♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet. ♪
(Bob clapping hands)
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We're the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Who's this guy, Brad?
- We are very fortunate to have
this young man here today
and we're gonna tell all about it
in just a second, but...
- Okay, today we're gonna talk about CBD oils.
- Ah.
- Are there dangers or precautions?
And we're gonna give you
a pharmacist's perspective.
And this is Chris, the pharmacist
who we are very
happy that has joined us.
Well I've been anting to do this,
this video for months.
- Right.
- I really...
It's taken a while to get him aboard, but--
(Chris laughs)
- Well he's a busy--
- A busy guy, yeah, so.
- Hi guys.
- Again, yeah Chris the pharmacist
we've had him before and hopefully
we'll have him many more times in the future
but he's gonna give us
the real scoop on it, right?
But I wait. - Right, so the science.
- Oh, yeah, we gotta get--
- If you're new to our channel.
- Sorry Chris we've gotta--
- No problem I can duck.
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- All right.
All I've been hearing about CBD oil, Brad,
is that it's good.
- Right.
- Like it's a miracle drug.
- Right, it's gonna...
You're gonna lose weight by it,
you can cure your cancer,
all kinds of things - And anxiety-depression.
and I'm thinking, well it's a CBD oil.
Does it look--
You know little bottles like this.
- Yeah it looks very harmless.
- Maybe it's one of those things that can work,
but we're gotta find out what's behind this.
So we've got Chris here, so.
- So, do we wanna say what it is first?
- Well I mean, CBD oil is one of the,
you know there's the marijuana plant
and basically, it's got about 140 some odd
chemicals that come out of it,
but the one that we're--
It's true that most people are interested in is
THC which is the one that gets you high
it's the one that everybody seems to be all about.
- Sure.
- But CBD is actually the one
that's kind of catching on
and it's an interesting chemical compound,
because you don't get high from it
and with the new guidelines in your state
and you should probably check
with your state's laws and ordinances,
but most of it's pretty much dekernalized,
because the CBD oils that you see everywhere now
in gas stations, supermarkets, pharmacies, vape shops
I mean they all basically come from, essentially, hemp.
And so hemp, by design, for basically the laws,
can only contain 0.3% THC.
So there's no chance that you can get high from it.
- Or less.
- To a degree and we say that with the degree,
because the, you know the products
that are out there, not everything's what it seems.
- All monitored the way it should be.
- I mean it's the wild wild west right now
and I think we really, you know,
I think we have to pump the breaks a little bit.
Some of the claims with CBD are a little crazy
and, you know, people want to gravitate
to something that's gonna help.
I mean if you have a problem like anxiety-depression
you know, you want relief from pain from cancer,
or arthritis or, you know, what have you
and actually, more importantly, seize your control.
I mean I think it really does
have applications for patients.
So, but we're probably easily 20 years
behind the 8-ball insofar as trying
to get up to date with the research
that needs to be done and--
- Which is interesting,
because it's been around a long time.
- It's been around for thousands of years.
- Right, that's what I thought.
- So it's not like it's brand spanking new,
but I think with the decriminalization
of marijuana and the states now legalizing it,
I think you're finding that people
are gravitating towards alternate
routes of healthcare.
- Sure.
- And I think that, again,
there's lots of research that needs to be done.
So it's not just a simple cut and dry yeah and try it.
- Right.
- I mean, it's something that may work for you,
but there's risks associated with it, too.
I mean we have to watch it,
you know it can make you feel nauseous or queasy,
it can affect your liver
so we do have to be careful and--
- And you mentioned the percentage of that,
can you do that again?
- Well...
- This was with seizures?
- Well, yeah and there's actually the only
prescription CBD product out there
is a seizure drug called Epidiolex
and it's used for two very specific
seizure disorders typically in children
and they've, you know,
it's right in their safety guidelines
it is a black box warning that says
you do need to make sure that
you're taking liver tests on these patients
and, you know, from five to 20% of patients
have had either liver failure
or at least liver injury.
So with that particular--
- Again, what was that, how much?
- Liver failure--
Oh, five to 20%.
- Which is a significant amount.
- And that's specifically for Epidiolex,
which is a very, very potent prescription version
of CBD, so it's not like the products
that you're getting anywhere else.
So, there's a clear distinction
that has to be made. - Sure.
- Isn't that a topical use or is it oral?
- Well, CBD can be ingested in many different ways.
You can--
- But I mean for that specific--
- For that one it's an oral medication.
- Oh, okay.
- So you take by mouth.
So from that standpoint
and, again, it's a very specific subset of people, so.
- Yeah, Chris, talk about how people
do take the oil.
- Yeah, so I mean CBD can be ingested--
So let's say you're somebody that has
you know, performance anxiety
if we're gonna do something like this.
I did not use CBD before we came on.
(Bob and Brad laughing)
- We better test you maybe.
- And it shows up on tests
so you do have to be careful with that
and we can touch on that later, too.
But, let's say somebody's a little bit
uncomfortable about speaking,
just an anxious situation
or just has an anxious day,
CBD does have a tendency to work for people
to help them to kind of
feel a little bit more relaxed in some cases,
but you should always check with your doctor
to make sure it's appropriate for you, so.
- And like doses,
is there any idea what dose to take?
- And, again, remember how I kind of said
wild wild west.
- Yeah. - Yeah.
- That's part of the problem
is we're really behind in the science
that we need to do applicable doses.
One interesting study that I read
that was, probably poor science,
but at least showed some results,
was a Brazilian study and there is,
you know they just took people that wanted to do,
kind of did a public speaking simulation,
and so they kind of came up with a target dose,
so they had about 53 people
come through the study
and basically set 'em in a scenario
where they had to speak in front of people
so it created that anxiety.
- Sure. - Sure.
- So they just didn't quite
feel right or comfortable.
So they tried varying doses of CBD
and so what they seem to--
and it was an oral dose,
it comes out to be 300mg
seemed to be the sweet spot,
so that seemed to work really well.
The interesting thing on the study
was that a does as low as 150mg was useless
and a dose as high as 600mg was useless.
- No kidding.
- But 300 was kind of right in the middle.
So it's kind of an interesting--
So that's just one example.
It wasn't double blinded so we didn't see
a placebo done with that,
so let's say, you know in my world
a lot of times doctors will prescribe Propranolol
for people for, you know speaking engagements.
It works really well,
but you know, it'd be nice to see it
get one-on-one.
- Right.
- You know, just to see what's going on.
- Compare the two.
- And I'm sure that there's
research facilities out there
and you know, in the university setting
it's a hot topic,
but it's hard to come by
so it's interesting the consumers
can get it all you want,
but the universities have trouble getting it
to study it.
- So it's kind of... - Okay.
- Yeah, kind of an interesting conundrum, so.
- So at your pharmacy,
I mean how is it offered?
- Well, where I work it's basically gonna be
something that's gonna be a topical.
So, it's gonna be something
that you would rub on to...
You know, so it's gonna be for pain
it can actually be used for anxiety,
it can be used to rest--
- So you just rub it on your skin?
- Yup and there's also--
- Non-prescription?
- Non-prescription right off the shelf.
- Right off the shelf.
- And then you know there's drops
that you can place underneath your tongue.
So we were kind of talking about ways to ingest it,
it's such a wide topic.
So you can vape it--
- So is it,
I'm sorry to cut you off,
but like when you get it in your pharmacy
does it tell dosages to take it at?
Or are people gonna be reluc-- - They have suggested--
- I mean do they just jump in and use it
as much as they want?
- It's interesting, 'cause I kind of
looked at some of the products that we carry
and so they have you know, for anxiety relief,
for pain relief, you know
to help you to rest, calms,
so they have all sorts of different names
and packaging that kind of suggest their uses
and they give guidelines,
but there's not a controlled dose.
So it's very, very difficult to figure out
just how much is enough
and so that's the problem.
Is we just don't have enough controlled studies,
(Chris clears his throat)
'scuse me, that show
what we should be dosing it as, the reg--
And you know, so they'll suggest a--
- Are these large companies that are offering this
that you feel that you can trust at this point
as far as the quality of the product
- You now, I mean, as a business person
I think they're all trying to get it right.
I would imagine that they're all trying
to make the best and greatest.
So I mean there's different ways to process it,
to extract it and they're working, you know,
to try and make it emulsified so that it absorbs better
more effectively, so that you're getting more
bang for your buck.
So I think there's a lot of good science
that's going into it,
but what we need is the science, the research
to show proper dose and proper frequency,
minimization of side-effects,
you know, things that we have to be careful with
insofar as liver damage and
you know which is actually a big thing with that.
You know if you're on a blood thinner,
I mean it's certainly something
that we wanna be mindful of,
because there is a risk for bleeding out
which is very, very significant.
- A lot of people are on blood thinners,
so this is really important for you to know.
- So if you're on blood thinners
and you're considering CBD,
you better consult with your physician.
- I would say,
I would just say no at this point.
- Okay. - Oh really?
- It's that cut and dry.
- Well, you know 'cuase you just don't know
and we don't know the doses.
It varies form batch to batch.
I mean there was a study that showed that
you know, they took all these samples of products
and only 20% actually had
the right amount of CBD in there.
- That's what I was wondering.
- So there was stuff that had much too much,
there was stuff that had much too little
and there was stuff that had actually
a lot of THC in there,
which is the active component in marijuana.
So and what I kind of said, briefly, earlier
so putting yourself at risk
I mean, you can test positive, so.
You know with the decriminalization of it
I think there's a lot of employers, these days
that may or may not have problems with it,
but, again, you should check with your employer,
you should check with your doctor.
I mean these are things that
you really wanna be clear on.
- Right if you're in a position that
there's no tolerance for it,
I mean maybe a pilot, or something like that,
I mean you don't want to take a chance.
- It could cause problems.
- Sure.
- So we wanna be real careful with that,
but again, you know with your own health, too.
You wanna make sure that
it's something that's safe with your medication.
So, I mean--
- So, Chris, how long you been a pharmacist?
- 24 years.
- So it's 24 years,
have you seen drugs like this before that,
I know I'm putting you on the spot,
but like that seems like
it's having so much promise
and then all of a sudden, you know,
they kind of unveil, take the wrapping off
and they find out, no this is not as good as--
- Yeah.
I've seen it on the prescription side of things.
- Sure.
- So there's many, many things that the FDA
has, you know allowed to go through
and then all of a sudden
as we get into larger scale
more mass people taking it.
- Yeah.
- All of a sudden there's acute liver failure,
I mean Viox was a very popular--
- Yeah, I was gonna bring up Viox.
- So I figured you guys are physical therapists
so I'm sure you guys remember that anti-inflammatory.
- Sure.
- My mom was on it and--
- It was a great drug.
- Yeah it was the drug!
- But, but...
(Chris laughs)
- Yeah.
- It caused cardiovascular problems
so, yeah, so they pulled it off the market.
- So we've seen this before.
I mean, you know, it comes out with great promise
and then you realize you know take the veil off.
- Yeah and I think, yeah there's times
when you have to pump the breaks.
- Yeah.
- And I think we just need to learn more
so that we can help people to,
hopefully maybe even help themselves,
but I think it works well when you have
a physician that's on board
and is knowledgeable with the products as well,
or your pharmacist or your nurse practitioner
or your PA or whomever you get
your healthcare benefits,
your care through. - Service, yeah.
- So I think it's important to make sure
that everybody has kind of a teamize approach
to ensure that we can do what's safest
for the patient,
to ensure that they're getting the safest thing
that they can do for themselves.
But we just don't even know real doses.
- Sure.
- Touching on that earlier example I said.
So it's really, really high--
- You go low you go high an it'd be ineffective
and you gotta really find that sweet spot.
So how do you do that?
- And what are the dangers if you're taking
other prescriptions?
- Right, right.
- So it's something to be
you know you want a grain of salt with this one.
You wanna be super careful with it,
but I mean, I think that it,
you know there's lots of studies
that are now showing that
yes it can help you with anxiety and depression.
So, is it something that we wanna embrace?
I think it's certainly something
that we can reach out for
and see if we can help some people.
- Sure, right.
- But, again, you wanna do it in
a very professional setting insofar as allowing
your doctor to be in on the care plan.
I think that's very, very important.
You know, some people self-medicate
and it's certainly a choice that can be made
by themselves,
but it's just something to just be aware
of the risks, I mean, so you wanna make sure
that probably if you're gonna be a user of it
that you probably see your regular doctor
to make sure that they're looking
at your liver functioning.
So that's one of the few organs
we don't replace well.
(Brad laughing)
So that's certainly something--
and that's not a joke.
- Yeah. - Right.
- I mean it's something that we have to
be careful with that,
because we just don't know these doses.
And, again, yeah so if you're gonna
choose something be consistent.
Probably go to the same source,
go to the same product.
- Sure.
- Go to the same retailer,
because I think from that standpoint
you can always guarantee that you're getting
at least the same quality product
that your body is adjusted to.
- So you mentioned anxiety and depression,
is there any other area that you think
this is really showing promise in right now?
- Well, yeah, I mean if you wanna look at,
specifically medical marijuana,
so it's a little bit off topic,
but medical marijuana has THC and CBD.
So you get the benefits of both.
- Sure.
- And it think from--
So if you're somebody that's suffering
severely from cancer pain.
- Sure.
- Or glaucoma, or and actually seizure disorders,
those three in particular probably show
that medical marijuana probably has
a real application in all three
for very different reasons.
- What about CBD oil?
- Well CBD oil will work in all those cases, as well,
but medical marijuana, specifically...
- But medical marijuana will be a step above that.
- If you are a cancer patient and you can't
you know you're taking something like
a very strong prescription narcotic.
- Sure.
- Don't know I'll just throw up Fentanyl, for example
or Oxycodone for example.
- Sure.
- Which are buzz topics
in the medical world, as well.
You know some people have just found that
the medical marijuana provides
them better pain relief
and they don't feel as weird
form the side-effects that the opioids create.
- Sure.
- So I think from a standpoint of quality of life
I think there's an application,
but again, we have to be super careful,
we have to make sure that
it's legal in your state,
we have to make sure that
your doctor's on board with it.
- We were talking before, Chris, you and I
and didn't you mention there is a CBD oil-based
prescription that is used for seizures?
- Yup.
- You've seen it's very effective and it's--
- Well, it's a newer product
that came out last year
and it's called Epidiolex.
- But isn't that the one that you said is topical?
- No, no, no.
These are there's actually some very--
For CBD oil and seizure control
there's some incredible videos out there
of patients that have had severe seizures
and then they take a CBD oil product
and actually I've seen it applied on a child's feet
and it actually abated the seizure.
I mean it's almost miraculous what it can do.
There are applications where they're studying
for Parkinsonism insofar as kind of helping with
the motor movement to try and help with
the issues with that.
There's some, actually interesting topically,
they talk about actually its improvement for acne.
So I mean it's certainly something
that can certainly help out.
I think the mainstays are gonna be
anxiety-depression, pain relief and seizure control
are the main ones,
but it's got a lot of other claims.
I think we have to be careful,
because there's some wild claims out there
that say it may cure cancer.
- Right.
- I think that the carrot is way out in front of
the horse on that one. - Sure, yeah.
- I think with proper medical research,
large scale studies,
I think maybe we can see some very positive
effects that may occur from it,
but we still don't know the dangers of it.
And you know and I think what we're gonna see
when more and more people
start to use these products
we're gonna start to see
a litany of side-effects do occur.
- Sure.
- That will become-- - Years down the road?
- Years, you know, days, years, weeks, months.
- Yeah.
- I mean it just kind of depends.
- Sure.
- You know, because if you report it to your doctor
then they can pout it into a database
and then they can actually learn from it
so we can do more for people and hopefully--
- They'll learn from experience,
especially if someone's been down the road
for a long time here.
(Brad laughs)
I mean in all seriousness,
I mean these things start to crop up.
So you really wanna have shown caution.
- Oh yeah.
Very much so, very much so.
- All right.
- Any other final thoughts?
- No, I mean I think, again,
I think we just have to make sure that
we're being careful with our usage of it.
I think it may have a place in medicine.
I just, you know I just stress to anybody
if it's an interest that you have,
to discuss it with your physician,
because I think--
- That's step one.
- Yeah, that's your first step you wanna--
Whoever your provider is, I mean
it's just something to just--
And then you know the sourcing of it
and the dosing of it, so.
- Right.
- Be consistent where you get it from.
- Sure.
- And I think there's a lot
of knowledgeable people out there
that do sell the products
and so, you know it's their life,
you know it's their livelihood.
And so they're gonna take the time
and care about you and try and provide
you with the best product.
I don't know that I would necessarily
go to your local gas station and buy it.
- Exactly.
- Because I don't think they're gonna be
the knowledgeable ones,
but when you go to a retail setting a retail store
that does sell these things
I think you can get a little bit more information.
Do research on your own, too.
I think there's small volumes of evidence,
but be careful with it.
And that's why I think it's important
to have a dialogue with your physician or caretaker,
because they're the ones that can help
kind of sift you through
what's right what's wrong,
was it really good data?
Are we missing something.
- Yeah.
- We just wanna keep everybody safe.
- Right.
- And I think that's the most important thing
that we can take away from this.
- Right.
- So once again we wanna thank Chris
for taking the time, all right.
Man does this guy have knowledge in his head or what?
- Yeah, it comes out well.
(Bob and Brad applauding)
- Thanks everyone.
- Yeah, thanks everybody for watching.