Sanctuary Spotlight: Dr. Gregory Smith
Click the hyperlinks to access Dr. Smith’s published works as well as more information on the topics covered.
Tell us a bit about your medical career. How did your path lead you to where you are today?
I trained at Rush Medical College in Chicago, and then I went into the Army for my residency, where I trained in preventive medicine at Walter Reed in Washington, DC. I don’t think I saw a joint for 27 years–never saw one in high school or in college. Marijuana was never part of my recreational background, but around the year 2000, I was out of the military and a doctor in California. They made us take this three-day course on medical cannabis, and it was so ridiculous how little they taught you. They basically told us everyone gets an ounce of weed once a month, and then you see them just to refill more ounces. There’s no concept that this is actually doing anything; we were taught they were getting high and then wouldn’t worry about their cancer or their pain because they’re high.
After that, I used it with patients and realized this is a serious medicine. I also realized you’re not allowed to learn about the endocannabinoid system in medical school because they could lose federal funding if they taught classes on it. It really pissed me off that this was the foundation because there’s a whole system that’s as important to our respiratory system, our cardiovascular system, and it’s called the ECS and we’re not allowed to learn about it because the medical school would lose funding. When you’re trying to help patients–and that’s what we’re trying to do if it’s your career for life–and they take away the direct neurological system because they’re going to lose federal funding, it’s not right.
I actually became quite a big author in the field of disability, and because I wrote books in that area, I had a really good Boston Medical publisher. I went to my publisher and said I was writing the very first textbook on medical cannabis that could be used in medical and pharmacy school. He looked at me like I was crazy.
He came up with a new imprint so it wouldn’t be associated with his publishing house. That was set up five, six years ago now, and Medical Cannabis: Basic Science & Clinical Applications is the most popular medical textbook in North America about cannabis. Because of that, people ask me to be on their boards in the cannabis industry, helping with ingredients, manufacturing, designing delivery systems. It took me two-and-a-half years to write that textbook. By 2017, I was pretty well-known around the world and would be invited to talk or train groups of doctors on medical cannabis.
What makes the FL cannabis market unique, challenging or exciting, both as a doctor and as a resident?
I have started grows in Denmark, Canada and five states in the United States, so I understand different markets; we’re about to start growing in Greece, so I understand that each one’s entirely different. In Florida, the big difference is that we have so many “snowbirds;” [there’s] such a large group of people that come for six to eight weeks or a couple of months every year. Getting them to recognize that their medical cards and their medical needs don’t stop just because they may be a candidate in Michigan has been a huge factor for our program here in Florida.
The average age of our patients is 50 years old, and that is the standard around the state. These are not kids trying to get high; these are people with arthritis, cancer, some serious conditions, inflammatory or autoimmune conditions that are using this as medicine. It’s a lot different from my experience in California; the average age would probably be like 25, but those are the two factors–travel and the age of the patients.
What are some common misconceptions about cannabis the average person holds? What do you wish more people knew about the plant?
The common misconception, to this day, is that it’s still snake oil. If I polled a hundred regular family doctors in Florida, they would think they’re smoking pot, they’re getting high so the pain doesn’t bother them, so their anxiety doesn’t bother them. Around the world and the medical community, they still don’t think it’s medicine. That is a serious barrier that we need to supersede.
Another common one is that weed is weed; you don’t really need to go to a dispensary because you can buy weed from the guy down the street. That is so wrong. There’s literal medical marijuana that tends to be equally balanced with CBD and THC. There’s weed to get high, which has almost no CBD, and then there’s weed to treat seizures and neuropathic conditions that’s got almost no THC. There’s all sorts of reasons to not just get what your neighbor’s selling.
One more is that it’s addictive. It’s been shown that about nine percent of people can develop a physical dependency on it. The best way to describe that physical dependency is caffeine; you get about as physically dependent as you would on a cup of coffee. You wake up in the mornings and want your coffee; you’re irritable, you don’t have your coffee, you have a headache, but you’re not going to go steal someone’s money for a cup of coffee. It is a very mild addiction for up to 90 percent of people; it’s not the type of terrible addiction you see with methamphetamines or opioids.
Broadly speaking, what sort of ailments, conditions or otherwise have you found where patients have benefited from introducing cannabis to their treatment regiments?
I have a textbook that just came out on how to use cannabis to get off of opiates. I’m reading the literature all the time, doing research all the time. Pain is number one; chronic pain, neuropathic pain, diabetic pain, cancer pain, so this huge category is number one. Anxiety is number two and [cannabis] is, without a doubt, one the most effective medicines for those two conditions. That’s probably 80, 90 percent of your patient population no matter what state you’re in. You can then get to autoimmune conditions like irritable bowel, inflammatory bowel diseases. It’s not just medical cannabis; CBD, which doesn’t require the medical card, helps with a variety of other conditions and is pretty effective. But when we’re talking about medical marijuana, [the two main ailments are] pain and anxiety.
What sort of research or studies done on cannabis have you found insightful or interesting in recent years?
What’s happening next is the varins–THCV and CBDV. These are two minor cannabinoids that have all sorts of novel effects on the body using the endocannabinoid system as well as some other receptors outside of the ECS. The biggest thing will be very effective weight loss with the use of varins; they actually cause the anti-munchies. When you smoke and you get hungry–especially for high-calorie, dense, fatty foods–this blocks it. Even if you are hungry, you don’t feel hungry; you can put pizza in front of me and I’m not interested. That’s the exact opposite of the munchies, and it’s using these two varins. There’s also hair regrowth, eyelash regrowth, probably some treatment effects on tinnitus, it’s all using this new class of minor cannabinoids called the varins.
We’ve already got four studies; three of them were NIH-supported. We had about 600 people lose an average of 3.5 lbs. of weight per month. It continues well past the nine-month mark with 30 percent improvement in blood sugar, blood fats, so this is going to be big. This is the treatment for the metabolic syndrome, which probably affects 25 percent of all adults over age 18. Metabolic syndrome did not exist until I was getting out of medical school sometime in the late seventies, early eighties, and it’s now 25 percent of the population. It’s a huge problem; obesity, hypertension, diabetes and fatty liver. The varins turn the clock back on the metabolic syndrome and reverse it.
What has you most excited for the future, both for yourself and medical cannabis in FL?
I think most of us as a community are looking forward to federal recognition and taking cannabis off of the Controlled Substances Act where it is still in Schedule I. That would be just huge; we could just treat it like alcohol or tobacco where you have to be a certain age to buy it yet and need a permit or license to sell it. It’s not an addictive drug–it’s certainly much better than tobacco and alcohol–but still have it regulated throughout the whole country [in the same manner].
If you consume, what are some of your favorite methods or products?
I’m kind of old school; we came up during the Mexican weed days, which was three-to-seven-percent-THC stuff. I really liked the delta-8 products and think they’re really under-recognized for a variety of reasons, probably because of the way they came out to the public. If delta-9 THC is a tequila, delta-8 is a glass of beer. You can regulate it; it’s much milder for whatever condition you might be using it for. It binds to the exact same receptors, it’s just very weak, so that really is powerful and I like it a lot.
Disclaimer: The views, information and opinions expressed in this piece are the interviewee’s alone and do not necessarily reflect those of Sanctuary Medicinals. The primary purpose of this piece is to educate and inform; it does not constitute medical or other professional services and advice.