Clinical Applications of CBD, THC and Cannabis Derived Therapies for Age Management Medicine - Full Course
Courses are Enduring Materials from a Clinical Applications for Age Management Medicine Conference
Over the past decade, the medical use of marijuana, CBD, THC, and other derivates of cannabis has increased exponentially in the U.S. Well over half the states have enacted laws in some form to allow physicians to prescribe marijuana medically—and by 2021, all 50 states may have laws allowing medical marijuana in some capacity. AMMG takes no political position on such uses—we are medical educators. That said, it’s clear a definite gap exists in medical education for physicians/healthcare professions who treat a rising patient base that is requesting or inquiring about medical marijuana for a gamut of disorders. AMMG stands in that gap to better educate and inform physicians so they are qualified to respond to this changing medical climate.
Scientific Rationale for the Use of Marijuana, CBD, and other Derivatives for Use as Clinical Applications
CBD (Cannabidiol) is emerging as a powerful supplement with a significant effect on our body’s endocannabinoid system. The endocannabinoid system has been shown to have a strong effect on the inflammatory, immune, cognitive and motor systems of the body. Cannabidiol (CBD) is one of over 80 cannabinoids, natural compounds found in industrial hemp. The endocannabinoid system (ECS) is perhaps the most important physiologic system involved in establishing and maintaining human health. Endocannabinoid receptors are found throughout the body: in the brain, organs, connective tissues, glands, and immune cells. In each tissue, the cannabinoid system performs different tasks, but the goal is always the same: homeostasis or balance. CBD has shown promising results in independent research and studies as a treatment for a variety of conditions including antiemetic, anticonvulsant, antipsyotropic, anti-inflammator, antioxidant, anti-tumoral, anti-anxiolitic/antidepressant, and more. We will review the basic science of CBD and the scientific evidence supporting the many applications of CBD along with the clinical applications of Full Spectrum Hemp Oil (CBD) that can be used in your medical practice.
This workshop will address the changing landscape relative to the use of cannabis-derived products, such as CBD oil and other CBD products. Federal statutes, such as the Agricultural Improvement Act of 201 8(the “2018 Farm Bill”), the Federal Food, Drug, and Cosmetic Act (the “FD&C”), and FDA and DEA guidelines relative to the classification of cannabis-derived products intertwine to create a complex regulatory framework within which health care providers must operate. Understanding the various regulatory schemes in place and how cannabis-derived products can be used and marketed is fundamental to compliance with federal law and relevant agency guidelines. This workshop will identify the relevant regulatory guideposts and provide direction as it relates to compliance with and understanding of this changing landscape.
Alzheimer’s disease (AD) is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks. Presently, it now ranks as the 6th leading cause of death in the United States. There are two types of onset of AD with various causes, classifications and stages. Medical cannabis is one of the natural treatments that people, especially baby boomers, are turning to for symptom relief and disease treatment; it [medical cannabis] has proven to be beneficial for many chronic, degenerative conditions, including Alzheimer’s disease. In this presentation, Dr. Joseph Rosado will discuss, what Alzheimer’s disease is, how many people are affected by and die as a result of it, what causes it, how it’s treated “conventionally”, what is in the scientific literature regarding Alzheimer’s disease and medical cannabis and how to manage/treat AD patients with medical cannabis.
With the growing prevalence of autoimmune diseases in the world, there is a huge need for therapies that improve and restore balance to immune function, without suppression. Cannabinoids and hemp oil have shown promising results for the improvement of autoimmune and inflammatory conditions, through mechanisms including the activation of CB1 and CB2 receptors. Positive preliminary data exist supporting the use of cannabinoids for the improvement of MS, IBD, mast cell activation syndrome, Lou Gehrig’s disease, arthritis, scleroderma, and type 1 diabetes.
It is often forgotten that the prime directive of life is successful reproduction, and few understand the critically important role played by the newly discovered Endocannabinoid System, in support of reproductive health. The Endocannabinoid System is an all-encompassing lipid signaling complex linking female reproduction with the collaborative functions of cognitive, emotional, metabolic, and immune health, ensuring optimal female fertility when all is in homeostatic balance. This lecture will provide an overview of the myriad ways in which the endocannabinoid system supports female reproduction and overall health and will review the female disease states which manifest with endocannabinoid system dysregulation. Health care providers will be provided the tools to enhance the health of the female endocannabinoid system and when needed, to safely and appropriately utilize plant-based cannabis to optimize female health and fertility.
There continues to be growing interest in the medicinal uses of cannabis for health maintenance and certain medical indications. In particular, the use of CBD for cognitive/brain health is rapidly growing, both in market demand and scientific research. CBD has application in limiting neurological damage following ischemic insults, such as stroke and trauma, or in the treatment of neurogenerative diseases such Alzheimer’s Disease, Parkinson’s Disease, and Chronic Traumatic Encephalopathy (CTE). Dr. Lewis will explore the science behind the endocannabinoid system (ECS), particularly in the brain, and the interaction of our endogenous cannabinoids and phytocannabinoids have with our ECS. Additionally, Dr. Lewis will discuss his clinical experience using cannabis phytocannabinoids, particularly the value of using CBD for anxiety, depression, and after head injuries.
There is a lot more to cannabis than THC and CBD, its predominant cannabinoids. Terpenes are the fragrant oils that give cannabis its aromatic diversity. Flavonoids provide synthesis of antioxidant properties as potent inhibitors of cyclooxygenase enzymes and prostaglandin E2 production. The “entourage effect” identified by EB Russo, M.D. in 2011 offers medicinal properties beyond the efficacy of single cannabinoid effectiveness or a single CBD remedy for a specific disorder like seizure management. Whole plant medicine combines cannabinoids, terpenes and flavonoids to provide pain, sleep, gastro-intestinal, mood and behavior, and neurological benefits. The analysis of terpenes allows patients to determine correct strains for their symptom management. Of the more than 200 terpenes and 29 flavonoids found in cannabis, six primary terpenes and five flavonoids are key to selecting full spectrum cannabis products.
The presentation includes a brief history of cannabis as medicine, a medical-legal concerns, addresses patient screening, chart documentation, patient forms, patient orientation; laws, endocannabinoid system, routes of administration. A visit includes overview applicable California laws, patient questions, review of patient history form and all records, take oral history, do physical. If the patient meets your and your patient’s approval criteria I provide the patient with written documentation of my approval/recommendation. In the visit I provide pertinent information as appropriate.
David Bearman, M.D.
Practicing Physician, Goleta, CA
VP of Quality Assurance and Credentials, American Academy of Cannabinoid Medicine
For millennia, the cannabis plant and its extracts have been used to treat a variety of illnesses. From the ancient Chinese to being added to the United States Pharmacopeia in 1850, cannabis was routinely prescribed as a “use as directed” medication until 1942. Now, with 30 states and Puerto Rico having legal programs, contemporary practitioners are struggling to understand how to integrate newly legal cannabis into patient treatment protocols. From micro dosing to macro dosing, the results collected by Dr. Gordon’s Compassionate Cannabis Clinic in the past year demonstrate the importance of individualized recommendations based upon debilitation and the healthcare goals of the patient. Dr. Gordon will explain his patient encounter protocol, including how determining a patient’s past use of cannabis is vital in crafting an effective treatment plan. Additionally, Dr. Gordon will detail the importance of education and teaching is in conjunction with patient control and delivery, as opposed to dosage protocols found in conventional pharmaceutical medications.
Barry Gordon, M.D.
President, Chief Medical Officer, Compassionate Cannabis Clinic, Venice, FL
Opiate abuse does not occur in a vacuum. Treating it requires taking a holistic approach that involves not only medical treatment but changing the paradigm. Treatment involves more than use of a substitute drug such as Suboxone or Methadone, or a psychoactive drug like Ayauasca or alternative and complementary pain killers like tumeric, Kraytom and/or cannabis. Opiate abuse is often a red flag to a history of growing up in a dysfunctional family, PTSD, ADD/ADHD or autism spectrum disorder. These comorbid diagnoses should be kept in mind when treating opiate abuse. Cannabis is an analgesic and an anti inflammatory. Its use in a chronic pain patient can decrease opiate dosage by 30-50%. Cannabis is also a harm reduction substitute.
David Bearman, M.D.
Practicing Physician, Goleta, CA
VP of Quality Assurance and Credentials, American Academy of Cannabinoid Medicine
- Practicing Physician, Goleta, CA
- VP of Quality Assurance and Credentials, American Academy of Cannabinoid Medicine
Dr. David Bearman is one of the most clinically knowledgeable physicians in the U.S. in the field of medicinal marijuana. He has spent 40 years working in substance and drug abuse treatment and prevention programs. Dr. Bearman was a pioneer in the free and community clinic movement. His career includes public health, administrative medicine, provision of primary care, pain management and cannabinology. His almost 40 year professional experience in the drug abuse treatment and prevention field includes being the Co-Director of the Haight-Ashbury Drug Treatment Program, being a member of Governor Reagan’s Inter Agency Task Force on Drug Abuse, a member of both the Santa Barbara and the San Diego County Drug Abuse Technical Advisor Committees, and a consultant to Hoffman-LaRoche, Santa Barbara County Schools and the National PTA. He has been recognized by the Santa Barbara Medical Society with the Humanitarian Recognition Award. Dr. Bearman is also the author of “Drugs Are NOT the Devil’s Tools: How Discrimination and Greed Created a Dysfunctional Drug Policy and How It Can Be Fixed” in 2 volumes.
Stockholder, CW Pharmaceuticals.
- Private Internal, Integrative and Regenerative Medicine Practice, Newton, MA
Derrick M DeSilva, Jr, M.D. is a practicing internist, a senior attending staff member in the Department of Medicine at Raritan Bay Medical Center in Perth Amboy, NJ, and a member of the Teaching Faculty at JFK Medical Center in Edison, NJ. He is past chairman of the conference planning committee of Age Management Medicine Group (AMMG), past president of the American Nutraceutical Association, and a recipient of the Alan P. Mintz, M.D. Award for Clinical Excellence in Age Management Medicine. Dr. DeSilva has received the Best Doctor Award by Castle Connolly for the past 19 consecutive years. He is the host of “Ask the Doctor” on WCTC Radio, NJ, and medical correspondent for Cablevision (News 12 NJ) as well as host of “Health Matters”. Dr. DeSilva is also a published author.
FACULTY DISCLOSURE: No Relevant Financial Interest in any Products or Services to be discussed
- Integrative Medical Group of Irvine, CA
- Retired Assistant Clinical Professor of OB/GYN, Keck-USC School of Medicine
- Consultative Faculty, Fellowship in Integrative Medicine, University of Arizona School of Medicine
Felice L. Gersh, M.D. is double Board-Certified in OB/GYN and Integrative Medicine. She received her undergraduate degree from Princeton University and her medical degree from the University of Southern California School of Medicine. This was followed by a four-year internship and residency in OB/GYN at Kaiser Hospital in Los Angeles. More recently she completed a 2-year fellowship program in Integrative Medicine at the University of Arizona School of Medicine. She specializes in all aspects of female health, with a particular focus on managing female hormonal dysfunctions. In addition to her many national and international speaking engagements, she works full time as the Medical Director of the Integrative Medical Group of Irvine. She served many years as an Assistant Clinical Professor of OB/GYN at the Keck/USC School of Medicine and currently serves as a Consultative Faculty member with the Fellowship in Integrative Medicine at the University of Arizona School of Medicine. Dr. Gersh has been awarded membership in the medical honor society Alpha Omega Alpha, named the outstanding volunteer faculty for the OB/GYN Department at USC-Keck School of Medicine, and identified as a Physician of Excellence for Orange County 16 years in a row. She has recently completed her first book, PCOS SOS: a Gynecologist’s Lifeline to Naturally Restore Your Rhythms, Hormones, and Happiness.
FACULTY DISCLOSURE: Pure Encapsulations: Speakers Bureau
- President, Chief Medical Officer, Compassionate Cannabis Clinic, Venice, FL
A 1981 graduate of the Ohio State University College of Medicine and a founding fellow of the American Academy of Emergency Medicine, it wasn’t until decades into his medical career that Dr. Barry Gordon even began hearing the words “endocannabinoid system.” Now Dr. Barry, as he is affectionately known, is at the forefront of the medical cannabis movement. For more than three decades, Dr. Gordon built a career working on the front lines of the American health care system, spending years in in Ohio emergency rooms. Opportunity came knocking when he took an early retirement from Alliance Community Hospital in 2015 and relocated to Florida with his wife Patty. He created Florida Vacation Telehealth P.A., which eventually gave birth to the Compassionate Cannabis Clinic. No longer tethered to a large healthcare organization, Dr. Gordon made the decision upon overwhelming passage of the Florida Medical Marijuana Legalization Amendment on November 8, 2016, to begin seeing and treating patients with chronic illnesses using cannabis therapy. Today, Florida is just one of 30 states that recognize the medicinal value of marijuana for the relief of symptoms associated from everything from neurological illness to chemotherapy. Dr. Barry has utilized his undergraduate degree in communications from The Ohio State University to advocate for patients before becoming the owner of the largest medical marijuana practice in Florida. He provides an unique voice and an ability to break down complex medical terminology, whether answering common medical questions or facilitating discussions on complicated ailments.
FACULTY DISCLOSURE: No Relevant Financial Interest in any Products or Services to be discussed.
- Colonel (Retired), U.S. Army
- Private Practice, Potomac, MD
- President and Founder, Brain Health Education and Research Institute
Michael D. Lewis, MD, MPH, MBA, FACPM, FACN, is an expert on nutritional interventions for brain health, particularly the prevention and rehabilitation of brain injury. In 2012 upon retiring as a Colonel after 31 years in the U.S. Army, he founded the nonprofit Brain Health Education and Research Institute. He is a graduate of the U.S. Military Academy at West Point and Tulane University School of Medicine. Dr. Lewis is board-certified and a Fellow of the American College of Preventive Medicine and American College of Nutrition. He completed post-graduate training at Walter Reed Army Medical Center, Johns Hopkins University, and Walter Reed Army Institute of Research. He is in private practice in Potomac, MD, and is the author of When Brains Collide: What every athlete and parent should know about the prevention and treatment of concussions and head injuries.
CV Sciences, Inc: Scientific/Medical Advisory Board Member
- Member, Buttaci, Leardi & Werner Law Firm, Princeton, NJ
Mr. Werner is a zealous advocate for his clients, both in and out of the courtroom. He has a varied litigation practice, representing physicians and other healthcare providers and organizations in civil litigation, criminal investigations and prosecutions, and professional licensing actions. Mr. Werner relies upon his substantial experience in assessing the substantive merits of allegations of fraud or professional misconduct to effectively—and realistically—counsel his clients on how to best respond to scrutiny from either third-party payers or regulatory agencies. He also assists clients with internal investigations into regulatory compliance issues and frequently advises his clients on proactive risk management and regulatory compliance, emphasizing how to proactively avoid payer or regulatory scrutiny in the first place.
FACULTY DISCLOSURE: No Relevant Financial Interest in any Products or Services to be discussed
- Medical Director and Co-Founder, PrimeHealth
Dr. Soyona Rafatjah is a board-certified Family Medicine physician and Medical Director and Co-Founder of PrimeHealth. She graduated summa cum laude from the University of Michigan with a BSE in Biomedical Engineering, received her medical degree from the University of Miami Miller School of Medicine, and did her residency training at Jackson Memorial Hospital in Miami, FL.
Prior to starting PrimeHealth, she was a physician at Parsley Health in New York City, a technology-forward Functional Medicine practice where she was integral to its rapid growth. Dr. Rafatjah also worked at the renowned Mount Sinai Beth Israel Center for Health and Healing, and Dr. Frank Lipman’s Eleven Eleven Wellness Center.
CBD oil: I sell a CBD product in my office (NuLeaf)
- Medical Director, Coastal Wellness Centers, DeLand, FL
- Advisory Board Member, Cannabidiol Life
After spending several years in central Florida working as an orderly, then an EMT/Paramedic and Heart Cath Lab technician, Dr. Rosado realized his passion for the medical profession. He started chiropractic school at Life College in Marietta, GA where he graduated cum laude with a BS degree in Clinical Nutrition and a doctor of chiropractic degree. After practicing for several years, he went on to Universidad Central del Este, in San Pedro de Macoris where in 2001 he graduated summa cum laude with his medical degree. In 2005 he completed his MBA in Health Care Management from University of Phoenix, and graduated magna cum laude. In 2018 he became a Diplomate of the American Academy of Cannabinoid Medicine. Since completing his medical training, he has worked as a physician, clinic and hospital director, director of the communicable disease division/epidemiology and immunization departments. Presently, Dr. Rosado is the Medical Director of a medical cannabis clinic in Ormond Beach, FL, the president and CEO of International Medical Consultants, the chief medical officer for Minorities 4 Medical Marijuana and International Cannabis Solutions USA. As an advocate, he was and is on the bureau of speakers for political campaigns and medical cannabis dispensaries/licensed producers. As a clinician he has worked with toddlers, children, adolescents, adults and geriatric patients for the recommendation of and management with medical cannabis. As a speaker/educator, he’s spoken throughout the United States and Canada, Mexico, Colombia, Costa Rica, Thailand and Italy and been interviewed by ABC, CBS, NBC, FOX, Univision, Telemundo and NPR local affiliates, Caracol Miami and Medellin and Leafly.com. And as an author he has published multiple articles in refereed medical journals, written the bestselling book “Hope and Healing – A Case for Medical Cannabis” and been quoted in Rolling Stone magazine.
Surterra Wellness: Speakers Bureau, VidaCann: Speakers Bureau, Curaleaf: Speakers Bureau, marijuanadoctors.com: Scientific/Medical
Advisory Board Member, Cannabidiol Life: Scientific/Medical Advisory Board-Member
- Assistant Professor, New York Chiropractic College
- Adjunct Professor, Everglades University, Sarasota, FL
- Adjunct Professor, South University-Tampa, FL
Betty Wedman-St. Louis, Ph.D. is a licensed nutritionist specializing in digestive diseases, diabetes, cancer and environmental health issues who has been a practicing nutrition counselor for over 40 years. Her BS in Foods & Business from the University of Minnesota introduced her to how the food industry influences eating habits. Dr. Wedman-St. Louis completed her MS in Nutrition at Northern Illinois University where she studied the relationship between prolonged bed rest and space flight weightlessness nutrient requirements. She had a private practice at the Hinsdale Medical Center before completing her Ph.D. in Nutrition & Environmental Health from The Union Institute in Cincinnati. Dr. Wedman-St. Louis completed her doctorate internship at WUSF-Tampa in Multi-Media Production for distance learning and online course development. Dr. Wedman-St. Louis is the author of numerous published articles on current nutrition topics including bariatric surgery, lectin toxicity, phosphates in food, folate, Vitamin B12, seafood nutrition, alpha lipoic acid and diabetes. She has authored columns for The Hinsdale Doings, Chicago Sun Times and Columbia Missourian and has taught undergraduate and graduate courses on nutrition. She has written a personal health column for the Tampa Bay Times and maintains a private practice in Pinellas Park, Florida. Her website is www.betty-wedman-stlouis.com.
No Relevant Financial Interest in any Products or Services to be discussed
Disclosure of Conflict of Interest
Faculty / Planner Disclosures – The Foundation for Care Management (FCM) requires everyone in a position to control the content of this activity to disclose any relevant financial conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by The Foundation for Care Management (FCM) for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.
Conference Planning Committee – Disclosure
Mary L. Corry, R.N. – No Relevant Relationships with a Commercial Interest to Disclose
Mark L. Gordon, M.D. – No Relevant Relationships with a Commercial Interest to Disclose
Edwin Lee, M.D. – No Relevant Relationships with a Commercial Interest to Disclose
Rob A. Kominiarek, D.O. – No Relevant Relationships with a Commercial Interest to Disclose
Cesar M. Pellerano, M.D. – No Relevant Relationships with a Commercial Interest to Disclose
John Rush, M.D. – No Relevant Relationships with a Commercial Interest to Disclose
George Shapiro, M.D. – No Relevant Relationships with a Commercial Interest to Disclose
No member of The Foundation for Care Management or the Age Management Medicine Group has any relevant financial relationships to disclose in regards to this activity.
David Bearman, M.D. – Stockholder, CW Pharmaceuticals
Felice Gersh, M.D. – Pure Encapsulations: Speakers Bureau
Michael Lewis, M.D. – CV Sciences, Inc: Scientific/Medical Advisory Board Member
Soyona Rafatjah, M.D. – CBD oil: I sell a CBD product in my office (NuLeaf)
Joseph Rosado, M.D. – Surterra Wellness: Speakers Bureau, VidaCann: Speakers Bureau, Curaleaf: Speakers Bureau, marijuanadoctors.com: Scientific/Medical, Advisory Board Member, Cannabidiol Life: Scientific/Medical Advisory Board Member
The following faculty reported that they had No Relevant Relationships with a Commercial Interest to Disclose.
Derrick DeSilva, Jr., M.D.
Barry Gordon, M.D.
Betty Wedman-St. Louis, Ph.D., RD
Paul D. Werner, Esq.
Acknowledgement of Financial Commercial Support
No in-kind financial support was received for this educational activity.
Acknowledgement of In-Kind Commercial Support
No in-kind commercial support was received for this educational activity.
Release Date: April 15, 2020
Expiration Date: April 15, 2022
Cannabis is not legal in all 50 states. You must verify if cannabis is legal in your state to administer.
- Discuss the essential evidence-based science behind the approved use of CBD, Cannabis and Cannabis Derived Therapies as an adjunct to your practice.
- Summarize the legal medical use of Cannabis and CBD and the role of the individual states, the DEA and FDA in its medical use.
- Discuss essential scientific information for the use of CBD, Cannabis and Cannabis Derived Therapies in patients with neurological Disease such as Alzheimer’s Disease, dementia, and other disorders such as autoimmune, inflammatory diseases and explain how to clinically apply this knowledge in your practice to improve patient outcomes.
- Discuss essential scientific information for the use of CBD, Cannabis and Cannabis Derived Therapies in patients in other areas of medical use such as unique female issues, pain particularly as an alternative to opiates, and gastro-intestinal issues autoimmune, inflammatory diseases and explain how to clinically apply this knowledge in your practice to improve patient outcomes.
- Summarize clinical practice guidelines and dosages for the use of Cannabis, while understanding the use depends on the particular laws of the state where the legal use of is permitted.