The Benefits of Cannabis with Dr. Rob Sealey

It's a Theory

Oct 31 2023 • 34 mins

Melanie Nicholson welcomes Dr. Rob Sealey, Cannabinoid Medicine Specialist, to the show to discuss the benefits of cannabis in a medical use capacity. Dr. Sealey breaks down misinformation and differentiates between recreational and medicinal cannabis use for listeners.

Dr. Sealey recounts how he was initially a GP but found his way into cannabinoid medicine through the encouragement of a particularly challenging patient who wanted to be the first to use cannabis medically in 2001. Through his experience advocating for her, everything he learned about cannabis and the benefits he witnessed in his cannabinoid patients, he eventually  left his family practice to focus on cannabinoid medicine full time. Dr. Sealey explains how cannabis can work with the body’s endocannabinoid system to help with receptors otherwise overloaded or unresponsive, thus shutting down pain from various ailments. He clarifies the many differences between rfull-timeecreational cannabis and medical cannabis and discusses how cannabinoid medicine can assist with arthritis, chronic pain, epilepsy, and a host of other issues. He is informative and passionate about how far research into cannabis can go in helping people manage pain.

“And we're starting to look at the endocannabinoid system, when it breaks down, it's implicated in fibromyalgia, irritable bowel syndrome, migraines, PTSD, asthma, osteoporosis... The list is going on and on. We're finding out that the missing link of why we're unable to manage a lot of these conditions is endocannabinoid dysfunction. It just goes haywire or it gets depleted. And that's why the opportunity to use cannabis in a variety of conditions is there.” - Dr. Rob Sealey

About Dr. Rob Sealey

Born in Saskatoon, Saskatchewan, Dr. Robert Sealey, B.Sc, M.D, attended the University of Nebraska on an athletic scholarship where he graduated with a Bachelor of Science in Biology. He then returned home to complete his medical degree at the University of Saskatchewan followed by a rotating internship in Akron, Ohio.

Since 1991, Dr. Sealey has had a full service family practice including hospital and long term care facilities in Victoria, British Columbia. Besides his work in General Practice, he has volunteered his services around the world including South Africa, Kenya, Vanuatu (South Pacific) and the Dominican Republic. He was also co-host of the nationally syndicated radio program “WiseQuacks” for over eight years.

As an active member of the peer sharing group Physicians for Medicinal Cannabis along with the Canadian Consortium for the Investigation of Cannabinoids, the International Cannabinoid Research Society and the International Association for Cannabis, Dr. Sealey has been involved in both the clinical and research aspects of Medical Cannabis since 2001.

With this background, he is acknowledged as an expert in cannabinoid medicine and accepts referrals from other physician colleagues including general practitioners, nurse practitioners, pediatricians, nephrologists, cardiologists, gastroenterologists, respirologists, oncologists, neurologists, rheumatologists, physiatrists, orthopedic surgeons, pain specialists, addictionologists, psychiatrists and geriatricians.

As well, sensing a void in knowledge among his peers regarding the use of Medical Cannabis in clinical practice, Dr. Sealey has travelled extensively around the world as one of the few instructors in this field of medicine. With the legalization of recreational marijuana across Canada in 2018, he is also an invited keynote speaker at public and professional events for his opinion on the potential implications of this ground breaking decision.

Dr. Sealey resides in Victoria with his wife Lana.

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Contact Melanie Nicholson | Melanie Lynn Communications Inc.

Contact Dr. Rob Sealey

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Transcript

Melanie Nicholson: [00:00:03] Hey, everyone, and welcome to It's A Theory. I'm Melanie Nicholson, and I'm taking you inside the world of leaders and entrepreneurs who are taking ideas and concepts and putting them into action. What really happened when they put theory into practice? Today we're talking about medical cannabis as a method of harm reduction with Dr. Rob Sealey. Harm reduction is an evidence-based strategy focused on safer use or managed use of drugs or substances, meeting people where they're at and not necessarily requiring people to completely stop using a substance. Dr. Sealey has been involved in both the clinical and research aspects of medical cannabis as a substitute for opioids and other substances since 2001. He's a big advocate in tackling misinformation regarding medical cannabis in clinical practice, and he currently practices in Victoria, BC on Vancouver Island. Let's chat with Dr. Sealey. Thank you for joining me today, Rob. I want to start with a bit of your background. I love your story. How did you end up specializing in medical cannabis?

Rob Sealey: [00:01:10] This is a question my mom asked me all the time. She said, what the heck happened? You took a wrong turn somewhere in the back. But, you know, I started out as a GP, so I trained over 30 years ago, went through the usual, you know, medical school and all the rest of it and set up a family practice. And I was doing that for probably about five, seven years before I came across a patient that challenged me. And not that I didn't have a lot of patient challenges, but this one particularly stood out because she was a patient that had chronic back pain and she was on disability. And there became a time when my only function was basically seeing her every couple of months to refill her opiates and she was on high-dose morphine, getting all the side effects related to it. She wasn't eating, she was nauseous. And the other aspect that I was doing was just simply filling out her insurance. And I knew that my role was pretty limited and I was pretty discouraged. And she certainly was as well. But one day she came to me back in 2001, maybe it was late 2000, and said, you know, Rob, Canada is going to have this incredible opportunity to be one of the first countries to allow cannabis for therapeutic purposes to be legal. And I went, Oh, okay, well, that's interesting, but I don't know what that has to do with me. And she said, Well, I want to be one of the first patients, if not the first patient in Canada, to go through the process. And I thought she was joking because I didn't know anything about cannabis.

Rob Sealey: [00:02:37] And I, you know, I still had the stigma growing up, you know, hearing about Cheech and Chong and going to the movies and all the rest of it. You know, it was an illegal substance and we were afraid of it. And we certainly didn't know much about it in the medical world. But she had sort of dabbled underground at that time and was having some success. And she wanted to come out of the shadows and become this patient, this advocate for others. And I said, well, you know what? I have no idea what you're talking about. I have no experience. And she said, Don't worry, Rob, I'll teach you. And I thought, Wow, that was pretty interesting. I mean, she said, I'll come along the journey with you and we can learn together. And I still put her off, you know, for a couple more visits. And she was very, very persistent. And she, you know, got the application in front of me. It took major hurdles, took nine months. We had to get second opinions. We had to get a passport photo. Anyway, she did become one of the first patients. And I was amazed at her response to using cannabis for her back pain was able to get her off of her opiates and get her back to work after she was off work for over six years at that point in time. And this was very, very unusual when a person's been on that long of a disability. So anyways, I did learn from her and after that point I kind of tried it in a few other patients here and there, but I stayed pretty underground.

Rob Sealey: [00:04:02] I didn't want to be that pot doc that, you know, my colleagues would frown upon. And so I kind of quietly did it underground for a while. And then some of my colleagues started to hear that I was doing this and some of them actually complained to the college, thought I should have my license taken away. And I continued to persevere, though, and more and more of my patients were starting to get some benefits. And I started to have some of my colleagues send me their patients. And so I did this kind of referral basis while still trying to keep a family practice going at the same time. So I was sort of seeing patients end of the day or weekends for cannabis, and it became a point where I had such a huge demand. I mean, this is, you know, in the last five, seven years ago that I decided, you know, I can't do both. I'm going to do just cannabinoid medicine. So from there, I'm full-on cannabinoid specialist in regard, there is no such thing. I make it up. I'm probably the only cannabinoid specialist. I've decided that it should be its own specialty. And so I take referrals from all sorts of other physicians and nurse practitioners, whether it be for pain management or addiction medicine. Even the oncologists are sending me some of their patients. So it's become a really interesting field of medicine that I kind of found this niche all because of this patient who really challenged me. And I was very, very thankful that she did that in the first place.

Melanie Nicholson: [00:05:30] And when you think about across the country, like is this specialty still just very, very tiny?

Rob Sealey: [00:05:37] It is. There's a number of cannabis clinics where physicians, nurses, counselling staff will gather together and they'll help navigate patients through the system and coach them on dosing and administration methods and that sort of thing. So there tends to be those aspects of clinics that exist, but there's not too many that I know of standalone cannabinoid medicine specialists. There's a number of my colleagues, there's still not a great number, but you know, a number that will be anesthetists or pain medicine specialists or rheumatologists who will also see patients for cannabis medicine. But this is my full-time gig and I believe I'm one of the very few that does it that way. And again, it's very, very rewarding. But I kind of put all my eggs in one basket to do just that as a specialty. And again, it doesn't really exist as a specialty, but in my world, in my mind, I think it should be, yeah.

Melanie Nicholson: [00:06:39] What's the difference between medical cannabis and recreational cannabis for someone who's struggling to stillphysicians' see the difference?

Rob Sealey: [00:06:47] Well, you know, that's so interesting because even physicians at this point in time, I mean, again, cannabis has been around for 5000 years. We know evidence that it's been through various cultures and various archeological digs that it's been around and purported that it works for this, that and the other thing. But in physicians minds, a lot of them still think it's fairly new. And I think that they believe that because it was legalized recreationally five years ago, just under five years ago, that they believe that was the moment that, okay, now it's legal, we can talk about it. But again, Canada sort of took the bold step way back in 2001. The difference that I see is intent, right? What are you trying to achieve? It's the same plant, but are you trying to use it for fun and for recreation? Much as you know, people would socialize? Versus are you truly using it as a medicine, as a therapy where you want to know a predictable outcome? You don't want surprises. People experiment with recreational marijuana, but when they're using it as medical cannabis, so different terminology, you're looking for a consistent, precise response. Very predictable. No surprises.

Rob Sealey: [00:08:08] I feel bad for a lot of patients out there that don't get the support that they should have from their physicians. And that's for a variety of reasons. A number of physicians still don't feel comfortable with understanding the plant and the different components and dosing, etcetera. And so they'll just say, well, you know, it's legal. Why don't you just go down to the local store and get some? You don't need me. You can just go ahead. But in essence, people end up fending for themselves. And this is not a, you know, necessarily a good thing, especially in seniors with arthritis going down to the local store. And if they're given a product that might actually have more risk of side effects, you know, that's not how we should be doing medicine, really. Like we wouldn't say to people with hypertension or asthma, Well, you know, you can go down to the pharmacy and see what they've got and, you know, treat yourself. So why should we feel the same way just because it's legal recreationally? We should give better guidance when we're using it as a therapy.

Melanie Nicholson: [00:09:13] You mentioned seniors. Is that one of the primary demographics that is using medical cannabis? I think...

Rob Sealey: [00:09:20] It is, yeah.

Melanie Nicholson: [00:09:22] So I wonder, is there a disconnect there that people don't realize that we're talking about my parents' age and forth, pain and arthritis.

Rob Sealey: [00:09:31] It's the number one driving demographic for using cannabis for medicine. Seniors have been around the block and more and more they're not able to get there as fast anymore. With arthritis and aging and all sorts of things that happen to us. And, you know, seniors have tried the various pharmaceutical medications and have either had intolerable side effects or ineffectiveness, and they might have kind of been exposed to cannabis previously and said, Well, you know what, my friend uses it. We talk about it over bridge and there isn't many good treatments for run-of-the-mill arthritis, for instance. Osteoarthritis wear and tear arthritis is pain management. And so more and more rheumatologists and the Arthritis Society of Canada says, well, maybe cannabis might be an option that's better than anti-inflammatories. It can upset the stomach, get bleeding ulcers or, you know, cause renal damage, kidney damage, increase blood pressure. So maybe cannabis might be an alternative option as an analgesic, as an anti-inflammatory in a safer manner. And those seniors with these types of conditions, again, are the number one demographic in, I live in Victoria on the West Coast where people come to retire and I like to say live with their grandparents, like it's a very, you know, we're a prehistoric society on the West Coast here, and there's a lot of individuals that develop arthritis. And so I've got kind of a biased practice on the West Coast because most of my patients are seniors. My oldest patient's 102, but my average-age patient is probably 80. And again, most of those with arthritis and chronic pain.

Melanie Nicholson: [00:11:19] The theory behind harm reduction is that you're sort of meeting people where they're at when it comes to that pain and not necessarily pushing them to stop a form of treatment, like they may be on opioids or something like that, but to give them the alternatives. You mentioned the doctors sometimes there's still a little uneasy on that. There's still a lot of mixed views on harm reduction in general, which medical cannabis falls into. Do you have any thoughts on that?

Rob Sealey: [00:11:50] Oh, don't get me started.

Melanie Nicholson: [00:11:53] We have so many minutes.

Rob Sealey: [00:11:54] We have three, we have three hours. Harm reduction, I think, is a fascinating topic with this. I mean, we used to think of, again, stigma. Cannabis or marijuana was a gateway drug. Right? Oh once you start down the slippery slope, you're going to end up on the street with illicit substances, etcetera. We're now using it the opposite way as an anti-gateway drug, not only from substances that could be, you know, harmful, and, you know, we're even looking for alcohol, tobacco, street drugs, using cannabis to intervene, basically help people feel better through their brain chemistry. And they're not looking for other substances to, you know, give them that feeling. But also there's a huge opportunity for cannabis substitution and polypharmacy. So, so many individuals get stuck into this system where, and again, I was guilty as charged as a family practitioner, a person comes in with, for example, pain. So what do we tell them? Well, Tylenol or Advil, you know, ibuprofen, if that doesn't work, we've got prescription anti-inflammatories. If that doesn't help, perhaps we might go the opiate route. And now people are getting upset stomach or nausea, so we give them an antacid. Wait a minute, the pain is so bad you're not sleeping so let's give you a sedative and maybe a muscle relaxant, you know? So you get into this system of having polypharmacy and every drug has a potential side effect.

Rob Sealey: [00:13:28] Now, put 7 or 8 together, not only their additive side effects, but their drug interaction possibilities. So you can clean up the medicine cabinet by using cannabis for a variety of those symptoms at the same time. And I think that was the big mystery. And I think that was what challenged us as physicians for years, is when people said, I use it for migraines and I use it for epilepsy, I use it for my Crohn's disease. It was almost like, wait a minute, you have an ingrown toenail, does that work for that too? Like, it's like too good to be true? It's snake oil. It's a travelling salesperson. Here we go again, right? Because there was not the evidence of how, you know, this worked. And then the code started to get cracked by scientists in Israel. And in their process of trying to figure out how cannabis interacts in our body, they uncovered a completely unknown system in our body. They discovered for the first time in the 1990s that we have a system called the endocannabinoid system. And I like to geek out and describe it a little bit because if we understand how important the system is, we understand how cannabis interacts with it, all of a sudden it makes sense why we can use cannabis for a variety of symptoms and conditions and again, why people will say they have success with it.

Rob Sealey: [00:14:50] So the endocannabinoid system is the chief operating officer of our body. That's a good way to think about it. We think about the cardiovascular system and the respiratory system and the neurological. All the organs belong to a single system, but the overarching endocannabinoid system - which again was not discovered until 1990s and is only now being taught in medical school, it's that new - its whole job is to make sure all the other systems are working properly. And how it does that is through a system of receptors that are everywhere, whether they be in the brain, the spinal cord, the gut, the heart, lungs, even our skin. These receptors kind of sense the local environment. And if everything's working properly, the receptors are quiet. Everything, everybody is happy. But if it senses that there's pain, there's arthritic pain in the left knee, those receptors will light up and they'll send a message that we need to protect ourselves. We need some help over in this area. And our body responds by producing what are called endocannabinoids, which are neurotransmitters or chemical messengers that rush out to those receptors, attach and shut the door. It shuts the gate on signals that are trying to harm us, like pain, inflammation, anxiety. Well, you can imagine arthritis doesn't just stop there. It's a progressive disorder.

Rob Sealey: [00:16:16] So we keep knocking on the door of the endocannabinoid system to say, help, help, help. And we're trying our best to protect ourselves and produce these endocannabinoids. But eventually we get pooped out. We can't produce enough, our supply gets depleted and in comes, the door breaks down, in comes pain, inflammation, insomnia, anxiety, all the symptoms that happen with chronic pain. Well, where does cannabis fit in? Well, it turns out in the cannabis plant, there's over 500 ingredients of which the most active ingredients are called phytocannabinoids. So plant-based cannabinoids, they kind of have the same size and shape, they interact with the same receptors that we have inside our body. So if our receptors are saying we have a problem in our left knee and our own body can't protect ourselves, we can isolate cannabinoids from the plant and basically supplement, shore up the defenses, and shut the door and signals that are trying to harm us. Well, if you can imagine if those receptors are lighting up in various parts of our body, those cannabinoids can help out in different areas. And that's why it can be useful for everything from epilepsy to migraines to even skin problems. It's that aha moment is if we have a system that basically needs help, we can supplement it with cannabinoids from the plant. And it's funny because people hear about THC and CBD and those are only two of the Phytocannabinoids.

Rob Sealey: [00:17:52] There's 144 cannabinoids. So there's other parts of the plant, you know, terpenes and flavonoids, and they all do a delicate dance. We're starting to learn more and more how they interact. It's an extremely complicated science, but so is the endocannabinoid system. And we're starting to look at endocannabinoid system when it breaks down, it's implicated in fibromyalgia, irritable bowel syndrome, migraines, PTSD, asthma, osteoporosis... The list is going on and on it. We're finding out that the missing link of why we're unable to manage a lot of these conditions is endocannabinoid dysfunction. It just goes haywire or it gets depleted. And that's why the opportunity to use cannabis in a variety of conditions is there. And if we understand how it interacts in our body, all of a sudden it makes sense. It's not just try this mango-pineapple gummy, it tastes great, try a bath bomb, go off in all directions and fend for yourself. That's experimenting. If we actually make it boring, make it predictable, we can isolate the cannabinoids from the plant and basically help out, wait a minute we need help in this area, this is what we would do. That's how medicine works. It's not just, like I say, well, this one's on sale, let's try it. Let's try this one, it's sugar-free. You know, that's too much experimentation and recreational.

Melanie Nicholson: [00:19:18] Is it challenging for people to see it because the science is, I guess in the grand scheme of things, relatively new?

Rob Sealey: [00:19:27] I think it is. A lot of physicians still, like I do a fair amount of lectures and I'll go out and I'll ask, what's one of the questions I say, Okay, put your hand up if you've heard of the endocannabinoid system. And five years ago, no hands would go up. And still at this point, I would say more patients know about the endocannabinoid system because they Google. They have this thing on the Internet called Google.

Melanie Nicholson: [00:19:48] I've heard of it.

Rob Sealey: [00:19:49] Yeah. No, it is. It's amazing.

Melanie Nicholson: [00:19:51] It's fascinating.

Rob Sealey: [00:19:52] Not everything, by the way, is true on the Internet. I just found that out, too. Yeah, somebody told me that yesterday. But apparently if you type in endocannabinoid system, so people when they're researching for their, when they're advocating for their own health, and they've heard from their neighbor that, you know, I take CBD and that and they'll start to research and they'll read about the endocannabinoid system and start going down that rabbit hole. I find more patients do that. Physicians don't necessarily have the time to go down the rabbit hole, so they're listening, you know, they're reading as much journals as they can. And this is still relatively new. Again, not being taught in medical school. So patients will often be further ahead in understanding the science of it than my physician colleagues, for instance. So that's a challenge, right? That's a real big challenge. Yeah.

Melanie Nicholson: [00:20:42] Practically speaking, you write a prescription, do you write a prescription for a patient?

Rob Sealey: [00:20:50] Practically speaking, you would think so, but it's actually not. So technically so, it is not called a prescription. It's called an authorization. And the reason that is, is because it's plant-based. So most of the cannabis that I'm talking about comes from a plant and it's isolated, these cannabinoid ingredients. I mean, there are some prescription synthetic cannabis, but for the most part, what we're talking about when you go down to the store or you have a cannabis oil, CBD oil and that sort of thing, it's plant-based, right? It's isolated from the plant. Because it's plant-based, under the system it does not have what's called a DIN, which is a Drug Identification Number. Those are what pharmaceuticals have. So they, every drug, every blood pressure pill, antidepressant, opiate, all have a DIN. That's an assigned number, makes it very specific. Because it's plant-based, there is no drug identification number and therefore it's not considered a prescription. It's technical terminology, but it's considered an authorization. So if a patient wants to use cannabis for therapeutic purposes, they are supposed to get an authorization from a physician. It's like a valid certificate, which then allows them to purchase cannabis from a medical licensed producer. Now, the vast majority of patients do not do that. 72% of patients just go directly to their local store. But again, you're kind of fending for yourself.

Rob Sealey: [00:22:28] And I'm not throwing shade at the local stores. I mean, it's a good access place. Easy. You don't need a physician. You don't need this authorization paper. You can just go down and see it and talk to the local person. But here's where it gets a little bit murky. The local person is working in a recreational dispensary. So think of it this way: If you had arthritis and you were 85 years old, would you go down to the liquor store and ask them which bottle of Merlot would help with your inflammation? Right? It's the same thing.

Melanie Nicholson: [00:23:06] 100%.

Rob Sealey: [00:23:06] So the other part of that equation is these individuals that are working in the recreational dispensaries don't necessarily have a lot of background in the use for therapy in medicine. They're not healthcare professionals. They, again, are akin to working in a liquor store. Now, some of them know quite a bit. I'll give them that credit for sure. But here's where they're shackled. Under Health Canada rules if a person goes into one of these recreational dispensaries and said, Can you help me with my arthritis and that individual behind the counter, the budtender, says, Oh yeah, take this and take that, they could actually lose their license.

Rob Sealey: [00:23:46] They're not supposed to give medical advice. So again, this is the challenge of when a patient's fending for themselves, they go to the local store where they may or may not get advice. They're not supposed to get advice and who knows what the advice is like. And I've been a fly on the wall in some of these places, and the advice is very variable if it's given at all. So again, the route that patients are supposed to go, and I think works well, is being under the supervision of a physician who can help manage their care, much as we do with asthma, hypertension, diabetes, etcetera. Why not have a health care professional monitor, you know, your care and give you suggestions as required? But I think that people don't understand. Physicians don't understand. A lot of them still will say, well, it's legal, you can, again, just go to your local store. They can help you out. That's not actually the way it should be done. But I think a lot of people still don't understand that you can go through this other channel under a physician or a cannabis clinic and get the authorization, get it from a medical supplier, and be very precise with no surprises.

Melanie Nicholson: [00:25:04] Do insurance companies understand what the authorization paper is versus a prescription? Like can I, if I'm paying out of pocket for medical cannabis for a treated illness or injury, can I submit that to insurance?

Rob Sealey: [00:25:20] That's a great question. So probably only 5 or 6 years ago there were no insurance companies in Canada that would consider the coverage of medical cannabis. That's changed. There was one insurance company that made the bold step after lots of pressure from its members to say, We will cover it under certain circumstances. And then it became a domino effect. Right now, there are 17 different insurance companies in Canada that will consider it under exceptional circumstances. Even insurance, like we have auto insurance in British Columbia, you know, WorkSafe or worker's compensation, they're covering it under certain circumstances. So the world is changing. But when you say exceptional circumstances, there can be some challenges there.

Melanie Nicholson: [00:26:05] What does that even mean?

Rob Sealey: [00:26:06] What does that mean? Some of the insurance companies will come back and say, Give us the DIN. Give us that drug identification number.

Melanie Nicholson: [00:26:13] Great, here's the plant.

Rob Sealey: [00:26:13] Knowing full well that it doesn't have a DIN.

Melanie Nicholson: [00:26:17] Right.

Rob Sealey: [00:26:17] So they'll say to patients, You can provide the DIN, we will consider covering it. Most of them will consider covering it under certain circumstances where nothing else has worked. So you kind of got to go through the hurdles. So, for instance, chronic pain. So if individuals have tried this, that and the other thing and again, either ineffectiveness or intolerable side effects, and you've proven that they've tried all these things and that they've had a positive response to cannabis, that's usually, you know, an avenue that it will be covered. The other aspects of the insurance company to look for is, they say, level of evidence. They'll say, you know, cannabis is used for all of these things, for instance, sleep and anxiety. We know a lot of individuals, I'm sure you've talked to people say, it works for my sleep. It calms me down for anxiety. Right? We've heard this.

Rob Sealey: [00:27:11] But if you actually look through the literature and say, show me the double-blinded, randomized clinical trials with placebo, we don't have that for sleep. We don't have that for anxiety. So a lot of times the insurance companies will say we need the best quality evidence before we're going to consider covering this. Where does the best quality evidence lie? It happens in four conditions, and these are the ones that insurance companies will usually cover, again, if you've gone through all the other standard therapies. Chronic pain, that's by far the number one, especially nerve-related pain. chemotherapy-induced nausea and vomiting. So people undergoing chemotherapy and they're sick, we've got great evidence about how cannabis can be useful for that. Spasticity and multiple sclerosis. Again, lots of evidence. And most recently added are specific types of epilepsy. Some of these childhood epilepsies where no other medications will work, we're seeing better benefits with the use of cannabis. So those are kind of the ones that insurance companies usually, that's what I get, people send me a form and say, my insurance company said, if you fill out this form, they'll consider it. Well, again, they sometimes just say, what's the DIN? Which tells me right away, No. Or they'll say, does the person have one of these four conditions? And if so, what medications have been tried previously? At the very least, patients can keep their receipts as a medical expense on their tax return. If they go through the channel of getting the authorization and purchasing from a licensed producer of medical. Not if they go down to the local store. The CRA kind of frowns on the mango-pineapple chewies. They want to see the medical stuff before they consider it an expense.

Melanie Nicholson: [00:29:04] Where do you go now? What is the next five years look like for this, for this space in terms of education? Is it more research, more science? Like where do we go now?

Rob Sealey: [00:29:16] All of the above. All of the above. I'm so, as you can probably gather, I'm so excited about this field. Every day there's new, interesting research. And I think that's the part, the missing link again it's been the science, and you hadn't had the opportunity to research. It was illegal to research. And in still many countries it remains that way. So the research that we are getting is starting to happen. And so it's basically proving what we thought, which is kind of nice, is we were on the right track and I get together with some of my, I like to call them cannabinerds, and these colleagues around the world. And we basically blog or we share our thoughts or we might have an online webinar, do some research papers together. And it fascinates me that in places like Australia and Israel and Germany, even though we're spaced so far apart, and we're kind of doing it where there's only a few of us in these places, we're on the same path. We're seeing the same things and we're sharing it. It's really exciting to see that, yeah, that's what I see, and that's what you're doing. And this is of course, this is why we do it. And it's nice to have that sort of backup and that reassurance that we are on the same path. But I think the research is only going to get better. And I think what's exciting is, again, we only talk about THC and CBD. If there's 142 other cannabinoids, you're going to start hearing about, if you haven't already, CBN and CBG and CBC, not just the network, but these are all cannabinoids that have their own aspects of how they interact with those receptors.

Rob Sealey: [00:31:00] And we're looking at specifics. What about CBG on the prostate? And so we're getting more pinpoint as far as which organ has these types of receptors and then the fascinating world of the endocannabinoid system and again, unlocking the potential there. And it might not just be cannabis, by the way. The more we understand endocannabinoid system, there might be a better way to alter, or help, or supplement the endocannabinoid system, might be enzyme blockers. And this is what the pharmaceutical companies are looking at. They say, well, cannabis works, you know, but it's kind of a shotgun approach. Can we be more precise and work at the enzyme at this level in the endocannabinoid system? So I think that's exciting. But the future is unlimited. Then there's even looking in petri dishes in the lab, you know, what is it doing to cancer cells? Well, we know that certain tumors have a lot of these endocannabinoid receptors. And so the National Cancer Institute is using cannabis to see what happens. And we're seeing some pretty interesting stuff in the lab. Then we're seeing it in animals. We haven't taken it full, you know, protocols in humans yet, but we certainly are hearing that humans are using it and getting some interesting results. So I think the future is unlimited. I think it's very, very exciting. And I can't wait to see what happens tomorrow because I think it's just happening that fast. Anyways, don't get me, don't get me going.

Melanie Nicholson: [00:32:39] Well, and congratulations for being on the forefront of this space. I mean, you've really been involved from the beginning. You've led the charge. And I think, I can imagine it's so exciting and interesting to see how it's going to progress. So thank you so much for sharing today and helping educate because I think, I mean, I'm a huge proponent of education and information. And I think the more we know, the less scary something might be. And hopefully this helps with that, too.

Rob Sealey: [00:33:07] Thank you very much. That was great.

Melanie Nicholson: [00:33:12] Such a fascinating conversation. And I love hearing about the research that's happening around medical cannabis and also how there's different things coming up. And then we apply it in a different way. And I think we sometimes forget that pharmaceuticals like Tylenol and Advil that we're all so comfortable with, they were there, too, and they started through this process. And it's an important process. Research and science, it's all rooted there. So important. Thank you, Dr. Sealey, for joining us today. Thank you for listening. Please like, subscribe and consider giving us a five-star rating on Apple Podcasts, Spotify or wherever you listen to your favorite podcasts. We'll catch you next time on It's A Theory.