written by Dianna Benjamin
Patricia Frye, M.D., wasn’t looking to be a part of the cannabis industry.
She practiced medicine for 20 years in California where medical marijuana was legal, but clinical cannabis never crossed her mind.
Dr. Frye made the transition from skeptic to advocate for one reason.
Cannabis medicine works.
Cannabis Prohibition is a Public Health Problem
In Dr. Frye’s words, cannabis found her. She was looking for a telemedicine position after relocating to Washington, DC. She took a role as a cannabis evaluator for a California-based clinic.
That’s when her perception about medical marijuana began to shift.
“The patients weren’t what I was expecting,” Dr. Frye said.
“They were older. They came from all walks of life. They were teachers, homemakers, truck drivers, restaurant owners, college professors, lawyers, doctors, every profession.”
The racist stereotypes produced by the war on drugs fail to convey the diverse range of people who use cannabis as medicine.
Dr. Frye’s first-hand experience with patients and their positive outcomes gave her insight cannabis prohibition ignores.
“After a year, I had evaluated about 3,000 patients. I walked away thinking, you know, this stuff is really pretty amazing. People should know about it, and they should have access to it. So I decided to open a practice here,” Dr. Frye said.
There is conclusive evidence supporting cannabis’ use as medicine. However, statewide medical marijuana laws cannot overcome obstacles created by federal prohibition. One of the biggest hurdles to accessing medical cannabis is a lack of insurance coverage.
Medical marijuana is not covered by insurance policies. Patients need to pay out of pocket for their medicine. This leads many patients to purchase cannabis flower, one of the cheapest forms of medical marijuana, for smoking.
Although it is the most accessible, smoking cannabis is not the healthiest consumption method for patients. Long-term cannabis smoking can cause damage to the bronchial cilia, the hair-like follicles that are crucial in defending the lungs against bacterial and viral invaders. This symptom is especially concerning in the age of COVID-19.
Ironically, opioids are more accessible than medical marijuana despite being more addictive and dangerous.
Given people of color are more likely to have poor health outcomes than white persons, the lack of affordable access to medical cannabis is a social equity issue.
Racism and Poverty Worsen Black Health Outcomes
“Zebras don’t get ulcers,” Dr. Frye said, paraphrasing biologist Robert M. Sapolsky.
“Zebras are eating their grass, living their zebra life, and doing fine. Then here comes the lion. Everybody goes into their stress response, which is necessary for survival because it makes them hyper alert. Once the lion is gone, they’re like, ‘nothing to see here,’ and everybody goes back to what they were doing.”
That’s why zebras don’t get ulcers. The problem is that humans are not zebras. When the lion is gone, many of us don’t move on. And there is an argument to be made that the “lion” is not ever gone.
“We get all stressed out and some of us get stuck in this circuitry where the stress never goes down. That chronic stress becomes a problem.”
Dr. Frye blames this stress on what she calls “transgenerational PTSD.”
“We’re always in a state of defensiveness or anticipation that something is going to go wrong or that we will be mistreated.”
This stress is the beginning of the problem, but there are socioeconomic factors that contribute to race-related disparate health outcomes.
“I think the other big part of our poor health and poor health outcomes is poor nutrition,” Dr. Frye said.
“The standard American diet is micronutrient deplete. It’s filled with processed foods, hidden sugars, and hidden salt. Overall, the whole push in this country is to have people eat more so that they buy more.”
Dr. Frye theorizes that the genetics of trauma survival and a lack of access to nutritious foods causes a vicious cycle of health issues.
“By virtue of the fact that they survived that middle passage, our ancestors probably had survival genes that got them through times of famine. So genetically, we may be predisposed to holding on to calories because we are descended from people who were able to survive that type of starvation,” she said.
“Because of that, chronic stress, and increased hidden calories, I think a lot of us have developed insulin insensitivity that leads to things like diabetes and obesity. Obesity leads to sleep apnea and insomnia which makes it more difficult to maintain healthy body weight.”
Cannabis Can Improve Health Outcomes
Cannabis houses chemicals called cannabinoids. The most abundant of these substances are THC and CBD. Together and in doses specific to each patient, cannabinoids can disrupt stress and improve endocannabinoid health.
The endocannabinoid system is responsible for facilitating sleep, mood, digestion, metabolism, and more. It controls synaptic communication in the nervous system.
Focusing on improving endocannabinoid health can have a positive ripple effect on overall physical and mental well-being.
“Stress can be relieved with CBD and low doses of THC. Cannabis can modulate glucose metabolism and fat metabolism. CBD is a good appetite suppressant,” Dr. Frye said.
“I certainly think it can help with mood. It can help with relieving stress and anxiety. It can interrupt — especially CBD — that kind of stuck circuitry.”
Cannabis is not a silver bullet, but it can help sick people — many of whom are economically disadvantaged people of color — feel better.
“It’s a shame that the health of African Americans and, and for the most part Native Americans and Hispanics, is so bad compared to everybody else,” Dr. Frye said.
“I think that cannabis can be very helpful in reducing stress and relieving anxiety.”
Dr. Patricia Frye is on the Society of Cannabis Clinicians Board of Directors, author of the award-winning book, The Medical Marijuana Guide: Cannabis and Your Health, and medical director at Takoma-SE Integrative Care, a medical clinic incorporating cannabis medicine as treatment for overall improved health. Her offices are located in Maryland and Washington DC’s Historic Anacostia.