Medical Cannabis Therapies · About Me u Dr. Allan I. Frankel u 38 years as a practicing Internal Medical Doctor, specializing in the use of dosed cannabis medicines for the past

Allan I. Frankel, M.D.

GreenBridge Medical Services, Inc.

[email protected]

2730 Wilshire Boulevard, Suite 425

Santa Monica, CA 90403

310-393-0640

Medical Cannabis Therapies

© Allan I. Frankel, M.D.

About Me

u  Dr. Allan I. Frankel

u  38 years as a practicing Internal Medical Doctor, specializing in the use of dosed cannabis medicines for the past 11 years

u  Recommended dosed cannabis medicines to over 10,000 patients during this time

u  Graduate of the UCLA School of Medicine

u  Presented multiple CME accredited Grand Round Lectures on Internal Medicine and Therapies in Medical Cannabis. Participated in round table discussions on the topic of future therapies and research for Medical Cannabis sponsored by the California Medical Association and the Los Angeles County Medical Association

u  Clinical Professor for 12 years for the University of California Los Angeles School of Medicine

u  Developed the Chartscape medical software program used by the UCLA Bowyer Cancer and the eScript medical software utilized by Kaiser Permanente Health System


How I Discovered Cannabis Medicine

u  Following a severe medical condition, I searched for alternatives to traditional medicines

u  I researched cannabis and found it to have the potential to relieve the symptoms of multiple chronic and serious illnesses

u  Cannabis is significantly less addictive and has less side effects than many pharmaceuticals used to treat illness

u  What was lacking in cannabis medicine was true dosing



The Key Players:

Endogenous Cannabinoids

Plant Derived Cannabinoids

The Major Cannabinoids

u  THC

u  CBD

u  THCA

u  CBDA

u  CBG

u  CBC

u  THCV

u  CBDV


Benefits of the Major Cannabinoids

u  Analgesic

u  Anorectic

u  Anti-inflammatory

u  Anti-ischemic

u  Antibacterial

u  Antidiabetic

u  Antiemetic

u  Antiepileptic

u  Antimicrobial

u  Antiproliferative

u  Antipsoriatic

u  Antipsychotic

u  Antispasmodic

u  Anxiolytic

u  Bone growth/repair stimulant

u  Immunosuppressive

u  Intestinal anti-prokinetic

u  Neuroprotective

u  Vasorelaxant


Cannabinoid Receptors


Cannabinoid Receptors


Neurotransmission


The Entourage Effect

u  In addition the primary cannabinoids, cannabis medicines deliver:

u  Other Major Cannabinoids

u  Minor cannabinoids

u  Terpenes

u  Flavonoids

u  Waxes


CBD Medicines Cannabis vs. Hemp vs. Synthetic

u  There are three types of CBD available to patients. The first is from the Cannabis plant, the second is from the Hemp plant and the third is made in a laboratory

u  CBD from the Cannabis plant is extracted from the flower and leaves of the plant and contains hundreds of minor cannabinoids, terpenes and flavonoids

u  CBD from the Hemp plant does not have as robust a profile of minor cannabinoids, terpenes and flavonoids

u  Synthetic CBD, which is created in a laboratory, has only a CBD molecule and does not contain any other compounds

u  In my clinical experience, CBD from the Cannabis plant is much more effective in relieving patient complaints at lower dosages than Hemp or Molecular CBD


Cannabis and the P-450 System

u  The interaction of Cannabis medicine with Cytochrome P-450

u  The effect of different Pathways of Cannabis administration

u  The effects of THC and CBD on Cytochrome P-450

u  Effect of changes in Cytochrome P-450 on other therapies

u  Cancer

u  Seizure Conditions



The Normalization of Cannabis Medicine


The Medical Cannabis Visit


Patient Complaint


Expected Outcome


THC Experience - Very Important


Any Contraindications/ Drug Interactions


Start Low - Go Slow (Most of the time)


Consistent Accurate Dosage Products


Know the Psychoactivity of Products


Determine Condition Appropriate Medication


Adjust Medication Based on Patient Reaction to Product Psychoactivity

Cannabinoids as Essential Nutrition

u  Endocannabinoid Role in Maintaining Your Body’s Homeostasis

u  Clinical Endocannabinoid Deficiency Syndrome

u  Fibromyalgia

u  Migraine

u  Irritable Bowel Syndrome

u  Endocannabinoid “Tone”

u  Cannabis as a supplement


Systemic Effects of Cannabis

u  Anti-inflammatory

u  Anti-spasmodic

u  Mitochondrial Modulation

u  Immune System Modulation



u  Anxiety

u  Neuropathic Pain

u  Autistic Spectrum

u  Irritable Bowel Disease

u  DJD and Metastatic Disease

u  Parkinsons Disease

u  Dementia

u  Myasthenia Gravis

Mitochondria

Specific Conditions

u  Traumatic Brain Injury

u  Insomnia

u  Seizure Conditions

u  Migraine

u  Multiple Sclerosis

u  Diabetes

u  Cancer

Palliative

Anti-Proliferative

Potential Therapeutic Uses


Case Histories

u  Myasthenia Gravis Case

u  Seizure Condition Case

u  Traumatic Brain Injury Case

u  Cancer Case


Myasthenia Gravis Case History

u  42 year old female, first visit 2014

u  Diagnosed with Myasthenia Gravis in 2001

u  Symptoms included: drooping eyelids, double vision, slurred speech, restricted swallowing and weak facial muscle movement


Myasthenia Gravis - Continued

u  Since 2007 she has been on 10 - 20mg of Prednisone daily. Her neurologist tried other “steroid sparing” drugs, but she was unable to adapt due to liver enzyme and white blood cell impacts.

u  Admitted to the ICU for three weeks in 2011 with a feeding tube, unable to speak or swallow and experiencing double vision. She received high doses of Prednisone and IVIg treatments while hospitalized.

u  Gained over 70 pounds of weight and experienced other negative side effects of the Prednisone.


Myasthenia Gravis - Continued

u  Tried several naturopathic therapies, all to no avail

u  I initially recommended a high CBD oral spray and capsule. She saw improvement of all symptoms within two days and within three weeks was able to reduce the Prednisone to 5mg/day with no withdrawal symptoms.

u  Within two months she was able to stop using Prednisone. Over the following months, we used several different dosing regimens and she remains off all other medications with continued improvement of all symptoms and no side effects


Seizure Condition Case History

u  Three year old male, first visit in June 2015

u  He had recently begun having seizures, escalating to several hundred per day.

u  Diagnosed by a neurologist as having Doose Syndrome, and was prescribed Depacote, which resulted in severe side effects.


Seizure Condition - Continued

u  At our first examination, he had stopped taking the Depacote and I recommended a CBD extract three times daily. Over the coming weeks his condition improved and his seizures activity decreased. We continued to up his dosage over the next months, and he went for periods up to 10 days without a seizure.

u  By mid 2016 he was greatly improved and his seizure activity had nearly ceased. In December 2016, his family celebrated one year with no seizures.

u  He continues to use high CBD cannabis extracts and has not experienced any seizures.



Traumatic Brain Injury Case History

u  44 year old female who had a car accident in May 2013

u  Had no memory of the accident and was confused; both crying and laughing at the scene. She was taken to the hospital, treated and released.

u  The next morning she woke up and immediately began throwing up. Diagnosed with a concussion by her physician, and severe post-concussed syndrome by a neurologist.


Traumatic Brain Injury – Continued

u  Symptoms worsened and included: she could not recognize faces, memory was severely impaired, loss of cognitive skills, depression and passing thoughts of suicide.

u  Prescribed Namemda and anti depressants six months post-accident, they did not provide relief.


Traumatic Brain Injury - Continued

u  I first saw her in October 2014 and recommended a high CBD extract capsule with lessening of symptoms within a week. At her next office visit, there was significant improvement in her appearance, demeanor and, according to her, many of her symptoms.

u  After two years on high CBD extract capsules. She feels she is now back to about 85% memory, and other symptoms such as emotions and motivation are slowly returning. She feels she is continuing to improve on the high CBD extracts and looks forward to returning to work and regaining her life.


Cancer Case History

u  51 year old female

u  Diagnosed with Stage 4 mammary invasive ductal carcinoma, metastatic to the liver, in August 2014.

u  Cancer type was estrogen and progesterone positive and HER-2 negative.


Cancer Case – Continued

u  Had a left breast mastectomy in October 2014 and started chemotherapy in November 2014. She had four rounds of Adriamycin and Cyclophosphamide, one round every two weeks. She chose not to do radiation.

u  Started Tamoxifen in January 2015 and her oncologist said he wanted to monitor the lesion on her liver. He advised her the Tamoxifen would keep the cancer “at bay” for a few years and if/when it the lesion started to get larger or spread he would switch medications.


Cancer Case - Continued

u  I first met the patient in May 2015 and recommended she start taking combinations of CBD and THC twice daily.

u  After three months the lesion on her liver started getting smaller and side effects of Tamoxifen began to subside.

u  In April 2016, 11 months after starting cannabis therapies, there was no evidence of disease in her liver and she was diagnosed cancer free.

u  Cannabis medicines also relieved her anxiety, depression, periodic nausea, muscle aches and joint pain and eased her hot flashes.


GreenBridge Medical Services, Inc.

[email protected]

2730 Wilshire Boulevard, Suite 425

Santa Monica, CA 90403

310-393-0640

For Additional Information Contact Allan I. Frankel, M.D.


Documents

Medical Cannabis Therapies · About Me u Dr. Allan I. Frankel u 38 years as a practicing Internal Medical Doctor, specializing in the use of dosed cannabis medicines for the past