Clinical Endocannabinoid Deficiency is a term regularly used in the medical cannabis world and refers to a collection of illnesses where low levels of endocannabinoids and their receptors contribute to disease development. So who better to speak to for a deep dive into endocannabinoid deficiency than Dr Ethan Russo, the neurologist and cannabinoid researcher who coined the term and has written three papers on the subject.Ethan shares how he initially came up with the theory, possible causes, which conditions share the cluster of symptoms associated with endocannabinoid deficiency, we discuss how poor endocannabinoid tone may contribute to the development of endometriosis, and how best we can strengthen our endocannabinoid system supplementing with cannabis, but also through non-cannabis routes such as looking after our gut biome and exercise. This episode is a must for doctors, patients and indeed anyone with an interest in deepening their understanding of the endocannabinoid system and how its dysregulation may well lie behind a host of pathologies. References:Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? by Ethan RussoClinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes by Ethan Russo

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A few months ago, I interviewed Dr Claude Cyr, a Canadian family doctor and author of a number of peer reviewed papers about the use of cannabis in palliative care for an article I was writing for Project CBD.Dr Cyr describes palliative care as the best ‘port of entry’ for integrating cannabis into medicine because it is one of the only disciplines where physicians actually have the time needed to spend with patients.He says: “Palliative care is a specific situation where we can actually put into question the core philosophy of medicine which is the evidence based paradigm. I think physicians need to stop obsessing over the evidence when their patients are dying and clearly telling them, ‘I’m really enjoying this, I’m getting huge benefits from this, I’m sleeping better, I’m eating better.’ But the physicians are nodding their heads and saying, ‘I hear you, but I can’t accept this because I’m still lacking evidence.’“But I think there is enough data out there to convince physicians that it’s safe for palliative care patients, and it’s predictable.” I particularly enjoyed discussing with Dr Cyr how the psychoactive nature of the cannabis plant can actually have a therapeutic place in end-of-life care, potentially helping a patient to accept their death. “When you look at the studies of psychedelics in depression and existential anxiety in cancer patients, some of these results have been dramatic,” says Dr Cyr. “Although cannabis isn’t a true psychedelic, there are some similar experiences that patients tell us about.”At smaller doses patients experience a psycholytic effect, a lowering of the defences allowing people to explore other aspects of their psyche, and that’s when they start making connections between different aspects of their reality.” A great, informative interview to be enjoyed.

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