Cannabis Therapies For Medicinal Use
College of Osteopathic Medicine grad helps lead the way in cannabis therapies
There are many reasons students choose to come to Touro University California. For Junella Chin – now Dr. June Chin – there were three. First, she knew she wanted to practice osteopathic medicine. Second, she liked Touro’s reputation. And third, having grown up in the Bronx, New York, she, “needed to get out of the cold.”
When asked if Mare Island had provided the balmy temperatures she craved, Dr. Chin laughed, “no, not really.”
But, despite the often-chilly weather, Chin did find a level of warmth she truly appreciated.
“I loved my experience at Touro,” she said. “Everyone was very accommodating and OMM faculty were very supportive.”
Chin, who graduated in 2005, spoke of several individual TUC faculty members who helped her along the way, including current Associate Dean of Student Affairs, Dr. James Binkerd.
“Dr. Binkerd mentored me on how to pursue my entrepreneurial path— to start my own private practice specializing in Osteopathic Manipulative Medicine,” Dr. Chin said.
For his part, Dr. Binkerd has equally good things to say about Dr. Chin.
“I have experienced the pleasure of working with Dr. Chin on the boards of directors of some professional organizations. This has afforded me the opportunity to following her professional growth and development,” Dr. Binkerd said. “I am proud of her success and gratified if I have played even a small role in encouraging her on her path toward professional development. She is an excellent example of the kind of graduate we hope to produce at Touro University.”
Along with Dr. Binkerd, Chin said she had many other mentors while at Touro. In fact, it was another individual, met during her time at Touro, who changed the course of Dr. Chin’s medical focus.
It began while she was working during a rotation at Solano Medical Center. The doctor with whom she was working one day told her matter-of-factly, “You know, you’ll never finish medical school.”
The statement was not meant to question her skill, desire, or academic ability, but rather, it was one of practicality. The clinician had noticed her leaning against walls in an effort to relieve the chronic pain she’d experienced since adolescence.
In fact, at age 17, Dr. Chin had been diagnosed with ankylosing spondylitis (AS), a condition that had grown worse in the ensuing years and left her body – especially her back – stiff and painful.
Much of the reason Dr. Chin had decided to pursue osteopathic medicine had to do with the fact that osteopathic treatment was the only thing that had been effective in helping relieve her AS symptoms.
But, by the time she reached Touro and was beginning her clinical rotations, the pain and stiffness were near constant and as the physician who told her she would never finish medical school pointed out, as a student she would be required to spend long hours on her feet, help lift patients, and generally participate physically in ways that could not be overcome by her intellectual ability.
Yet, there was hope.
The attending physician during that rotation had had success treating terminal HIV/AIDS with cannabis. The treatment not only helped relieve pain, but also aided in sleep and relaxation. He suggested Dr. Chin try a cannabis tincture to see if it could alleviate some of her pain. He did not call it “CBD oil”, at the time. He just said it was a type of “cannabis strain” that did not produce euphoric and sedating effects like regular marijuana.
Dr. Chin was more than a little hesitant.
“I just thought, marijuana? Oh my gosh I could get into so much trouble!” she said.
Legally, Dr. Chin’s fears were completely unfounded. In fact, cannabis for medical use had been legal in California since 1996 when voters passed Proposition 15, the Compassionate Use Act.
Still, during her undergraduate years at Cornell and then as a Touro medical student, she was serious about her studies and never indulged in any kind of experimentation with marijuana or any other substance.
But one weekend night, when the pain grew especially intense, Dr. Chin – skeptical still – finally placed a few drops of the tincture under her tongue and went to bed.
“The next morning, I felt better,” Dr. Chin said. “A lot better. It was amazing.” By the end of the weekend, she was convinced the tincture was working.
Following her graduation from Touro in 2005, and as Dr. Chin began her DO practice in a few California locations including Costa Mesa and Newport Beach, she began to use cannabis as an additional therapy for some of her patients. The treatment proved especially helpful in palliative care – helping manage pain and ease insomnia – in patients with only a few months or years to live.
But as her experience using cannabis grew, and research expanded (indeed there are hundreds of scientific research articles regarding cannabis use as medical treatment – medleafrx.com/research-on-medical-cannabis.html) Dr. Chin began integrating cannabis into more and more of her overall practice – with sometimes astounding results.
Dr. Chin has recounted numerous times the story of a young epilepsy patient named Liam (pseudonym for privacy). The toddler was experiencing as many as 100 seizures a day and his prognosis was bleak. But with the implementation of cannabis as treatment, his seizures were reduced to about four a month.
“He wasn’t expected to live past the age of three,” Dr. Chin said. “He was wearing a helmet, seizing all day long. Now he’s doing regular kid things – taking swimming lessons, playing baseball. He went from seizing all day to living a relatively normal life.”
Such is the promise and power of cannabis treatment. So promising in fact, that the FDA in 2018 approved Epidolex, the first cannabidiol sanctioned for use in several seizure-related illnesses. Epidolex is approved for use in patients as young as two.
“If the FDA is approving cannabis for use in young children, you can extrapolate how safe it is,” Dr. Chin said.
Yet, Dr. Chin is quick to point out that cannabis is definitely not a cure-all. It can be an effective treatment, but she always combines its use with standard of care and traditional osteopathic manipulative medicine. And while cannabis efficacy is now widely accepted for many health issues, Dr. Chin said she understands why some patients and some physicians are still hesitant to include it in an overall treatment plan.
After all, she was initially incredibly skeptical herself when first using cannabis to treat her own chronic condition. And if she’d been bolstered by California’s early adoption of medical marijuana treatments, moving back to New York with her DO husband seven years ago, brought home the fact that such cannabis use was still a very new thing in many parts of the country and world.
New York passed medical marijuana legislation in 2014, nearly 20 years after California. And although cannabis is now legal in New York for both recreational and medical use – its medical use remains highly regulated.
“There’s a great deal of prescription monitoring in New York. Every prescription is logged into a database and monitored very closely,” Dr. Chin explained.
Beyond simple legal matters, there is also the issue of educating the public about the documented effectiveness of cannabis and removing the skepticism and judgement that sometimes accompanies its use.
“It’s really a matter of educating people,” Dr. Chin explained. “I spend a lot of time speaking to PTAs and at schools and other community-led efforts. We need to remove the stigma for parents and patients when it comes to cannabis use in treating illness.”
That may not be a problem much longer, as cannabis in most states is considered appropriate treatment for basically, “anything a doctor deems necessary,” according to Dr. Chin. That includes everything from diabetic neuropathy, to arthritis, auto immune diseases, migraines, fibroids, and more.
“Cannabinoid receptors are the most abundant receptors in the brain,” Dr. Chin noted. “It works on the inflammation pathway, like ibuprofen, but without hurting the gut.”
Both CBD – the version of cannabis that does not include THC, the chemical associated with “getting high” – and CBD in combination with THC are used to treat patients.
The combination can help alleviate pain, balance circadian rhythm and lower cortisol, helping reduce insomnia and anxiety in some patients. Cannabis is also helping physicians combat the opioid crisis by providing a safer alternative for patients with many chronic conditions.
Several methods are used to deliver the cannabis treatment to patients including, tablets, capsules, tinctures, gummies, suppositories, topicals, and inhaled formulations such as vape and dried flower.
“Obviously I prefer patients not inhale and irritate their lungs,” Dr. Chin said. “So I always encourage the other form factors.”
Today, with doctors beginning to use cannabis to treat such a variety of ailments, interest and enthusiasm surround its possibilities has grown exponentially.
“Cannabis continues to be a top research interest in medicine,” Dr. Chin said. “All across the board, cannabis science and health are growing in a variety of areas.”
That growth means Dr. Chin will continue to not only serve her patients by offering a cannabinoid option, but also continue in her efforts to educate those patients, the public and her fellow physicians on proof and possibilities offered by the drug.
“I’ve always felt being an osteopath was like being a traditional physician…but more,” Dr. Chin said. “Osteopathic medicine satisfies my desire to help others holistically and integrating cannabis into my practice is simply a part of that.”
And it’s a part of it that has paid off for both Dr. Chin and her patients.