctor Hall,
do you want to take that on start us off
with that.

Speaker 1 (08:05):
Well, the common treatments for sickle cell disease are penicillin
propyle axis. As mentioned in pediatrics, hydroxyurea is a very
widespread drug that has been proven to have benefit. However,
over the past forty to fifty years, there have been

(08:26):
very few drugs developed for sickle cell disease specifically worldwide.
The only real drugs came about within the last five years,
such as endari which is amino acid derivative a BACBO
and boxellator. Unfortunately, one of those drugs has already been

(08:50):
pulled off the market, So we are very deficient worldwide
in an armamentarium of possible specific, fake or what we
call disease modifying drugs for this disease and this disorder.
We are left with treating symptoms and complications from the
end organ damage and that covers the entire body because

(09:13):
you know, your blood goes everywhere in your body, so
every part of your body.

Speaker 4 (09:17):
Can be affected.

Speaker 2 (09:19):
Yeah, doctor blackshear, you were treating patients for over thirty
five years. You want to share a little bit about
what your what you would you know, how you would
treat your patients when it came to their sickle cell disease,
especially the children.

Speaker 3 (09:32):
Well, yes, as doctor Hall said, we used it about
the age of three months. We'd like to start penicillin prophylyxis.
It's a very interesting story and it goes with some
of these treatments, but we like to get it started
by three months and they stay on penicilin until age

(09:55):
five years. And pediatrists may have to deal with the
fact that kids want to be like other kids. They
want to do the same things that all other children do,
and so we have to try to work with parents
to modify their activities so they won't feel different and

(10:15):
learn what their limitations are so that you know, they'll
know where to stop. So part of ours is trying
to get children through to not have some sort of
complex by the time they get through childhood and start
dealing with other problems when they get to be teenagers.

Speaker 2 (10:39):
Yeah. Yeah, you kind of touched on a little bit,
doctor Hall about how treatment has evolved over the years.
And you're a qualified medical marijuana position here in the
state of Florida, So can you let us know it's
sickle seller qualifying disease in the state for medical marijuana
use and how can patients actually use cannabis if they

(11:01):
have sickle cell?

Speaker 4 (11:02):
Okay, So, as we know, marijuana is not an.

Speaker 1 (11:07):
FDA approved drug for treatment across the country because it
is restricted by the DEA schedule as a Schedule one,
meaning officially untitled no clinical benefit. However, we've known from
eighty years of research and practice that marijuana was a

(11:30):
medication up until the nineteen thirties and then it was
removed and delisted, and the clinical benefits of it worldwide
have been elucidated first by the Israelis, the Canadians, and
multiple other research groups around the world, so it can
be used. It can be used very effectively for inflammation reduction,

(11:52):
it can be used effectively for pain control, and it
is not as toxic a pain medication as our opium
narcotics with their high risk ratio on respiratory depression and overdose. However,
that brings us to the government, and the government still
has it restricted and classified in the US several states,

(12:18):
so on a state level, many states have legalized medical cannabis,
about thirty two I think thirty two.

Speaker 4 (12:26):
Is of the last count out of fifty.

Speaker 1 (12:29):
Florida is a little bit restrictive in it its legalization.
Florida has not taken it to the second stage of
recreational use. It's still only medical only, and Florida actually
only allows eleven diagnostic conditions that are primary diagnoses, such
as AIDS, HIV, post traumatic stress disorder, Crohn's disease, ulcerative collidis, glaucoma. However,

(12:57):
there is one category that Florida allows, which is terminal illness.
Fortunately for sickle cell disease, especially SS, if you don't
get treatment, you die of course kind of Southern profile
access has proven that in the pediatric age group and

(13:18):
throughout all the life span of a sickle cell patient,
they need treatment. So therefore, my opinion, and this has
been an opinion shared in several medical cannabis groups, is
that sickle cell disease classifies as a terminal illness if untreated. Therefore,
that is the selection we use, which is terminal illness.

(13:42):
The state, the Office of Medical Marijuana Use, which is
a department of the which is a division of the
Department of Health in the state of Florida, has no
questioned that They've seen that listed hundreds of times by
me for many patients, and there has been no question.

Speaker 6 (14:01):
So that's what, okay.

Speaker 2 (14:04):
So how is medical cannabis used to treat people who
are living with cell phsease.

Speaker 1 (14:12):
The primary use is in pain control, because, as you know,
sickle cell disease is just a lifelong of chronic pain
with acute exacerbations, and most of the patients are on
long term chronic opioid narcotics at high dose, and it's
always a very difficult balance and act for these patients

(14:35):
when they have a crisis and they need more medication
than what they're already prescribed, and they go to an
emergency room or an urgent care center and they get denied.
Most of the time, they can use medical cannabis and
either an acute basis or a chronic basis, especially Indica strains,
because their pain control benefit is very high and their

(14:58):
risk ratio is very Oh, you can take high dose
medical cannabis and not risk respiratory depression, which is unlike
what happens with opioids. That's a primary effect. Secondary effect
is with so Cannabis is a complex drug. It has

(15:21):
over three hundred chemical components within it, divided between what
we call cannabinoids, terrapenes, flavonoids, etc. The two main cannabinoids
that people know are THHC and CBD. THHC is the
one that primarily acts on pain receptors. However, CBD primarily

(15:42):
acts in the brain as well as on inflammation, and
the use of CBD or low THHC medical cannabis is
very good for information and sickle cell disease has multiple
points of inflammatory change, and disorders who use a lot
of CBD tend to have lower information and doctor Brontick

(16:07):
can tell you about some of her research on inflammatory
markers in.

Speaker 4 (16:14):
Sickle cell disease that she's.

Speaker 1 (16:17):
Done in conjunction with a company called Functional fluid Ix.
These markers can be measured and can correlate with the
severity of the disease in the patient.

Speaker 2 (16:27):
Yeah, and I'm glad you teed up. Doctor Brontik is
always going to ask about the research aspects of this.
Can you share what you've learned and with the foundation?

Speaker 1 (16:38):
Yes.

Speaker 5 (16:38):
So we you know, monitor patients depression scores. So we monitor,
for example, PHQ nine. We assess their social determinants of
health and believe it or not, if they're utilizing cannabis.
We do see that these scores improved because there's so
much stress that's associated with the disease.

Speaker 6 (17:00):
Anything that can really take these stress markers down.

Speaker 5 (17:03):
Not only do we see see it from their completion
of forms, but we can also see it even at
the biomarker level. So when we send out labs for
pace selecting or VCAM, these are endothelial lining inflammatory biomarkers,
and we can actually see decreases in those biomarkers that

(17:24):
are very stress induced. Our patients, you know, utilize marijuana
a great deal. We encourage them to sign up with
doctor Hall because we don't want them to use anything
from the street because you know it could be laced
with something, so encourage you know, if we learn it

(17:44):
they are desiring to use or they may be using
from a source you know that's not medical grade. We
do have them, you know, have an appointment with doctor Hall.
We know that costs can be a factor, so the
fee is reduced used for the sickle self populations with
doctor Hall, but then when they actually have to go

(18:05):
to the cannabis dispensary, you know there is a cost
associated with that, so you know that may be a
deterrent for them to actually get in good medical grade marijuana.

Speaker 2 (18:15):
Yeah, Doctor Black share in your role, do you have
people asking you if they should consider cannabis to treat
their sickle cell disease.

Speaker 3 (18:25):
No, I have not had that so far. I may
have to this symposium. I may have that question for pose.

Speaker 2 (18:35):
Yeah, yeah, I know you mentioned that when we were
preparing for this conversation that you said some people have
said that they're using it, but they may not be
using it specifically for their pain management. Can you talk
a little bit about that, because that goes back to
doctor Brondie's message about do not use street level cannabis

(18:55):
as a treatment. No.

Speaker 3 (18:59):
I mentioned that I had read a paper someone had
gone on the reasons their patients with sickle sale were
using marijuana, and.

Speaker 2 (19:09):
Of course.

Speaker 3 (19:12):
For pain control and you know, a better out look
on life was among them. But there were a few
that said that they used it to get high, and
so that that was not helping the situation at all.

Speaker 2 (19:28):
Didn't say that, but.

Speaker 3 (19:31):
As doctor Hall says, you know, marijuana, as to me,
seems less toxic than those high doses of opioids. So
even if they get a little high and they get
some help with circle sell, that's still better than you know,
the risk of opioid, you know how those opioid use

(19:56):
and all the problems that I'm sure doctor Hall and
doctor Brown you see.

Speaker 2 (20:01):
Yeah, would you all like to reply to that comment.

Speaker 5 (20:04):
Yeah, Well, we like to recategorize that getting high as
just a reduction in their stress level. So and then
they can add on more CBD, which doctor Hall can
discuss to take away some of that psychoactive effect from
the cannabis.

Speaker 6 (20:18):
So doctor how you want to comment on that component.

Speaker 1 (20:21):
Yeah, So this is the other difficult thing about cannabis.
Unlike like say licenterpril, which just has like maybe three
variations with some diret ins tact on it, cannabis has
thousands of variations available just in this state alone, just
in Florida and in Colorado, California, there are thousands more.

Speaker 4 (20:45):
And the mix.

Speaker 1 (20:48):
Depends on what's called the testing and the profile, the
chemical profile of all these hundreds of cannabinoids in there,
and you can alter the ratios to reduce that get
high feeling or increase that get high feeling, like in
certain recreational but just sticking to medical cannabis, it is

(21:10):
quite possible, and the Canadians have shown this very well
that you look at the patient's inflammatory markers, you look
at their pain medic like their opioid utilization, and there's
a way to calculate a conversion to THHC with that.
And then you look at other factors too, things like
lumbar spine degeneration which is in my field, hip and

(21:36):
shoulder arthropathy and other factors like that which can affect
how you might want to bring in. Even other cannabinoids
like CBG or CBM or cb C c d N,
which work more on joint disorders, So there's a lot

(21:57):
there's a way to really prescribe it. Unfortunately, in Florida
we can't prescribe it like that. I did med school
in Montreal. In Montreal, a physician can actually write a
prescription with ratios of cannabinoids, give it to the patient,
and patient goes to the dispensary and gets that kind

(22:18):
of cannabinoid, not as a smoke type dispense to them
to target. And I should also mention that in Florida
there are like six or seven different varieties of modes
of delivery, you know, flower smoke, vape, edibles, gummies, oral pills, creams, lotions.

Speaker 4 (22:39):
We tend to.

Speaker 1 (22:40):
Discourage vape type and flower type in our patients because
they have lung disease and their risk of lung disease.
And the modes that actually carry better prescription level cannabinoid
percentages are the oils and the edible.

Speaker 2 (23:00):
Okay, and doctor Hall, I was going to ask you,
and you talked a little bit about what's happening in Canada,
can you talk about how someone in Florida can get
a legal medical marijuana card here.

Speaker 1 (23:12):
So you have to see a physician who is certified
by the Office of Medical Marijuana used such as myself,
but there are hundreds of others. You make an appointment.
Your first appointment has to be in person. You get
a history and physical exam and then they are supposed
to discuss with you the different modes of deliveries and
the different ratios. Then they register you into the medical

(23:38):
marijuana Registry run by the state. The patient then has
to pay a seventy five dollars fee, and that is
annual seventy five dollars a year to the state. Then
they get registered in the system. Once you're in the system,
you can shop. You don't actually need the physical card
because it is tied to your driver's license and your
Social Security number, and once in the system they can

(24:02):
go to a dispensary give their number or their card.
You get the card like three weeks later, and you
can shop and buy. You can shop them buy based
on what the doctor has allowed in your profile, so
you have to discuss with your doctor what you want
in your profile. There are three profiles. There's a low
THHC profile, a medical marijuana profile, which is a regular

(24:24):
THHC profile, and a flower profile. So the doctor has
to do all three of those and give explanations of
your diagnoses, and then you can shop. And every two
hundred and ten days or six and a half months
you have to revisit the doctor and get an update,
but you can do that second visit or subsequent ones

(24:45):
by telehealth.

Speaker 4 (24:46):
Ever since the pandemic.

Speaker 2 (24:48):
Yeah, can you talk about the value of having if
you're going to use medical marijuana, actually working with your
primary care physician, especially if you have sickle cell disease.
So you know, Doc Blacksher was still practicing one of
our patients was using cannabis. Wouldn't it be valuable that
they are working collaboratively with their medical marijuana physician and

(25:08):
their primary care position in their healthcare journey.

Speaker 1 (25:12):
That is ideal. I tend to only get that ideal
state with the pediatric patients because with patients under the
age of eighteen, you're required to collaborate by the state.
But with the adults it varies varies a lot based
on the primary care physicians how open and amenimal they
are to understand the medical cannabis. Some of them are certified,

(25:36):
but a lot of them are not. Sometimes after work
with a neurologist instead or a pomonologist or someone like that.
So the teamwork does make it better because that way
we can coordinate. As we increase the cannabis allowance, the
other physician can be decreased in the opioid prescriptions because

(26:00):
the cannabis allowance is coordinated with their PDMP the drug
monitor and profile, So we see what opioids that are
on and one should be going up as the other
one is coming down because you don't need that many
opioids when you're taking cannabis.

Speaker 2 (26:17):
Interesting, doctor Bronte, I want to touch back on what
you said about, you know, reminding people not to use
street level cannabis. But if you look, you know, you
travel around Florida, you're going to see a lot of
these CBD stores, right and they're selling you know, the
vape stores and all of that. Can you talk a
little bit about why people should reconsider going there versus

(26:38):
coming to a qualified medical cannabis physician to get cannabis,
you know, the CBD products or something like that to
help them with the sickle cell.

Speaker 5 (26:48):
Well, the retail stores, you know, do have some flexibility.
They can sell up to zero point three of THC.
There's something called delta eight. But you can have you know,
a little THC on that retail side, So those are
likely still pretty safe to utilize. You have to look
at the brands and you know, just make sure that

(27:09):
everything is on the up and up there. We don't
discourage patients from going into those type of retail shops.

Speaker 6 (27:16):
We actually have one at the Foundation.

Speaker 5 (27:19):
Oh you have CBD CBG and the low THHC is
what that's called that you can sell at the retail level.
But outside of that, if they you know, are you
know trying to purchase you know from friends off the street.
And you know, I've really seen bad outcomes of people,

(27:39):
you know, really having psychosis you know, related to something
they've utilized off the street and may have long term
effects you know, from that psychological effect. So we really
discouraged you know, street use of drugs, of any drugs obviously.

Speaker 2 (27:53):
Yeah. Well, I like what you said about that it's
in your in the Foundation where you have a medical
component to it, right, Yeah, I guess I was saying.
The difference would be if you walk into the convenience
store and you see these products that say CPT on
the right right.

Speaker 5 (28:10):
Yes, so those are there and as far as I know,
you know they can. I don't think they're if they approved,
obviously they're not. But I don't know, doctor Hall, would
you recommend people going into seven to eleven and getting
their CBD.

Speaker 2 (28:23):
I see them on the counters. I'm not knocking. I'm
not just trying to give people. Again.

Speaker 5 (28:28):
I think those are okay because you know, we could
purchase those and then sell them in our store.

Speaker 6 (28:32):
For example, we purchase them wholesale.

Speaker 2 (28:35):
Yeah.

Speaker 1 (28:35):
Look, you have to be very careful in Florida. First
of all, for the street flower, street flower in Florida,
almost forty percent is laced with something else. So I
really tell people that it's risky to buy street flower.
As far as the shops selling low THC products, most
of the products are good. All the products are supposed

(28:57):
to have a QR code on them that is linked
to their certificate of authenticity or their testing. You must
check that because sometimes you will check that and be
very disappointed with what the components are of the product.
Because not all the products. I would say ninety percent
of them are good, but ten percent of them are
not good. So if you go into a store, just

(29:19):
carry your phone, scan the QR code, read the results,
make sure, it's good before you purchase. But there are
good products in stores because I mean Walmart, for example,
sells a highly good product, CBS sells a good product.
You're well established. CBD shops do sell a lot of

(29:41):
good products, just like at the Foundation also sells products
that we review their certificate of testing.

Speaker 2 (29:51):
Yeah, Doctor Blackshaw, I liked it. Oh, Dr Bronte, did
you want to add to that? No, I was just okay,
Doctor Blasha. I wanted to ask you a little bit
of out what kind of lifestyle changes and I would
love for each of you all to touch on this.
What kind of lifestyle changes do you recommend for people
living with sickle cell Because you talk a lot about
the chronic pain, you know, having to take these different

(30:13):
kinds of medications. What are some of the lifestyle changes
that you recommend? And Doctor black Shaw'll start with you
and then work our way through the panel.

Speaker 3 (30:22):
Well, a big one is whatever can reduce stress for you.
Stress is a big component and it can be various
things for various people. You know, various patients, good diet,
good family relationships. So you know, with in situations where

(30:48):
these don't exist, it's very difficult to get to stress
leveled down, and so you know, that's why in pediatrics
we try to work within trying to help the child
be you know, do what other kids do as much
as possible within what they can do without you know,

(31:12):
causing multiple episodes of pain and whatnot, so they won't
feel different, you know, compare to other children.

Speaker 1 (31:22):
But those are the big ones.

Speaker 3 (31:24):
If you could keep your stress level down and recognize
your limitations, that will go a long way in uh
in helping a lot of a lot of SUCCELT patients
know their limitations, but they won't follow them.

Speaker 2 (31:41):
H h Right, that's the hall.

Speaker 1 (31:46):
Yeah, I think that that what doctor black Shaer has
said is primary importance. And the secondly, I would say,
be in closing constant, frequent communication with your primary hematologist
or your primary care doctor who's treated you for your
sickle cell because it does affect every organ in the

(32:08):
body and you do need to get regular checkups, not
just be treated for pain, and you can live decades
and decades, well into your sixties and seventies with good care.
We've seen it. We've seen it over and over. It
is not a terminal disease without treatment, I mean not

(32:29):
a terminal disease with treatment, but it is terminal without treatment.
So if you visit your doctor every month, it should
be every month. A sickle cell patient needs to see
their primary hematologists every month.

Speaker 5 (32:44):
Yes, so sickle cell disease is a chronic disease, and
we keep managing it as though it's an acute process
every day, all day long. But that chronic process really
means that, you know, the referrals that the patients need
to have their organ success puminologists, cardiologists, nephrologists, they need
to see all of those. I know, it's burdensome on

(33:06):
them from time to time with having all of these appointments.
One of the things that we're trying to do is
bring some of that in house, you know, to reduce
them always having to go out to these different locations.
But the stress, if they can reduce their stress level,
it really does impact their overall health, just the way
they approach their day, the way they approached life. On

(33:28):
the adult side, they have issues with jobs and just
maintaining relationships from time to time. So reducing the stress
and having mechanisms and resources for the patients is so
important as well. Massage therapy, acupuncture, reiki, therapy, their complementary
and alternative medicine and practices that we can utilize. What

(33:52):
we see right now for the most part is just
palliative care with pain management and ivy fluis and there's
so much that we can do. And now we do
have cures with gene therapies. Not many patients have access
to those cures yet, but that's something that we're trying
to change as well. So we just look forward to
having many resources and many types of treatments available for patients.

Speaker 2 (34:18):
Okay, well, we're getting some really good questions from the
folks who are watching Tim and we can bring up
the question from Yen please. So Yen is asking what
are some of the best practices for providers who want
to recommend cannabis in a trauma informed, culturally sensitive way,
especially in communities historically marginalized by the medical system. We

(34:42):
would like to take that on.

Speaker 6 (34:45):
Answered Doctor Hall question, I would I had to.

Speaker 1 (34:49):
Read it twice. This is a trauma informed. The real
thing is providers who are i would say, in cahoots
or in agreement with the basic concept that cannabis is

(35:10):
a medication and should be treated as a medication. So
if you know a provider who has been thinking about
becoming certified, encourage them to attend a meeting. There are
medical conferences on cannabis every year in Florida. It's a
huge one in Orlando every summer, and become knowledgeable read

(35:37):
about it. Because in med school we might have had
one or two side mentions in pharmacology class about medical
cannabis and receptors, but we certainly didn't get a full lecture,
and it wasn't something that was taught, So you have
to learn it on your own. So feel free to
encourage your provider to become knowledgeable of medical cannabis. When

(36:02):
the provider becomes knowledgeable of the literature.

Speaker 4 (36:06):
And the.

Speaker 1 (36:08):
Science behind it, than they usually have turned around.

Speaker 2 (36:12):
Okay, well, this has been a really rich conversation and
I wanted to give each of you the opportunity to
share some closing thoughts. So doctor Blasher, I like to
have you share some closing thoughts on cannabis as a
medical treatment for people living with sickle cell disease.

Speaker 3 (36:29):
Actually, before this seminar, I actually had not given a
whole lot of thought to cannabis because that was not
something that we really dealt with in children but I'm
really impressed with some of the information that I have gotten,

(36:52):
and I suspect that I will, through the Foundation get
some information and I know how to reach doctor Bronte
and doctor Hall. I won't know how to reach.

Speaker 2 (37:06):
Because they are.

Speaker 3 (37:07):
Experts in there in this area.

Speaker 2 (37:10):
I'm glad this is open and I open for me too. Yeah, great, great, great,
doctor Hall.

Speaker 1 (37:18):
Well, I just want everyone to just think positively. As
doctor Bronton mentioned, we are getting more and more access
to stem cell transplants, gene therapy, gene editing. It's a
little expensive and cost prohibitive for most patients right now,

(37:39):
but the doors are opening for that as treatment. There's
a lot of research going on across the world on
new drugs, new treatments, new interventions, and there is even
a little bit of research ongoing on medical cannabis as
drug and invention and sickle cell disease. So it's not

(38:02):
as bleak a diagnosis as if it was fifty years
ago or sixty years ago. So it's really as different now.
So be positive, don't be too depressed, don't let the
stress get you down, and just link up with your
doctor every month.

Speaker 2 (38:19):
Thank you, doctor Bronjack.

Speaker 5 (38:21):
Yes, so cannabis holds a lot of promise in addressing
the hallmarks of sickle cell disease, which is chronic pain,
acute pain, sleep disturbances, anxiety.

Speaker 6 (38:33):
We know that there are some barriers.

Speaker 5 (38:35):
Out there for our patient population, you know, particularly in
our communities where they face limited access to the medical
cannabis due to costs, the location of the dispensaries, and
just historical criminalization of medical marijuana, you know, use and
people are still in jail because of that. But we

(38:56):
do want to, you know, continually address the stick and
mistrust and just let our patients know that this is
an option for you and it really can prolong their
life and reduce their symptoms and hopefully slow down the
progression of organ damage because we're tackling that stress, you know,

(39:17):
through cannabis and some of these components such as CBD
and CBG.

Speaker 2 (39:23):
So very really oh no, you can keep going.

Speaker 6 (39:28):
It's very promising.

Speaker 2 (39:30):
Wonderful well, Doctor black Share, Doctor Bronte, Doctor Hall, thank
you all for being a guest on this Conversations on
Cannabis Virtual form brought to you by the Medical Marijuana
Education and Research Initiative at Florida and m University. Thank
you to everyone watching this program. Tell us what you
think about this form by completing the survey posted in
the comment boxes on Mary's social media pages. If you

(39:53):
complete the survey, your name will be entered into a
drawing in August twenty twenty five to win a one
hundred dollars gift card provided by one of Mary's partners.
We also want to encourage you to go to the
Florida Department of Health Office of Medical Marijuana Use website
to learn how to obtain a legal medical marijuana card
in the state of Florida. And we encourage you to

(40:14):
go to the Florida and M University's Merry website to
learn more about this initiative, its educational programs, and about
cannabis use in Florida. Thanks everyone.

Speaker 3 (40:29):
The views and opinions of our invited guests are not
necessarily the views and opinions of Florida Agricultural and Mechanical
University or the Medical Marijuana Education and Research Initiative.