A Personal Journey with CBD
By Paul J. Lynch, MD, Co-Founder & CEO of Arizona Pain Specialists
Digital - August 2022
My experience with medical marijuana started not as a physician treating patients, but rather as a father desperate to find help for my son. My second child, Austin, suffers from a severe seizure disorder called electrical status epilepticus of sleep or ESES. Austin began life as a healthy newborn and hit all normal developmental milestones, until age 3 when he began to rapidly lose all language skills. He was often agitated and in distress, sometimes becoming violent toward others or himself. As we sought a diagnosis, we learned that Austin was experiencing seizures 85% of time he was sleeping. This is a classic sign of ESES, with significant seizure activity during sleep resulting in stagnation or regression of the child’s development. As a parent, it is heart wrenching to watch, especially when you are unable to help your child. We pursued treatment from multiple specialists, but Austin continued to decline.
During this time, I saw a 2013 news report by Dr. Sanjay Gupta regarding a 6-year-old girl named Charlotte Figi. Charlotte suffered from Dravet Syndrome, a rare and severe form of intractable epilepsy. She was having upwards of three hundred grand mal seizures a week and had lost the ability to walk, talk or eat. After exhausting all other medical treatment options, her parents decided to pursue the controversial treatment of marijuana. They were able to obtain a medical marijuana card for Charlotte in Colorado and found a marijuana grower who grew a strain of marijuana that was high in CBD but low in THC. After initiating treatment, Charlotte became virtually seizure-free and regained her ability walk and communicate.
I began extensively researching CBD and its medicinal uses, hoping that this might be an option for my son Austin. I learned about the endocannabinoid system (ECS), which is not something that is heavily taught in medical school as we are still learning about its functions. The ECS acts as a molecular bridge between the body and the brain and is responsible for regulating and balancing multiple systems in the body, including pain, sleep, mood, inflammation, metabolism, and reproduction. Cannabinoids (such as CBD and THC) function as neurotransmitters within the endocannabinoid system.
However, controversy surrounds CBD, as most people think of marijuana or weed when you say CBD (insert Cheech and Chong song here). While marijuana does contain CBD, the cannabis plant actually produces two main cannabinoids: CBD and THC. CBD and THC have an identical molecular formula, but their molecular structure differs, thus they have different effects in the body. THC has a psychoactive effect, while CBD does not. Medical research has noted CBD to have analgesic, anti-inflammatory, anti-anxiety, antipsychotic, and anticonvulsant properties.
Some of the regulation on CBD began to loosen with the 2018 Farm Bill. This bill changed the definition of cannabis products. Those with greater than 0.3% THC by dry weight are defined as marijuana (and thus federally illegal), but those with less than 0.3% THC were defined as hemp. This allowed for the cultivation of cannabis plants that were high in CBD but low in THC and initiated a rapid expansion of the CBD marketplace.
After a long and winding journey, we were eventually able to obtain a high-quality CBD product for my son. After a few months of CBD use, we began to see changes in his behavior. He regained the ability to communicate. His agitation regressed, allowing him to calmly interact with the world around him. His nighttime seizure activity dropped from 85% of the night to only 8%. Over the past 9 years Austin has been on several CBD products, including most recently the prescription CBD medication Epidiolex. Austin has continued to make significant strides, and I can’t imagine our family without him.
Experiencing how CBD helped my son, I considered how it may also be able to help the chronic pain patients I saw in my practice every day. But I wanted to ensure my patients had access to a high-quality CBD product without the stigma of THC or marijuana. During my research, I learned that CBD can be isolated from many different sources, including fungus, algae, sugar, and citrus. I was most intrigued by an innovative technology called cyclic terpene assembly, or CTA, which uses a compound called limonene from citrus peels. During CTA, CBD is created from the limonene molecule with the use of heat and pressure. The CBD produced by CTA is completely free of THC and unlike synthetic CBD, it is molecularly identical to the CBD found in the cannabis plant.
After years of research and development, we produced a product called Holistic Pain. Our product contains high-dose CBD made from orange peels along with three other ingredients know to have beneficial properties for those suffering from chronic pain. Our product is completely free of THC because it is not created from the cannabis plant.
We have had great initial success with Holistic Pain in our own patients, but I acknowledge the need for further reliable and high-quality data regarding the effectiveness and long-term effects of CBD. We are currently pursuing several different studies within our practice to validate the anecdotal feedback we have received from our patients, while also evaluating its long-term safety and effects.
I am a proud father of a beautiful son who suffers from a severe medical condition. I am also a board-certified pain management physician who seeks to provide the highest quality of care to my patients. Both experiences led me to research the medical benefits of CBD and recognize the need for high-quality CBD products that are free of THC. As a medical community, we should continue to destigmatize and further advance CBD as a viable and important treatment option.
Learn About the Author:
Paul J. Lynch, MD, is a double board-certified and Fellowship trained interventional pain physician practicing in Arizona and Texas. He completed his medical degree from University of Oklahoma, College of Medicine, and Fellowship from Texas Tech University. Dr. Lynch is Co-Founder & CEO of Arizona Pain Specialists, Pain Doctor, Texas Pain, and Boost Medical. Dr. Lynch was recently featured in the Summer 2022 issue of Arizona Physician magazine.
Abu-Sawwa, R., & Stehling, C. (2020). Epidiolex (cannabidiol) primer: frequently asked questions for patients and caregivers. The Journal of Pediatric Pharmacology and Therapeutics, 25(1), 75-77.
Lynch, M. E., & Campbell, F. (2011). Cannabinoids for treatment of chronic non‐cancer pain; a systematic review of randomized trials. British journal of clinical pharmacology, 72(5), 735-744.
Argueta, D. A., Ventura, C. M., Kiven, S., Sagi, V., & Gupta, K. (2020). A balanced approach for cannabidiol use in chronic pain. Frontiers in pharmacology, 11, 561.
Russo, E. B., Guy, G. W., & Robson, P. J. (2007). Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex®, a cannabis‐based medicine. Chemistry & biodiversity, 4(8), 1729-1743
Bergamaschi, M. M., Queiroz, R. H. C., Chagas, M. H. N., De Oliveira, D. C. G., De Martinis, B. S., Kapczinski, F., ... & Crippa, J. A. S. (2011). Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naive social phobia patients. Neuropsychopharmacology, 36(6), 1219-1226.