Ep. 459: Dr. Ethan Russo

August 8, 2019

Dr. Ethan Russo, Research Director of the International Cannabis and Cannabinoids Institute (ICCI), discusses ways to create a better, safer cannabis. Russo points out the dissonance that exists between public opinion and regulators – while 80-90% of the public already believes that cannabis is a medicine, the medical community must conduct clinical trials in order to prove that cannabis is a medicine. Russo also dismisses the idea that cannabis is an understudied substance: “Cannabis is actually very likely the most studied drug in the history of mankind, because there have been decades of research on it, mainly focused on its harms.” Now, he says, we must collect the same amount of research on cannabis’s therapeutic uses.


Seth Adler: Dr. Ethan Russo joins us. Welcome to Cannabis Economy. I'm your host, Seth Adler. Download episodes on canneconomy.com. That's two Ns and the word economy. This another one of the sessions from our digital workshop, so you can hear it here, or see it there on canneconomy.com, along with all the other sessions. First, a word from Bedrocan and then Dr. Ethan Russo.

Seth Adler: Bedrocan is a patient-driven global pharmaceutical-minded cannabis company. Their entire end-to-end process is GMP certified through Dutch, and ultimately European authorities. Bedrocan is the market leader in Europe for medical cannabis, and has been the sole supplier to the Dutch government for 16 years. Through the Dutch government, Bedrocan provides product to 15 countries currently.

Seth Adler: As a science-based company, Bedrocan invests in clinical research. The Leiden University conducted a double blind placebo-controlled clinical trial on Fibromyalgia with Bedrocan products which yielded promising results. They're now working on a followup to that study. Bedrocan is also working on the extent to which cannabis can reduce a reliability on opioids. Bedrocan believes that clinical research is key for the future of the company, standardized product, the industry and the patient. Visit bedrocan.com for more information.

Seth Adler: Okay, we've got Dr. Ethan Russo with us. Thank you so much for doing this.

Dr. Ethan Russo: My pleasure.

Seth Adler: Yeah. So here we are at the Cannabis Economy Digital Workshop. Your session in particular is better, safer cannabis. When we talked about doing this, this is what we came up with. Number one, why did we come up with that as the session? Number two, if you could, just give folks that might not know you a little bit of your background. Folks in the scientific community of course do, but for anybody that might not.

Dr. Ethan Russo: Sure. Well first about me, I'm a board certified pediatric and adult neurologist. I was trained pretty much in the usual fashion through medical school and pharmacology, but I had always harbored an interest in medicinal plants. After a sabbatical in the Peruvian rainforest in 1995, I quickly became embroiled in the cannabis controversy, let's call it, that really came ahead with Proposition 215 in California in 1996.

Dr. Ethan Russo: As I was trying to do formal research on, I was being stonewalled by the U.S. federal government. I really delved into the topic in a much deeper fashion and became enamored with it, both the complexity of the cannabis plant and the endocannabinoid system, which we all harbor and which explains the versatility of this medicinal plant. It became a second career.

Dr. Ethan Russo: Subsequently, in 1998, the year that GW Pharmaceuticals began pursuit of a pharmaceutical form of cannabis, I was brought on as a consultant and that turned into a full-time position in 2003. I was involved in the development program of the prescription pharmaceutical forms of cannabis Sativex and Epidiolex.

Dr. Ethan Russo: Currently, I'm the Director of Research and Development for the International Cannabis and Cannabinoid Institute.

Seth Adler: Okay. Really, the GW pharma work is impressive and also intriguing. Before we dive in here, I wonder what would be your key takeaways understanding our current landscape?

Dr. Ethan Russo: Sure, well the experience at GW Pharmaceuticals was it's certainly illustrative. Contrary to popular belief or disbelief in this instance, it is possible to make prescription pharmaceuticals from plants. That has been done with both Sativex and Epidiolex. But, the vast majority of people around the world are not using cannabis in that fashion.

Dr. Ethan Russo: What we've got now is three echelons of activity. The limited pharmaceutical market with a high degree of standardized, proven safety and efficacy through clinical trials. A second echelon would be supplements that have a certain amount of standardization, but have not necessarily gone through the full pharmaceutical development program. Third, and most prevalent, is just a generic use of cannabis in whatever form: as flowers, as extracts or any of the cannabidiol products that are proliferating online these days.

Seth Adler: Mm-hmm (affirmative), all right so one, two and three. That is what we're looking at. What we should be looking at is specific disorders and the treatment of specific disorders. Of course, some of us are. When we bring this up as a point of interest, what is there to say here, besides everything?

Dr. Ethan Russo: Well, a great deal. Again, cannabis is one of the most versatile medicinal plants on earth. It really has application to a great number of conditions that are otherwise recalcitrant to conventional treatment. The best established of these are the following: certainly, treatment of chronic pain in whatever form; cannabinoids actually excel in treatment of neuropathic or nerve-based pain; where opioids do a very poor job and actually in many instances should be contraindicated.

Dr. Ethan Russo: Additionally, cannabis as Sativex is approved in 30 countries outside the US for treatment of Spasticity or muscle tightness in Multiple Sclerosis. Additionally, cannabidiol as Epidiolex, is now approved for treatment of severe seizure disorders: Dravet and Lennox-Gastaut syndrome. That is in the US. It was FDA approved last year in 2018.

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