Evidence of meeting #110 for Veterans Affairs in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was use.
A recording is available from Parliament.
5:05 p.m.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
Before you started on cannabis, had you had any problems with alcohol?
5:05 p.m.
Voices
Oh, oh!
5:05 p.m.
Liberal
5:05 p.m.
Director, Sleep Wake Awareness Program
On the alcohol issue, it's back to basic neuroscience. A lot of the veterans were self-medicating with alcohol. Alcohol is a depressant that allows you to sleep. My veterans who overnight were taken from seven, eight or 10 grams down to three had to revert to alcohol at times, because they didn't have access to the cannabis they needed for sleep.
5:05 p.m.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
That's very useful. Thank you.
Dr. Thirlwell, you said that the regimen you're using is high THC at night to help with sleep.
5:05 p.m.
Director, Sleep Wake Awareness Program
It really depends on where the brain is at and if there has been brain trauma on top of the PTSD or mefloquine on board. Some brains will do very well with sativa at night because it reorganizes their brain. That's a frontal lobe injury aspect. Whereas sativa is traditionally to be used during the day, it seems that higher THC does help most veterans at night, but that's not across the board. It's very individualized and non-homogenized.
As well, we have to talk about the entourage effect from all the terpenes that are in the marijuana, which no one is speaking about.
5:05 p.m.
Liberal
Doug Eyolfson Liberal Charleswood—St. James—Assiniboia—Headingley, MB
Thank you.
Dr. Walsh, what was your take? You talked about restorative sleep. Do you have any data as to whether the higher CBD strains or the higher THC strains are helping with that?
5:05 p.m.
Associate Professor, University of British Columbia, As an Individual
If we were to look one area where we need more research, it's in comparing different strains of cannabis. A lot of what we know comes from talking to people who are using cannabis rather than administering the cannabis ourselves, so it's very hard for us to characterize what kind of cannabis people are using. There is some evidence that CBD can be helpful for sleep. THC can also be helpful for sleep. Also, the combination may be helpful. THC, to the extent that it dulls pain, can help with sleep. CBD is more directly tranquillizing.
5:05 p.m.
Liberal
February 27th, 2019 / 5:10 p.m.
Conservative
Robert Gordon Kitchen Conservative Souris—Moose Mountain, SK
Thank you, Mr. Chair.
Thanks to all of you for being here today. We greatly appreciate it.
I was hoping that Dr. Bonn-Miller would still be here. I had a couple of questions for him, but perhaps some of you might be able to answer them as we go through this.
Obviously, without research, we end up having no guidelines and no standards. We don't know the prescription levels to be used. We don't know the strengths—or the strains, as we've just heard—as to what's to be used along those lines. One of Dr. Bonn-Miller's comments was that he believed the pharmaceutical companies need to be funding a lot of this research. To me, that type of study design has a huge bias. With that bias, you lose validity and you lose all sorts of intrinsic issues.
I'll start with you, Dr. Walsh, and then maybe Dr. Thirlwell can comment on that, as well as Max.
5:10 p.m.
Associate Professor, University of British Columbia, As an Individual
I think we're right to be somewhat concerned with the influence of money on the research process. That goes across the board; it's not special for cannabis. A lot of what we know about medicine today has been funded by pharmaceutical companies, and people have noticed the same problems you're talking about.
There are safeguards in place. I'm doing a study that's funded by Tilray. They're a licensed producer of cannabis. I don't get any money directly from Tilray. They don't impact my salary. My salary is paid by UBC.
I think that's typical for a lot of clinical trials. There are firewalls in place to maintain the integrity of the research and the integrity of the scientists who are conducting these trials. I think we need to be careful with that, but I don't think we can take that potential off the table, because we need so much research and the industry is one of the interests that's going to be able to fund that without dipping into, as you guys know, the already heavily taxed public coffers.
I don't think we could have a special case for cannabis whereby industry is not allowed to fund research. That's how so many of our medicines come to market. We do need to be careful about bias and ensure that the protections are in place.
5:10 p.m.
Director, Sleep Wake Awareness Program
I agree with what you're saying about bias. My approach to medical cannabis from the beginning has been the old approach of medicine: sit down and listen to your patient. There's no reason why doctors can't start with that and monitor patients closely. The veterans have taught me how to do medical cannabis by sitting and taking the time to listen to their journey though this catch-22 quagmire.
The paradigms are changing and shifting. There are new rules of engagement across the board, both in marijuana medicine and in all areas of our society. Why can't the licensed producer companies be mandated by the government to put a percentage of their profits into one pot for research?
5:10 p.m.
Conservative
Robert Gordon Kitchen Conservative Souris—Moose Mountain, SK
Do you have any comments on my question on the biases?
5:10 p.m.
As an Individual
All I'm going to say—because obviously, I'm no professional—is that, from my perspective, the pharmaceutical industry needs to be kept away from the natural state of the plant. There were studies showing that there was a synthetic version of THC which was created that cannot compete with the natural product. There's always a way to make a pill into a buck. This isn't one of those cases. In order to have effectiveness in treatment, the vegetal state or natural state of cannabis has to remain intact.
I do agree with the last doctor; I'm sorry, I forgot your name. I do agree that the licensed producers could help fund research, but having said that, it all comes down to the training of the doctors, which is influenced by the pharmaceutical industry that also funds the different faculties that train those doctors.
I had a personal issue with my GP, who was a new graduate and had no willingness. He wanted me to be on pills. I had to fire him and find a doctor who was willing to work with what I'm working with.
5:15 p.m.
Conservative
Robert Gordon Kitchen Conservative Souris—Moose Mountain, SK
Thank you.
Throughout our study so far, we've had Dr. MacKillop here, and he talked a little bit about chronic use disorders.
I'm particularly interested in some of the research that looks at suicidal behaviours with these chronic use disorders. I'm wondering if you would comment on that, Dr. Walsh.
5:15 p.m.
Associate Professor, University of British Columbia, As an Individual
There isn't evidence linking cannabis to suicide or self-harm. There have been some reviews of it, and the conclusions of the reviews are that there is no way to make that causal association. People who suffer with PTSD and anxiety are at high risk of self-harm and suicide, and they're also more likely to use cannabis, but there is not a link with cannabis causing suicidality.
5:15 p.m.
Conservative
Robert Gordon Kitchen Conservative Souris—Moose Mountain, SK
Dr. Thirlwell, do you have any comments?
5:15 p.m.
Director, Sleep Wake Awareness Program
I agree with what you were saying, and I remember looking at the data of that. From the veterans perspectives and from what I'm hearing from the mouth of the veterans is that, since they have started cannabis, many of them no longer think about suicide. When they were on the pills and the multiple medications, drooling like zombies and not being able to put a thought together, suicide was very, very close.
