Why women are turning to cannabis for menopause & pain

[0:00] You know, when we first met in 2013, you introduced yourself as the pot doc, which is something that still stuck in my head. [0:07] I think I said sometimes patients call me the pot doc. [0:10] Yeah. [0:10] I probably wouldn't have adopted that moniker myself. [0:12] No, but you seemed welcoming of it. [0:14] I didn't mind. [0:15] You didn't mind it. [0:16] How have things changed, would you say, over the last 12 years or so when it comes to cannabis? [0:20] I think things have changed immeasurably. [0:22] There is a universal or seemingly almost universal acceptance at this point that cannabis or cannabinoid-based approaches [0:29] to things like medicine and therapy are alternatives for folks where we didn't used to think of them as options before. [0:36] One of the areas that you seem to be focusing on now is women. [0:40] Why women's health? [0:41] So women are largely underserved and underrepresented in medicine. [0:45] We know this. [0:46] And when it comes to things like chronic pain, for example, which is generally almost always the number one indication for medical cannabis use, [0:53] depending on where you are in the country, women suffer from chronic pain conditions more often than men. [0:57] There are studies that suggest that women are more sensitive to pain, and yet they are often underserved with conventional medications. [1:05] When it comes to pain again, and specifically with women, things like endometriosis, is that a viable area of study? [1:11] We actually have a clinical trial focused on exactly that for that specific reason. [1:16] So when we think in the big picture, gynecologic pain affects more than one billion, B, with a B, women worldwide. [1:24] When we think of endometriosis, something like one in ten individuals will have endometriosis. [1:30] And for the folks who have endometriosis, they are often debilitated. [1:35] They can't live their lives. [1:36] They lose sleep. [1:37] They lose productivity because they can't go to work. [1:41] And conventional medications don't necessarily do the job. [1:44] And so when you see people trying cannabis or cannabinoid-based therapies and saying, [1:49] hey, this is more helpful than the NSAIDs I was taking, there's got to be something to it. [1:53] Let me share something with you that I learned in Tulsa. [1:55] You know, we spent a week there. [1:57] There's this woman, April Ayers. [1:58] She was a former real estate person who decided to transition to the cannabis industry. [2:04] She's in her mid-50s. [2:05] She told me that her dispensary, which is called Cowboy Kush, [2:08] the average demographic is a 54-year-old woman that comes in there. [2:13] It's an all-female staff. [2:15] And one of the nights that I was there, everybody that came in was a woman. [2:20] And they were there for sort of this learning seminar on cannabis for women. [2:25] I'm just curious your top-line thoughts. [2:26] Is something happening with regard to women and weed? [2:30] So I think that women are, again, vastly underrepresented in both the cannabis industry [2:35] and in terms of the actual patients with the cohorts that people are trying to treat. [2:39] But they're often the people who need the most help. [2:42] And so that is beginning to change. [2:45] People are much more willing to come forward and say, I want to try this, I want to try that. [2:49] There are many more women now in the cannabis industry. [2:51] And women in the cannabis industry are invested in helping other women [2:54] understand the what's and the why's and the how's. [2:58] And that is a game changer for people. [3:00] That's really something when we think about the lack of education in the general public [3:04] and specifically with health care providers who don't know much [3:07] and who will tell, most responsible health care providers will tell their patients, [3:11] I'm not sure I know enough about this, so we may have to recruit other folks to help fill in the blanks. [3:17] Many of the women there, again, 54-year-old being the average age, [3:20] were coming in for hot sweats and night sweats and hot flashes and headaches and mood disorders. [3:27] A lot of overlap with the reasons people took cannabis in the first place. [3:30] In the first place, exactly. [3:31] But a very specific demographic of people. [3:33] Where do you think this goes? [3:35] In terms of the future? [3:37] Do you think recently, as you may have read, the black box warning on hormone therapy got lifted. [3:41] Of course. [3:42] It took 25 years, and it makes sense in so many ways if you look at the data. [3:48] But I think part of what we were seeing is that there weren't a lot of great options for women, [3:52] especially during this phase of life with menopause. [3:55] What do you think is driving the interest of women when it comes to cannabis? [3:59] I think that when we think of menopause and the things that, again, [4:03] the top three or four things that affect women in terms of hormonal dysregulation, [4:07] again, mood dysregulation, sleep dysregulation, chronic pain, aches and pains, [4:11] people will tell you, I have aches and pains in places and spaces I didn't know I had. [4:16] And so it echoes exactly what we see across the cannabis landscape anyway. [4:22] And people are now much more invested in exploring things that may be helpful [4:26] and not harmful to them in the aggregate. [4:29] One thing that surprised me was the use of cannabis during pregnancy. [4:33] And I just want to riff with you a little bit here because I sort of am working through this myself. [4:37] The idea that, you know, you can develop significant nausea, vomiting during pregnancy, [4:43] you can have significant pain, mood disorders, all the same things that we talk about with cannabis, [4:48] those things can get amplified during pregnancy. [4:51] At the same time, we think, God, that doesn't sound right. [4:54] The idea that a mom might expose a developing baby to cannabis. [4:59] How do you think about it? [5:01] I think about it as a very, very challenging topic. [5:03] And I think, again, cannabis is not one thing. [5:07] Some of the folks that I've spoken to who choose to use cannabis or cannabinoids while pregnant [5:11] are using things that are high in non-intoxicating cannabinoids [5:14] with maybe just, quote, a scoach, if that's a term, of THC. [5:20] That's usually where they are. [5:23] Other people will use products that anybody uses for recreational purposes. [5:26] They take a hit or two. [5:27] It's challenging because there is some data, clearly, that suggests there are negative effects [5:33] to the unborn child. [5:34] It really depends on what you're using, how often, when, so many things. [5:38] Based on what we do know about cannabis overall, [5:40] is there anything to specifically say about cannabis in pregnancy? [5:43] I don't know that we have all the answers yet. [5:45] There's been a fair amount of investigation in this particular area [5:48] because people in different parts of the country, [5:52] there are particular demographics, I think, that are affected [5:54] and that come forward and talk about their use of cannabis and cannabinoids. [5:58] This was the only thing that got me through. [6:00] But I think we don't have all the data. [6:02] We don't know everything. [6:03] Had you heard the term cannabom before? [6:04] Yes, I have, yes. [6:06] So what is a cannabom? [6:07] It's sort of like a soccer mom, but at the end of their day, [6:10] they may go home and instead of having a cocktail or something else, [6:13] very often cannaboms are those who have decided to turn to cannabis [6:16] or cannabinoid-based therapies instead of alcohol. [6:18] Do you think that's been driven by the decrease in stigma, [6:22] the dissatisfaction with alcohol, all of that? [6:25] Yes. I think the Surgeon General coming forward [6:27] and talking about the relationship between alcohol and cancer [6:30] changed, again, the nation's perspective of alcohol. [6:34] You know, there's a sort of a collective rut row. [6:36] Now what? We need to have something. [6:38] And so, you know, THC-infused beverages [6:41] or cannabis-infused beverages became incredibly popular. [6:44] You can find them everywhere. [6:45] There's a study from the University of Michigan [6:46] which has found that women between the ages of 19 and 30s or so [6:50] are now a larger user of cannabis as a demographic than men. [6:56] Does that surprise you? [6:56] It doesn't really surprise me. [6:58] I think that, again, women are more likely to lean into things [7:01] that will help them with multiple aspects of their lives day to day, [7:05] whether it's taking, quote, the edge off at the end of a day [7:08] or to address sleep disruption, mood dysregulation, or chronic pain. [7:12] When it comes to the Women's Health Initiative, [7:15] what are the big unanswered questions for you? [7:17] So for us right now, I think one big unanswered question [7:21] is how best to leverage some of these non-intoxicating cannabinoids [7:25] with certain terpenes to give individuals real pain relief [7:29] where you can change the trajectory of someone's life [7:33] as opposed to just living with being completely debilitated [7:37] for three or four days of a month. [7:39] And that's really, truly what happens to people. [7:41] They will tell you stories where they have to physically pull a car over [7:45] because they can't drive anymore. [7:47] They will tell you they missed their daughter's first recital. [7:50] All of these horrific stories that don't sound terrible on their own, [7:53] but in the aggregate, are a game changer and life-changing. [7:56] Where do you think this era of women and weed goes? [8:00] Does it continue to grow, do you think? [8:01] I do, because so many are in need. [8:07] It's really, again, when I think of the number one billion, [8:10] one billion worldwide have gynecologic pain. [8:14] That's an astounding number of people. [8:17] And if there's a possibility for a fraction of those individuals to be helped [8:21] and not necessarily introduce tremendous harm and risk, [8:25] we should be exploring that. [8:26] Women are increasingly more inclined to speak up and to be seen, [8:31] to be heard and to be treated. [8:33] You know, a lot of people don't come forward and say things like, [8:36] I actually have been suffering terribly with anxiety or depression. [8:39] My husband doesn't know. [8:41] My kids don't know. [8:41] I can't let anybody know, but quietly I fall apart every day at X o'clock. [8:48] And since starting this, I don't have that anymore. [8:51] It's a game changer.