BY MARIE LODI
The legalization and cultural acceptance of cannabis in mainstream society has undoubtedly grown significantly in recent years, and it’s worth acknowledging how a certain group of proponents have played a major part in helping us get there—medical professionals. Many cannabis-friendly physicians have recognized the medicinal and therapeutic wonders of the plant for a large part of their careers, and in the process, they’ve witnessed firsthand the industry’s progressions.
Recently, we learned about two such open-minded professionals, Dr. Genester Wilson-King and Dr. Jeanette Jacknin, and both of whom have been working with cannabis before the big, green boom. In the second installment of our two-part exploration of the complex intersection of medicine and weed, Dr. Melanie Bone and Dr. Jordan Tishler discuss their fascinating career trajectories, and what convinced them to believe in cannabis when much of the stigma was still attached to it.
Dr. Tishler practiced emergency medicine for over 20 years before incorporating cannabis into his career. While working with the VA, where he saw thousands of veterans whose lives had been destroyed by substance addictions, none involving cannabis, Tishler became interested in studying the plant. “This apparent lack of harm led me to wonder whether there was any validity to cannabis medicine and provoked me to spend a couple of years digging into the medical literature to find out,” he says. At first, Dr. Tishler went into his research with skepticism, but says that eventually he felt that with the appropriate attention to a patient’s medical condition and correct dosing administration, cannabis could be a very effective medication.
“The key decision point for me was in looking at the way in which some patients were not getting adequate treatment via conventional medications,” Dr. Tishler explains. “In my world, everything begins and ends with the patient.” He soon realized that he would not be able to practice cannabis medicine at the VA or other institutions he had been associated with, so he started InhaleMD. “I never set out to be in private practice, but rather found that this was the way in which I could circumvent some of the red tape and provide this kind of care to patients. My model has always been to select the sickest patients and to work with their care team in these large institutions to provide appropriate medical treatment,” Dr. Tishler says.
This led Dr. Tishler to start the Association of Cannabis Specialists, which has since grown to become an international organization. “The goals of this organization are to educate cannabis specialists about providing high quality, evidence-driven care, and to educate other clinicians as to when they should refer patients to a cannabis specialist. Additionally, we strive to educate lawmakers about the regulations and tools that clinicians need to take care of their patients, helping them better understand patient’s needs in order to provide appropriate products for them.”
One of Dr. Tishler’s areas of expertise is the treatment of sexual dysfunction, for which cannabis is extremely effective for but rarely talked about. “I have a number of patients who come to see me for this issue primarily—but I also find that many of my patients who come to see me for the more obvious sets of illnesses report that, as a side benefit of their treatment, they are now having some of the best sexual encounters of their lives,” he says.
When it comes to areas of improvement in the industry, Dr. Tishler says the biggest problems he faces currently stem from the lack of understanding that medical patients are completely different from recreational users. Because of this, he, and the Association of Cannabis Specialists, assert that there are two major changes that need to happen once cannabis is legalized at the federal level. First up: cannabis needs to be written by prescription, as is protocol for most conventional medications. “[This] is a good way of communicating to the patient how to use the medicine properly, but also prohibits the point-of-sale from misdirecting the patient,” he says. “We also believe that both dispensaries and product manufacturers should not be making claims about their product’s medical value without appropriate scientific studies to prove it.”
Dr. Melanie Bone, MD, FACOG
Dr. Melanie Bone is a board certified OB-GYN, a medical marijuana provider, and long-term Stage lll breast cancer survivor based in Florida.
Dr. Bone has been a practicing OB/GYN for 30 years, with a primary focus on menopause medicine. Her patient base consists of women who are searching for options to manage menopause, including the integration of women’s health and cannabinoids. “As a long-term cancer survivor, I recognize that we are born with certain health risks, and that other risks are lifestyle-related,” Dr. Bone says. “Both influence our overall health, but managing our risks and wellness necessitates the use of both allopathic and complementary interventions. To me, quality of life is paramount. My role as a practitioner is to guide patients to find the sweet spot of medicine where they maintain their physical health while attending to their global wellbeing.” Dr. Bone arrived to her work with cannabis after learning that one of her children, Carlton, had used cannabis in order to treat anxiety. “Unfortunately, while at the therapeutic boarding school they were attending, Carlton contracted a rare, life-threatening disease called Steven Johnson Syndrome (SJS) due to the mood-stabilizing drug Carlton was given,” Dr. Bone says. After recovering, Carlton shared that the reason they [Editor's note: Carlton’s preferred pronoun is “they”] used cannabis was to treat social anxiety and mood issues.
“In navigating the traumas of our past relationship, and how cannabis impacted things, I was able to separate personal experiences and attitudes from broader dynamics, to the benefit of my relationship with my children,” Dr. Bone explains. “Learning how cannabis might offer potential alleviation for symptoms my child continued to experience and witnessing their growth through responsible cannabis use, motivated me to reevaluate my beliefs and do my own research.” Dr. Bone and Carlton ended up launching a cannabis edibles business in Oregon shortly after cannabis became recreationally legal there.
Through her patients, Dr. Bone has seen firsthand the positive effects of cannabis for those with extreme medical issues. One patient of Dr. Bone’s had been using 30 Percocet pills during each menstrual period in order to tolerate painful cramps. The patient was skeptical about using cannabis, but read that it could help. Now, the patient no longer needs to use narcotic pain medication for her period cramps.
Dr. Bone says she sees the same reduction in opioid use among patients who use cannabis for pain of all varieties. “It is almost a given that motivated patients can reduce their narcotic intake by 50% within the first three to six months of using medical cannabis,” Dr. Bone explains. “I see prescriptions going down, and in states like Florida where obtaining opioid prescriptions is becoming more difficult, this is very significant. Having seen the relief patients get from having access to cannabis gives me hope in the face of this horrifying opiate epidemic.”