Pe109 Cannabis for Dementia, Brain Health & Older Adults

The Science of Cannabis is evolving quickly, and new discoveries are showing its use as a neuroprotectant in preventing and possibly reversing Dementia in Older Adults. It seems like the group of people that can be helped the most by cannabis also have the most stigma they must overcome. Our guest is Linda Jacobson, Founder of Elders Together and we discuss how cannabis is one of the keys that may allow us to live a quality life past the age of 120.

Resources from episode, Project CBD & Americans for Safe Access


Episode Transcription:

Wayne Schwind, Host: Joining us today is Linda Jacobson. Really excited to have you on today Linda, we'll get a little bit about your background and your focus. But I'm really excited because this is - the conversation we're going to have is definitely a new territory that I don't - we've kind of hit on here and there but we haven't really went deep into and that's really focusing around cannabis, older adults, elderly and you know, cannabis being so new and the science and what products work for what and don't. You've had a strong focus on this, especially with your background, I think your experience really merges nicely into cannabis. So really excited for this conversation and appreciate you coming on.

Linda Jacobson, Guest: Thanks, Wayne. I am so excited myself. Your guests, and you, have taught me so much over the past year, year and a half and I'm honored to give a little bit back.

Wayne: Yeah, I appreciate it. I think I do most of the learning. So let's give listeners a little bit of you know, Introduction to yourself. When someone asks, "What do you do?", what do you normally tell them?

Linda: I normally tell people about my interest in helping people understand and adopt new technologies. So I've worked for my entire career as a journalist and teacher and marketer in the science and tech space, specifically in in science and technology related to health care and education. And about 10 or 12 years ago, I focused more sharply on science and technology for supporting brain health and lifelong cognitive fitness and finding ways to help people stay thinking clearly and ways for those who have cognitive impairment to enjoy life more. So about, oh about nine or 10 years ago, I started exploring the research found - findings around the benefits of cannabis for maintaining brain health and addressing symptoms associated with brain conditions. And I was fascinated and excited and I decided to add cannabis science and technology to my list of topics. And so I go out and I give talks to older adults about topics related to emerging science and new technologies.

Wayne: Yeah, that's so interesting. When you were focusing on - even when it was just science and technology Were you always focused on older adults and around brain health?

Linda: Only in the past 10 years or so I - in my early days, I was focusing on specifically on the technology of virtual reality and later augmented reality to use for healthcare and medical training and education and anatomical visualization. So I was working with lots of different types of, of scientists and then medical professionals to help them understand how they could use virtual reality in their - in their medical practice or their healthcare practice. But about 10 or 12 years ago, I actually had to become a caregiver myself. For my grandmother, who developed dementia. I don't think it was Alzheimer's. I think it was a different type of dementia, but I was - I was really disappointed by the lack of sophisticated or even basic technology as a way to help improve a person's life who has, who has a brain condition. So I, that's when I decided that I wanted to spend the rest of my career in helping develop virtual reality and augmented reality applications to help in elder care. And so that's, that's been my focus. And it was along this path that I came across the benefits of cannabis in this context as well. So yeah, so my focus really is on brain health and even even for people in their 20s 30s and 40s. You know, it's a it's a, it's just as we're discovering so much about cannabis right now, neuroscientists are discovering all new things about the brain. So I like to link the two.

Wayne: Yeah, no, it's amazing because it seemed like cannabis - you talked about earlier 20s and 30s. And then older adults - does cannabis seem to have preventative possibility and then once the - maybe if we're talking about dementia specifically or any other ailments that set in, cannabis also has kind of a therapy reactive treatability to it as well?

Linda: Yes, that's correct. So there is this theory, that is now going to be proven out in major research trials, that the proper use of cannabis can protect brain cells and even encourage the regeneration of brain cells, which is kind of mind blowing in itself. But then, by the same token, it's understood, documented, and there's scientific evidence that the use of cannabis is really helpful in reducing symptoms of dementia that cannot be treated any other way. There's, there's been no new dementia treatments in 15 years, the ones that exist, don't have lasting effects and also have really nasty side effects. So when we talk about dementia, we're just talking about this range of cognitive impairment conditions that could be mild and what we know you know, long time is people being senile or forgetful, all the way up to the, the dreadful loss of one's ability to recall, ou know things about their own life. (Yeah. memory.) So yeah, so the - when I first was discovering the, the evidence around the medical benefits of cannabis, the way I did it actually was kind of geeky I, I wrote patent applications for computer scientists and virtual reality inventors. So when you write a - start to set out to find out whether an idea is unique and has not been claimed by somebody else, you could go on to the US government website, maintained by the Patent and Trademark Office, and you could plug in search terms and and find what's been filed before. So out of curiosity about 10-12 years ago, I went on to the US Patent and Trademark Office website and I ran a search on the term cannabis and maybe on marijuana. And I was - I was shocked to find something that many your - many of your listeners may already know that the US government had filed and received a very broad patent for the use of cannabis medicine as a neuroprotective agent and a treatment for people with neurodegenerative disorders. And so there it is, right in black and white, the US government's own data about the benefits of cannabis for for brain health.

Wayne: Yeah, how does that - I mean, it's still Schedule I and they filed the patent. Is that just a huge hypocrisy that, I mean, no one's supposed to talk about? Because I mean, that completely contradicts Schedule I, right?

Linda: Right? Yes. I, you know, I it's, it was a patent that probably was filed with the anticipation or the expectation that at some point in the near future, it would be rescheduled or descheduled. And at that point, then the US government would be able to license this invention. However, it's taken so long that the that that particular patent is now expired, and -

Wayne: Does that open source it then?

Linda: Yes, in a way. Yes, yes. But there's even better, better science and better patents that have been done. So for all your listeners who may be curious I, I encourage doing a patent search for cannabis inventions and you'll see what's out there.

Wayne: Wow. So yeah, that was what you kind of did talk about dementia a little more there, and I want hit on that just deeper to kind of explain that to listeners. So that is really kind of a blanket cover all for any kind of mental or mind disability that starts happening could be slow, it could be extreme and Alzheimer's fits into that as a category a dementia. Is that correct?

Linda: That's correct. Dementia is kind of a catch-all phrase for a range of little-understood conditions or diseases or disorders in which parts of the brain are no longer functioning normally. And Alzheimer's disease is a type of dementia disorder. It is the most common and it's also very little understood. Neuroscientists are starting to think it's actually not one disease but a number of different conditions that have come together. But in the, in the area of dementia disorders. It's such an old school word "demented", you know, I remember as a kid listening to the Dr. Demento and dementia was such a such a Dickensian term, but there are dementia disorders with other names such as vascular dementia, and Fronto-temporal dementia. And the list goes on. And with each of them having different types of symptoms and different potential causes, but none of them has a treatment. None of them is understood well enough to prevent it or to cure it.

Wayne: Yeah. So it's really unknown. And it sounds like - is cannabis leading, I mean, the one of the best discoveries we found that has any kind of preventative or treatment that we've discovered for this, then it sounds? Like (it seems like it) right it's kind of early for understanding it right now.

Linda: That's right. That's right. Well, people are starting to understand that the endocannabinoid system plays a large role, a potentially large role in the processes associated with aging. And it's it's possible, theoretically possible that deficiencies in the endocannabinoid system lead to decline in brain function. And so it's theoretically possible that supplementing the endocannabinoid system with external cannabinoids and terpenes and the other wonderful compounds in the plant could actually prevent the progression of decline, or least mitigate the symptoms associated with the decline. I'll give you one example it is well documented that people who have serious dementia, whether they're living at home with their loved ones or already in some type of facility, they almost all experience this sudden feeling of agitation and anxiety and fear right around the time when the sun starts to set, no matter what time of year it is it whether you know it's summertime and it's late in the day or winter and the sunsets early or you're in this hemisphere or across the world. It's universally experienced so much that this symptom has a name called "Sundowning". And cannabis is widely used in Dementia Care around the world to reduce sundowning. And it's effective and it's it's, it changes lives. It's changed lives, for caregivers and for families and definitely the people who have this condition

Wayne: Wow. Is that sundowning something to do with the endocannabinoid system changing during some the sun setting?

Linda: Well, that we don't know. That, that will be, I hope, probed in the upcoming studies being funded at neuroscience centers of excellence like Harvard and MIT and in the - in the UK, in the United Kingdom there the Alzheimer's research organization just funded major research study to try to identify the answer to your question. With a great influx of funding, it's also happening in Australia these studies to find the answer, and probably the world leader in exploring the use of cannabis to mitigate cognitive disorders is, is Israel.

Wayne: Fascinating. I've got so many questions, I'm trying to see where we should focus. I do want to make this episode, you know, we have a lot of people that are in the industry that listen but I want this to be consumer facing as well. And so let's talk a little bit more about the endocannabinoid system. I think a lot of people in the industry know about it, but if they're a consumer or an older adult outside, maybe not. Can you explain what that is? Exactly. And something fascinating. What I've heard from a lot of doctors in school is they teach about it for about a week or two at most. And it seems to be one of our biggest nervous systems in the body, which seems hugely important, but taught very little in school. Is that accurate? And if so, why? And what is the endocannabinoid system as well?

Linda: Right? Yes. So it's so accurate, it it's a it's fascinating to start learning about the politics around education, medical education, but setting that aside, and without, I don't want to miss, misrepresent the people who discovered this and because it happened in several places at once, but let me just explain very briefly that the human endocannabinoid system - Endocannabinoid is actually short for endogenous cannabinoid system, that means something inside you. So the human endocannabinoid system is really part of a whole new body system that works in conjunction with the other body systems. And those include the central nervous system, the muscular skeletal system, the gastrointestinal system. So the human endocannabinoid system is known to basically help manage processes in the body that that we rely on day to day - from movement, to sleep, to common conversation, to running, running with your dog on the beach, you know. So the this, this human endocannabinoid system generates its own neurotransmitters that communicate with parts of your body to make sure your body works correctly, but it also responds to the compounds in the cannabis plant, right? So, so cannabis is is known for its cannabinoids, which are known scientifically as phytocannabinoids or plant cannabinoids. So, the cannabis plant compounds interact with the human cannabinoid system to produce desirable results which is basically the functioning of your body. And and it is now believed that the human endocannabinoid system plays a fundamental role in, in protecting the body from disease and also in helping to keep the rest of your body healthy while there is some disease happening in the body. So it - there's some fantastic resources I, I hope I didn't do it just some injustice with a really high level explanation but the the fact is that the scientists are discovering and now starting to really study the, the mechanism known as the human endocannabinoid system and slowly but surely it's being adopted by - very, very slowly - being adopted as a topic for for teaching and study in medical schools in the US.

Wayne: And we don't have to jump into the specifics, but is it quite simply the prohibition and propaganda of not wanting to, you know, recognize this natural relationship from this cannabis plant with the system in our bodies and government, you know, trickling down to education and universities not wanting to discuss it and learn it? Is it that just simply because of prohibition? Or is there, more?

Linda: I would say that that is definitely a factor because of the legal, the legal restrictions on the research that could have been going on for many years to identify it. But also, it's, you know, to just set aside blame, or pointing fingers for a minute, the - it's also the advent of very sophisticated medical imaging systems that have enabled this discovery. So the, there's like these nuclear, you know, magnetic resonance spectrometry systems that are required to explore the body at this molecular level, have only really been developed and implemented in the past couple of decades anyway. So it's partially politics and restrictions, but it's also just the progression of scientific discovery.

Wayne: Hmm, got it. Yeah, I learned about the endocannabinoid system a couple -a couple years ago, probably only and I was just fascinated to learn that our own body produces cannabinoids internally, and then when we're off balance or they're low levels, and we're not balanced for whatever reason that might be even stress, anxiety or sickness, and then this plant is literally just filling the void that our own body should be creating that it's not, and it's like they're that close, they're that similar? It's like, it's too eerie, how much, that natural that you know cannabis is to health and well being , that is just it's crazy to think of all this prohibition that we're just pushing through finally now.

Linda: Right? Yeah, it's amazing. Well, you know, the recent research has identified inflammation. And I'm not talking about in this case like a cut or a burn on your skin but inflammation the brain like it - in the blood vessels and in tissue in the brain, well, that that inflammation is possibly a culprit in the development of depression and neurodegenerative disease and other conditions that tend to develop later in life, right? So we know that inflammation is bad and oxidation is bad. And, and it's believed that depression this inflammation may actually lead to the development of dementia disorders or at least cognitive impairment. And so that - it's also clear that cannabis compounds are anti-inflammatory, really effective at reducing inflammation. So now, now it's really starting to be understood that in low doses, cannabis can reduce inflammation and improve mood and reduce stress in the proper doses. And and so there's this - There's a, you know US scientists research scientists now saying that if if we could use compounds derived from cannabis to restore normal Endocannabinoid function, we could be reducing inflammation and potentially helping to stabilize moods and, and reduce depression and anxiety. All of which, you know, it's well understood that stress, depression and anxiety have a relationship with the development of dementia.

Wayne: Yeah. Do you think cannabis will be covered one day by health insurance?

Linda: Yeah, you know, I do. I yes, I do believe that there will be. I do believe that at some point, these alternative approaches to medications will be covered by health insurance. The fact is that the dementia disorders do not have, like diseases symptoms that require medical care, but do create dependency so that people who have dementia need help with activities of daily living like getting dressed or brushing their teeth or taking a shower or preparing a meal. And, and until recently, families had to pay out of pocket for professional help for anybody who needed this kind of assistance. And we've just now just now the whole US Medicare system is is going through a change to allow reimbursement for professional care that's non medical. So there's changes going on at, at the administrative - at the federal level to allow reimbursement for care because it keeps people out of hospitals and avoids people sapping the larger institutional healthcare system, and I believe cannabis, cannabis treatments will head in that direction, too.

Wayne: Yeah. Yeah, I want to we were talking a little bit before we started, I want to make a distinction for the listeners, and then go a little deeper into some specific questions around, you know, what products what questions to ask. The distinction is we've been talking quite a bit about dementia and elderly patients. But you also have a focus on what you'd call older adults and even sports performance and more kind of the well-being, what maybe you would call recreational, maybe not, but do you want to make the distinction between those two categories, older adults versus elderly? And then I've got some questions to ask around that, how cannabis works for each group, similarities, differences, things like that.

Linda: It's a really interesting topic you know, the semantics of aging (Yeah) are like a practically political now you know, and the aging movement doesn't have any single one, kind of, you know, Rosa Parks or Martin Luther King Jr. or Gloria Steinem or Harvey Milk, but I think that, that that person will emerge. And there are definitely ways that we talk about older people that are really alienating and so, so I don't use the term seniors, but I will use the term older adults to refer to say people over 50. And then we're talking about decades, right? People are living routinely now into their 90s and their hundreds. So a person who's, you know, 92 may be out there running, running marathons and sprints and playing a mean game of tennis while a person who's 72 may have advanced dementia, and not be able to live alone anymore. So you can't even distinguish people anymore chronologically, that way. So the the ways in which we take care of our brains when we're middle aged, 40s and 50s, are really going to have an impact on our successful aging as we get into the 70s, 80s, and 90s. So, it's, you know, there's a continuum there of awareness and self care. I have to backtrack, and I apologize but, regarding that discussion about insurance coverage of cannabis medications. I just want to say that that actually is already happening because there are FDA approved pharmaceutical medications that are covered by insurance it with a proper prescription and Sativex is one you know that there is a isolated synthesize THC product that's used In, in dementia care routinely, that's produced by GW Pharmaceuticals, and that's a regular FDA, you know, sold by pharmacies. And just recently, the FDA approved an epilepsy medication called Epidiolex, which is a whole plant CBD extract, to treat severe epilepsy conditions. So those are covered by insurance and that is another signifier of the coming change. But yeah, just so those may be given to people who are have early onset dementia when they're in their, in their 60s or 70s. Or a person who is 110 now, but yeah, so go to the more recent question, Wayne, and I'm going down different branches road, back main, the main trunk of the question, which is - Yeah, I, I'm a baby boomer, I was born near the end of the baby boom, I don't normally group people together by the generation in which they're born, I group people according to their, you know, their, their independence and the health condition and, and the way they engage with the rest of the world.

Wayne: Yeah, that's a really good point. And I like that. And I think that's a trap sometimes thinking, well, this age bracket versus this one, but like you said, someone could be pushing 100 and be the athlete and someone could be early 70s, 60s and, you know, have the issues. So that's a really important point I think to make when we talk about cannabis. And so with that in mind, you know, there's so many different kinds of cannabis products out there. And the science of it. You know, in this industry, we learn a lot about the different compounds and the interactions and how they mix together or using different ones with other ones but for a consumer, it can be very complex, I think and confusing. Our product selections different for what we might call elderly or someone that is dependent versus older adults who are independent and maybe looking for more of that well-being or, you know, in performance enhancement, you might call it (Very different.) How was that?

Linda: Well, you know, it's really great that people know about the effects of the plant compounds and the different formulations and how they work. But it's also really important to know that as we get older, the less THC is required to achieve the minimum desired effect. And not only does your chronological age affect your reaction to a cannabis product, so does your genetic background. You know, what, what, whether you're descended from Eastern Europeans versus Africans versus Asians, that will affect your reaction to THC. And so will your medical history, as well as the, the medications and supplements, if any that you're currently taking. So it's really important to be patient. If you haven't found the right combination of compounds to achieve what you need, you know it everybody, everybody's different and the older we get, the more different we get. You know, there's this truism that when you've seen one, when you've seen 1 85 year old, you've seen 1 85 year old. You can't, you can't generalize the the health condition or the way and a single 80 - all 85 year olds will respond to the same product.

Wayne: Yeah, yeah, that's what makes cannabis difficult as there's many different compounds and it's, I guess even in pharmaceuticals there's a little bit of trial and error to see if a product works. With cannabis products when you're talking to people do you - Is it still a lot of trial and error and experimentation to figure out what works, or how do you go about recommending either a specific product or how they should find a product that might work for them?

Linda: That's the most common question asked when I talked to audiences with, for community groups or I go into an assisted living community or I talk to a group of professional caregivers and, and it's, it's a little frustrating right now that there is no one single answer and that you I do recommend the classic you know, start low and go slow, but it's important to find out the goal of taking the cannabis medication so. So that's like the first thing you start out with is to prioritize the, the desired outcome, because you might be willing to experience being high if it'll help you get to sleep better. You know, you might say, Okay, I don't mind being a little dizzy if the trade off is that I get to sleep through the night, or someone else say, you know, I don't want to be dizzy. I don't care if it makes me sleep or not. So, you know, the, the goal, the top symptom to address is really where you go first in trying to identify the product. And then you have to talk with folks about what their budget is, and what how they want to use the cannabis. You know, some people are really wary of smoking. Others are not. So I mean, one of the most common questions is how do tinctures work? So there's a real interest in understanding these new formulations and ,and how they work. It's a lot of fun that - you know that you talked to older adults and it's really easy to get a good laugh because there's so many is, you know, so many decades of nonsense that we have to, no pun intended, weed through, you know? So I think it's really important to know, either as a consumer or as a professional helping a consumer that most older adults about, you know, people, let's say 50 and older, have a very different relationship with cannabis than anyone born after 1970 due to just the decades of propaganda, demonization of weed and incarceration, so that, that's - that factors in to ability to like have an open mind and an open heart about, about using this. So you kind of have to peel back these layers of the onion to get to the heart of the matter which is - what do you want to do? How much money do you want to spend? What - do you want to get high, or is that a fear that you have? And - and, you know what? What is it? What kind of method do you want to use? What - What is your preferred method?

Wayne: Do you find a lot of older adults almost have guilt or shame even wanting to try cannabis still with that like momentum of that propaganda?

Linda: Absolutely. Yes. 100% there's still a lot of internalized stigma around it and I, I, I go in and talk to audiences of residents at assisted living communities. And they'll be very eager but they, then when I say well, would you like to find out how you can try some and go get some, though they'll like, look around. They'll say, well yes, but only if you don't tell the manager. You don't - Oh, yes, but don't ever tell my daughter, or Yes, but I can't talk to my doctor about it. So this is, this is prevalent, this is pervasive. And I'm in the - I'm in the Bay Area, I'm in Northern California, where you know, hippies have been out on Hippie Hill and Golden Gate Park smoking joints for 50 years. And even here, there's this strong, strong stigma associated with cannabis use. And with the people, and with the people who use cannabis and I think that may be keeping, keeping older adults out of dispensaries too you know, they can't relate. So yeah, it's it's, it's a big problem, and it's one of my goals is to reduce the stigma, and help normalize the topic just to talk about it. And not feel like you're going to be judged.

Wayne: Yeah. Do you see it shifting? Do you notice a change?

Linda: In different regions, I notice a change. So, there's conservative neighborhoods and cities where the - it's a little bit more slowly changing. And then there's the more, you know, progressive or liberal or, you know, more diverse areas where people are just annoyed that their city has a moratorium on dispensaries. So yeah, it's not - it's not consistent. I think it's generational for sure, but regionally people differ in the way they embrace it. (Yeah.) Or whether they compress their lips and hold their arms like your mom when she was angry, you know, you're, I get all the time, you know.

Wayne: With cannabis consumption and you know, fitting into a lifestyle and how you see this evolving into people's well-being and we can separate it for each group, older adults versus elderly, elderly that might be dealing with more of a medical ailment. Do you see cannabis being consumed daily for older adults? Or would it be kind of spaced out or multiple times per day in lower doses? Do you see it becoming like a regular part of a healthy lifestyle living once you're in an older age?

Linda: Yes, yes. And I - and I have heard and seen medical doctors with geriatrics expertise who practice cannabis medicine just explicitly saying it doesn't work if you use it once. And its most effective in small consistently spaced apart administered doses. So, so much like a good diet, like you don't only eat, you know, once a week, (Yeah, right.) So yes, I do see the emergence of a dosing schedule that is based on very low doses administered throughout the day. Similar to how just, how a painkiller might be, you know, you a wrench a muscle, you know, the doctor will say, Okay, here's some, you know codeine with Advil in it, and take it either four times a day with water or, or as needed. So a lot of the current medical doctors who have recommended cannabis for elderly people who are in the care of others will write on the recommendation the acronym PRN. That stands for Latin term meaning take as needed. So yeah, there's also that approach too, where if you have a sudden spasm of pain, you might grab a tincture right away or a vape pen. Whereas if you're trying to encourage you know, 12 hours of calm you might use a very heavy duty patch instead.

Wayne: Is that a big benefit, and unique, around cannabis that you can almost take it on demand as you need it and how you notice your body's reacting versus it seems like many pharmaceuticals are, you know, every six hours one pill and very regimented and you're not supposed to go higher or lower with that - does cannabis have a lot more I guess margin for error would you call it or flexibility in its use?

Linda: In my opinion and my, my experience it does because - just simply because there's no one cannabis medication and you know what, you might have a CBD rich tincture or, or vape or something that you use throughout the day to minimize anxiety but then you may only go for your high THC formulation at at night for, for going to sleep or for reducing exercise pain. But then it really depends on the, on the situation in which it's used. And a lot of medical doctors and other clinicians really want those dosing regimens identified and, and approved and articulated and, and I - and that's where a lot of the research is going is to coming up with those dosing regimens because a lot of doctors won't talk about it because they don't know how to guide their patients on how to use it. So there's not only this fear of losing their license to prescribe opioids, which is I think an unfounded fear but a fear nonetheless. But there's also this general lack of knowledge that they were taught in medical school about how to prescribe pharmaceuticals based on the you know, pharmaceutical, the pharmaceutical companies insights and discovery from their staff scientists and how to use it and achieve the right effect. And that that's lacking right now in cannabis meds but it's it's emerging. Some amazing medical people talking about dosing and consistent titration approaches, such as Ethan Russo is a great one and on the east coast and here in the West Coast, a doctor named Hergenrather, Jeffrey Hergenrather, those are just two right off the bat who are talking about specific dosing regimens and, and frequency of administration.

Wayne: Got it. I saw on your website to you do some training and consulting with family care, or for family care providers. What does the landscape look like with family care providers? I'm guessing this is very regional across the country, but you know where it's not still not legal for cannabis but Are they starting to adopt it recommend it to their patients? How does that part of the - not industry but medical care sector - look?

Linda: So for many people - and let's let's focus right now on the the brain fitness and and helping people to get through the day if they have cognitive impairment. There's no effective pharmaceutical or surgical treatments and doctors don't know what to do. And so there's a lot of openness and almost desperation on the part of family caregivers to find something that will help bring relief to their loved one. So people in - I'm finding that family caregivers versus let's say volunteer unpaid caregivers are incredibly open, but a little - A little frightened by what they think they know. Such as the possibility of causing psychosis or making grandma high and and giggly and even watching you know, Dazed and Confused right, there. There's a lot of fallacy a lot of fear of getting high. But the the professional caregivers, more and more are having an open mind because the institutions associated with their profession are starting to issue statements saying, guess what, folks, this is really valid and we need to be looking at it and we need to lobby for legalization so we could do research. So this, this is the - for instance, the American Nurses Association is very specific in their guidelines for nursing with cannabis. The, the American Physicians association is another one, that's very, very vocal in talking with, with people about the need to understand and research cannabis, so it could be used, you know, with greater precision and greater evidence. So, so there's, you know, these these different bodies, even the American Medical Association, which has a lot of ties to the pharmaceutical industry, is starting to relax its stance, but I think that that's, you know, it's going to come down from these, these august bodies, you know, to influence the medical people and influence the faculties at medical schools and across the board and into the, you know, the legitimacy of this as a strategy for promoting and maintaining brain health.

Wayne: Yeah. What would you recommend, I think if, you know, for older adults, where do they go? What steps can they take if they have that stigma they, they're worried about talking to their family care provider - and maybe even if they're okay with it, but they might not know that, you know, they're in a state that's legalized, they can walk into a dispensary, but that I can imagine is, if you have that stigma is even heavier to walk into one of those stores. What steps can they take? Like how do they gradually or carefully approach cannabis and see if it can help them?

Linda: Yeah, I, I always recommend two websites for their incredible online free resources that are, that are written for, for these audiences. And, and I'm sure you've you've heard of both and you may have bookmarked them, like I have on every single device I have. One of them is Project CBD. So the website projectcbd.org is just a cornucopia of cannabis education that addresses specific conditions associated with aging. So you could download booklets and articles. They, project CBD even publishes a list of, of interactions with other, with other drugs that are - that I routinely hand out to professional clinicians and caregivers. So you could download a booklet called a Primer on Cannabinoid-Drug Interactions by Adrian Devitt-Lee, and that's a Project CBD publication. So that is something that any, any cannabis aficionado should be able to pull out if they're asked, okay, what happen- My mom is taking a blood thinner, what do I need to know? So that's one great site and another great resource is the organization Americans for Safe Access and their website safeaccessnow.org also provide downloads of free booklets about the use of cannabis for specific groups of people and specific disorders. So you could, you could download a whole booklet on cannabis and aging that will provide this terrific overview of, of ways in which cannabis could help somebody who's dealing with some of the health issues associated with, with aging. And that, that, like the - one of the most common ones is insomnia, for instance, and just to demystify when I talk about these mysterious, old people afflictions, they're pretty much things that all of us experience all through our life, but that seem to get worse as we get older. (Yeah) so yeah, so those - I send people to safeaccessnow.org and to ProjectCBD.org and also on YouTube. There are videos by geriatrics clinicians in which they speak specifically about cannabis for older adults and they give great advice to consumers. So, Eloise Theisen, T-H-E-I-S-E-N, is a great name to look up on on YouTube to find her lectures. Dr. Lori Vollen, V (as in Victor) O-L-L-E-N also has some great tutorials on YouTube and then you could find her website so and, and the list goes on. So that and that's the resource that I like to provide to people to kind of be a conduit to this information.

Wayne: Yeah, we'll put links to those in the show notes as well so people can go to those. How - so I'd like to look at you know, THC products. If I someone listening is in a state where cannabis is legalized either medically or recreationally versus CBD products that can be bought online if they're not in a state where they can go into a store. So they they find these resources, they dive in, they learn whether it's them, or maybe their caregiver if they you know have a medical ailment. They're like, all right, this type of product, they're finding something that works. If they're not in a state where they can walk into a store, how do you recommend going through the process of trying to buy something online? Which is really risky right now because it's, you know, a lot of companies that are trying to make a quick buck. Some great companies out there, how do you kind of talk someone through that?

Linda: Yeah, you know, I've heard the great phrase, I went to the Cannabis Nurses Network conference earlier this year, and someone described CBD as the gateway drug to THC. And, and I - you know, you could always start with exploring CBD, there are unbiased review sites that will recommend highly-regarded CBD products for treating certain symptoms, so I - you know that that's always a place to start could be in exploring whether some full spectrum hemp based CBD product can provide some relief to you while recognizing and, and basically you know taking as fact that the - that you're missing the entourage effect right of the whole plant with THC. But that's, that's where it - that's the only place to start. There's really no other choice unless you could travel to a legal state and then experiment and not all legal states will, will allow out of state residents to come to their dispensary. There's, there's a few - there's a few states that do accept out, that do allow out of state adults to, to buy from their dispensaries and use their products while they're in the - while they're still in the same state. So yeah that, that's - right now it's the it's the only option when in those states where you can't access CBD - I'm sorry THC. So, yeah.

Wayne: Let's talk about some of the - I saw on your website as well. You said "marketing hype" that you hear in cannabis, and there's - it's almost like a new language, these different words we're using to describe products. So I'd like to talk about a couple of them for consumers as they're looking for products and they might be able to understand what these words mean versus what they don't. So starting off you mentioned there what you said full spectrum versus you know, and whole plant or hemp. Those are a couple that consumers are going to hear -, what does full spectrum or whole plant mean? And what does, maybe we call it, the isolated version - what's the differences there? Should a consumer be looking for that difference or care about that?

Linda: Yes. And, and right now I have to say that I learned so much of what I learned from your own episode 50 (Yeah, that's a good one) with Emma Chasen and, and all the great materials that you and she have put together and made available to the world. So, the - and the question that you just asked me is, I made a list of the Top 10 questions I hear the most from older adults. (Let's go through those, yeah) And, and I ranked that one at number three, you know, I you know, as number two and number three. What's the difference between hemp and cannabis and marijuana? And then three, what's the difference between THC and CBD? And so in talking about Full Spectrum and whole plant. Really, this most simplest way to convey that is to say either you're using all the compounds in the plant to create your treatment to extract and process and create your cannabis medication or you're pulling out some of the, some of the compounds and isolating them from the others. And there is a real belief that the combination of all the compounds in a plant that make an extract much more effective and that, a lot of studies are going in right now toward understanding - trying to understand and document and, and benchmark those, those advantages of using a compound or an product made from the cannabis plant that has trace THC in it, whether traces or not, or the so called hemp plant that has been traditionally cultivated for other uses and not getting high. So it's it's a really rich, deep, very nuanced topic and it's - sometimes it's hard to encapsulate the answer in just a few sentences but that's that's where I, I just focus on you know, using all the ingredients or taking out some of them.

Wayne: Yeah

Linda: Full, full plant - whole plant or full spectrum.

Wayne: Yeah, versus maybe just CBD only or just THC only from the plant. And that's, that's kind of where I wanted to go a little deeper because I was asking about buying products online. It seems like many of the CBD products that are available online are mostly made from isolates, which is CBD only, you're not getting full spectrum. Is there a way for a consumer to identify that when they're looking at a product or is it kind of a mixed bag of knowing what exactly you might be getting? I guess someone could tag it full spectrum. You hope they're telling the truth. But is there a way to identify a CBD isolate product?

Linda: You'd have to ask the manufacturer for the certificate of analysis. You know, that's that's really where the, you'd hope there they'll be transparent, honest information about the test results for that product. And, and if the product has not been tested by a third party lab and issued a certificate of analysis around the contents, then you don't want it. So So. Yeah, I there's very little regulation and, as you know, and there's also, from state to state, different laws about what you could say on the package, you know? So you know, you're not allowed to sell sparkling water that has CBD isolate in it but you, on the package but you are allowed to sell a sparkling water that has hemp extract, even though it's the same thing. So it's very confusing for consumers right now, and there's no easy answer, other than being able to confidently identify the source of the ingredients and the, you know the, the strength, the potency and the quality of the ingredients.

Wayne: Yeah, that is what I've seen on packaging - hemp oil or hemp extract - and I've wondered if that might not necessarily mean it even has CBD in it. (Right? Yes) If it's a, yeah, supplement product more so right? (Or made from hemp seeds right?) Yeah made from hemp seeds. Yeah, that one was always confusing. I also thought you know, we were talking about health insurance covering cannabis and those two products you mentioned Epidiolex and Sativex both being isolates. Is that correct? Not a full spectrum product?

Linda: Epidiolex is the first full spectrum product that's been approved through randomly controlled trials by the FDA.

Wayne: Oh so it is full spectrum? Okay, that's good.

Linda: And there you know, believe it or not, the FDA has a really robust website about their opinion of cannabis products. So there's, it's - you could find it really easy easily on the on the US Food and Drug Administration website. They have a really lengthy and quite well written section called "what you need to know and what we're working to find out about products containing cannabis or CBD." And, yeah, so it's, it's something that you'll put on your site.

Wayne: Yeah, we'll put it in the show notes too. I hadn't heard of that one. Yeah, I'm definitely gonna go dive into that on the FDA website. That's great. Well that's such a good I think overview and there's absolutely so much more to dive into for people that want to learn more and you know, kind of figure out how cannabis might work for them. I kind of wanted to end on if, and let me know if you don't want to dive into this but you know, your grandma getting dementia and kind of sparking your interest to look at cannabis and go into this area. Would you mind talking at all about her - was she using, did she try to use cannabis to help with that? What that experience was like, and maybe some, whether results or the experience that others might be able to learn from?

Linda: That, and you know that - that's such an interesting topic for looking back because I at the time, was using cannabis, I've used cannabis my entire adult life and now I know, in retrospect, I was using it medically. I was using it for help with anxiety and depression. But when my grandma had developed dementia, I was still not outspoken with my family or friends about using cannabis myself so it never would have been an option. But you know, what happens with people who have dementia disorders, when they're really advanced, is that they forget people around them and they can't make new memories and they don't remember recent history, but they go back to their childhood or their early adult years. And those memories can cause a lot of anguish or, or not, you know, depends on the person's life, but my grandmother was in a boarding care, you know, a small, private assisted living community and, because she couldn't live alone anymore, and they were is really no medications and the the, the worst her dementia got the less she remembered English. So my grandma was an immigrant who arrived in this country as a holocaust refugee and spoke German and Yiddish. And as her progression, as her dementia progressed, she started forgetting how to speak English and the caregivers did not, like thought she was like speaking gobbledygook and would give her sedatives, you know because they thought she was losing it.

Well, okay, fast forward to recent past and at Harvard, McLean psychiatric hospital recently, there was a patient who was an elderly gentleman named Mr. Spier, who was the head of a beautiful and very well funded, philanthropic family foundation, but he as a boy who had been imprisoned in the concentration camps. And he developed Alzheimer's in his 90s and was brought to the hospital for hospice care. And similar to my grandma's experience, he kind of regressed but became very, very fearful. He thought he was a kid back in the concentration camps and the only medication that helped him, that the family brought in even though the Harvard psychiatric team didn't know about it, was cannabis. And cannabis restored this man's calmness and his comfort. And after he died, the family decided to devote funds from, from his foundation to exploring how cannabis could help other people who were in that situation. And so this was just recently in the news that the, that the - Harvard has received a significant amount of funding from a family similar to my family, but with a lot more money, who could help people do really, really important research into cannabis to treat agitation and help sleep for people like this. So the Spier Family Foundation, you know is an organization that's S-P-I-E-R they're doing amazing work and I hope I wish - you know I get really sad when I think about how I wish I could have brought cannabis to my grandma, but I never thought of it.

Wayne: Yeah, that - I mean, that's the stigma that, the momentum of all that it's. Yeah, we're finally overcoming it, starting to, pass the tipping point hopefully. And it's just, it's crazy to think about the grief and suffering that could be prevented or at least alleviated significantly. So Many people, I can't imagine how we're going to look back in 50 years on this period of prohibition, it's going to be sad, but thankfully, we're making changes now.

Linda: That's right. That's right. You know, there's this this old like kind of silly saying that you can't teach an old dog new tricks. And now we know that scientifically, that's not true, that - you know that older people can learn and retain what they learn. So, you know, we're going to be teaching a lot of old dogs, a lot of really great new tricks and learning a lot along the way. So it's awesome that you spent the time talking about this for our elders and for our future selves.

Wayne: Yeah, I want to end on this question - with your focus on science and tech and bringing cannabis into this for brain health and longevity, I would say - do you expect the human life expectancy to you know go up in let's say, 50 years, 100, where we're living around 100 with quality life? And maybe dying - sounds crazy to say, but passing away around 120-130 being more normal? Do you expect that to happen with all this technology advancements?

Linda: Yes. Yes, the - the longevity research community really does believe that it's possible to extend lifespan by 50 years in the next couple of decades. And that it actually - it can be a lifespan where you're healthy and happy. You know, right now, we wouldn't want that. Right now dementia is happening because scientists figured out how to keep the machine going the meat, right, our organs that - they've got everything figured out to some extent except the brain. So that's why we have dementia because we're living longer. There's a greater life expectancy in developed countries. But we don't know how to keep the brain going to so it's it's a really interesting time. Yeah.

Wayne: That's amazing. Linda, thank you so much. Where can people find you if they want to learn more and any projects or anything you want to let listeners know about that you want to share?

Linda: Thanks for asking, Wayne. I have a website called elderstogether.com and I would welcome any questions or suggestions or outreach through my email there linda@elderstogether.com, and these days I am partnering with registered nurse Barbara Blazer and we have developed courses for assisted living staff people, assisted living managers, to help them understand the use of cannabis in dementia care and we received approval from the California Department of Social Services to present that course. So we're, we're scheduling that right now and actively engaging with care providers, both - both family caregivers as well as professional to help them be more effective and, and help people achieve a lot better quality of life.

Wayne: Amazing that's, that's so cool to hear the state approving that to be taught in these facilities and we've also talked about possibly having Barbara on in the future, so that could be a really cool conversation as well. And I'm fascinated by this. It's definitely a topic or area we haven't gotten deep into, so I'm so happy that we did, I think listeners are really going to enjoy this one. I think it can also help a lot of people, so thank you, Linda, so much for coming on.

Linda: Oh, thank you Wayne! To your long life and better living, and I look forward to hearing lots more from you about this and helping you get the word out.