Plucking the electric daisy: Dermatology explores the use of medical cannabis
Cannabinoids are not new; researchers have been looking at their medicinal effects since the 1940s. What is new is the recent proliferation of their use in our culture, largely due to the increased availability of cannabinoids, cannabidiol (CBD), and THC products that have come from new legislation and legalization in most states.
Enter dermatology, a science that is ever keen to discover new potentials and possibilities for medical cannabis. Adam Friedman, MD, will discuss this topic when he presents “Use of Cannabinoids in Dermatology." Dr. Friedman answered a few questions in advance of his session in an exclusive interview with Dermatology World.
DW: What is your reaction to the rapidly growing marketplace for cannabinoids?
Dr. Friedman: The pace at which legalization and utilization of cannabinoids in the commercial medical arenas outmatches the speed at which both research and education can be performed effectively or disseminated, respectively.
DW: How do you see all this fitting into the future of dermatology?
Dr. Friedman: Given the breadth and diversity of skin pathology and the complex and interwoven nature of the cutaneous endocannabinoid system, it should come as no surprise that many of the claims made by over-the-counter and dispensary-provided products fit in the dermatology space. That said…show me the science! We need bench to bedside investigations supporting the hype. For example, I co-developed and am studying a nanoparticle formulation of anandamide, an endocannabinoid, for the treatment of cutaneous lupus. I am fortunate to have a diverse and talented collaborative group that has facilitated detailed evaluation from cell culture to mouse model and now hopefully to human studies. We need others to get on board with doing good science to both ensure therapeutic efficacy and understand mechanism.
DW: Can you offer a preview of what you’ll be presenting?
Dr. Friedman: The presentation will take attendees on a magical journey through the biology of the endocannabinoid system (meaning your inherent system that responds to endogenous and exogenous cannabinoids), ultimately honing in on the cutaneous endocannabinoids system. There will be a rapid-fire review of the available, and mostly preclinical, evidence supporting the use of phyto, endogenous, and synthetic cannabinoids in multiple inflammatory skin diseases.
DW: Are dermatologists prepared for patient questions on cannabinoids?
Dr. Friedman: Your patients will ask and you need to be armed with the basic fund of knowledge to respond with confidence. We need to be asking ourselves: What is the evidence? What are the limitations? What are the regulations? How do I freakin’ do this?? These are all legitimate questions I hope to address in the session. I will wrap up with practical pearls on how to “recommend” medical cannabis, what requirements are needed, and safety considerations.
Adam Friedman, MD, is professor and interim chair of dermatology at George Washington School of Medicine and Health Sciences.