A Top Cannabis Doctor Answers Your Coronavirus Questions
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Dr. Junella Chin is an osteopathic physician, founder and chief medical officer of MedLeafRx, an integrative medicine practice in California and New York. She is also the author of the book Cannabis & CBD: For Health & Wellness.
With coronavirus (COVID-19) on everyone's mind, we asked her a bunch of questions about how cannabis and CBD can help boost your immunity and reduce your anxiety.
Jon: Dr. Chin, thank you so much for being on the show. Tell us a little bit about your background. What is osteopathic medicine?
Dr. Chin: There are two types of physicians in the United States; there’s M.D.s and there’s D.O.s. Both types of physicians have a full right to admit people to the hospital, prescription rights – full practicing rights are identical. But osteopathic physicians have an extra year of anatomy and physiology in medical school and they also learn what’s called hands-on osteopathic medicine. That’s manipulative treatment. You might be familiar with chiropractic care. Chiropractors are not physicians, but they do hands-on manipulation. Osteopathic physicians are physicians that also do hands-on care.
Jon: How do you integrate cannabis into your practice?
Dr. Chin: I see patients in the context of a full medical practice, so when patients come in, I take a full history and exam. I’m looking at their list of medications, past medical history, and I look at everything first as a physician, making sure that the standard of care has been followed.
Usually, when patients come to see me, they’ve exhausted all medical options, so they are looking for an integrative physician – someone that can talk about not just cannabis, but also diet and nutrition and what’s called functional medicine, integrating both Eastern and Western medical philosophies.
Jon: So important, because I think oftentimes just traditional medical doctors won’t even entertain the thought of “alternative medicines,” which are not really alternative at all – they’ve been used for thousands of years – or diet. It’s so important what you do. But you will also recommend traditional pharmaceutical drugs as well, correct?
Dr. Chin: Yes, I write prescriptions. I’m really taking the best of both worlds. If you can think of on one side we have conventional medicine, what we see in the hospitals and the clinics, really expensive but also invasive and very great for emergencies – things like what we have now if you had a heart attack, a stroke, an injury, or if you are affected by the coronavirus and you need invasive care for lung health, for instance. Then on the other side, we have alternative complementary medicine, which is a catchall term. It includes acupuncture, homeopathy, Ayurvedic medicine.
And in the middle is integrative medicine, and that’s where our practice specializes. We cherry-pick the best of both worlds, looking at scientifically validated therapies from both conventional and alternative systems.
Jon: What made you decide to become that kind of a physician as opposed to a more traditional route?
Dr. Chin: For me, it was because I was a patient before I even became a medical doctor. I was diagnosed with an autoimmune disease of the spine called ankylosing spondylitis. There’s no cure; it’s just palliative care. But basically, your spine fuses so the bones in your spine don’t move anymore. Just think of them crazy gluing together so you can’t bend and touch your toes, you can’t turn and look at your blind spot when you’re driving. Most patients will take lots of pain medications throughout their lifetime, and then they’re on drugs that are actually very toxic to the body.
For me, studying to be a physician, I would wear this brace all the time around my back, and one of my attendings – I was in San Francisco at the time, and this was shortly after they legalized cannabis. One of the attendings asked me about it. He specialized in HIV medicine, and he said, “Look, you’re not going to finish med school at the rate you’re going. You have to stand up all the time, and you’re never going to finish.” So he actually introduced me to cannabis medicine, believe it or not.
Jon: Is that when you discovered cannabis as medicine, at that point in your life?
Dr. Chin: Exactly. When he handed me that first tincture bottle, he didn’t call it CBD or anything like that. He said, “This is marijuana steeped in alcohol.” [laughs] He said, “It’s not going to make you very high.” That’s all he said. “It’s not going to make you very high, so don’t worry.”
Jon: Not very high, yeah.
Dr. Chin: “But take it at night, take it when you’re not on call.” He said, “It really helps my HIV and AIDS patients with their pain.” And that’s all he said. I remember sitting with that bottle on my dresser for weeks on end, like, should I do it, shouldn’t I do it? I decided to try it because it was either that or drop out of medical school.
Jon: Wow. And obviously, the results were positive for you.
Dr. Chin: Exactly. After the weekend, I knew something was working, so I decided to dedicate my medical career to figuring out how this plant works, why I didn’t learn about it in medical school, how come my colleagues didn’t know about it. And I was in California. I was in where you’re at now; I was in the middle of a switch box, the perfect place.
I was learning to be a conventional doctor, going through a D.O. school, and then I was learning everything I could about this plant medicine – and then integrating other things too, which I had to for my own healing. I did integrate acupuncture. But I did take anti-inflammatories. I took Celebrex, I took Vioxx. And I still do both. I don’t only do alternative medicine. I do find that you have to find what works for you and be a partner with your physician.
Jon: I want to talk about the coronavirus – and I know people have a lot of questions about the use of cannabis right now, both to protect their immunity and strengthen their immunity and also to cope with the stress that they’re feeling. Those seem to be the two questions that we’re getting the most from our readers.
I had asked our readers to give me some questions, knowing that I’d be talking to you today, through Instagram, and there was a ton of them. I’ve curated and sorted through some of them, but I would love if we could just ask you a few and get your medical expert opinion on some of these questions that I think a lot of people have, holed up in their home in the coronavirus cocoons that we have now created for ourselves.
I’m going to start with the Highpriestessapothecary had a question, and her question actually echoes the question I hear the most, which is this idea of is smoking cannabis or CBD right now too harsh on the lungs? Given that coronavirus is a respiratory disease, is this something that we shouldn’t be doing at all? Should we be medicating in other ways altogether through tinctures or capsules, etc.? This idea, is smoking just too hard on the lungs right now?
Dr. Chin: That’s a great question. As I’ve been seeing patients throughout the last couple of months, I have been encouraging patients, consumers, to change the way that they’re consuming cannabis if they’re doing an inhaled version, whether it’s a vape or if they’re using the dried flower. You just don’t want to bring any irritants to the lungs
You could be a very experienced smoker and prefer the vape form, but you want your immunity, you want to be in optimal health. There’s really no excuse to give your body any irritants. Right now it’s allergy season, so everyone’s respiratory health is going to be compromised anyway. So if you could avoid vaping, sharing joints, using pipes, I think that’s an ideal way to just arm your own immune system better.
Jon: That includes whether you’re smoking oils or flower, just any kind of use of the lungs to consume cannabis might not be advisable at this particular period?
Dr. Chin: Exactly.
Jon: Okay. Alexandrabadaro asks: Is it true that smoking increases the possibility of getting the flu or a virus because it opens the nasal areas?
Dr. Chin: It doesn’t increase your chances of getting the virus, but because you are, again, creating this inflammatory response in the nasal passages and weakening the respiratory system, any person with a weakened respiratory system – or a weakened immune system, for that matter – increases their chances of getting any virus, not just the coronavirus. Or a cold or a flu. That is why just putting that off for as long as you can and trying to use edibles, drinkables, tinctures at this time is much safer.
Jon: Does partaking in cannabis in any form at this point affect the probability of getting this virus or any virus? Is there something about cannabis that would make you more susceptible in any way?
Dr. Chin: No, there’s no study, there’s nothing that I’ve read or come across that shows that increasing consumption of cannabis will help you increase the chances of getting the coronavirus.
If anything, I’m looking at this from an inflammatory standpoint. If you’re already using cannabis as an anti-inflammatory, anti-pain, if you just look at your body as this terrain, this soil, if you’re decreasing the overall inflammation in your body, it’s one less thing for your body to worry about. You can do this through exercise and good restorative sleep. Anything to decrease the inflammation, decrease anxiety, decrease stress in your body will boost your immune system.
If using cannabis does that for you – whether you’re using it for pain, maybe you’re using it for muscle spasm – that will help as well, because it’s modulating that immune response.
Jon: This is a similar related question from Amanda E. Leaf. Have cannabinoids been shown to have any effect on viruses, such as influenza? Obviously we wouldn’t know about COVID-19 at this early stage, but are there any benefits from using cannabinoids while sick with such viruses? You talked about them being anti-inflammatories; is that an answer to that question as well?
Dr. Chin: Yes, it’s a similar question. Cannabis is shown to be antiviral, antibacterial, and immune modulators. I think it can be effective. Is it the only thing that is the sole thing, the magic thing? I don’t think so. But I think it could be part of your regimen.
Jon: Are there certain terpenes that we should be aware of in terms of enhancing immunity, certain specific cannabinoids that you focus on in terms of protecting ourselves and helping our immunity?
Dr. Chin: The wonderful thing about terpenes is you don’t just find it in the cannabis plant, but you can find it in other plants as well. Your kitchen, for example. Beta-caryophyllene, which is found in black pepper, is a very potent antioxidant.
If you look at pinene, also found in pine, that actually relieves symptoms of asthma and it counteracts anxiety. So actually, for my patients that have asthma attacks or have a little bit of wheezing during the allergy season, when they use a little bit of pinene essential oils and terpenes, that can actually help open up the airways. That’s really, really effective for that.
Eucalyptus as well, that’s a terpene. Also anti-inflammatory and antioxidant, and it also decreases anxiety. Limonene. There’s a reason why you walk down the supermarket and you can smell this fresh, lemony scent, and it’s very uplifting. That’s also a great anti-anxiety as well, and it boosts immune support. That’s why you have your lemon in water, lemon in tea with honey. Those are the types of things. Terpenes have their own therapeutic and medicinal properties.
Jon: Where does CBD come into this? Does CBD have any sort of antiviral properties? How should one think about CBD?
Dr. Chin: CBD does have antiviral and antibacterial properties, but the most important potent thing about CBD is it decreases inflammation, and we all have inflammation in our body. If you think of your simple diabetes patient, or someone even with simple low back pain or migraines that come and go, that’s an underlying inflammation of the body.
If you can take down that inflammation, it’s going to be better for your health because the common thread of all diseases is chronic inflammation. It’s that low-lying inflammation.
Jon: What do we know about CBD and stress. You said it’s a known anti-inflammatory. How does that help with stress?
Dr. Chin: Stress is such a broad umbrella term, right? We really have to figure out, what is the stress from? Is the stress from lack of sleep? Is the stress from chronic pain, or is the stress from PTSD, anxiety? The number one thing that I see in my clinic is chronic pain, and then I would say insomnia and anxiety. And all that contributes to stress. So they check the box of stress in my intake form, and then they check the pain, insomnia, anxiety. Finding a strain or a chemovar that addresses that underlying problem of stress would be the key.
Jon: In this particular case, I think a lot of people would say, “My stress is coming from worrying that I might get the coronavirus or worrying that somebody I love might get the coronavirus,” or all the anxiety that is surrounding the coronavirus. “I’m going to lose my job, how am I going to get paid? The economy is falling apart,” all the crazy thoughts that we’re entertaining right now. I guess you’d call that anxiety. That would probably be considered anxiety. I know there’s a lot of different facets to that, but is there something that CBD helps with those kinds of thoughts?
Dr. Chin: Sure. CBD works on GABA receptors in our brain, which really tells our body to slow down and power down and that we’re safe. So we can definitely have people use CBD chemovars – and lower doses of THC.
Lower doses of THC I think are very beneficial for a wide range of medical patients. I even have patients that say, “I can’t tolerate THC at all. I had a really bad experience,” but if you go low enough on the dose – again, microdosing, giving days between dosing – it can be very, very effective.
Also, though, I want to mention being careful of the pharmaceutical drugs that you’re taking as well. A lot of people with anxiety might be already on prescription medication, anti-anxiety medication or antidepressant. So you do want to be careful when you are supplementing with cannabinoids to know that they are working together. You just want to make sure you talk to your doctor or you’re not overconsuming one or the other. If the doctor says, “I want you to increase your Zoloft,” that doesn’t mean you can increase your cannabis at the same time as well.
Jon: Sisters of the Seed asks, are there any cannabinoids that have specifically antiviral/antibacterial activity?
Dr. Chin: Those cannabinoids with the terpenes that I just mentioned. I don’t like to use the name “strains” because that varies so much, but if you’re looking at the chemovars or the cannabinoid profiles of your third-party tested product, you would look for those cannabinoids rich in those different terpenes. That I would imagine would have very good antiviral, antibacterial, immune-boosting properties.
Jon: Ashleyh1112 asks a question that might be different for each patient, but I should ask you, and that’s regarding dose. She asks, how much and how often do you need to use cannabis to increase your immune function, and can it raise immunoglobulin levels? But let’s talk about the first part of that. How much or how often do you need to use cannabis? If one can’t get an appointment with you or another integrative doctor, how do they self-dose and how do they know?
Dr. Chin: Dosing has always been the number one question for all practitioners and for consumers and patients. The biggest challenge is you just have to find the right dose that works for you. You can search on the internet and that’ll give you this generic dosing chart or little things that you can punch in your weight or your problem and it tries to spit out this best dose scenario.
But in actuality, it just varies from person to person. I have a man that came in the other day that was 215 pounds; he needed less cannabis than this petite woman who was 98 pounds. They both had MS, so the same diagnosis. Two milligrams might be good for one person and entirely ineffective for another.
For me, I always tell patients to microdose. Less is more. Try a lower dose. For example, let’s say 1 mg of THC, and then you might want to stop for a couple of days, and then you might want to take 1 mg of CBD, and then journal and figure out which one made yourself feel better. Try the tincture, and then go up an accurate measurement.
Jon: How long should you generally wait before you increase your dose?
Dr. Chin: For my novices, I usually have them do the same dose for the first 3 days, even if they don’t feel anything, because it does take your body time for the receptors to open and for you to even get in tune with your body. If you are experienced, I think daily you can increase the dose and titrate up.
Jon: Let’s talk a little about the hygiene issue here – and maybe it’s obvious right now. Cannabis, a lot of it is sharing. People like to pass a joint around, and there is a sort of sharing culture around cannabis. That I would imagine is not advised right now, given what we’re facing with social distancing. Are there other thoughts that you have in terms of making sure that you’re very safe in your consumption of cannabis at this point?
Dr. Chin: Of course. Social distancing is really hard, especially I think in the cannabis-using community. We love to hug and we share. As human beings, we don’t like isolation. Our body, our essence, our soul knows that. But there are really major reasons to change our behavior right now. This really is a reasonable sacrifice to do now to avoid catastrophe later and personal suffering.
So of course, frequent handwashing, not sharing the joints and pipes – that’s an ideal way to stop the spread of the virus. There’s a lot of people that are asymptomatic carrying the coronavirus, so just because you’re not coughing or you don’t have a fever or you look perfectly well, that’s not an accurate way to judge whether or not I’m going to share that vape pen with that person.
So just holding off until we get situated and we know what’s going down, wiping things down like your phones, wiping down the area that you work with if you’re working in a metal or glass area with your cannabis products. The coughing and the sneezing, your cough pocket – you might want to do that as well.
Jon: A lot of people are feeling a tremendous amount of anxiety right now, me included, and are looking for relief from CBD/cannabis products. What do you recommend we do in this situation?
Dr. Chin: I would say a lot of consumers with anxiety, number one is to not watch network news. [laughs] Stop watching the network news. It’s very hard, and now we’re on our phones more than ever. Every time it flashes or gives us a notification, we’re looking and we see the numbers rise.
But you really want to look at cannabinoid products that are sativa-based, more CBD heavy. I think that would be great. And then microdosing on THC cannabinoid profiles, because too much THC can take you over and you can overconsume and become quite uncomfortable and more anxious.
So now I think microdosing is more important than ever, because there are therapeutic effects. You almost feel like nothing’s happening when you’re microdosing. It’s very subtle, but you feel like “I feel like I did yoga,” or “I feel a little bit more settled in my skin, a little more comfortable in my skin.” That’s where you want to stay. Less is more at this point.
Jon: Does CBD need THC, and vice versa, does THC need CBD to be fully effective? Can you just take a full spectrum CBD product and feel the effects, or is it different for each person?
Dr. Chin: Again, that’s different for each person, and then it always depends on what type of product you’re taking. If you’re doing a beverage product, most beverage products are using a CBD isolate. Some beverage products claim to help you relax, and some do, but a lot of them are using isolates just for the flavor profile. So you might need a little bit more of that CBD isolate.
Some people who take full spectrum might notice that they are not consuming as much as they normally would need. Again, depends on your body, depends on what you’re used to.
Clinically speaking, I see consumers and patients get the most mileage with a full spectrum because they are getting all the rich cannabinoids, CBD, THC, but also the terpenes.
Jon: Is there anything that I have missed that you would like to impart to our listeners from a medical standpoint that might be beneficial for them to know?
Dr. Chin: I think the most important thing now is don’t waste your money running out and buying a bunch of supplements either. A lot of patients are going to Amazon and spending tons of money on immune boosters and trying to get their body as “healthy” as possible. You really want to make sure that you’re looking at your diet, eating a rich diet of unprocessed foods.
Exercise is great. Even though you’re at home, go to your park, go to the yard. I went hiking with my kids over the weekend, Bear Mountain. Exercise moves the lymph fluid, the lymphatic system. Your muscles are contracting, your mind is staying healthy.
And sleep. Now that we don’t have a work schedule, you still want to maintain this routine and make sure that you get enough restorative sleep as well.
I think those are really very important. Using cannabis, if you’re already using cannabis, is very helpful as well.
And I actually want to talk about using cannabis for your skin, topicals. Let’s say you have eczema or psoriasis or a dry skin condition, now that we’re entering the allergy season. I’ve been noticing a lot of flareups with stress of patients that have dermatological issues. Your skin is also a reflection of your immune system, so you want to make sure that you do take care of your skin in a way that makes sure that it’s protected, that it’s not splitting from the dry weather.
There’s a lot of cannabinoid products – I’m a chief medical officer for Saint Jane; I think you had Casey Georgeson on last time. Things that are rich and nourishing is very, very important to protect your skin.
Jon: What about washing your hands? We talk about these antiviral – but they kill all the bacteria, right, these Purells and stuff? Is it important to counter that with things that are enhancing the skin as well?
Dr. Chin: That’s why I mentioned that. My patients with eczema or psoriasis, their fingers are literally splitting and fissuring because of the Purell, and they’re washing their hands so much. It’s totally drying out, and they’re bathing more, you’re using wipes more. You have to keep your skin intact.
So making sure that you’re using things that will protect that epidermal layer is really, really important because you don’t want to be susceptible to infection.
Jon: This is all such amazing advice. I’m scribbling it down as I talk to you, even though I’m recording this. [laughs] It’s super important. Dr. Chin, thank you so much for taking the time to talk to us.
Dr. Chin: You’re so welcome. My pleasure.
Jon: Her book is Cannabis and CBD for Health and Wellness. Is there a website that I should also recommend people go to?
Dr. Chin: drjunechin.com.
Jon: Terrific. Thank you.