Jordan Tishler, MD, is a Harvard Medical School faculty and a Cannabis Specialist. His focus is on providing excellent care for patients using cannabis as medicine. His private practice, inhaleMD, has treated thousands of patients.
1). How do you think COVID will impact/change the future of the cannabis industry? Aside from the impact on the larger economy, which will recover, if slowly, I think COVID will have a dramatic effect on the overall provision of healthcare. For example, telemedicine. Prior to COVID, I had used telemedicine many times, but sparingly. I generally felt it was more convenient than it was really a good way to provide care. In some ways, I do still think that the idea of Urgent Care being done basically by an almost anonymous millennial via an app to an unknown physician is problematic. Medicine is about relationships that matter. However, now that I’ve been practicing exclusively by telemedicine I have to say it’s pretty good. Relationships still matter, but it’s clear that it’s not the telemedicine that’s the problem. Telemedicine can facilitate the relationship and care just fine. It’s really just about how you set up the practice and how you dedicate yourself to your patients. As for the broader cannabis industry, I don’t see a lot of post-COVID changes.
2). Have you seen an increase in clients during COVID? Yes, we’re definitely seeing a surge in patients. This is in part due to increased stress and anxiety. It’s also partly due to recreational shops being closed. It has presented some interesting challenges: of the people who have been using recreationally, there are two groups, those who are truly recreational, and those who have been self-medicating. We’re not interested in providing cards to recreational users, but are very interested in providing care and benefit to the self-medicating crowd.
I have long maintained that healthcare should not be DIY. There are many ways that guidance from a knowledgeable and caring clinician can lead to better and safer benefits. Further, the industry has a tendency to provide “advice” that they’re not qualified to give, and that stems from a conflict of interest. After all, they’re there to sell lots of weed. That’s not necessarily in the best interest of a patient. It turns out that much of the “lore” out there is just wrong. 3). What are your thoughts on recreational dispensaries in MA not being considered essential during COVID? I agree. When the focus must be on keeping people safe, recreational outlets should be closed. Before anyone gets the knickers in a twist, let me say that I think booze stores should have been closed too. And, the argument that people were self-medicating doesn’t fly either. As I mentioned above, if people are sick they should, and should be encouraged to, seek medical attention. If they’re sick enough that they need this medicine while we’re in “lockdown” then they’re sick enough that they really shouldn’t be winging it. 4). Can you provide some insight into some of the most exciting cannabinoid research taking place in MA? Staci Gruber at McLean hospital has done some very interesting research lately. She did a series a few years ago on recreational users looking at memory and other mental performance tests. Not surprisingly, subjects did better when they were sober than when they were stoned. However, when she did the same tests on patients, she found exactly the opposite. They did better with some cannabis onboard, presumably because they are sick and the cannabis was helping. There have also been a few observational studies done in the past year or so that looked to define who was using cannabis and how/why. I find this less compelling, largely because it has been done to death. These are good studies to generate ideas for further study but alone can’t prove anything.
5). What would you identify is the biggest difference in the MA cannabis industry from one year ago? There’s been a large push in the industry over the past year to launch a large number of recreational shops. A year ago we were just at the start of this, now there are many (despite the minor current set back). Moving forward we need the industry to stop trying to convince patients to DIY their care. They need to stop undermining physicians’ recommendations and stop giving medical advice. Unfortunately, this seems like it’s going to require intervention by regulators. Dr. Tishler reached at inhaleMD.com or by calling 617 477 8886.