Hello, it's Anthony Chadwick from the Webinar Fest welcoming you to another one of our vet chat podcasts. Very fortunate today to have Steven Sittal on an expert in in pain management using CBD oils. But I, I'd like you perhaps Stephen, just to introduce yourself, tell us your, your history and your journey as as we like to talk about.
Sure, thank you for having me. As you mentioned, my name is Steven Sittal. I'm an RBT, with a special interest in pain management and cannabinoid medicine, in our animal patients.
I currently am at Stanford University, Stanford University, the Department of Neurobiology, and I also help run what's known as the veterinary Cannabinoid Academy. And, also was very happy to put out one of the first textbooks in cannabis therapy and veterinary medicine, published by Springer Nature, last year. So very excited to be here with you and kind of share some of my knowledge about this exciting topic.
Thanks Stephen, it's, it's a really fascinating area. Obviously it's been talked about for quite a long time about how cannabis can be used in people for an anaesthesia and pain management. Obviously, tell us a little bit about the history of cannabis being legalised, because obviously in America, in certain states, and obviously in Canada it's now a legal product, isn't it?
Yeah, it's, it's changing almost every day, for a while there prior to the pandemic, we were seeing laws being changed, literally every week, and usually more favourable, at least here in the United States. Cannabis has a really interesting history, at least in the United States legally speaking, prior to 1939. It was mentioned in the pharmacopoeia in the United States for treatment of several disorders, including menstrual pain in women, colic and horses, so it was a, a drug that we were using in veterinary species and then in 1939, is when we had a prohibition against, cannabis in the states.
And then I believe in 2012, Colorado was one of the first states in our union to legalise recreational marijuana, . And after that, several states did approve medicinal use or recreational use of marijuana within their particular state. With the understanding at the federal level, it was still illegal, so it's some really interesting laws and we don't necessarily say prescribe cannabis here, we'll say recommend, which has a different legal meaning within the context of these pharmacy acts in independent states.
And of course the whole sort of CBD oils can of course come from marijuana, but they can also come from hemp as well, so perhaps tell us the difference between the two different products. Sure, that, that's a very important distinction in the United States. I know in Canada, and certainly the UK can have a different definition, but in the United States.
We, we have a delineation between a hemp plant and a marijuana plant, even though they are the same genus of plant cannabis sativa L, we have one plant known as marijuana that has greater than 0.3% THC, which is a compound that is intoxicating to animals and people. And then we have the hemp plant, which has less than 0.3% THC, and those hemp plants also tend to have high Concentrations of CBD among other what are known as phytocannabinoids or cannabinoids, that work medicinally in animal and and human populations.
So that is a really important distinction and most of the CBD oil products that we are getting here in the United States and I would say worldwide are largely derived from hemp plants, not marijuana plants. And so obviously CBD oil. From hemp shouldn't cause intoxication.
Theoretically, yes, we should not see intoxication. That really comes down to, the quality of the manufacturer. And then even how some of these products are, stored and, processed.
So CBD in an acidic environment or a, a hot environment, usually above 210 °F, I don't, I can't do Celsius conversion in my head. I'm sorry. But when we get these high temperatures, we can actually convert these compounds like CBD into THC.
So storage and, and processing is gonna be really important to maintain the non-intoxicating compound CBD or these other phytocanabinoids. So CBD kept at very high temperatures, may become unstable and may cause issues. Correct.
Yeah, so definitely at least here in the states where it gets really, really hot, don't leave it in your car, where, where you can cook. You could get an extra effect from it. And, and of course hemp can be used for making clothes as well, can't it?
I know hemp is a very sustainable product, so there's we we like to talk about sustainability, it's a, it's a nice plant, you can get many uses from it. Yeah, hemp is an amazing, amazing, plant and, and material to work with. So you mentioned clothing.
It was the dominant product used in rope, in our, you know, the, the early days here in the states. It was actually required, to be grown by farmers when George Washington was alive and our money used to be printed on hemp paper, which is even more interesting. Now there's a, because we have so much biomass from the production of these CBD oils and these other CBD products.
They're taking this biomass, which also has really good anti-fungal properties and making what's called hempcrete. So they're mixing it in concrete and making these bricks that don't get mildew that are stronger for earthquakes, especially here in California where we have a lot of earthquakes, really cool, uses with the biomass that, these, these farmers are now finding other than just harvesting for these, these, CBD and THC molecules. So a lovely circular economy going on there, no no wastage, it's, it's all good stuff.
Obviously the CBD oils are now becoming more and more accepted and obviously there have been, obviously studies on this, also clinical studies. Tell us a little bit about some of the, the areas that the studies are suggesting CBD oil may have a place. Sure.
Similar to what humans are, are using cannabis, whether it's hemp or marijuana for, so things like pain, sleep, anxiety, potentially cancer or neurologic diseases like epilepsy, we tend to see a mirroring effect of, use in animals, you know, if. People are saying, wow, this product seems to work really well for me. I want to try this in my animals.
So anything that we see really good success with people we tend to see in our animal friends with the top three, being pain management, epilepsy, and things like anxiety, with a, a close runner up being cancer. And we have to be careful a little bit because there aren't. Really good studies so far for some of the latter things like cancer and epilepsy yet.
We do have a number of studies, at least in dogs. Showing good efficacy of CBD, decreasing pain scores in canines. We have a number of studies showing good safety margins for dosing of these products in dogs and cats now, which is exciting and certainly a very important first step.
As far as the efficacy, for these types of products for things like anxiety or stress in animals, we still have a lot of work that needs to be done. You know, I, I see all the time. Pet parents asking about CBD products for fireworks or some events that usually triggers some anxiety in their animal and they want to give a high dose of a CBD product thinking it will help.
I, I want to contrast that and say CBD at higher dosages can actually be more of a stimulant and can actually make your animal more uncomfortable. So if we're gonna be using these types of products, formulation and appropriate. Dosing is gonna be really important and hopefully, especially because we are medical professionals, it will be evidence-based, based off signs that we have.
And right now for anxiety, we don't have very good studies, suggesting efficacy there. It's not to say I won't use it, but I will use it, very cautiously at very low doses, and being very. Cognizant of these little changes that might be happening with our our patient population.
So overdosing is, is possible and I suppose the worry is, you know, I walked down the streets in in my city and you can see places that are selling CBD oil across the counter, so it's, it's, it's a medicine that we need to, or it's a compound that we need to have respect for, isn't it? Absolutely, and I, I think it's fair to, to call it a medicine, you know, in the states, I believe in the UK as well, you, we do have, Epidiolex, which is an FDA approved medicine. It's a purified CBD product, manufactured in the UK, so it's, it's absolutely a medicine and I, I think the other important thing that we need to remember is we are always told by our physician, if we're taking multiple medications, or we're gonna add another medication or even a supplement for that matter, we.
We should let them know because there could potentially be drug to drug interaction. And that's certainly something that we see with CBD in particular, if you have animals that have chronic pain, chronic, common chronic pain medications include gabapentin, or pregabalin, for dogs and cats. It's also used as a anxiolytic as well.
But when we find that animals that are on gabapentin and then started on CBD. They're very sleepy for a number of hours or even days. Maybe there's some weird behavioural changes as well, so it, we can't ignore the potential for drug to drug interaction, with these compounds as well, because they induce different enzymes from the liver that will enable or disable the, the efficacy of the other drugs the animal might be on.
But also I think it's about quality of the product and and obviously there are presumably, I believe some producers that perhaps aren't. Quite as ethical or as careful in their production as others, perhaps. So, what are the potential issues or problems that can you, can you get with other products?
That is probably one of the most important points I hope everyone takes away from this podcast is certainly, there are bad actors when it comes to the manufacturing of these products, especially here in the states where it's largely unregulated. I did a study in 2020, where we pulled 30 veterinary label products that were purchased over the counter. We looked what was on the label, and then we tested what, was actually in the product.
And in general, we found Relatively good compliance with what was on the label and what was on the product, but there were some standout products that were very concerning. The least concerning but a waste of money for pet parents was some of the products didn't have any CBD in it at all. And ironically, they happen to be the most expensive of the products that we purchased to do this study.
So that's certainly disappointing. And then we had a, a number of products that had higher levels of contaminants and we only looked at 5 main contaminants. Which happened to be heavy metals and other elemental things, things like cadmium.
Arsenic and lead, one of the products had such high levels of lead in it that it would be illegal to sell here in the United States. Oh, it is illegal to sell in the United States. So, this is where I, I wanna tell pet parents and even practitioners it's really important to establish a relationship with a manufacturer or a vendor and ask for something called a certificate of analysis which any reputable company would be willing to give you and it will tell you.
The concentration of CBD or any of the other phytocannabinoids in that product, it should have a fungicide and, and pesticide analysis to make sure we're not getting any of those contaminants in the product and certainly things like heavy metals like lead, as I mentioned earlier. And it's a really good point. I've just been writing an article about pesticides, some of which might be banned in the EU but are found in food that comes across, you know, presumably pesticides on, on hemp and marijuana, so we've got to make sure that they don't get transmitted in.
Do, do we have such a thing as organic, marijuana? Is a lot grown without pesticides or is pesticide a big part of the growing of the crops? You know, it's, it's interesting.
I think a lot of the companies now, because these compounds are formed on the outside of the plant and a sticky resin on the outside of the flower of the hemp or the marijuana plant. So anything that we spray on these plants gets stuck in the sticky resin and can be difficult to get out. And what's interesting and interesting and sad phenomena that happened in the United States when legalisation of these types of products occurred.
We had lobbying from these cannabis growers to increase the allowable amount of pesticides and fungicides in these products and in some cases they increased up to 5000 times what they were before. So that is very, very concerning. So a lot of cannabis growers.
At least in my opinion, the good ones are really trying to go for this organic, approach, and, and interestingly enough, I believe the USDA is now allowing for hemp, not marijuana to be, labelled as organic within the United States. Fantastic, Stephen. Now, at the beginning we talked about the Khan Academy, not the Khan Academy, but the the CA double N cannabinoid Academy.
Tell me a little bit about that and is that a resource that people can go to, how can they make use of that? Yeah, the vetan Academy was established, oh, I can't remember how many years ago now, by a colleague and I, because we, we founded a dearth of information for not only veterinary practitioners, but also, pet parents, and We pride ourselves on being non-biased and, and not necessarily trying to market or sell any products in particular except for the t-shirts that we, designed, but that's, that's a different story. We're not selling any cannabinoid.
Are they made of hemp though, the t-shirt? They are not. Oh, that's a good point.
I made of hemp. Oh, you got me. But yeah, it's, it's an unbiased, research-based website for practitioners or pet parents to go to.
That we, we believe has really good quality information, because we see so many companies now trying to do this education component which by and large most of them are, are pretty good, but then we also have again those bad actors that are maybe putting some information out there to kinda help push their product rather than give quality information. And where do you see yourself and, and perhaps the product going in the future? What, what other areas do you think that CBD oil might get used in, you know, I know you spoke about the, spoke about the anxiety studies which perhaps are are still ongoing.
Is there other areas as as well as cancer, Can again for the, for the, the pain component obviously to the, the disease? Yes, cancer is a really interesting topic when it comes to cannabinoid therapy. There's, there's two trains of thought.
There's using cannabinoids, things like CBD for alleviation of symptoms related to that cancer or even the, the cancer treatments an animal or a person might be undergoing. So things like nausea, and. Discomfort, sleep, etc.
And then there's those that want to use these, these compounds as an anti-neoplastic or as an anti-cancer, drug as well. And those are two very, very different dosing schemes. But what we're finding with cancer in particular in humans and in dogs are.
Have been some in vitro studies in dog cell lines of different cancers. We're finding that each cancer will take a very specific formula, a ratio of CBD to THC to maybe some of these other phytocannabinoids, things like CBG or CBN or even including these things called turbines that are also found in these plants. For a specific type of cancer.
It's certainly not gonna be a one product treats all type of cancer. And certainly there are other types of cancers such as those in the, the mouth or the throat where THC is actually less beneficial and can actually proliferate certain types of cancers. So it's really, really important.
I know we're, we're kind of impatient. I think a purified CBD product is probably the safer thing to do for cancer right now, but. If you want what's called a broad spectrum or a full spectrum product with all the things in it other than just CBD I think we need to be a little bit more cautious because we just don't know if they are gonna be beneficial or harmful for these different types of cancers.
I suppose the danger is when a new product comes along that that seems to have a lot of, you know, beneficial effects, it can be thrown at everything without thought, and I think that's what, what, hopefully we won't see with with CBD oil. Well, we're, I think we're in the midst of kind of cleaning that up right now, to be honest. But certainly, you know, as the wave heads east, at least from where I'm at towards the UK, certainly I hope you guys will learn from our mistakes.
Yeah, that's fantastic. I mean it's, it's really interesting because it is starting to come. It's obviously been led from America as, as often happens.
So it'll be really interesting to make sure that we, we learn from some of the cool stuff that you've done and, and others. Stephen, you know, I must admit I, I always talk about our webinars and our podcasts. If I can learn one thing that helps me .
Potentially take that into practise. Obviously I don't practise myself now, but then it's been beneficial, so I really hope that the listeners will have got something from what is, you know, a, a fairly new product in the UK, but nevertheless, I think one that has some really interesting properties and I, I'm sure we'll become more of a, a part of the vets Armamentarium as we move forward into the next few years. Brilliant.
Yes, I, I hope so too, and I'm always around and as I mentioned, we have that fun website that we, we always update and we have a link to the textbook there as well if anyone's super interested and wants to nerd out. That's fantastic, Stephen, and we'll, we'll look out for the t-shirts as well. Oh yes, the hemp t-shirts, I need, I should write that down.
Thank you so much, Stephen, that's been really great. I really appreciate your time as well. Take care.
Thank you for having me.
