Cannabis For Alzheimers and Dementia with Fabricio Pamplona AKA Dr. Cannabis
Fabricio Pamplona was dubbed “Dr. Cannabis” after being voted as “the scientist that was supporting the illicit network of CBD distribution in the country.” This was meant to criticize Fabricio, but instead, he was happy to be recognized for a doctor that was patient first.
Fabricio’s work has a heavy focus on aging, specifically Alzheimers and Dementia. We met him after his talk at SXSW called, “Cannabis and the Aging Brain” and we wanted to learn more.
In this episode we talk about his findings on this subject as well as the cannabis world in Brazil.
Fabricio, do you mind introducing yourself telling us what you do, where you do it, and how you do it?
I am a Pharmacist by training. I have a career in cannabinoid science or cannabinoid from ecology more specifically for the last 15-years. I did my masters and Ph.D. on this subject, including a two-year internship as a guest researcher at the Max Planck Institute of Psychiatry, where psychopharmacology was born.
In the last eight/nine years, I have been involved in new ventures involving new treatments and clinical research involving cannabinoids and new products here Brazil and Latin America.
Right now, I’m working more as a consultant in this field with clients in Latin America and a client in the United States.
What was it that led you to want to start investigating cannabis and its use in psychopharmaceutical and pharmaceuticals in general?
People often ask me and expect that I’d say something very intriguing or very personal or mystical about the plant. That’s not the case. I love to understand how pharmaceuticals work. Particularly the ones that activate the central nervous system.
Back in 2000, there was a very influential paper on the rebirth of cannabinoid science, where people describe the endocannabinoid system using the first CB1 endocannabinoids that were out there at the time.
At the time, they had just started to realize how endocannabinoids were very important for combination, emotion, and neuroplasticity in general. I realized this was important enough to pursue a career in and that it would have an impact on people. I realized cannabinoids were fundamental from a physiological point of view.
My first step into that career was trying to design therapy based solutions for the endocannabinoid system. In Brazil everyone was looking at cannabinoids and thinking about addiction, tolerance, and things like that, I was one of the very first of my generation to start speaking about therapeutic potential [of cannabis].
What is your Role in the Overall Cannabis World?
To a great extent, I still position myself as a scientist in the field. Though I do interact with lots of different pharmaceutical companies, activists, patient associations, and patients themselves.
In 2012 when the patient’s associations started to happen here in Brazil, they invited me to become a founder and a director in what today has become the most significant Medical Association in Brazil. I thought a lot about that, I was motivated enough to do that for the patients and engage in medical indication.
I realized that, although I understand that activism is important, my role in this whole thing is more to be a scientist. And even going beyond that – trying to be more useful than a scientist enclosed in a laboratory, I jumped into product development. That was my bridge for something more real and more helpful for people.
I remember very clearly when the very first patients were coming to me. I worked as a clinical research engineer and patients came to me with this brown extract mixed with oil. Most of the patients were parents from children with epilepsy.
They came to me saying “doctor, I don’t know exactly what is inside this, but this thing is reducing the frequency of seizures in my children my child. I know it’s not totally legal, it’s probably cannabis or marijuana. I don’t understand exactly, please help me because this is marvelous.”
They came to me as if it was something magical. That’s when I realized I could be useful in this space.
Then I was quoted in a very influential (it’s called global) Journal/newspaper here in Brazil and voted as “the scientist that was supporting the illicit network of CBD distribution in the country.“
I was honored by that, by being acknowledged as the guy that was supporting the patients, this is my motivation to do this, my purpose if you will.
A few years later, I was called Dr. Cannabis.
We saw your talk at SXSW called cannabis and the aging brain. Can you give us a summary of what that talk was about and about your research?
This is a very long story, but I’ll try to summarize it.
I identified a new molecule that interacts with the endocannabinoid system. It happens to be a molecule that enhances the interaction of the Anandamide with the Cb1 one cannabinoid receptor.
This molecule empowers the true agonist of the endocannabinoid system to act on its receptor. This molecule is called Lipoxin, and it decreases during the aging process, particularly after the person is 50-years old or older. Lipoxin levels go way down after the age of 50, and if you reach 100-years almost not there anymore.
This is a natural part of the aging process. This molecule (Lipoxin) has a neuroprotectant through the CB1 receptors, and it’s a very potent anti-inflammatory molecule as well. I have hypothesized that when we age because of the drop in the Lipoxin levels the brain and the whole body becomes vulnerable towards a certain number of diseases and it’s probably a parallel to what is considered to be the endocannabinoid deficiency syndrome.
I kind of confirmed the hypothesis that people that have aged well have high levels of Lipoxin and people that aged badly or develop dementia or Alzheimers during the aging process, they have lower levels of Lipoxin.
In my talk at SXSW, I explained how the changes we see in elderly people fit with the therapeutic potential the cannabis. Depending on the case THC or CBD or cannabis as a whole for the elderly. Cannabis is perfectly fit for many symptoms that we see. That’s probably the reason that the most significant population increasing the use of cannabis is about 50-years of age or older.
Is there is a risk of overuse, what was the volume of cannabis that you would have to ingest to see adverse effects?
Cannabis abuse could be smoking several joints of high potency cannabis every day (Note: In Fabricio’s SXSW talk, it was about 5-10 joints). This increase will estimate the brain age more than 10%, it is like if you are 50, your brain is like 55/56. It’s not really a big deal I’d say. We know that cannabis abuse reduced CB1 expression, down-regulates the receptors. It could mean cannabis abuse will speed the process of losing the endocannabinoids Taunus over the aging process, so that’s the only point of concern here.
Give us a brief summary of what’s happening with legalization and medical use in Brazil and what you see the future looking like for the country?
I was involved in the last four or five years in sensitizing the government to put a regulation in place, and two days ago it just happened. Now we have a proposal of regulation for medical cannabis in Brazil. It’s going to be discussed for two months with the public and then the contributions of different actors to the field, the government we will see again and draw and define our regulation.
Back in March 2016 is really the time where medical cannabis started to be present as a tool in the medical effort. But we don’t have products being produced in Brazil so far. Physicians can prescribe, but they need to access products from other countries. Some states in The US for CBD and Canada for instance or Israel when it comes to THC.
What’s changing right now is that they put in a proposal of regulation for cannabis cultivation and for pharmaceutical product registration. These are two parallel initiatives, and it looks like it was inspired by Canadian regulation. I was personally involved in this visit of the Brazilian regulators in the cannabis cultivation sites, particularly of Canopy, Bulacan, and MedRelief at the time. These are the three sites they visited. I know they went to Israel and several other countries (Holland) before putting this regulation place, but I can see that Canada was very influential.
What does that mean? It means that the cultivation sites would have very strict security plans, biometric access control, and access control for every production site. Tracking would be insane for the early years. All the cultivation sites will have to be indoor, which is kind of silly. They are concerned with safety because Brazil can be violent depending on where you are, particularly when it comes to drugs and drug trafficking.
Storage would have to be extremely fortified, bank style, similar to Canadian law. And you would only be able to cultivate for research, as a university, or for product development, etc.
You would not be able to cultivate at your house or with your friends, not even in patients association if you are not linked to a research or development plan.
They will just allow a few pharmaceutical forms: pills, liquids, tinctures, emulsions, capsules, things like that. They won’t allow vaporizers, they won’t allow flower, they won’t allow any pharmaceutical form that would make it easier to deviate the use of the plants or the products from the medical standpoint.
On the innovative side, they will speed up or facilitate the registration of the products. They understand that we already have a model to state the products are safe for some patients. And they would take some registration without clinical trials, just based on information from the scientific literature. For chronic pain, palliative care, or epilepsy, for instance, they will have a fast track – provided that the company at least engage in research and publicly report the results of the studies along the way over the years. It’s not a prerequisite for registration, but you need to engage in research and pharmacovigilance.
For the benefit of the population, I think they are taking an important step, although they are relatively late countries in Latin America. I think it’s an important step and I’m very conscious one it’s going to open up, open up what is suspected to be the biggest market in Latin America.
People are estimating the direct impact on close to four million patients. If you include clinical indications like chronic pain and then sleep. Probably after an initial two, three years the market will be something like five billion dollars already. So, it’s really a significant impact on the economy and on the patients
Every conversation is linked to scientific development so right now research funding in the country, and this kind of boost in the cannabis space will react, but I’m expecting that a lot of people will jump in
Whats your One year, five years, and ten year predictions with regards to where you sit in in the cannabis research sphere in Brazil?
I would say in the short term we are going to open the gates for external products – Companies that are already positioned in the cannabis space worldwide who enter the country with basic products, CBD, tinctures, 1:1, products for pain, MS, and high THC content products for chronic pain.
In five years, I’d say that some Brazilian companies will you know grow muscles and have more innovative products coming into the market. That’s more or less the timeline that I see my product applications into the aging process, for instance, coming into place.
And in ten years I’ll bet most of the companies worldwide which are not stable enough will bankrupt, and we’ll have a bunch of big conglomerates dominating the market, and probably Brazil will be one essential piece of this conglomerates in Latin America.
I’ll bet that Brazil will become the biggest producer of cannabis at least for Latin America if not the Americans in general in ten years. We need to soften the regulations a little bit, this includes greenhouses, even outdoors cultivation, that will be necessary but this will come if the time in desensitization of the regulator’s in my opinion.
Is there a conversation in Brazil about the potential environmental impact that cannabis might have?
I don’t see this conversation picking up right now. What I do see is the interest of big commodity producers like sugar cane producers or soya producers. I’ve seen their interest in the ecological advantages of producing hemp over sugarcane or over soy. Even if it is as a rotation culture or something like that but also for you know the kind of products that you can make it biodiesel beat paper be fabric, things like that.
I wouldn’t say that cannabis will pressure the Amazon more than it is already big pressured. I’d say those big commodity producers will shift to cannabis and hemp when the right time comes.
Is there anything that we haven’t talked about that you’d like to mention that you think is essential for the public out there to know?
There are a lot of things on the cannabis horizon from a scientific point of view. I would say that understanding the synergy between different compounds is one of my main areas of interest.
Last year I presented some research showing that CBD, when it’s in the plants that saying the phyto extract, is way more potent than when presented isolated. This kind of thing is a critical area of research, and I’d like to motivate physicians and medical boards who have experience in the natural products of cannabis to report what they’re seeing.
So far, I see a significant mismatch from what’s written in the papers of companies with the accumulated experience of physicians and patients.
In the case of CBD, for instance, I see that people report 5 to 10-times lower than what is written in the scientific papers. Having this experience becoming public whether printed or on YouTube is so important because the regulators have a different understanding of what cannabis does because they don’t talk with people they just read papers.
We need more public interaction, more space to talk about clinical experience and patient experience with cannabis. Patient experience is a big inspiration for us as , and all the information is solid there, we don’t need to see fish see to know if we can fish more.
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