Dr. Daniel Stein, a respected Neurologist opens up to United Patients Group John Malanca, as he discusses incorporating eastern and holistic medicine into traditionally trained physicians’ and healthcare professional practice. He acknowledges that talented doctors bring a combination of the art and science of medicine—which is particularly important when introducing cannabis therapy to western-trained physicians.
Dr. Daniel Stein is one of John Malanca’s favorite go-to Neurologists, who came to the cannabis space a bit later in his professional career as he took note of his patients reported improvement on cannabis.
After researching and learning the science behind this holistic and important plant, he now incorporates cannabis medicine into all appropriate aspects of his treatment. In this podcast Dr. Stein and John discuss a number of neurological conditions and his approach to the use of cannabis along with western medicine.
Watch and learn as they talk about Degenerative Illness (Alzheimer’s and Parkinson’s Disease), Chronic and Acute Pain Syndromes which include opioid dependence and freedom from suffering, and a variety of movement disorders (including Parkinson’s but also other conditions including essential tremor, Tourette’s, torticollis, Huntington’s).

Of interest to our entire audience, our guest discusses the often included qualifiers in nearly all states–Insomnia and Anxiety.

Transcript

Cannabis, Neuroscience, and Treatments for Brain Conditions. Dr. Daniel Stein

John Malanca 0:03
This is John Malanca. With united patients group be informed and be Well, today’s special guest is actually a good friend of mine, Dr. Daniel Stein out of Sarasota, Florida. And here’s a great little intro cannabis got me interested in neuroscience, and now I’m returning the favor. So welcome Dr. Stein. Dr. Stein’s formal studies, including a neuroscience bachelor’s degree at the University of Rochester, New York, a medical degree at Albany Medical College, neurology residency at the Cleveland Clinic foundation and neuromuscular fellowship at the National Institutes of Health. Dr. Stein is happily married to Joyce, who I haven’t met yet, as well as your four four daughters which I haven’t met but I have met a which you don’t add in here is your beautiful dog Brody. So how is Brody Doing

Dr. Daniel Stein 2:00
is good. He’s right over there.

John Malanca 2:02
Yeah, maybe we get a little cameo cameo was ready to. Dr. Stein is practicing. He’s a practicing neurologist in Sarasota, Florida, associate professor in clinical medicine at Florida State University Medical School and is the owner of the I guess your clinic called neurology of cannabis in beautiful Sarasota, Florida. And it’s a great office. I’ve filmed in Dr. Stein’s office, we were there for a week and they did a master class on on on brain. Yeah, the science of the brain and the healthy brain. And but he takes patience. You know, we’re in the midst of COVID right now but takes patience via phone, as well as telemedicine and Chanel still with you. She sure is awesome. She’s wonderful. So if you do give Dr. Stein a call. I’ll leave all that information here. She knows his gatekeeper so be nice to her. So welcome Dr. Stein. Good to have you on The show

Dr. Daniel Stein 3:00
Thanks so much, john.

John Malanca 3:01
So what do you been up to my friend and we’ve done a lot together over the years and and thank you for being open again to come on, on. podcast, your united patients group.

Dr. Daniel Stein 3:13
My pleasure, I’m happy to help spread the word. And, you know, when we did that program with a brain masterclass, yeah, it it helped put me on the radar on the internet radar. So I’ve been getting other calls, doing some writing, doing some other presentations. So, thank you very much for that.

John Malanca 3:32
Awesome. It was always always fun working with you. And then I want to talk about what you’re doing, and your upcoming speaking events as well too, and we’ll get in that too. So, you know, neuroscience, how do you become, you know, a New Yorker making it down? Well, a lot of New Yorkers make it from north to south and so that was kind of silly, but, but how did you get involved with cannabis?

Dr. Daniel Stein 3:58
Well, like Like you said, At the opening, yeah, cannabis got me interested in neuroscience initially because when I went to college with my friends on the first floor of the Gilbert dormitory, we we experimented a little with cannabis and I became very interested in how that all worked, you know, the science of brain and behavior. And there was a major available called bio psychology and that was an old combined degree between biology and psychiatry. So I talked to some professors and we actually put together a new major called neuroscience. And I got my bachelor’s in neuroscience because I was interested in brain and behavior how marijuana affected brain and behavior and that’s how it all started my that was my my entrance into neuroscience studies. Which which is,

John Malanca 4:53
you know, we’ve had so many different conversations here because cannabis normally is taught in school. Especially back then. And so you were kind of ahead of head of the game in studying this and the effects of the brain and, again, which brought you into your career now And so, what have you seen because this is going on 27 years now.

Dr. Daniel Stein 5:17
Right? Well, you know, we’ve been in Sarasota for 27 years and I did my studies in Rochester back in 82. I turned 60 this year, john,

John Malanca 5:25
happy birthday.

Dr. Daniel Stein 5:27
Thank you. Thank you.

John Malanca 5:28
And you look professional because I wasn’t expecting you to put it put put a jacket on especially in Florida, in the middle of summer. And you know, but you look good as as always I turned 53 this year so I’m right behind you, my friend.

Dr. Daniel Stein 5:43
Right on Well, hopefully we will we both have a long way to go and look cool. I think that you know, cannabis is actually giving me a little bit of rejuvenation, you know, professionally, because my neurology practice up until just a few years ago. was focused on traditional medicine. I did my fellowship at National Institutes of Health, I was a clinical scientist in a very conservative sense. Even though cannabis made me interested in neuroscience, initially, my training was strictly Western. And so it didn’t really involve a whole lot of any kind of therapeutics, plant medicine, none of that until recently, and now, this sort of renaissance in plant medicine in the West and cannabis in particular has been a real shot in the arm for me I we’re enjoying it very much. It’s so

John Malanca 6:38
you bring up the the western, I guess, train physicians and so how do you see that combination going because, you know, there is a stigma still as a stigma in this and and I’m liking what I’m seeing that a lot of these medical professionals are kind of opening their eyes to other modalities and doing a commission I mean, I you know, I’m a fan of bringing an arsenal to the game if it if it helps patients.

Dr. Daniel Stein 7:07
I think I think the I think the barn doors open and there’s no shutting it, you know, Western trained physicians are now basically being forced to learn something about cannabis medicine because it’s it’s legal for medical use in 33. States. Recreational I believe still 11 and patients are asking for it. So doctors need to learn about it. So out of just sheer necessity. Western trained physicians who never learned anything about cannabis medicine in medical school, are being forced to open their minds and embrace consultants like myself, so that we all can learn together.

John Malanca 7:52
It’s so what have you seen because your practice is not only you know, people think Brain issues for elderly you know, dementia, Parkinson’s, Alzheimer’s, you’re seeing a whole gamut of patients coming in there, right?

Dr. Daniel Stein 8:08
Sure. Well, neurology, the discipline of neurology, some may not realize includes not only dementia and stroke and things like that, which you were saying, but also back pain, neck pain, Tourette Syndrome, problems with development, autism, and also develop acquired problems, you know, brain tumors, epilepsy, things like that. So it’s the the science of Neurology really encompasses a very wide range of problems.

John Malanca 8:42
And so in your practice, when you have patients coming in there are these patients that are total cannabis, naive patients that that are just looking for something else. I mean, I mean, you’re the name of your practice in neurology of cancer. antivirus just says it right there on your door. And so, you know, what do people say when when I mean this is this, hey, we’re trying to find other things or we saw you on a TV show or, or, you know, another show and you know, and we’d like to see what our options are. How does that work it out.

Dr. Daniel Stein 9:19
I think it’s probably 5050 between cannabis naive patients and patients who have been self medicating in some way shape or form, but want additional guidance and they want to become legal. You know, so so we have a lot of people that have some experience, and now they want to take it to the next level but also, like I mentioned all these other doctors that are referring their patients to me, that are cannabis naive, the older population, for example, and it’s a bit of a dance we do and we have a conversation about candidates therapy because I don’t want to I don’t want to put anybody on the spot. So my usual opening is Something like, we’re going to talk about cannabis today. And you may have some experience with cannabis already. And then they either volunteer that information or not. And then we go from there.

John Malanca 10:13
It’s funny, they use a volunteer because a lot of parents don’t want their kids to know. really well. You’ve been yelling at me this whole time for trying cannabis. And you actually tried it back then. And so, you know, I’ve run into that I even talked to old high school friends that have come back to me say, thank you. And I said, for one, he said, My mom is actually, you know, trying cannabis and I said, Why are you thanking me? Like, I’ve been trying to tell her for years, but of course, she comes you, john. And, you know, and that makes it okay. And I feel sometimes like, you know, I’m not a parent, but I’m an uncle. And so I get my little nephew to do things that mom and dad can’t get him to do. And so I think having, you know, that support system and sharing Now that it’s, I don’t say widely accepted in the medical Route Route, but having a doctor talk about it, because not all doctors are open to this. And I say that because I work with a lot of retirement communities. And I asked that question, how many of you have had this conversation with your doctor? And some hands, some hands go up other ones saying, you know, I had this conversation and my doctor says, you know, if I hear you using this, I’m gonna ask you to get another doctor. And I just think that’s wrong. And I don’t want our listeners or patients out there and I always tell them, even if you live in, in a illegal state, it’s not illegal to have that conversation. And if you don’t have if your doctor is not open to it, ask him or her. Do you have any recommendations of other doctors in this field that recommend cannabis and I’m certain that happens with you. You must get recommendations from other doctors in your field to say I’m I’m not up to speed on cannabis in the brain. But I know Dr. Stein is and and you know, here’s his number and give him a call. And so I’m assuming that I think we talked about that that you do get a lot of recommendation referrals from other doctors in

Dr. Daniel Stein 12:16
your area. I do and I’m happy to see those patients and and very happy to see those doctors being open minded. And I you know, the tide is definitely turning so yeah, we’ll see less and less of those, you know, those prohibitionist attitudes so so that is that is definitely changing

John Malanca 12:36
you know, in Florida is coming around to you know, I’ve ever back that a Florida and Texas we had a lot of patients that would call us from Florida in Texas, saying you know, we don’t have access and then when Florida opened up, you know, you have a lot of your snowbirds that come down, you know and are happy to treat and that’s another another thing we talked about it becoming a cannabis refugee when you really don’t have to become a cannabis refugee. But let’s get back on what your your practice is about the neurological side and the neuro conditions. One that comes up quite a bit lately. And it was shocking to me that this is one of the top I don’t say killers, but I guess you could say killers. I was thinking it was cancer and other things. But Alzheimer’s and Parkinson’s is on that list of the top three or top five. killers in adults, right?

Dr. Daniel Stein 13:29
Sure. Well, it’s, you know, those are the the most common degenerative illnesses we call Parkinson’s and Alzheimer’s, degenerative illnesses, because it’s a progressive age related loss of function. Over time, there’s more and more problems that developed. So those are the most common degenerative illnesses in adults. Yes.

John Malanca 13:53
And why? Why are we seeing more of that today than we did? Growing up, you know, when we were As your kids age,

Dr. Daniel Stein 14:01
I think there’s a few reasons, you know, people are aware of it for starters. So you know, we have better diagnosing and better communication. So we’re just hearing about it more. Plus the population is living longer. So, you know, if you live long enough, chances are, you’re going to lose enough nerve cells, even you and I, eventually, and then develop one of these degenerative illnesses. You run out of dopamine, for example, and you’ll get Parkinson’s. You run out of acetylcholine. These are neuro neurotransmitters, and then you’ll get Alzheimer’s. So or something similar, and I think a lot of it has to do with education. Oh, people are getting educated about it, and we’re living longer and we’re doing better at making the diagnosis

John Malanca 14:49
is it’s funny, I’m going to go off a little track here. I’m reading a book and I was thinking about the other day is into the magic shop by Dr. dodi, Dotty. And you know, he’s a neurosurgeon. I know. It’s all with the brain. But anyway, when I was reading that I was thinking about, you know, the thing I recently found out too is the eyeballs are the only part of the brain that’s out of the skull.

Dr. Daniel Stein 15:18
Oh, that’s the only part of the central nervous system

John Malanca 15:20
that you’ll never see. But but but it’s connected is part of the brain.

Dr. Daniel Stein 15:23
Yes, most definitely.

The are the gateway to the soul, remember?

John Malanca 15:28
Yeah, yes. So

Dr. Daniel Stein 15:32
yeah, definitely. Very good.

John Malanca 15:34
And so I see I mean, I, you’re in my mind, we haven’t seen each other for COVID. But I think about you quite a bit and learned a lot over the last few years of working with you as well. You know, with Alzheimer’s and Parkinson’s and we’ll tie in, in, in in dimension so share, can you share how they’re all connected because dementia and Alzheimer’s and they’re all kind of intertwined with each other, correct?

Dr. Daniel Stein 16:05
Yes, in that broad category of degenerative illnesses. And that’s, that’s something that I think most of your listeners will have some connection to either with, you know, a family member or with personal concerns because everybody gets old God Willing old enough, and then something happens. So, degenerative illnesses like Parkinson’s and dementia and other conditions like Huntington’s disease, for example, are age related loss of nerve function, which we’re still trying to understand. And one of the things for example that we’re learning is that oxidative damage to the nerve cells for which people take antioxidants like vitamin E, vitamin C, yeah, and help protect the neurons and cannabis is a very potent antioxidant. So experiments, bench experiments not so much clinical but preclinical experiments we’re learning that the antioxidant properties of cannabis may help slow down degenerative illness by way of being antioxidant. And one of the things I like to at least amuse myself by thinking about is the Neil Young’s the Neil Young album and song you know that rust never sleeps you know how Neil Young talks about rust never sleeps? Well, that’s oxidative damage. Yeah, what is oxidative damage to iron and rust never sleeps because it’s always been an oxidative Lee damage then. And that’s what’s unfortunately, going on in our brains and bodies. Yeah. And if you can reduce oxidative damage, perhaps by using cannabis in a prophylactic way to prevent and protect, prevent damage and protect nerve cells. I believe that there’s a chance that we can at least delay enough nerve damage to preserve nerve function that’s one of the really exciting parts of cannabis and neurodegenerative disease.

John Malanca 18:10
So, Wendy, Wendy, in your opinion, when do you think that type is, you know, that rust you know, effects starts happening in our brain and nerve jamming, degenerate damage, Is it 20 3040 5060 7080 or even where is it all the above

Dr. Daniel Stein 18:30
all the above rust never sleeps, john when Wow, when you’re born? Yeah, the metabolic machinery in your body produces these oxygen radicals that are called these oxygen radicals are molecules of oxygen that need to bind to something. They’re they’re radicals they’re open, they’re like ions. And these oxygen radicals are produced as a part of normal metabolism at any age. Your body has to handle those oxygen radicals with antioxidant functions to maintain cellular health and so that’s day one to the to your last day, your body is handling oxidative damage.

John Malanca 19:15
So incorporating cannabis for a patient to incorporate cannabis into their protocol for prevention if you want to say because topic comes up

Unknown Speaker 19:26
of,

John Malanca 19:29
you know, an adolescence brain. When is it when is too young too young to try cannabis? You know, and your recommendation is, from our previous conversations, generally isn’t always about smoking. It’s more Are you are you still with the sublingual absorption that way? or What are you looking at nowadays?

Dr. Daniel Stein 19:49
Well, you know, especially in the time of COVID, you want to protect the lungs as much as possible. So yes, in general, inhaling your cannabis therapy may Not be, you know, the best way, especially, you know if you’re younger if you’re old and have pulmonary issues. Yeah, and you don’t have to inhale cannabis to get the effects so it’s it seems to make more sense medically to use things like tinctures and capsules, edibles things like that.

John Malanca 20:20
It because cannabis so why, you know, it’s funny, I always talk about this. You know, six months ago I was saying there’s about 113 different cannabinoids. Now I met the 140 mark on cannabinoids. And generally I’m seeing 120 to one 160 where are you on that lineup?

Dr. Daniel Stein 20:42
I’m there with the 140 you know I I recently saw some articles by Dr. De Marceau Vincent de marzo and DD marry from technicon. Yes. And, and they’re in the 140 range. And that’s kind of where I’m taking my cue on that. And just so just I just want to go back Just to cover this one thing about inhalation therapy. Yeah. Because I know there’s people out there that are saying to themselves, no, I don’t agree inhalation is the way for me. And the answer is to that. Yes, absolutely. There are situations where inhalation is the best way. And of course, this is very independent medicine people choose their own route of administration, and I love that. But in general, for medical care, inhalation therapy is preferred, if you need immediate response. So let’s say you’re having a migraine, you’re not going to sit around and wait for an edible to kick in you need to inhale your medicine. Get rid of that migraine, and and be on your way. So there’s a there’s, there’s a time and a place, I think, for each of the administration methods, but what we were talking about before in terms of preventative Yeah, they occident Health Maintenance type of thing. Don’t think you need to inhale to to achieve that.

John Malanca 22:03
So that the quick oxygen and so that’s why I was going in with the cannabinoids because we really had spoken about the cannabinoids leading up here. And are you seeing some of the cannabinoids for our listeners that are cannabis naive or not in the cannabis plant cannabinoids are well I say the most popular that everyone knows is THC. THC has been around that’s a that’s a cannabinoid CBD which you’re seeing everywhere nowadays is another cannabinoid CBA CBG CBN. They have all 140 of these cannabinoids have their purpose. The goal is not to get high. People think I want to I want to stay away. I don’t want the recreational part of the plan. I want the medical part of the plant. I personally believe that they’re all they all have the benefits of being medical in some way or some way or form. Wine you know my brother has been in the wine before. for 30 years and so you can have a sip of wine or you can have three bottles of wine sipping wine, you’re not going to feel anything three bottles of wine, you’re definitely going to feel something and the same thing with TC, you know, TC is very beneficial. At the same time, you can have minute amount two to five milligrams, 10 milligrams depending on how your body reacts to that and still have some great success. So in your practice, Dr. Stein with preventative Are you incorporating the other cannabinoids?

Dr. Daniel Stein 23:28
Yes, and use and and using mainly whole flower and football? Yeah, because we don’t, we don’t have a good extraction method that that is equal to what nature provides. And if you could extract all the cannabinoids and recreate the balance of whole plant,

John Malanca 23:53
whole plant so when you’re excuse me when you were saying hello, fly, I’m thinking I was thinking that you were getting the flower and the bud and in And smoking but yeah, I’m with you whole plant.

Dr. Daniel Stein 24:03
Yeah, so that’s where all the cannabinoids live. Right. And so, you know, I think it’s, I think at this stage in the science of cannabis medicine, we don’t know which combination of cannabinoids works best for which conditions we just don’t know. So you can break it down and use THC or CBD or, you know, CBG. And I think that’s fine for some things. But in general, since we really don’t know, it’s, I think safe and more likely to be effective to use the whole plant when possible.

John Malanca 24:37
And I like I said, it’s not a one size fits all. So what works for me may not work for you or your other patients that have the exact same you know, senior male, early stage Parkinson’s, or dementia, one may have success with one formulation or ratio or cannabinoid, while the other one might find have something else. So finding that sweet spot is really important. That’s why I’m a big advocate and big fan of having a medical professional involved. When it comes to recommendation of cannabis, you know, because you do look at the age of the patient way to the patient, the sensitivity the patient, what they’re going through, and a lot of cases that drug to drug interaction too. And so with your, because Parkinson’s dementia and Alzheimer’s, it’s such a big topic right now. What are you seeing? And I know again, I’m kind of second guessing myself, because it’s not a one size fits all. But what do you what do you what are you seeing with your patients that are that are, I guess, having success?

Dr. Daniel Stein 25:41
It depends on what they want to achieve, you know, everybody has certain symptoms that bother them the most. And now we’re not talking about slowing down the underlying disease process which is the for example, the oxidative damage, but rather symptomatic therapy. And that’s really the reason most people come to the clinic, they have a symptom. They want to treat it. And we can talk about, you know, general health, maintenance and all that. But mostly people come in because they have a symptom. They can’t sleep, they can’t eat, they, they’re restless and agitated. They they drool too much. You know, there’s all these different symptoms that bother people in those categories of Parkinson’s and dementia. And we address those, you know, one at a time and try to come up with an effective treatment protocol to address that particular symptom.

John Malanca 26:39
And are you seeing I always see reversal, but are you seeing success in slowing the progression down?

Dr. Daniel Stein 26:49
No, I can’t say that we are. You know, it’s, you know, in order to see a decrease in progression. You really have to Follow patients for at least two or three years. And you have to compare them to other patients in a similar situation. It’s difficult really to demonstrate that in the clinic.

John Malanca 27:12
And so with somebody that has maybe it’s it is this topic always comes up, you know, is it hereditary? Is it hereditary?

Dr. Daniel Stein 27:24
Some of these degenerative illnesses are hereditary. There’s a, there’s hereditary forms of Parkinson’s, Alzheimer’s, and of course, Huntington’s. But there’s also sporadic is the other way it goes sporadic cases are those cases that develop without a genetic predisposition, as far as we know. So the answer is yes. and No.

John Malanca 27:47
in how does it work on the brain, I had an email who this is a lady that actually wrote us in contact me from Germany and she saw us on our master class and So she was asking a question I said, Actually, I’m going to be on with Dr. Stein today. And and what’s your question? And I’ll ask, so she say, Hey guys, for someone, a friend who has been diagnosed with early Alzheimer’s, if he does a cannabis therapy, vaporizing one to one ratio of THC to CBD, how likely is it that the TC will compromise his short term memory while hopefully reducing the inflammation in his brain? What I’ve read and heard in your classes and presentations, that cannabis therapy is helpful holding off dementia. While the short term memory aspects don’t get mentioned. And I’m almost done here. After one year my friends cannabis therapy, his short term memory has gotten worse, at least not better. We don’t know how his inflammation has improved. He for now has stopped the cannabis therapy. I did look for case studies on this but could only find indications that there is not enough studies and they need to be completed over time. So can you add to that and help help help answer that question?

Dr. Daniel Stein 29:06
I love that question. You know, that’s an educated consumer right there. Yeah. You know, we we all know she watched she watched her course that’s why Oh,

yeah, right on. I know.

John Malanca 29:19
But yeah, no, that’s it. That’s. So Ingrid has followed us and so yes, if you

Dr. Daniel Stein 29:24
so the the well known effect that cannabis reduces short term memory turns out not to be as much a problem in most older patients as you might think. And I can tell you personally, when I first started using cannabis therapy in patients with early Alzheimer’s, I was concerned that their short term memory would get much worse as a result. And if you’re careful and don’t use too much THC, it doesn’t turn out to be that much of a problem. And if you can Use a plant extract or a whole plant, a product that has pining which is one of the terpenes. That medicine that medicine, that part of the plant medicine actually can enhance memory, because it provides the opportunity for more acetylcholine to hang around the neurons. So pining can counteract the short term memory effects of THC. And so that’s a that’s something that that particular listener and maybe some other people in your audience might be interested in. Yeah. In general though, the the dude, where did I leave my car problem? Doesn’t seem to be that obvious in patients with Alzheimer’s, maybe because the nerve cells in their hippocampus are not working that well to begin with. I don’t know. But it doesn’t turn out to be that much of a problem.

John Malanca 30:56
Well, I’m laughing here what why is it that so Sometimes when you use cannabis, you remember things you’re like, Oh my gosh, I would never why. What brings that on? Yeah, well during the news, dude, where’s my car?

Dr. Daniel Stein 31:11
Yeah. You’re talking about during the cannabis experience you have and

John Malanca 31:15
you’re like, Oh my gosh, if I wasn’t on cannabis right now or intoxicated, I would never have thought about that. And I would have forgotten it. I mean, how does that work out?

Dr. Daniel Stein 31:24
All right, john, I’m going to give you a memory physiology lesson here that you’re going to really enjoy. Okay. There’s two parts to memory function. One is registration, you have to put the information in and the other is retrieval. You have to get the information out. And if either of those are not working, you have a memory problem. Okay? Now, some people have a problem with registration. They don’t put the information and they’re distracted. They’re not focused. There. Their hippocampus isn’t working. They can’t really Register information. And if you can’t register the information, there’s no way you can recall it later because it’s not in there. Yeah. But there are some people that have the memories registered, but they can’t pull them out. And that’s the part that I think you were just mentioning those memories, those thoughts are in there. But they’re not accessible until you use cannabis to maybe open up some of those parallel networks. And then you can access those, those memories and those thoughts through different pathways. So you’re retrieving memories better when you’re high, let’s say and, and patients that have memory issues when they’re smoking cannabis are probably not creating the memories well enough. It’s not so much the recall as it is they’re not generating the memories.

John Malanca 32:54
So that’s like a hard drive on your computer that’s full and you do a What do you call it? A systems Reload, where they kind of like, okay, we’re opening this up and we’re gonna bring all the memory back in there too. So like, Hey, what’s that? So there

Dr. Daniel Stein 33:07
you go, yeah, you can’t retrieve what you never saved in the first place.

John Malanca 33:13
And sometimes it needs to opening open the mind and open the

Dr. Daniel Stein 33:16
mind can access those memories. But if you’re too distracted, and there’s too much going on, you’re not going to create the memory and then that’s it, you’re not going to be able to retrieve it. So gotcha. The two parts

John Malanca 33:30
lesson by Daniel Stein.

Dr. Daniel Stein 33:33
I didn’t come up with that. I’m just, I’m just the vehicle here. China passes through.

John Malanca 33:38
I like I like the vehicle. So let’s let’s talk about me, we can go on for hours and hours an hour to me. We talked about CTE. We can talk about you know, pain, autism. Let me go back in here, you know, I was I was listening to a podcast with Joe Nemeth Famous Joe Namath, you know, New York Jets. And were you just fan from being up there? Are you? Uh, john was?

Dr. Daniel Stein 34:06
No, I was actually a Jets fan. Yes, sir.

John Malanca 34:09
So with all the keys had about, I want to say eight to 10 different concussions and an eight to 10 different eight to 10 concussions in his lifetime, I believe is what i would i read when I recall what he was saying. He was doing some hyperbaric chambers actually down in Florida. And they showed from the studies in scans, that the white spots were rejuvenating itself. Is that, you know, I heard that I, you know, a few months ago, I was like, I can’t wait to get on this call with Dr. Stein. And we can talk about that. Have you heard about that with hyperbaric in regenerating the brain?

Dr. Daniel Stein 34:46
I have, and I’m not sure that it’s a genuine therapy ready for primetime?

Unknown Speaker 34:53
Exactly. Hmm. I you know,

Dr. Daniel Stein 34:56
it depends a lot of what you’re referencing depends on how the brain is studied, you know, if it’s the white spots, that’s usually what people refer to when they see the MRI scan. Yes. But if you’re doing a more sophisticated measure of amyloid plaques, which developed from multiple concussions, then you’re going to you’re going to need a PET scan. Okay.

John Malanca 35:20
And I don’t know when he had,

Dr. Daniel Stein 35:22
yeah, so if so, you know, if someone is doing a hyperbaric treatment, because they suspect a problem with circulation, they could certainly see, at least theoretically see some improvement in the circulation on the MRI scan, based on some of these signal changes the white spots, but does that really pertain to the amyloid plaques that we see in you know, recurrent head injuries like an athlete, so I’m skeptical, can you tell? I’m skeptical?

John Malanca 35:56
Yeah. Yep. And I think you’re Your buddy over your right shoulder is a little skeptical.

Dr. Daniel Stein 36:03
That’s right. He did hyperbaric didn’t help him at all.

John Malanca 36:06
Ah, that’s great. Hey, where’s Mr. Lennon? I’m used to seeing john lennon up on your walls. He in the other room.

Dr. Daniel Stein 36:13
He’s at the house. Actually. He’s at the house. We brought him up. Yeah, I should bring him back. I knew you’re gonna ask about

John Malanca 36:19
Come on. I’m a big I’m a big john lennon fan. Well, thank you for that. And I know in your office and so any athletes that are listening to Dr. Stein works a lot of athletes as well. For for these head injuries. You want you want to go into athletes and head injuries at all. And before we move on to some other disorders, you want to stick to stick to some other things.

Dr. Daniel Stein 36:41
I think head injury is an important topic, you know, you know, not just for professional athletes, but you know, for kids that are, you know, trying to, you know, preserve neurological function. Their parents are really trying to preserve it for them. You know, what, what do we know about repetitive head injury in football, for example, and whether or not that translates to cognitive problems later on, and I think the science continues to evolve. I know it does. And we’re learning more about it and the rules that the NFL changed over the past five and 10 years to reduce the risk of concussion. That’s all being adopted by the, by the, by the clubs that are, you know, caring for these kids that are, you know, playing, playing on the weekends here in town. So, you know, I think it’s an important topic, but I think the science is going in the right direction, and we will see less accumulated brain damage as a result of these repetitive traumas as we go forward. I that’s another I think, popular topic where the science is going in the right direction, and it’s something that people are learning and so I’m, I’m happy the way things are going with that.

John Malanca 37:58
Do you think because I know There’s talk about, you know, stopping Pop Warner football and youth football. But football is America’s sport, I think I don’t think it’s going anywhere. And it’s looking to take on in different leagues in different different countries right now as well. And so, you know, I think they’re, they’re building these helmets to help, and I know it’s helping, but are they on the right path for long term.

Dr. Daniel Stein 38:33
So the helmets don’t help as much as you might think. Even though a lot of really smart people are creating better helmets to reduce the amount of force that gets to the brain. The problem with concussions for most cases is that is the shaking of the brain in the skull. So the helmet could prevent skull fracture, for example, and it can absorb some of the energy so it’s not transmitted to the brain. But it’s the stop and start that really causes the nerve damage in most players and so the brain gets shaken up even though you have a helmet on and that’s what causes the nerve damage and you know that were that we’re seeing most often. But just as an as an interesting aside, I want to just share with you my rugby patients story because what I learned and I found really interesting was that rugby players who do not wear helmets have pads. Yeah, or pads like football. They have less concussions than American football players because they they just take better care of their heads they the way they tackle and block and so forth. They they move their head to the side so they don’t have that head to head collision. So when you have a helmet, sometimes there’s a false sense of security you feel kind of impervious Because you have a helmet on, but that’s not true. You have to still protect your brain you have to keep your head up when you tackle. You don’t want to, you know, put your head down and spear. Yeah, you know. So I, it’s really interesting the way it’s going but I think it’s going in the right direction then and the accumulated brain damage will be less if we can do the studies now again with PET scanning to look at amyloid plaques because that’s the pathology that develops in patients with chronic traumatic encephalopathy. You mentioned CTE and and that’s the that’s the condition That’s so scary for so many of these athletes.

John Malanca 40:36
Yeah. Which, again, leads into other things were like acute pain and opioid dependence. And can you talk about chronic and acute pain? syndromes?

Dr. Daniel Stein 40:50
Sure. Oh, that’s a huge topic. You know, athletes just to kind of create the segue have pain. They get they get Beat up real bad and they have learned that cannabis works well to control pain, but they’re at risk for losing their contracts. If the league that they’re, you know, enrolled in that they’re employed by have these, you know, old, you know, cannabis prohibition laws so we’re seeing a change as a change in the league’s being more tolerant of cannabis use for medical purposes like pain control, so that these professional athletes don’t have to take opiates. And and cannabis is so much safer than opiates that it seems obvious to almost everybody except a small minority of what we call the Neo Neo prohibitionists. So that’s a whole nother topic, but in general, cannabis is very effective for pain control. And for the most patients, if we can get them off opiates, if they’re dependent or addicted to opiates, we can transition that To cannabis and they do find

John Malanca 42:03
it easier on gut liver everything else throughout the body as well and and bring bringing down the dependence. You know I’ve had a few people on our show recently talking about the benefits of opioids that are prescribed and following the way they’ve been prescribed that there is there they are having some success some some patients and knock on wood I’m not one of those that is in pain 24 seven, some of fibromyalgia patients, you know, some Crow’s patients, you know, where they’re able to even combine cannabinoid, their therapies with with opioids and habit having success. Do you ever work with that? Are you is that part of your practice at all in combination? Are you more let’s go the more of a natural route.

Dr. Daniel Stein 42:49
So I listened to that podcast john good.

John Malanca 42:51
Okay with Claudia Miranda and Beth das, okay.

Dr. Daniel Stein 42:54
And and I appreciate where they’re coming from. There are patients that are opioid dependence to control their pain, the same way that people with high blood pressure are dependent on their antihypertensive therapy. It’s not a bad thing to be dependent. If you if you’re using a medication and it helps you, and you need it and you’re dependent, that’s fine. That’s different than addiction. Addiction is when you have a psychological drive to use a particular substance, even though it’s detrimental to you. So that’s different. So if you’re opioid dependent and you’re getting along fine, I don’t see a problem with that. As long as there’s no addictive related, you know, social and psychological problems. If so, people come to me and they’re, they’re interested in cannabis therapy and they’re completely happy and healthy on their chronic opioid therapy. I’m, I’m okay with that. You know, it’s, it’s okay. And I think that your guests during that podcast that you recently published, really, you know, they they shared that message loud and clear. They also, were talking about how the opioid crisis may be amplified or overblown by a group of people that are stakeholders in that industry. And and that is true. We have had pharmaceutical companies promote opioid use among doctors, groups of doctors use it because they get rich from prescribing it. So there’s a lot of bad actors out there that are part of this opioid conundrum. But there’s also a lot of people using opioids that are addicted that want to come off. That’s the way I kind of look at it all.

John Malanca 44:46
And cannabis can help with that. Yes, sir. Absolutely. Cannabis can help with that.

Dr. Daniel Stein 44:51
I believe it can send and we have research that shows that it can and we’re starting to understand exactly how that works, which is so exciting.

John Malanca 45:00
You know, we have a lot of rehab centers that call or patients that are in the rehab centers, they call and they’re, they’re trying to get off of one substance. And they’re they know that they can have success with cannabis doing it but still because it’s a federal schedule one federal one scheduling one schedule one substance, they’re not allowed to have it. And, you know, and so, you know, they’re looking at it as Okay, you’re getting off one illegal narcotic to try another one. And so, you know, and, you know, disappointing because I’ve listened to doctors talk about that in the benefits of cannabis helping to get off of pain medicines and other opioids with success and ease easier on the body. So hopefully, a lot of the study that’s going on not only in your practice, but also with cannabis in Being beneficial for helping pain patients get off of opioids that maybe are doing more harm than, you know. Bring this talk talk to the top of the top of the level here. I think so

Dr. Daniel Stein 46:14
I think that, you know, there’s a disconnect between policy and laws and and what’s best for people. You know, we know there’s a disconnect there. And the whole scheduling of marijuana back in the 60s with Nixon as a drug that has no medical value and high likelihood of addiction is complete nonsense. So we need to eliminate that whole scheduling, you know, paradigm and replace it with something that’s, that’s more realistic.

John Malanca 46:48
It’s nonsense, really. We’re seeing that, you know, the scheduling. I mean, it’s like you said it’s legal in 33 states. You know, it’s been illegal in the state of California, the medical level since 1996 and 2018. became recreational Oh, but 1996 you know, I mean, it’s in if we didn’t live in a you know our story of Colin’s father with with stage four lung cancer metastasized to his brain, you know, we didn’t live in a legal state, we would have even had that opportunity. It wouldn’t have come it wouldn’t have been in our conversation. And, you know, thank goodness, you know, it worked on it. You know, but the only reason it worked, I should say the only reason worked one reason why it worked is we were able we could legally obtain it. You know, yeah, we had legal access to it. And so hopefully, some of this red tape will drop to the wayside with this upcoming election and prime election after that, and hopefully, it’s no more than two that it will be available for a lot of patients because I know you know, when Florida became legal boy, oh boy. You mean that we used to we used to get received calls from so many Floridians Help, help, help, help help. A lot of Floridians, you know, that I still speak to on a regular basis and those times would drive out to California. And however they got their medicine home for their loved one, they did it, you know, and now a lot of these patients don’t have to leave their their state and don’t feel like a criminal and doing it too. So you know, so you talk to your senator, talk to your your, your your local council men or women and and see if you can get you know, get this on the ballot, wherever you live. And you can also everyone go to their department of health web pages for whatever State Department of Health Florida Department of California Department of Health, Oregon. And you can see where your cannabis laws are, what’s acceptable, what qualified conditions you have, you know, and where you where that falls in and, and who to write to if you have any questions. Let’s go with the you know, the topic of Parkinson’s comes up quite a In movement disorders, Tourette’s is another thing. You want to talk about what you’re seeing in your practice with those patients.

Dr. Daniel Stein 49:10
Parkinson’s is very common. It’s a, it’s, it takes different forms and in different patients, different treatments are needed. And cannabis does not always work in Parkinson’s. So for example, Parkinson’s patients often have a problem with balance, and and they’re stooped over and they’re shuffling, and they fall all the time. Cannabis does not really help with that, unfortunately. But if they have a painful muscle stiffness, and you use cannabis, it can help the muscles relax, they can get a more restorative sleep, they can exercise better, and maybe it can improve their overall health and mobility by loosening up the muscles but that’s duped. shuffling type of motor dysfunction usually does not respond all that well to cannabis.

John Malanca 50:05
Even speech, my my aunt’s going through this with a Mako, his wife, my aunt, you know, she’s going through this and he says, you know, her speech is like, almost like she has a stroke, but also like she’s drunk, and they’re not using cannabis. So can this help?

Dr. Daniel Stein 50:25
So the speech with Parkinson’s patients is usually low volume, and there’s no inflection, it’s very monotone. So I’m going to give you my Parkinson’s impersonation right now. Okay. So I’m talking like this. I’m talking very quietly and I my speech is not going up or down. It’s just staying in one volume and one tone, and sometimes it’s hard to understand what I’m saying. So there’s speech therapy for patients that have that problem. There’s A therapy program here called loud ello UD because patients with Parkinson’s look like they might have had a stroke and their speech is affected. But if they can project the air through their lungs and larynx and out, they can do better with their speech. Cannabis I haven’t found particularly helpful for that specifically, but what cannabis can do is increase the animation level. So patients with Parkinson’s, their facial expressions are are reduced and they they they don’t look animated. They look. They look like they have a mask on. In fact, we call it that we call it a masked faces. And cannabis can help improve that somewhat. But dopamine replacement therapy with cinemate, one of the old standard pharmaceutical drugs, works great for that. So I think the key to treating a Parkinson’s patient is is integrative using conventional therapy like dopamine replacement, and also cannabis where it’s helpful. For example, cannabis can work Quite well, for a sleep disorder that Parkinson’s patients get. It can work very well for a condition called dyskinesia, which is a an involuntary muscle spasm, or tremor. These are also involuntary muscle contractions. So, cannabis works really well to reduce dyskinesia in some patients, tremor, it can help with sleep, but it doesn’t work all that well for the postural and balance problems.

John Malanca 52:31
You mentioned sleep. You know how important is sleep? I know how important sleep is. And a lot of times this is almost like a domino effect when you don’t have sleep. All these other ailments that you may be going through can intensify. You know, pain may be one of them your balance, stress, anxiety. And so can you talk about the benefits of cannabis and sleep and insomnia?

Dr. Daniel Stein 52:56
Sure. Well, I’m going to break it down, john. This is the way I analyze all these things. Question. I’m breaking it breaking it down. So in Parkinson’s patients, they have a unique type of sleep disorder that affects the REM cycle, okay? And those individuals are not paralyzed. You know, during REM sleep, you’re supposed to be paralyzed, and your eyes are moving, but the rest of your body is still and you’re having lots of dreams. But Parkinson’s patients have this REM sleep disorder, where they’re no longer paralyzed and they’re acting out their dreams. They’re punching and kicking. They’re, they’re doing all these kinds of crazy movements. So that’s one type of sleep. That’s important to restore. Because we know that REM sleep is so important. So that’s one thing. But then if you take someone else that does not have Parkinson’s that has problem with falling asleep, cannabis can be very, very helpful. Well, you know, there’s so much sedated and relaxation properties to cannabis that’s high in your scene and linalyl Most of the cannabis varieties out there are very high and missing. And that’s why we call them quote indika varieties, because they have a tendency to put you into couch as they used to say. But truth be told, it’s really more about the chemical composition that makes indika indika when you’re talking about effectiveness, and then we’re talking about nursing, and so if you have trouble falling asleep, you want a cannabis product that’s high in mere scene and linalool to help you relax and fall asleep. And then there’s people with sleep maintenance problems, so they fall asleep fine, but they wake up every two or three hours and they can’t get back to sleep. So those individuals do better with edibles because it helps them stay asleep because it lasts throughout the night. Instead of just you know vaping or using tinctures which were off after a few hours so you know depending on sleep problems with initiation or maintenance REM sleep disorder, there’s all these different types of sleep disorder that you have to unpack, figure out and then design your therapy specifically for that individual.

John Malanca 55:09
Do you ever share with your patient that have that interruption REM sleep, that take an edible? Have something by the side of your bed? Because if you did good and get up, have a glass of water, go to the restroom or wake up? Sure, take some morning help you help you go back to sleep.

Dr. Daniel Stein 55:27
Absolutely. Absolutely. edibles not so much in the middle of the night because it takes 90 minutes to kick in. But if you if you have a fast acting edible, you know, some of the products coming out now are these emotions that make the cannabinoids water soluble and so you can swallow them and they get absorbed in the upper part of the GI tract and they work relatively quickly. So that’s pretty cool. But you know, usually it’s inhalation or tinctures that you want to use in the middle of night because they they kick in faster.

John Malanca 56:01
A couple times you brought up terpenes and I’m a big fan of terpenes and for our listeners terpenes everyone knows what a terpene is. is basically stop and smell the roses and that you know I stop and smell roses wherever I am in a briefing back to my grandmother, childhood, she was a rose, the rose Queen, and you know but smelling that smell, it brings me back to that. Everyone has essential oils, you know going in you know, that’s a big thing right now essential oils, stopping and smelling a citrus, a lemon, a lime, you know, those are different terpenes lilou which is lavender helping for calmness for sleep. And so each of these terpenes have healing and medical benefits just like the different cannabinoids do in a lot of companies and a lot of are in I guess making products in combination, a lot of whole plant as you were talking about, you know, already has the natural terpenes in there. I was talking to a doctor recently and, and I thought it was great is they would have, you know, lineup of cannabis there and they would let the patient smell smell and which one The Patriot patriot was really drawn to is you know, as they said, well let’s try that with you. And they’re having success from what that the terpene was drawing them to that that that certain I don’t like to say strength is strains I can grow one strain on California you could have the same seeds. They are in Florida. And maybe it could be completely different in the in the test results. Can you talk about that? Because I love that story. And I always share that story of what was down there and they can even breaking off other clones from the mother plant. Oh, yeah. grown in there and they’re still have you’re having different results when it comes to testing. Can you talk about that? Sure.

Dr. Daniel Stein 57:59
Well My disclaimer first is I am not a grower, and I don’t know, half or a third or a 10th of what the growers know. But I did read this study where a variety of cannabis that had certain, you know, characteristics when it was grown in one greenhouse, had different characteristics, different chemical compositions, when those clones were grown in another greenhouse, because the soil was different, the light pattern was different, the gases in the atmosphere were different. So in order to create a consistent cannabis variety, there’s a lot of different variables you have to control for. And there are companies that are doing this, you know, to the nines, you know, if you look at what GW Pharmaceuticals does to create, consistent, cannabinoid, you know, profiles for their, for their products like Sativex and epidiolex Dave David have created a condition where those variables are all controlled for and the products are consistent. But for most people, like you said, you take a seed of Northern Lights and grow it in, you know, one part of town and in another part of town, and you’re going to get different plants to some degree.

That’s, that’s at least what I heard and read and I

John Malanca 59:26
liked because it you know, it’s frustrating when you have a patient that calls you and says, You know, I want Blue Dream. And I’ve been in a dispensary is where you go in there. And it’s not Blue Dream, they’re just using, you know, using using these marketing names. And so I always, you know, share with with with patients a cause, look to see, you know, hopefully it’ll get beat get to that point because if a patient find something that works for him or her, works for them, and they want to continue on That route of taking it just like you would with a pharmaceutical or Tylenol or Advil, any of those, you know, they want to have consistent every single time. And chances are that grower grew that and the next crop didn’t turn out exactly the way it did in the first crop, which that patient was having success with. Hopefully, it’ll get to that point where we’re able to have it’s declassified or even unclassified, as many would say. And they’re able to have these controlled studies, as well as the patients will know Oh, you have diabetes, take the issue of Parkinson’s take that you had dementia take that you have cancer, take that. And hopefully that is where this plant will go in to become a medicine a true medicine again, with the American Medical Association, you know, are you what are your thoughts on that?

Dr. Daniel Stein 1:00:48
This is this is it in a nutshell. You’ve really hit the nail on the head. There’s a spectrum of product analysis that needs to be done depending on What your indication for use is. So if you have, you know, autism or epilepsy and you need a certain type of cannabis to help you control that problem, you need products that come with their certificate of analysis. So you can be sure that you’re getting the cannabinoid and terpene profile that’s effective for you. And if you’re not, so Ill that you need that level of analysis. Fine, then you can get your cannabis products from, you know, a traditional or heritage grower that smells great when you put your nose in the jar. And you don’t necessarily need their certificate of analysis because, you know, the nose, nose and you’re going to use that product in the right setting and it’s going to work beautifully for you. So this I think, is going to be the, the spectrum one part, at least of the spectrum of cannabinoid medicine going forward. There’s going to be the The medical arm with the highly sophisticated analysis and specific uses and then there’s going to be you know, the more general type of medical cannabis use which is akin to recreational or self medication that may not require that degree of analysis and we’ll just have to see how it shakes out. So

John Malanca 1:02:25
with that degree of analysis, are you you know, for those patients that truly need the same consistent dosing every single time and you mentioned GW pharmaceutical with Sativex and now EPA dialects, are you what are your thoughts on it like I was anti EPA, dialect and all these pharmaceutical companies coming in here, and recently, my friend his daughter, she’s 20 now. functioning autistic woman. You know, you No, but has tried cannabis and again it was fluctuating all over the place of when when when product was working the next time they would go the product it wasn’t working and it was up and down, up and down. And so there there neurologist out in Southern California you know say well I don’t know about cannabis and so she said, Well, there’s a pharmaceutical product called epidiolex. And he was kind of brought back he’s like, so if you want something go he was saying there really isn’t a regulation, okay? You want regulation. There’s a pharmaceutical company write me a prescription is normally called a recommendation. But now because the the I guess the government’s involved in you in pharmacies or or carry it, it’s a prescription. So he wrote her prescription wrote them a prescription and they’re on and it’s working. It’s a controlled dose every single time and insurance is covering it. And they’re able to have it insurance covered 100% it’s expensive, but it but their insurance is covering it. I want to I think they’re paying $200 if that and but it but it is working and so it’s something that I wasn’t on board with but seeing this work, I mean, I was blown away blown away. And I know a lot of you know, my fellow colleagues in this industry or anti GMP pharmaceutical or epidiolex being being, you know, one cannabinoid in there, are you what are your thoughts on that, you know, working in this industry you know, in neurology as well as working with autistic patients.

Dr. Daniel Stein 1:04:40
I think that pharmaceutical companies and and r&d in the cannabis space that promotes single molecule therapeutics is an important part of what we’re doing. I don’t think it’s the whole part by any by any means, but it’s important And so the the combination, and I don’t mean to, you know, I don’t mean to be a hedger here, but I truly believe that Western style single molecule pharmaceutical study of cannabinoid medicine has a very important role to play, as does whole plant, traditional medicine that we have, you know, so much more to learn about here in the West. So I think there’s a role for each and I can tell you, john, that for my 70 and 80, and 90 year old patients that come in here cannabis naive and want to try something to help them fall asleep or something during the day to help them you know, reduce their headaches, for example, or improve behavior. I need that specific CBD to THC ratio, if I don’t have that CBD to THC ratio for that patient. I’m really sure shooting in the dark and I and I can’t really promise them that the unintended effects of cannabis aren’t going to cause a problem for them. Because those folks don’t want to get high. They don’t want to be overly sedated. They want to take their medicine in, in a way that they’re comfortable taking, it reduces the chances of those psychoactive effects. And the only way to do that is with the help of the pharmaceutical approach of breaking down those cannabinoids, isolating them and then recombine them, perhaps with the proper sprinkling of terpenes. And then providing a product that’s consistent and effective and safe. But that doesn’t mean we still don’t need the other, you know, the, you know, the heritage growers and so forth. Because that is so important for reasons that, you know, we don’t even understand completely, you know, you can’t throw out the baby with the bathwater. And I think that each approach has its has its role.

John Malanca 1:06:56
Now I’m a whole plant advocate all the way and I just think that You need these other cannabinoids working together the entourage effect and, you know, but if something works, you know, I just think, you know, and I share this all the time, there’s times people call us and I route them away from cannabis and I say, you know, where I do a lot of the, in the integrative oncology world and other other modalities and I say, you know, I’ve seen higher success rates with this modality, you may want to try that, you know, and see So, you know, being a health advocate, you know, I want to help help people as well. The one thing before I want to get off on epidiolex was disappointing is strawberry flavored. You know, and it’s just like, Come on, guys. You know, why? Why strawberry, but again, it’s for the taste, and a lot of people don’t like the taste and it’s, but I the same time thinking, well, you don’t want people to think it’s, you know, when I was a little kid, I had my stomach pumped because I had those St. Joseph aspirin that tastes like orange because it tasted delicious. You know, and my parents are out of town. They let my grandparents watch me and my uncles And I had a fever they, they came back in and I’m knocked out. I don’t even know how old I was three, maybe four, Lucky

Dr. Daniel Stein 1:08:08
could have gotten sick.

John Malanca 1:08:09
Yeah, you know, because it tasted delicious. And I just think when you have something like that with the strawberry flavor, I just hope you know it, they’re not gonna just take more and more and more just to do it. But the one thing I have to hand it to the epidiolex they have a whole 800 number that’s connected to these pharmacies, that they have a counselor on hand, and I’ve been on the calls with them. And they know even if you wanted to try to find your sweet spot, which my friends were doing, you know, they say, Well, how can you use, you’re already out you shouldn’t be out until this time, they said we know, our sweet spot was this, this and this where you had a, you know, calculator for this, this, this and this and got it we’ll make notes and so they’d call how’s everything going and so, you know, I like that portion of it. And so and again, it gives people legal Access in all 50 states, you know, not just 3033 states and it’s sad because a lot of conditions, the qualifying conditions aren’t, you know, you know, pain was just accepted as a qualifying condition in the state of Connecticut. We’re in Utah, epilepsy was legal but cancer wasn’t you know, and I just think that’s that’s that’s wrong and you know, and then you’re kind of forced to play the game and I don’t say break the law but you better believe it. You know, me, I’m not advising anybody do this but it was my level and I would do anything in my power. It breaking the law was that I would do it to get to get them medicine to so everything leaves you know, sleep is so important. You know, and sleep. When we have that when we as I mentioned is like a domino effect. You if you don’t get your your your sleep, I’m lucky to get six, seven hours, you know, there’s times I used to have two hours and there’s time, you know, I, you know, I hear people go to bed at 10 and they wake up at 10am like, there’s no way I could do that, you know, I mean, the time that I love sleeping like that, if I’m totally jet lagged, and I fly overseas, and then come back, and it’s like, Okay, do that once every other year, you know, get it get a really good night’s sleep. But it sleep is so important that, you know, it can lead to stress, anxiety, and other things that go on. Can you talk about how important that is? And that it can lead to other ailments and the breakdown as well as inflammation in the body as well. I mean, so it has a whole wave pattern of, you know, how important sleep is,

Dr. Daniel Stein 1:10:44
Oh, sure, you know, the whole the whole circadian rhythm day tonight, and all the different biological processes that are functioning during the day and night. If that gets messed up, then you know, things just Don’t work the way they should. And there’s so many different reasons for those problems.

John Malanca 1:11:08
Oh, trouble with Are they a lot? I lost you your sound there for a second.

Dr. Daniel Stein 1:11:12
Okay. There’s a lot of reasons for these different problems to arise.

So you want to try to figure out why people are having sleep.

John Malanca 1:11:22
Your volume went down a little did I know if your mic mic is there, right? We’ve done so. Well. I didn’t want I didn’t want that to end like that. No, I’m good. I hear you. There you go. You’re back. Good. Okay. So your rhythm.

Dr. Daniel Stein 1:11:39
Yeah. So when it comes to sleep issues, the bigger picture is the circadian rhythm. Yeah. You know, are you a shift worker? You know, are are you you know, are you drinking too much caffeine? You know, I mean, there’s a lot are you taking too many excedrin people don’t even know there’s caffeine and etc. Sometimes So, you know, there’s a lot of different things that you can do, which we call sleep hygiene, if you can, if you can control your behavior and your lifestyle to improve sleep through, you know, reducing alcohol intake after a certain hour, reducing food intake after a certain hour, not taking naps, you know, after three o’clock, you know, there’s so you want to do the sleep hygiene. And then if you’re still having trouble with sleep, and you need something to recalibrate or correct your circadian rhythm. cannabis is great for that. And you’re absolutely right. If things don’t work well, with sleep, you can have all sorts of problems you can become psychotic, you can, you know, you can have hallucinations, you can start acting really crazy. So, yes, it’s very important and out. Can I just go on a little bit?

John Malanca 1:12:54
Come on. I love having you.

Dr. Daniel Stein 1:12:56
All right. There’s there’s there’s a A process a normal, physiologic process that happens in the brain only when you sleep. And it’s called the glymphatic system, the glim phatic g Li m, okay. PHA t IC you know, everybody knows about the lymphatic system, you want the lymph to flow. The lymph are the fluids in your body that help clean out the garbage, that’s the lymphatic system. You have lymph nodes and so forth. Well, in the brain, there’s a system called the glymphatic goi, okay, because it has to do with glial cells. But the point is the glymphatic system in the brain functions when you’re asleep only and the function the purpose of that system is to clean out debris and garbage. So imagine if you’re not having proper sleep, and your your neurons are being bathed in fluid that has all these, you know metabolites that are That are gunking up the works. That can’t be good, john. So, you know, we don’t even know we’re still learning how important sleep is and now we recently learned about this lymphatic system. So I think the take home message like you said is sleep is important. It’s, it’s super important for for a healthy day. And there’s lots of different reasons there’s so many different reasons that sleep is wrong, or interrupted or not helpful. And cannabis can help sometimes reset circadian rhythms and give people restful sleep no doubt.

John Malanca 1:14:35
Before we go, you know you and I’ve talked about the pillars of health Can you talk about the importance of pillars of health and you know, cannabis is a great but health and bringing it all together keeping the mind alive in you know, you’ve heard these stories or studies I should say of the these. I want to say they’re nuns that have a The Parkinson ratio and nuns and dementia ratio and then it very low because they sit and do crossword puzzles his hats. Is that true? Yeah,

Dr. Daniel Stein 1:15:10
well, there’s a thing that we call it, we call it cognitive reserve, okay. And if you’ve studied and read and remained active in terms of brain function, you are more resilient when it comes to aging and losing some neurons. So you have a higher cognitive reserve, you can, you can tolerate losing a few new neurons because you’ve got all these other connections that you’ve established. So, yes, cognitive reserve is super important. You want to remain active in terms of socialization, that helps cognitive function, which is

John Malanca 1:15:45
tough right now, because of this COVID. I mean, a lot of Yeah, I have an aunt, she’s a nun. She’s in a retirement community for nuns, you know, and she’s up in upstate New York, and she’s going nutty because she says, They won’t let us out of our room. I can’t go out can’t walk around my mom said you know you want you want me to send you some some snacks or some food she goes they won’t even let that in here. And just last week or two weeks ago they let them out, let them out but the nines up right let the nines out. You get to get some fresh air she’s like, Oh my gosh, she said

Dr. Daniel Stein 1:16:22
my happiness came back and go in so much do a lot for the brain and that you know, I think it’s important and I’ve talked about this about getting out throughout especially here in this time. Get out Get some exercise, get some vitamin D, pick up a new hobby, can you talk about the pillars of health we cut you off on that but pick a up a hobby, if it’s playing the piano, you know, doing crossword puzzles doing something you get that you know, get that mind going again, he he shared how important that is. It’s important. It’s important to know, we have we have our God given bodies that are supposed to work in a certain way that we can take care of with proper feeding and exercise and fluid balance and promote general health, just through maintenance of what we have in our own bodies. Because remember, cannabis is just a supplement for our own endocannabinoid system. And if you can take care of your own Endocannabinoid levels through proper diet, and exercise, and mental health, then you may not need any cannabis supplements. Let’s face it, recreate in our own bodies endocannabinoids like an and amide into arachidonic glycerol and there’s actually hundreds now of other transmitters and, and, you know, lipid molecules that we can we can use without having to resort to supplemental cannabis to increase our cannabinoid tone. It’s called So yes, the pillars of good health are ever so important for maintaining our general well being, and possibly, you know, enabling us to avoid the need to take supplements whether it’s cannabis supplements or or vitamin D supplements or vitamin D supplements you can get a lot of that from your environment and through Healthy Living no doubt about it.

John Malanca 1:18:25
Before we go, what would you again this is not to replace a one on one with the to do disclaimer. So this is not true on one with your own personal doctor. You know, what would you recommend for patients on a a wellness plan? preventer like wellness keeping the body back to balance

Dr. Daniel Stein 1:18:48
in terms of in terms of diet and exercise, I’m not a very good proponent right now cuz I’m in a low phase of those pillars for myself. So I’m just you know, I’m just being honest here. But in terms of general health, it’s it’s important to maintain a healthy diet, the Mediterranean diet with healthy oils is very important. We know that the cognitive part we talked about in the socialization is important. And and the rest, like we talked about this the sleep so we’ve been hitting on the different pillars and if you can maintain socialization and follow a healthy diet, avoid excessive alcohol, chances are you’re going to do okay, because, you know, there’s only so much you can do. And I think that in general, you know, our population is becoming more aware of that, at least in some demographics. But unfortunately, you know, most people do need some supplements, you know, they they don’t have enough endocannabinoids or they’re deficient because of genetic reasons. We don’t really know all about that yet. And for those individuals supplemental cannabinoids in the form of you know, medications Cannabis can be super helpful for so many so many people in so many ways.

John Malanca 1:20:06
Well, I appreciate I appreciate that and you share. I mean, you’re doing a lot and I know you’re about to take a trip and I don’t know if that’s been canceled or not. Are you are you stuck to present in teach via via cameras nowadays? He talked about what you’re doing, how they can find you. I know you do consultations, via phone via video, and you still seeing patients in your office, so please have at it.

Dr. Daniel Stein 1:20:36
Well, right now, we’re not seeing patients in the office. You know, the COVID thing in Florida is awful right now. And we’re doing telemedicine. Yeah, we’re doing telemedicine for neurology and also for cannabis. We do have some requirements for face to face visits outside of telemedicine and we do that in our parking lot. So I will put on my mask and I’ll go out and patients drive by. And I do like a drive up cannabis console. So, you know, we’re doing what we have to do to remain in compliance and also provide the service. As far as other ways that you know, our clinic neurology of cannabis is functioning. I’m doing presentations, mostly it’s webinars now, I’m going to be part of a webinar in Lima Peru coming up later this month actually, the Society of cannabis clinicians has a has a Latin outpost and and and they’re promoting education in Peru because of the way cannabis laws are changing there. So I’m going to be doing a webinar with other Doc’s to educate the neurologists in Peru and that’s I’m really looking forward to that. I’m doing a presentation in South Africa. With the South African Society of integrative medicine. I’ve been asked to Give a few talks out there. So I don’t know if we’re gonna make it out there in April or not. But that may end up being virtual. So I love giving presentations if, if anybody’s interested in in getting educated, reach out to our clinic neurology of cannabis comm or info at neurology of cannabis calm, I will see those emails. And I’ll be happy to do the best I can, you know, remotely for now and in person when that’s when that’s possible. That’s

John Malanca 1:22:30
possible. So hopefully sooner than later too. So Dr. Stein, always a pleasure. great having you great working again. And and hopefully we’ll get to the point where we can be in the same office together again. Yeah, sooner for our listeners to that 60 year old man, there’s about to be a grandpa. graduations to you and your wife.

Dr. Daniel Stein 1:22:55
Thanks, john. Yeah.

John Malanca 1:22:56
And we’ll see you soon, everybody Jamila A united patients group being formed and be well. Bye bye boom.