Cannabis’s biggest antagonist is the stigma that surrounds it. Whole plant medicine has the potential to significantly benefit the pharmaceutical industry by complementing their efforts to bring patients relief from their ailments. Systems dynamics consultant/researcher, Ruth Fisher, PhD, explains how cannabis has the option to flourish but needs to stop having its efforts for growth and research hampered by opinions.
Can you tell us a little bit about your background? How did you become interested in medical cannabis?
Ruth Fisher: I have a PhD in economics, and I am a researcher and consultant in the area of systems dynamics, with experience in healthcare and technology. I use modeling and data analysis to look at how the healthcare system or technology systems create value for different participants or stakeholders, how systems evolve over time, and how to generate better outcomes at the system level.
I had tried cannabis recreationally, but it wasn’t my thing. And, truth be told, my attitudes toward cannabis had been negatively shaped by the stigma. I had become aware of medical cannabis during the early 1990s, when it was receiving attention for its use by AIDS patients. However, at the time, I quickly dismissed the idea that cannabis could provide actual health benefits, though I condoned its use by patients as a means of escaping from their disease.
I came to cannabis in 2015 when my brother asked me to help him figure out how to improve the benefits he was getting from cannabis to treat his multiple sclerosis (MS) pain. His neurologists told him that he might benefit from using medical cannabis, but the doctor could provide no guidance himself, so my brother was left to figure it out on his own. I was shocked to hear that cannabis was actually providing positive effects, but all that really mattered to me at that point was helping him figure out how to use it more effectively. I started reading about cannabis, and I haven’t stopped reading. The more I know about cannabis, the less I feel I know, but the more intrigued I become. Cannabis challenges me in all my areas of interest: healthcare, science and technology, industry evolution, market competition, and general system dynamics.
Please tell us about your article “Transitioning to 21st Century Medicine: The Promise of Whole Plant Medicine.” What inspired you to write this piece and what do you hope people will take away from it?
Fisher: My article, “Transitioning to 21st Century Medicine: The Promise of Whole Plant Medicine,” describes how advancements in science and technology have led the pharmaceutical industry to evolve to where it is today, why the industry has not been more effective in discovering effective treatments for patients, and how to change the system so as to generate more effective treatments.
My brother’s experience with MS in general, and cannabis in particular, has made me a strong and passionate advocate for alternative healthcare treatments. At the same time, the part of my brother’s journey with his health problems that has had an impact on me, perhaps more than anything else, is how poorly the traditional healthcare system has been able to meet his needs. Since I’ve been learning about and advocating for medical cannabis, I’ve seen just how many other people have had that same experience.
Let me say that I have tremendous respect for doctors and all the other people in the healthcare system who do their best to help others. In fact, my father was a private practice physician, and he was my hero and role model. But I think the current healthcare system is failing a lot of patients. As a game theorist and researcher, I’ve seen how the system has evolved, and I understand why it generates the outcomes it does. A good friend once told me that it’s useless for a consultant to tell someone they have a problem unless she can also tell that person how to fix the problem. My purpose for writing this article is to tell people what the problem is, why it exists, and how to fix it.
What do you hope will change in the cannabis industry? Where do you find the most difficulties and how do you deal with them?
Fisher: Cannabis is a very new industry that has sprung up from scratch and whose operations are being figured out by industry participants as they go. The industry’s product (a drug), its scientific and technological potential, its medical potential, and its commercialization potential have all attracted a huge variety of participants. The sheer absence of information, amount of misinformation, and the disinformation out there, combined with the massive complexity of the plant, the supply chain, and the medical use has created unparalleled amounts of chaos. The uniqueness of the cannabis industry, particularly its botanical and medical complexities, means there will always be chaos. However, I think two areas need particular attention.
One big problem that I believe must be addressed is the wholesale lack of accuracy and transparency of information about the contents of cannabis products. Testing standards must be established and enforced so that cannabis product contents can be accurately assessed. All users must be ensured that the cannabis products they buy are free from toxins that could be harmful to their health. All users, and medical users in particular, must have access to product contents—profiles of cannabis compounds and any other additives—so they know what they’re getting and can figure out which products work for them and which do not.
The other big problem is regulation. The Schedule I classification of cannabis is clearly impeding development of the industry. Aside from that, I think the power of the regulators must be tempered. As it stands, regulators can—and do—change regulations on a dime. This has been devastating for anyone currently conducting any type of activity in the cannabis industry, and it has severely dampened much more entry into the industry. So much beneficial activity—science, technology, and medical advancements—are being terribly delayed by the Schedule I classification and harsh regulatory regime in cannabis.
How do you deal with the stigma surrounding cannabis?
Fisher: I, myself, had bought into the cannabis stigma. I had tried it; there were plenty of people I knew and respected who used it, and I still condemned its use. However, as soon as I learned about the endocannabinoid system (ECS) in our bodies and how wondrously cannabis acts on our ECS, I was absolutely convinced of the tremendous potential of cannabis for helping with our health and well-being. Education is what convinced me, and I believe education is what will convince others. I will educate anyone who will listen about cannabis.
Do you think there should be more research into the medicinal properties of the cannabis plant and its interactions with the endocannabinoid system?
Fisher: Absolutely! We have just begun to understand the plant and how it works in our bodies. And it was scientists trying to figure out how cannabis works in the body that led to the discovery of the ECS in the first place. In other words, studying cannabis and the ECS helps us understand more about how our bodies work in all areas, not just in cannabis or the ECS. At the same time, the more we understand about how the plant interacts with our ECS, the better able we will be to use cannabis extracts and isolates, not to mention design derivatives and synthetics to improve our health and well-being.
I believe the applications researchers discover for using cannabis, cannabinoids, and endocannabinoids to improve health and well-being are going to mushroom. And it doesn’t stop there. The science and technology—plant genetics, cultivation techniques, extraction techniques, molecular chemistry, mass spectrometry, emulsion technologies, medical delivery mechanisms, and pharmacokinetics, just to name a few—are all being pushed to their limits and advancing quickly, thanks to research and development in cannabis. These advances in the science and technology of cannabis will have massive follow-on effects in many other industries.
Do you think whole plant medicine has the potential to overcome pharmaceutical medications?
Fisher: I believe plant medicine has the potential to fantastically supplement current and future non-plant medicines developed by the pharmaceutical industry. But for the historical achievements by pharmaceutical companies, we would still be dying young from bacterial infections. Traditional pharmaceutical techniques have had a huge amount to offer and will continue to do so. At the same time, traditional medical treatments would be massively enhanced by the addition of whole plant medicine.
What topics to you plan to tackle next in your cannabis writing?
Fisher: I’m currently looking at how licensed cannabis suppliers—growers, processors, distributors, and retailers—for both medical and recreational uses and in different states are configured in the industry. Are most activities conducted by independent companies? Are companies aggregating horizontally, that is, forming chain locations? Are they aggregating vertically, that is, performing more than one activity in the supply chain? Both regulatory pressures and competitive pressures affect how companies choose to configure themselves across the various activities in the supply chain. The configurations that result from these pressures will have important implications for the accessibility of cannabis for consumers, such as: Will there be much variety in forms and formulations of use? Will prices be high or low? Will quality be high or low? Will recreational use squeeze out medical use?
Do you have any additional comments you would like to add?
Fisher: Most traditional scientists and healthcare industry participants recoil at the suggestion that cannabis be legal and widely available for medical use. Their immediate reaction tends to be, “we don’t know enough about how it works in the body!” In other words, using cannabis is risky.
Whether or not cannabis is risky is not the appropriate question. Every substance on the planet is potentially risky, if used inappropriately. All it takes is a quick glance at the labels or inserts for any package of medication to see that any medication involves risk.
The appropriate question to ask is: Do the benefits of cannabis exceed the risks? For most people, the answer is yes.
It will probably take decades for researchers to really figure out how cannabis works in the body. However, in the meantime, millions of people either do not have access to, or have been utterly failed by, other forms of medication. What do all these researchers propose all these people do until researchers are satisfied that they finally know enough about how cannabis works to recommend its use?
To read Fisher's article “Transitioning to 21st Century Medicine: The Promise of Whole Plant Medicine,”, please visit: https://www.cannabissciencetech.com/view/transitioning-to-21st-century-medicine-the-promise-of-whole-plant-medicine.