Cannabis Doctor Reveals ALL (Part 2)

An exclusive interview with anesthesiologist and cannabis expert Dr. Deb Kimless

Written by Alex Reid
Posted March 27, 2019

Editor's Note: This is Part 2 of our exclusive interview with Dr. Deb Kimless, anesthesiologist and medical cannabis expert. If you haven't read Part 1, you can start with that HERE. This interview has been edited for clarity and readability.

Dr. Deb Kimless: CBD is a chemical constituent from a cannabis sativa plant. It's the second most abundant — first is THC. CBD doesn't sit on the same receptor that THC does that causes intoxication, yet it interacts with our biologic systems and other receptors in ways that can make CBD a good medicine.

Not everyone is going to respond the same way to it.

Meaning if you have pain, some people see pain relief with CBD, but some don't. Just like some people respond well to Tylenol and others don't, right?

The beauty of what I see with CBD is that people are able to have access in all 50 states. 

Clear Health Now: Because it doesn't have the same intoxicant effects as THC?

Dr. Kimless: Right, that's the only reason. So it is psychoactive. It reduces pain, which can cause anxiety. It can help be a relaxant. So there's a difference between psychoactivity and intoxication, if you notice I use very differently.

CHN: That is interesting. Yes, there's an important distinction there.

Dr. Kimless: It's a huge distinction because intoxication, like you're high or you're drunk or whatever, is the negative.

But if you have anxiety and panic, and/or depression, and CBD can help you with that, then it's psychoactive in that it mitigates those issues, but it's not intoxicating.

But I don't like to vilify one cannabinoid and exult another.

The best way cannabis works is synergistically with all of the constituents as best you can get them, even if it's an extract. Because then you need less of each one.

So, I've got a lot of patients using a microdose, a teeny tiny amount that they don't feel the effects of it at all even though there's a little bit of THC in it. But it helps with their pain, anxiety, depression, and muscle spasm, and a whole host of other issues.

Which, now if you become intoxicated, I almost look at it as an overdose.

CHN: And that almost speaks to a broader principle that we shouldn't think we've outsmarted Mother Nature — the plant's evolved this way alongside humans for good reason.

Dr. Kimless: It's interesting that you say that because our endocannabinoid system preceded the plant. So the endocannabinoid system is found pretty much in every living thing except for insects, and even insects have something similar.

CHN: So we actually have endogenous version of these in our body right now?

Dr. Kimless: Yeah, this is not taught in traditional educational platforms. So it's never taught in a biology class, it wasn't taught in my medical school. It wasn't taught in my tens of thousands of dollars of CME credits from traditional CME purveyors.

But we do have it! A bioactive system called an endocannabinoid system. Its sole function is to maintain physiologic balance or homeostasis. And it interacts with every other biologic system from thinking to pooping and everywhere in between.

And life as we know it wouldn't exist if we didn't have an endocannabinoid system. Because implantations, ecto fertilization of an egg, would never happen without it.

And we're not taught this. So the components of the endocannabinoid system are these endocannabinoids. “Endo” comes from “endogenous,” from within. And “cannabinoids” means our body makes these chemicals that are similar in activity to the chemicals made in the plant, phytocannabinoids.

So the endocannabinoids interact with all of these different things so our body makes a bunch of them. We have a bunch of receptors that they sit firmly on. And the plant, some of those chemicals also interact with those receptors as well. And then we have enzymes that take those endocannabinoids and break them down.

CHN: You mentioned microdosing. Can you share a little more about that?

Dr. Kimless: It was really a thought experiment at first. Let's say someone smokes a gram of cannabis recreationally. If 20% of it is THC, in that joint you have 200 milligrams.

And if you smoked that joint by itself, 30% or 40% goes up in smoke, but you still end up with the 60 to 80 milligrams. And I'm thinking, well, if our endocannabinoid system is this biologic system that's maintaining physiological balance, then you may not need that much.

In the body, endocannabinoids are made on demand. They're used locally, so not throughout the whole body. So if you have a problem in one spot, that's where you'll see an enhanced amount. It's rapidly broken down and not stored.

So to me, it didn't make sense that a lot was good. And so I consulted with a company out of California that actually did a whole plant extract of microdose cannabinoids, and we conducted some clinical trials. And when I say microdose, I mean less than two milligrams total cannabinoids.

Half of it was in the raw form, half of it was in the heated form in naturally occurring ratios. So we're talking 0.5 milligrams of THC and 0.05 milligrams of CBD, and the same thing for the acid forms, and we were seeing incredible results with patients.

CHN: That's fascinating. And there's a benefit in situations where you wouldn't want to become intoxicated, I imagine the intoxicant effects are much lower or not at all.

Dr. Kimless: No one has experienced any intoxicating effects with that. And this ranges from children as young as eight to adults as old as 88.

In order to get intoxication, you have to have a chemical that creates intoxication. You have the receptor for which that chemical can interact. And you have to have enough of that chemical to sit on enough of those receptors in order to have that outcome.

So yes, you have the chemical; yes, you have the receptor. But you don't have enough of the chemical sitting on enough of the receptors to create that intoxication.

So with microdosing you get a tremendous benefit without overdoing it. And honestly the beauty is in how little you need, because this is a highly regulated industry, this medicine is really expensive.

CHN: We've heard people talk about the benefits of both CBD and cannabis for pets. Is that something you can speak to?

Dr. Kimless: Yeah, so actually as I said, every living thing has an endocannabinoid system, except for insects. So pets are no different than people.

The only thing is that you worry about how their brains are formed and what their receptor burden is. So a little bit goes a long way on a pet compared to equal weight of a person.

I'm actively looking into it because I'm very interested in it as a pet owner. I feel like veterinarians are sort of as restricted as physicians in education regarding the endocannabinoid system, and I think they're just being introduced to it.

CHN: You mentioned that your interest in cannabis is part of a broader interest in a lifestyle, more preventative approach to medicine. Do you want to talk about that broader philosophy for a moment?

Dr. Kimless: So lifestyle medicine is a new boarded medical specialty. It actually looks at creating a strong foundation for health, wellbeing, healing. So there's a bunch of different touch points, one of which is what you eat.

So, it makes sense. If you're eating garbage, you're probably going to get sick. And as you look at the obesity rates in this country, and if you look at cancer at younger and younger ages, and diabetes and all kinds of things, and that people are going to be living less than generations before us.

I mean so all of that is hugely important and actually it sounds like it's common sense, doesn't it? But we need a whole medical specialty for it, to look at it in detail, and I had to study and take the board for it.

But it's a philosophy that I ascribe to. I don't charge my patients. But there's nothing free, and so what they have to do is they have to change their diet. That's how important I think it is.

CHN: It certainly does make a lot of intuitive sense. Most people are eating three, maybe more meals a day. So if it's something you're doing every single day and has such a direct impact on your body I guess of course it will have an impact on your health.

Dr. Kimless: We are what we eat, literally and figuratively, and unfortunately what we think of as food and what we were taught about as food are basically the same misinformation or disinformation that was told to us about cannabis.

So anyway that's the lifestyle piece of it, and cannabis is expensive. You have to go through a lot of hoops to get it... it's not easy. It's not like going to a pharmacy and saying, "Okay, here's my Medicare card, and fill up my prescription," or whatever you do.

It's cumbersome and it's difficult, and again your zip code will determine what you have access to or not. Start with your job. Start with your lifestyle. Get up and move, don't smoke. Don't think any part of alcohol is good for you.

Texting people and being on technology all day long is not good for our brains. It's rewiring out neural connections in a way that's probably not good for us.

I hope this is helpful for people.

CHN: Absolutely. I have no doubt that our readers will be fascinated. Anything we missed talking about?

Dr. Kimless: So I am trying to publish a letter about a patient who is dying of cancer and had access to a sub-lingual CBD tablet that I formulated. And went from a pain scale of seven to eight to less than one in less than 20 minutes.

But I've been rejected so far by JAMA and the Journal of Clinical Oncology.

And I just submitted it to the American Journal of Medicine, and I'm sure I'll get rejected from that. Interesting, huh?

At this point I almost feel like it would be good to continue to get rejected because that'll get attention!

CHN: It would certainly get people's attention.

Dr. Kimless: It's not even a study — it's a conversation. It's a real life, and it happened when I was there. It was just like I want to share something that you can do across state lines, not intoxicating that low risk... and I found it incredibly surprising that I've been rejected but I'm kind of liking it now. I hope I get rejected from everyone.

CHN: You'll have to keep us posted about that. So any parting words for our audience?

Dr. Kimless: I'm not here to persuade anyone.

I want to educate so that they understand that there are different options and tools because again, not everything works for everyone. Same thing in traditional pharmaceuticals. That's why there's a ton of different types of blood pressure pills.

Why? Because not one thing works for everybody.