Medical Doctor Pivots to Create a Cannabis-Focused Practice

dr rachna patel

Dr. Rachna Patel has a background in emergency medicine and completed her medical studies at Touro University College of Osteopathic Medicine and her undergraduate studies at Northwestern University. She has been practicing in the area of medical marijuana since 2012.

Learn why Rachna pivoted to make the focus of her practice cannabis and why cannabis related treatments may be the future.

Key Takeaways:
[2:09] – Dr. Rachna’s background
[5:11] – Dr. Rachna talks about her day to day practice
[6:52] – Dr. Rachna talks about patients’ motivations for coming to her office
[7:57] – Dr. Rachna’s recommendations on what symptoms to use cannabis for
[9:03] – Cannabis very effective for anxiety
[11:12] – Using cannabis to conquer opioid addiction
[13:27] – Instances where cannabis is not a good treatment option
[22:24] – Cannabis and cancer
[24:14] – Is the endocannabinoid system discussed by MDs?
[27:24] – Dr. Rachna gives her thoughts on the vaccine controversy
[28:47] – Dr. Rachna answers some personal development questions
[33:59] – Dr. Rachna’s contact details

Important Update:
What are the five trends that will disrupt the cannabis market in the next five years?Find out with your free guide at: https://www.cannainsider.com/trends

 

Read Full Transcript

I am pleased to have a medical doctor on the show today to discuss how she is integrating cannabis into her practice. Dr. Rachna Patel has a background in emergency medicine and completed her medical studies at Touro University College of Osteopathic Medicine and her undergraduate studies at Northwestern University. She has been practicing in the area of medical marijuana since 2012. Rachna welcome to CannaInsider.

Rachna: Thank you for having me on the show.

Matthew: Give us a sense of geography. Where are you in the world today?

Rachna: I am located in the Bay Area in California.

Matthew: Okay an I mentioned your background and education a little bit there, but can you tell us a little bit more about that and how you pivoted into the cannabis practice?

Rachna: Sure. So like you mentioned my background is in emergency medicine and while I was going through training there were a couple of cases that really stood out in my experience while I was training. So one was seeing a ten year old boy who had come in having overdosed on oxycontin. He was barely breathing. The second scenario was a woman who had previously been admitted twice to the ICU because she had overdosed on opioids and in both scenarios the doctors had predicted that there’s probably a 90% chance that she will die and fortunately she didn’t, but there was a night that I was working in the emergency room and there she was coming in again seeking opioids.

Third situation is basically overall in general I saw a lot of elderly patients that came in. They are on a sleuth of medications and a lot of them would come in just completely out of it because they had taken too much of their opioids. The fourth scenario was going through what’s called a toxicology rotation and this is when basically all you deal with are overdoses on prescription and over the counter medications. So big picture here, you step back. I started off medical school wanting to really truly help people, but what I was finding is that the very medications that I’m prescribing are harming people. So there’s something wrong with this picture.

Now at the same time I happened to find an ad on Craigslist there said medical marijuana doctor needed. So that definitely peeked my curiosity and I started looking into the field. I didn’t even know that it existed. Then what I started doing was I started going through the research on marijuana. I was looking at the studies that were out there, what they said and at some point I was compelled enough where I was like okay I think there’s something to this. It has a lot of potential for pain management and as it stands in medicine we don’t have a good option for long term pain management. So any good doctor needs a lot of clinical experience and there was no formal training experience in medical marijuana. There still isn’t. So what I decided to do was work at a medical marijuana clinic, and that’s where the journey started and here I am today.

Matthew: Wow. That’s an interesting path. What’s your day to day practice like today?

Rachna: So day to day mainly I just practice in the area of medical marijuana and I treat a wide variety of conditions mainly chronic pain, anxiety and insomnia.

Matthew: Okay. You saw the Craigslist ad and that was just kind of something that sparked your interest, and then what further from there when you said hey I’m looking for alternatives to some of the maybe more hash alternatives in terms of medications out there.

Rachna: It’s not that I was looking for an alternative, but as I started to do the research on marijuana I learned that it has a lot of potential to be a great alternative. So I was reading about how there was a study done by Dr. Donald Abrams on how using marijuana helps to reduce the use of opioid medications. I saw how it helps patients with multiple sclerosis, patients with arthritis and whatnot. These are all preliminary studies that I read about but they definitely peaked my interest. It was a stark contrast to what I was seeing in the emergency room with opioids.

Matthew: So most patients that come to your practice are they looking for alternatives or what’s they’re primary motive for coming to see you? They’re saying hey I want to try some botanical solution with cannabis or just like the fact that you’re open to it or how does that work exactly?

Rachna: Typical scenario is that I have patients that have spun their wheels with conventional medicine and they’ve tried, when we talk specifically about pain management, they’ve tried the opioids. A lot of times patients are then moved on to antidepressants and then they’re moved on to medications that are typically used for seizures. Then they get injections with cortisone which is a steroid. Then they try alternative options like acupuncture or massage or chiropractics and nothing is really working for them. So mainly what they tell me is Dr. Patel I’m here because I’ve spun my wheels, I don’t know what else to do and I’m going to just try this as a last resort.

Matthew: Okay. If you were to rank the top conditions or symptoms you recommend cannabis for, what are the top two or three you would mention?

Rachna: So the top three, like I said, chronic pain, insomnia and anxiety.

Matthew: Chronic pain, insomnia and anxiety. Now this is kind of anecdotal and subjective, but why do you think most people are experiencing anxiety now and do you feel like it’s at a higher level than points in the past?

Rachna: A lot of patients will tell me that a lot of anxiety… I’d say half of my patients it’s due to work related anxiety, work related stress and the other half it has to do with just they get nervous in social settings, especially where there’s like large crowds of people or speaking in front of a large group. So those are sort of the general trends that I’m seeing in my practice.

Matthew: So do you think cannabis is an effective treatment for anxiety and if so what’s the best kind of application to help there?

Rachna: Yeah, actually I find there are certain conditions where the medical marijuana works better than prescription medications and I definitely say anxiety is one of them. The alternatives aren’t that great. Typically benzodiazepines are used and these are medications like Ativan, Diazopam, Xanax is a commonly prescribed medication for anxiety. They’re highly addicting and they’re highly sedating as well. So it does impact the quality of a person’s life. What I found with medical marijuana is that patients can use it on an as needed basis. They don’t need to use it on an everyday basis which is the nice thing. Anxiety can sort of range the spectrum.

There are those that have it on an everyday basis. They have panic attacks very often during the week, and then there are those where it’s more situational. It just depends on the situation. So what’s nice about medical marijuana is that you can sort of, you know, once you start taking it, you don’t have to take it on an everyday basis. You can take it on an as needed basis. So that’s what I like as a physician, but that’s also what my patients like about the medication as well.

Matthew: You mentioned a little bit earlier about helping with opioid addiction. How does that work exactly and how effective is it as an alternative to other forms of dealing with opioid addiction because it seems like we’re really at a huge huge amount of the population is suffering from this, some areas of the country worse than others. We don’t really seem to even talk about it. There’s not a national dialogue about it. It’s kind of buried underneath, we kind of sweep it underneath the rugs. Where do you feel like the level of opioid addiction is or opioid addiction and how can we use cannabis to help with that as an alternative?

Rachna: Let me make a distinction here. So I get the patients that are not looking to get addicted on opioids. So that’s one group of patients that are using it but they’re using it very cautiously. Then there are those that are actually addicted to opioids. So let’s start with the patient population that I see. Now based on research, again this was a research study that was done by Dr. Donald Abrams, he basically in his study, the results showed that marijuana helps to reduce the use of opioids in terms of dosing. The reason is is that marijuana enhances the effect of opioids.

Say you typically take two tablets of an opioid. By using it with marijuana you can get away with using just one tablet because that one tablet will be made more effective with the use of marijuana. Now what I’ve seen in my practices that’s definitely the case. There are patients that are able to significantly reduce the dose of the opioid that they’re on, but I’ve also found that there are patients that are able to come off of the opioids. Again they’re using the medical marijuana on an as needed basis. Now when it comes to addiction, I’m going to be honest with you, I don’t treat in general a lot of patients that are addicted to drugs. I’m also a believer that I don’t think one substance should, if you’re addicted to a substance, I don’t think you should replace one substance with another substance because that’s still addiction in and of itself. So I can’t say much about that based on the experience that I’ve had.

Matthew: So we’ve talked a little bit about what cannabis is good at treating or is a helpful tool in your tool belt. Are there any symptoms where cannabis is not in your opinion been a good treatment option for patients?

Rachna: There are certain patient populations that I’m very cautious in recommending medical marijuana to. To start off with, any patient that’s had a history of psychotic episodes. The reason being one of the chemicals in marijuana, THC, has psychoactive properties, and if you take too much of it, it will cause hallucinations. So it makes these patients that have already had a history of psychotic episodes even more prone to getting other psychotic episodes because of that psychoactive effect of THC so that’s one population.

The second population is are my patients that have some sort of underlying heart condition. The reason being again marijuana can, if you overdo it, increase your heart rate. So you don’t want to put too much of a demand on the heart to the point where it could potentially stop beating. So that’s another population. In patients that have lung conditions, obviously they don’t want to be smoking or even vaping marijuana because it can exacerbate their underlying lung condition. Of course patients that are pregnant, that are breastfeeding, I tend to err on the side of caution with these patients. There are studies that go both ways. So there are studies that show that it has no impact on a growing baby, but then there are studies that also show that using marijuana while you’re pregnant can cause pre-term labor and delivery and also cause low birth weight as well. So those are the areas that I’m generally or those are the patients that I’m generally cautious in recommending medical marijuana to.

Matthew: So you mentioned smoking and vaping. I mean if the patient was going to do one or the other would you say hey vaping is a little less harmful or do you say look just don’t do any of them, skip that?

Rachna: It depends on what you’re vaping. There are concentrates that are extracted in solvents which I don’t recommend using. Because at this point we don’t have information on if there’s anything residual left over after the whole extraction process. We don’t know how many parts per million there are of that residue. Okay and if there are toxic levels of it, then it’s doing harm to your body. So overall I don’t generally recommend to my patients that they smoke marijuana. Long term it does do damage to the lungs. It does make you more prone to infections like chronic bronchitis for instance. Then vaping, as I said, I’m cautious about the concentrates.

Matthew: We’ve reached a really high level of autoimmune conditions or disorders. I want to ask you about that, but first can you just maybe rattle off a few autoimmune conditions and your opinion about why there’s so many autoimmune issues going on right now?

Rachna: Actually I’ve dealt with an autoimmune condition and that was hypothyroidism. For the longest time, I was diagnosed in my 20s and I had been on medications for the longest time, and in medical school they teach you that it’s lifelong condition. So about a couple of years ago I decided to stop eating sugar and try to eliminate as many carbs as possible in my diet. What that actually did was it reversed the autoimmune condition. My thyroid levels completely normalized and I’m now off the medication. So speaking from a personal experience, I can’t help but say that what you eat has a significant impact especially on autoimmune conditions.

Matthew: Okay yeah and autoimmune conditions often have an inflammation component with them. Why is that and is cannabis helpful in treating or helping the inflammation aspect of autoimmune conditions?

Rachna: Yeah so basically what an autoimmune condition is is that your body is attacking your own body. There is some sort of signaling that went awry and now your body is just attacking your own body. What happens is that attack process results in inflammation. Now the way marijuana sort of plays in is that marijuana does have anti-inflammatory properties and based on research in mice we know at a very cellular level what the marijuana is doing. So mainly it does three things. One is that it’s causing the death of the cells that are attacking your own body. The second is that the signaling that’s going on amongst these cells that are attacking your body the marijuana suppresses that signaling.

Now the third thing is is that marijuana activates T regulatory cells. This is a type of cell that we have in our body that ensures that the body doesn’t respond to chemicals that are signaling hey attack the body. So that’s how by affecting the cells that are attacking the body their communication process and then affecting T regulatory cells, this is how marijuana is reducing the inflammation that goes on. Specifically, clinically conditions that I’ve treated where there’s an autoimmune component to it those are psoriasis, arthritis, rheumatoid arthritis, Crohn’s disease, so those are just some of the ones that I see very commonly.

Matthew: Okay. What’s your reaction from colleagues when you tell them you’re in the cannabis space? Does their facial expression change at all? I mean you’re in the Bay Area so people tend to be more familiar with cannabis out there, but is there any kind of wrinkled brows or anything like that?

Rachna: It’s really interesting because when I first started my practice in 2014, we’ve made a lot of progress since I would say 2014 onwards, but when I first started my practice. Typically what a doctor does when they start a practice is that you go around to other doctors to let them know that hey you’re in town and basically if they have patients that would benefit from the specialty that you practice and they refer patients to you and then if you have patients that would benefit from whatever they practice and you refer patients to them.

So I remember going to a variety of different specialists; neurologist, oncologists and just to let them know hey I’ve opened up this practice. I specialize in the area of medical marijuana and I basically got the door slammed in my face. Nobody was willing to meet with me. What’s really interesting is that now, this is now my third year of practice going on to my fourth year. I now actually get referrals from doctors that I’ve never even met before. So I think we’ve made a lot of progress in a span of a very short time. So I would say overall definitely the perception has changed. I realize that doctors in general tend to be conservative so I do have patients that still come to me and say hey I am a little concerned about telling my primary care doctor that I use marijuana for medical reasons. Then I’ve also had patients where they have told their doctor and it was met with a lot of that finger pointing like you shouldn’t be doing this sort of thing. So we still have a ways to go, but I think we’ve made a lot of progress.

Matthew: What about cancer? There’s a lot of people listening that have a friend or family member with cancer or they themselves have it and they’re wondering hey is a possible application for me.

Rachna: Sure so there are a couple aspects of cancer that the marijuana I found helps greatly with. So for anybody with cancer that’s undergoing chemotherapy they end up experiencing, as a side effect of the chemo, nausea, vomiting, complete loss of appetite. So those are areas where the medical marijuana helps greatly. It helps you reduce the nausea, gets them to stop vomiting, gets them eating again, and anybody who has used marijuana can speak to this because they’ve probably experienced the munchies at one point or another. So we know that it definitely stimulates appetite.

Now what I want to touch on is this whole sort of claim that’s going around, especially on the internet, that medical marijuana cures cancer. There is certainly research out there, preliminary research, in cell cultures in mice that does show that marijuana does have anti-cancer properties. It does fight cancer. Now we don’t know if this is the case in humans yet. We don’t have enough research number one, and secondly clinically I actually haven’t found that to be the case. I’ve seen quite a few, I’ve been doing this since 2012, so I’ve seen quite a few cancer patients and nobody has really come back to me and said hey Dr. Patel, the marijuana cured my cancer. So I think we have jumped the gun in coming to that conclusion. It very well may have the potential but we need more information at this point.

Matthew: In medical school do they talk about the endocannabinoid system or is that still something that’s just not really discussed in the medical community yet?

Rachna: Not at all. Marijuana is presented as a drug of abuse not as a clinical treatment. So no, we never learned about the endocannabinoid system. A lot of what I learned is based on just going to Pub Med and reading the journal articles that have been published on this. Of course what I learned in medical school helped tremendously the basic concepts that you learn, like for instance in pharmacology, biochemistry and whatnot, using those concepts. It helps you to sort of put all this information together, but no it’s definitely not taught. I mean I graduated medical school back in 2009 so it’s been a couple years and obviously we’ve made a lot of progress with medical marijuana itself as a treatment option so I don’t know currently if it’s taught at any medical schools.

Matthew: Was that kind of a strange moment for you when you realized hey I know all about the pulmonary and respiratory system. It’s like how can this whole system exist, and it’s like we don’t even talk about it or it’s not even acknowledged. It’s kind of a strange thing isn’t it?

Rachna: Yeah it is. I believe I read somewhere that it’s a system with the second highest number of receptors in the body. So it is definitely something that’s having a huge impact on the human body. I mean if there’s anybody out there listening who is a medical school faculty member or an administrator that I think I encourage them to make this a part of their curriculum.

Matthew: Okay. I like to ask guests a few personal development questions to help the audience get to know you a little bit better so I’m going to jump right in. Is there a book that has had a big impact on your way of thinking or has been a good lens into a learning opportunity for you that you would like to share with listeners?

Rachna: Yeah. So I don’t know if you’ve heard of this Hindu texted called the Bhagavad Gita.

Matthew: Yes.

Rachna: So I grew up with my father quoting that book. So I have learned so much about life from him just quoting it. An example that I can tell you about is one of the things that’s said in the book is don’t focus on the fruits of your labor, focus on the labor. I think that’s very relevant to American culture. We’re so goal oriented. So I remember growing up and even recently going to my dad. Just being an overachiever I would go to my dad and I would be like dad, I’m going to get a 4.0, and I remember him telling me just focus on learning the material. I remember when I opened up my practice I was like dad I’m going to be the best medical marijuana doctor there is and he said you know just focus on serving each patient and be grateful that that patient help you put food on your table. So he really kind of sort of just kind of pulls me back and reminds of what really matters at the end of the day. So a lot of what he’s telling me he’s learned from this book.

Matthew: Very nice. It’s kind of balancing the yin and the yang there, kind of hardcore goal setter versus kind of a spiritual path there.

Rachna: Yeah.

Matthew: Yeah I’ve had that book recommended before and the Dao De Jing which I’ve read and these are some huge spiritual texts out there now. Anything else that you heard from your dad, any other words of wisdom that would throw out occasionally?

Rachna: Yeah so growing up he told me this one story that always stay in thought in my head. So he told me that this woman went to Buddha and said it’s really unfair that I’m suffering so much in life. So the Buddha told her okay well here’s what I want you to do. Go to a house and find me some mustard seeds from a household that’s never suffered, and nobody in the household has ever suffered. So she goes around trying to find these seeds from a household from people that have never suffered, and she’s trying and tying and she’s unsuccessful so she goes to Buddha and she says I couldn’t find any seeds from a household that’s never suffered, and pretty much he was like well that’s your answer.

So I think the lesson my dad was trying to teach me is that struggles are important in life and they make you who you are. So that’s a story that’s always sort of stood out in my mind. I remember him telling this to me. I mean none of this made sense when I was five years old, ten years old, but now it’s like wow, I can’t believe I have this amazing person as my father that’s taught me so much.

Matthew: That’s great. Is there a tool web based or otherwise that you consider indispensible to your day to day productivity?

Rachna: So you’re talking to a millennial. All of it is essential, but I mean even things as simple as Gmail. I’ve been using it for the past, I don’t know, 15 years now. So even Facebook, I mean I was an early adapter when it came to Facebook because I think what Mark Zuckerberg had initially done was that he only allowed access to certain colleges and I think he had started it in February of 2014. I remember reading about it in our college newspaper in April of 2014 and I was like this was interesting. So I joined. So I think that’s a hard question to ask to a millennial. It all at some point becomes crucial to your survival.

Matthew: Right. So would you say millennials are miscategorized sometimes. Obviously you’re employed, you went to medical school. So do you get frustrated when people say hey millennials are kind of like they don’t do anything because clearly you do.

Rachna: Yeah we do but we just do it in our own way. We don’t necessarily follow social norms. Yeah I’m a doctor, but I’m a medical marijuana doctor. So yeah.

Matthew: There’s something to the generation thing. I read a book called the Fourth Turning by a gentleman at a university that studies generations and there is a big impact on our world view and our outlook and how we relate to people just from our generation. Everybody including myself likes to think we’re a unique snowflake, but I’m a Gen Xer and there’s certain characteristics that I read about and I’m like holy I do relate to that and how did I pick these things up. They just kind of stick to you like gum on your shoe.

Rachna: Yeah totally.

Matthew: Hey in closing can you let listeners know how they can find you online and connect with you?

Rachna: Sure. A couple of different channels that they can connect with me. One is my website which is www.drrachnapatel.com. I won’t spell it out for you but I’m assuming you’re going to put it in your show notes because it’s long. Second is my YouTube channel. I’m always trying to put out information on commonly asked questions, conditions that can be treated by medical marijuana, conditions that can’t be treated by medical marijuana. That’s on my YouTube channel. Then thirdly I know there’s a lot of people with questions out there so every Wednesday on my Facebook page I have an Ask Me Anything Wednesday and you can post your questions in the comment section and I’ll either comment or if it’s a very common question, then I will do like a Facebook live answer to that question.

Matthew: Now can they ask you unrelated questions like what’s your spirit animal or does it have to be strictly related to cannabis and medical questions?

Rachna: It doesn’t have to be. They can ask me, I mean as long as there’s certain bounds, I mean some people kind of like take it to an extreme and that’s kind of weird. So as long as it doesn’t get weird it’s okay.

Matthew: Okay good to know. Alright, well Rachna thanks so much for coming on CannaInsider today we really appreciate it.

Rachna: Yeah thank you for having me on your show. I appreciate it.

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