Rethinking Painkillers: Cannabis For Exercise Recovery, Part 3

[00:00:00] Ellen Scanlon: This podcast discusses cannabis and is intended for audiences 21 and over.

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[00:00:45] Anna Symonds: Athletes are kind of the canary in the coal mine for opioids in a lot of ways. Or for pain issues, because we have so many injuries, even in certain professional leagues, the players get painkillers pushed on them, and they get heavy duty pharmaceuticals pushed on them, because They need to get back out there and play because there’s millions and millions of dollars on the line.

[00:01:07] Ellen Scanlon: Welcome to How to Do the Pot, a podcast helping you feel confident about cannabis. I’m your host, Ellen Skamlan.

[00:01:21] Ellen Scanlon: You just heard from Hawaii based Anna Simons, a former elite rugby player and the executive director for the Etheridge Foundation, which supports scientific research into plant medicine and psychedelic treatments for opioid use disorder. Welcome to part three in our series celebrating the Paris Olympics and focusing on the surprising connections between cannabis and fitness.

[00:01:45] Ellen Scanlon: Throughout the series, we’ve been questioning old stereotypes and exploring how cannabis is helping people move their bodies more. In part one, we learned how weed can improve a workout with journalist Hilary Ockhauer. She shared how cannabis can help lower anxiety, relieve chronic pain, and bring more joy to movement.

[00:02:07] Ellen Scanlon: Part two took a look at why cannabis is banned from Olympic and international competitions, despite not being performance enhancing. We discovered why active people are incorporating cannabis into their fitness routines and got great tips from people who have found a new workout buddy in cannabis. I hope you’ll listen if you haven’t yet.

[00:02:30] Ellen Scanlon: Today, we’re getting into what keeps people from moving and exercising. Can you guess? Unfortunately, it’s pain, whether it’s from an injury or a chronic condition, pain is a big part of why CDC data shows that two thirds of Americans are not getting enough exercise. And for many years, Americans have been turning to opioids for pain management.

[00:02:57] Ellen Scanlon: For the past decade, the opioid crisis has ravaged communities and families. It’s responsible for the loss of an estimated 187 lives every day. I see striking parallels between the early days of the AIDS epidemic and the current opioid crisis. Earlier this summer, we released a series celebrating pride that shared how the AIDS crisis in the 1980s led to California becoming the first state to legalize medical cannabis.

[00:03:30] Ellen Scanlon: During the AIDS epidemic, patients and advocates transformed suffering into positive action and sparked a national legalization movement. I hope this weed and workout series helps you learn more about cannabis as an alternative to opioids for pain relief. I want to shed light on the opportunity we have to transform this tragic situation and provide safer alternatives for pain management.

[00:04:07] Ellen Scanlon: In today’s episode, I’ll talk more with Anna Simons, the executive director for the Etheridge Foundation. Musician, Melissa Etheridge created the foundation in honor of her son Beckett, who died at 21 from causes related to opioid addiction. Anna will share how she discovered the benefits of cannabis for rugby related injuries and why she’s so passionate about cannabis as an alternative to prescription painkillers.

[00:04:36] Ellen Scanlon: We’ll also hear from Dr. D’Andra Asike, a Maryland based anesthesiologist at Johns Hopkins University School of Medicine. Dr. Isike is a mom, a United States Air Force veteran, and as you’ll hear, a somewhat unexpected cannabis advocate. She currently serves as the spokesperson for Doctors for Drug Policy Reform, the first physician organization dedicated to the legalization and regulation of cannabis.

[00:05:04] Ellen Scanlon: Dr. Osike believes strongly in a holistic approach to chronic pain, and that includes cannabis as medicine. I’ve heard from many medical experts that cannabis is considered a very safe medicine, especially compared to the alternatives. In the U. S., we’re still waiting for the rescheduling of cannabis from a Schedule 1 to a Schedule 3 substance.

[00:05:31] Ellen Scanlon: When that happens, it will open up the doors for more research into how cannabis relieves pain. If you have questions about the safety of cannabis medicine, we’re sharing all we know in today’s show.

[00:05:58] Ellen Scanlon: Before we get into this week’s episode, I want to talk for a second about How to Do the POTS newsletter. The newsletter is a twice a month resource that will help you feel confident about cannabis for health, well being and for fun. The newsletter is also our direct line to you. You can hit the reply button and let me know what topics or guests you’d like to hear on the show.

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[00:06:42] Ellen Scanlon: Dr. D’Andra Isike is an anesthesiologist and a pain specialist. I asked her how common chronic pain is in the U. S. and what impact that has on people’s ability to exercise regularly. 

[00:06:55] Dr. Deondra Asike: Reported in 2021 by the Center for Disease Control and Prevention was that approximately 51 million persons, so that’s roughly 20.

[00:07:04] Dr. Deondra Asike: 9 percent of adult persons experience chronic pain and 17 million of them were patients who experienced high impact pain. So this is pain that substantially restricts activities of daily living. And why such alarming statistics? Well, honestly, I’m not sure, but here’s what I think contributes to the high prevalence of chronic pain.

[00:07:25] Dr. Deondra Asike: Here in the United States, there’s inadequate pain management training in medical training programs. So this leaves doctors ill equipped to treat chronic pain. And there’s also a limited access to pain specialists. Non pharmacological treatment options such as acupuncture or Reiki therapy are inadequately reimbursed.

[00:07:46] Dr. Deondra Asike: And there are implicit biases that largely affect pain management care for older adults and racial and ethnic minority populations. Lastly, I’d say that I believe that pain is undertreated because there is a fear, and it’s a real fear, of addiction, tolerance, and adverse events with pharmacologic treatment options such as muscle relaxants and opioids.

[00:08:09] Ellen Scanlon: Dr. Isike shares the many ways that chronic pain can affect a person. 

[00:08:15] Dr. Deondra Asike: Chronic pain contributes to physical, emotional, mental, and spiritual suffering. As a result, there is a high prevalence of disability in patients with chronic pain, and disability itself can result in poor health outcomes, social isolation, and devastating economic consequences.

[00:08:35] Ellen Scanlon: As an elite rugby player for many years, Anna Simons endured a lot of injuries, including broken bones and an injured back. She kind of accidentally stumbled onto cannabis for pain relief. 

[00:08:48] Anna Symonds: Over the years had just thought of cannabis as something recreational and treated it that way. First tried it as a teenager, so I knew that it really wasn’t a big deal, even though we were getting all these like anti drug messages.

[00:09:01] Anna Symonds: Marijuana is dangerous. I was like, uh, I mean, it doesn’t seem like it, right? I think the lightbulb kind of went on maybe in my, my late twenties. Playing in Oregon, you know, it’s a very cannabis forward state. Very cannabis friendly, and so I had a good time. Number of teammates who would partake and often together after games.

[00:09:27] Anna Symonds: And I remember one time, instead of joining the drinking circle, I went off with a group of friends that were smoking, and then I literally felt the pain relief wash through my body. Just like a cooling, soothing, like, ah, and I was like, oh, it was just a light bulb, like realization. I was like, is that why you guys do this?

[00:09:46] Anna Symonds: My cannabis consumption was sort of sporadic and not strategic for a long time, and then I started going, Oh, so by the time I hit my early thirties, it was sort of came with as alcohol tailed off and I was paying attention to my body and what actually helped. It’s like, Oh, cannabis does, and I started getting more strategic and more deliberate about what I consumed, when I consumed, and the amount.

[00:10:11] Anna Symonds: And sometimes that would mean the little nibble. Like there was a period of time when I was also doing MMA along with rugby. And so I was training. A lot. I was just training every day and maybe one day off a week and still working. And I had to get good sleep, right, to keep up with that. So, I had to get to sleep on time.

[00:10:28] Anna Symonds: And so I, I started using my friend’s homemade edibles. They were really strong. So, I would take the tiniest little nibble and that would just help me sleep. Help me get to sleep, have a good quality rest. So, I started to just experiment more with what amount, what timing, what consumption method helps support my rest and recovery, essentially.

[00:10:50] Ellen Scanlon: I asked Dr. Asike, what do we know about how cannabis helps to relieve pain? 

[00:10:56] Dr. Deondra Asike: In a simplified way, there are molecules in cannabis that are known as cannabinoids. And they bind to various receptors in our body and have a direct effect on nerve signaling. So, they guide the way pain, for example, is perceived, transmitted, and processed.

[00:11:16] Dr. Deondra Asike: Animal studies have demonstrated pain relief and synergistic effects when cannabinoids are given alongside other medications used in pain management, such as morphine, gabapentin, and anti inflammatory medications, but human clinical studies have also shown improvement in pain relief, as well as quality of life improvements and improvements in physical function and sleep.

[00:11:42] Ellen Scanlon: Anna Simons had a severe back injury, and she tried everything to get rid of the pain. 

[00:11:48] Anna Symonds: In 2013, I injured my back. I herniated a disc in my very low back and two above it bulging. And with that came a lot of pain and extreme spasm and, you know, those muscles like locking up. I went to the doctors, I went to the chiropractor, acupuncture, I went to massage, I did everything I could for it, and I got prescribed muscle relaxants, painkillers.

[00:12:11] Anna Symonds: I tried those things, but cannabis still works the best for relaxing my back muscles. It’s the best medicine. And so that was another huge realization. This is an effective medicine with less side effects than these prescription pills, so why are we blocking people from it? You know, that’s wrong. It’s medicine.

[00:12:30] Ellen Scanlon: If you’ve suffered from chronic pain, you know how debilitating it can be. According to the American Medical Association, up to nearly 20 percent of people who take prescription pain medications can develop an addiction to them. A person is at risk of developing an addiction to opioids after only three to five days of taking a prescribed pain reliever.

[00:12:56] Ellen Scanlon: Dr. Asike explains why she believes cannabis is a safer alternative for patients. 

[00:13:03] Dr. Deondra Asike: The desperation for safe and effective pharmacologic treatment options continues to this day. It’s not going away. So, the current and the ongoing opioid crisis provides an excellent opportunity, in my opinion, to fully explore the potential that cannabis has in chronic pain management.

[00:13:23] Dr. Deondra Asike: Cannabis has a more favorable safety profile, not just as compared to opioids, but also to other non opioid medications that are often used in pain management. Because let’s not forget. Tylenol, aspirin, you know, the non steroidal anti inflammatory drugs, they’ve been associated with emergency department visits, hospitalizations, and deaths.

[00:13:47] Dr. Deondra Asike: Real world evidence is demonstrating that cannabis and cannabinoid products are reducing daily opioid consumption. And this is highly relevant given the current opioid epidemic. This outcome was observed, you know, when cannabis therapy was under the direct guidance and supervision of physicians. And so, that’s absolutely the direction that we need to go in as it relates to cannabis and cannabis therapies in the U.

[00:14:14] Dr. Deondra Asike: S. right now. 

[00:14:15] Ellen Scanlon: Dr. Isike explains some of the common side effects of opioids. 

[00:14:20] Dr. Deondra Asike: They can change your mood, but they can cause you to be sleepy and dizzy. Very commonly, especially after surgery, people can get nauseous and vomit. Opioids can cause you to itch and interrupt your sleep. Constipation, and that’s a big one because constipation, your body never gets used to it.

[00:14:37] Dr. Deondra Asike: So, when people are taking opioids chronically, they’re gonna chronically have to be on some sort of bowel regimen because constipation is one of the effects that your body will never get used to. And then there’s the potentially deadly respiratory depression and your body never gets tolerant to the respiratory depressant effects.

[00:14:56] Dr. Deondra Asike: And so that is why it’s a huge issue because you may get tolerant to some of the central nervous system effects. And so you increase your dose and then you keep increasing your dose as your tolerance builds. But as you’re doing that, it’s risky in terms of the respiratory depression and especially some of the more, we call them potent opioids.

[00:15:15] Dr. Deondra Asike: You know, it can just be devastating and deadly. Long term opioids result in immunosuppression, and they can result in adrenal insufficiency, low blood pressure, and they can cause this thing called hyperalgesia. And so hyperalgesia is when there’s some increased sensitivity and exaggerated response to pain.

[00:15:35] Dr. Deondra Asike: So you overreact, basically, to a painful stimulus. There is also a possibility of new or worsening depression with chronic use of opioids. And so when I look at that list, I’m like, wow, certainly cannabis can make people sleepy. That could be a desired effect as well. People can get dizzy with it chronically.

[00:15:58] Dr. Deondra Asike: There’s a risk of hyperemesis, but the things that people mostly complain about, which is the constipation, specifically the respiratory depression, because it’s potentially deadly, you don’t see that with cannabis. And that is because there aren’t those receptors and the brainstem for the cannabinoids as there are for the opioids.

[00:16:16] Dr. Deondra Asike: And so that is why respiratory depression is not a concern. If you take too much cannabis, you may not feel well, you may have an unpleasant experience, but it’s not potentially deadly.

[00:16:35] Ellen Scanlon: Runner’s high, that balanced, happy, content feeling of wanting to run, or swim, or bike, forever. It’s something I hope everyone has more of. When I learned that the runner’s high is real, that it’s actually my body’s own endocannabinoid system feeling balanced, it made a lot of sense to me. That feeling is basically why I like weed.

[00:17:01] Ellen Scanlon: It’s also why I love Camino, one of my favorite women run edible brands. They create mood enhancing gummies with effects that are tailored to how you want to feel. Camino created freshly squeezed recover gummies with a minor cannabinoid called CBG, which is known for its anti inflammatory and anti anxiety effects.

[00:17:25] Ellen Scanlon: The recovery gummies aren’t just for exercise. Maybe you’re wrapping up a hectic workday, your mind is racing, and your body feels tense. However it happens, taking time for recovery is how you give your body what it needs to rest and heal. Camino’s recovery gummies are available in select states. I’m so excited to offer our listeners 20 percent off Camino gummies that ship right to your house.

[00:17:53] Ellen Scanlon: Some people like the recover gummies before exercise and others like them afterwards. I’d love to hear what works best for you. Use promo code DOTHEPOT when you visit shopkivaconfections. com for 20 percent off your order. I’ll add links and all the details to the show notes. Thank you for supporting the brands that support our show.

[00:18:23] Ellen Scanlon: Anna Simons is an ambassador for a nonprofit called Athletes for Care. It’s an organization of legendary athletes from every sport who use their influence to improve global standards of health, safety, and quality of life. She explains the pressure on professional athletes to take opioids for pain.

[00:18:45] Anna Symonds: Athletes are kind of the canary in the coal mine for opioids in a lot of ways, or for pain issues, because we have so many injuries. Even in certain professional leagues, the players get painkillers pushed on them, and they get heavy duty pharmaceuticals pushed on them because they need to get back out there and play because there’s millions and billions of dollars on the line.

[00:19:06] Anna Symonds: I actually became part of Athletes for Care in around 2017. And, um, It was hundreds of mostly retired professional athletes, but from across all kinds of sports. And we had like Olympic medalists and Super Bowl champions and, you know, everybody in there. The amazing thing crossing all those sports, amazing in a bad way, was people talking about their issues with becoming dependent on opioids for chronic injuries and pain.

[00:19:33] Anna Symonds: And the encouraging thing was, People talking about how cannabis, and in some cases just CBD, helped them get off opioids and manage their pain and return to a level of functioning and reconnection with their body and be able to do activity again. You know, I’ve heard that story so many times, and that’s another reason why that group was formed, because When people have gone through that, they’re like, I need to tell everyone like there’s another way you can feel better and you cannot get sucked down into this terrible dependency on these really just pernicious drugs.

[00:20:09] Ellen Scanlon: Anna explains how she feels when she consumes cannabis for chronic pain. 

[00:20:14] Anna Symonds: With chronic pain, you become so used to carrying it that when you feel it lift up off you, it’s an amazing relief, not only physically but mentally. Where you’re like, oh, that is so nice, like this burden is just lifted for a little while.

[00:20:30] Anna Symonds: And that’s what I’ve felt cannabis do for me, where it all just loosens up and the pain, it just feels like, you know, you’re carrying something so heavy that you’re used to that, and when it’s lifted off, you feel so glorious and light. Something about the mental burden of chronic pain, to have a little break from that every now and again, to have it lifted off, it’s just so beautiful.

[00:20:52] Anna Symonds: It’s a gift. I just think that, like, how, how can we block people having access to that? 

[00:20:59] Ellen Scanlon: If you’re dealing with pain and haven’t tried cannabis yet, Dr. Isike has a few tips to help it go smoothly. 

[00:21:07] Dr. Deondra Asike: I often ease people into it with something at night. And I also look at the CBD to THC ratio. That’s a big thing.

[00:21:15] Dr. Deondra Asike: I look to see what the CBD ratio and specifically a ratio of four to one or greater. Tends to be better tolerated than say something one to one. For example, 

[00:21:25] Ellen Scanlon: even if you’re suffering from chronic pain Dr. Aseke finds that movement is an integral part of feeling better 

[00:21:33] Dr. Deondra Asike: Movement is definitely a piece of any chronic pain management regimen because pain is subjective And so I really try to mainly focus on not the pain the, in terms of the score, but your function.

[00:21:45] Dr. Deondra Asike: So physical function and movement are big in terms of goals for chronic pain management. I do want you to identify just some activities, some physical things that you’re trying to do and let’s work towards that goal. But following any sort of strenuous physical activity, I tend to. Encourage rest, muscle relaxation, and reduction in inflammation, and so cannabis products can do that as well to aid in those goals.

[00:22:12] Dr. Deondra Asike: So typically it’s a topical product or tinctures is a big one there just given their onset and the length of relief that the patients are looking for. 

[00:22:21] Ellen Scanlon: If you want to talk to your doctor about cannabis for pain, Dr. Isike has some advice. 

[00:22:27] Dr. Deondra Asike: Hypothetically, you know, you have a patient who’s living in a state that has legal access to cannabis for medical or even adult use, and they want to talk to their physician or healthcare professional about their use.

[00:22:40] Dr. Deondra Asike: I’d say the direct approach is best, but to help you do that, perhaps take a family member. Or a friend. And then if they’re with you in the conversation, maybe they ask, Oh doc, what’s your comfort level with cannabis? Take a friend, take someone with you to the visit. Maybe that will help give you the courage to just be direct and share maybe even what you know.

[00:23:03] Dr. Deondra Asike: and how you know it and you come prepared. Maybe you come with a handout of places where they might gain additional information or a place that you’ve found as a resource. 

[00:23:15] Ellen Scanlon: Dr. Asike explains how she helps new patients who want to try cannabis for pain relief. 

[00:23:21] Dr. Deondra Asike: I ask patients, what are their goals? Where is the pain?

[00:23:25] Dr. Deondra Asike: How do they want to consume cannabis? There’s this fear coming in that like they have to feel high in order to get relief, but they’re afraid that I’m going to start with that, right? But I ask, you know, what’s your comfort level? What’s your experience with cannabis? Where is your pain? Most of them, Which I, I don’t blame them at all.

[00:23:44] Dr. Deondra Asike: Want to try the least, we call it systemic. They don’t want to take it that can potentially have whole body effects. So, we may try a topical or like a balm. Most of them, if it’s chronic pain that’s been going on, they’re having difficulty sleeping, you know, we’ll start at night and kind of see if I can get them just into restorative sleep.

[00:24:02] Dr. Deondra Asike: Because when you’re sleeping better, your brain can just handle. chronic pain better. And so that in and of itself is just like a huge victory. I take any and all victories as it relates to chronic pain because it’s extremely complex, you know, it’s subjective, but we try to have small wins. 

[00:24:18] Ellen Scanlon: In her work as an anesthesiologist, Dr.

[00:24:21] Ellen Scanlon: Isike is fighting stigma against cannabis by making sure she talks about it like other common substances. 

[00:24:29] Dr. Deondra Asike: Just pretend that you’re my patient and you’re getting ready to have hip surgery, okay? So, after I, you know, introduce myself to you and I’m going through a systematic review, just going over all the reasons you see doctors and take medications, I’m trying to get in the short amount of time we have together before your surgery, an opportunity to know your, your medical history, your social history as it pertains to anesthesia.

[00:24:53] Dr. Deondra Asike: And so, for that part, I ask people, do they take any medications for their mood? Do they use alcohol, tobacco, cannabis, or herbal supplements? And when I say it in one sentence with all the things, it doesn’t make one stick out more than the other. If they say no, then I move on to something else in my review of systems is what we call it.

[00:25:12] Dr. Deondra Asike: And so, I’ve heard colleagues, they’re listening and they say, Oh, I overheard how you say it and so now I’m going to, I see it that same way now. The more I say it, it’s a, you know, domino effect. At least I hope. I think they like that non judgmental approach that I just take with everyone just to normalize use because it’s very normal.

[00:25:30] Ellen Scanlon: Anna is also working to change the stigma around cannabis within the sports world. 

[00:25:36] Anna Symonds: For athletes, rest and recovery is super important. And it’s the physical part, like sleep and your muscles loosening up. But then also there’s the mental part too, like I really enjoyed consuming with teammates the night before a game because you have all this pre game anxiety that’s just a normal part of being an athlete and you learn to expect it and you learn to manage it to a degree.

[00:26:00] Anna Symonds: But with cannabis, it’s a really nice distraction where you can laugh with your teammates, eat some healthy snacks, and then get good sleep. So that mental part is also really great, sort of the anti anxiety properties and the, the bonding. And I’m like, well, that’s the spirit of sport. There’s the physical mental part, mental slash emotional, right?

[00:26:21] Anna Symonds: Because anxiety is both. And athletes shouldn’t be denied that, and they shouldn’t have to apply for exemptions. But for me, it was a really good resource for recovery. There’s a lot of people quietly using cannabis and it’s no accident that Athletes for Care is mostly almost all retired athletes who are like, now I can tell the truth.

[00:26:44] Anna Symonds: And for me, I was actually still playing for several more years, but I had reached the point in my career where I knew I wasn’t going to get picked anymore for national team stuff or anything. So, like, my window of opportunity is closed there, so I’m not threatening an opportunity, right? But still a lot of stigma.

[00:27:01] Anna Symonds: And especially in sports, there’s a lot of people, um, decision makers and gatekeepers, like coaches and athletic training staff who are not. Uh, educated on the science of cannabis and cannabinoids and the endo cannabinoid system, which is just such a shame. And, and a lot of them don’t necessarily want to be educated because of the stigma, they just push it away.

[00:27:23] Anna Symonds: The testing that they’re subject to, they can’t even use CBD because of the quote unquote, risk of it being contaminated. Like their coaches are like, don’t even use that because if there’s some THC in there and you get caught, like our whole team gets in trouble. Sanctions, whatever, it’s a scandal.

[00:27:41] Anna Symonds: Athletes are being denied this very innocuous, essentially supplement. That’s anti inflammatory, and all that really makes me mad. And I am in a position to speak out about it, and so I do. And progress is slow, but it’s happening. 

[00:27:57] Ellen Scanlon: This is the final episode of our weed and workout series. In the series, we looked at how cannabis can help with exercise motivation, improve a workout, and be an alternative to opioids if you’re injured or in pain.

[00:28:12] Ellen Scanlon: I hope this series has helped you feel more confident if you’re looking to add cannabis to your workout or your recovery. I’d love to hear how it goes for you. If you liked this episode, please share it with a friend. We love new listeners and are here to help everyone feel confident about cannabis.

[00:28:35] Ellen Scanlon: Thank you for listening to how to do the pot. For lots more information and past episodes, visit, do the pot. com. Are you one of the thousands of people who love how to do the newsletter? If you’re not getting it, please sign up at do the pot. com. And if you like how to do the pot, please rate and review us on Apple podcasts.

[00:28:58] Ellen Scanlon: It really helps people find the show. Thank you to writer Joanna Silver and producers Maddy Fair and Nick Petrie. I’m Ellen Scanlon and stay tuned for more of how to do the pot.