Dr. Mark Berber
This website must not replace advice and treatment offered by your
own doctor or therapist. It is for general guidance only.
Allen Carr's "Easy Way to Stop Smoking" helps readers stop smoking for good! I highly recommend this book which worked for me and many others. Nicotine patches, gums and sprays are, like cigarettes, nicotine delivery devices and will not bring about the change in attitude required to stop smoking.
The Easyway to Stop Smoking
Anxiety Disorders, the commonest psychiatric disorders of all, are treated with cognitive behavioral therapy, relaxation techniques and medications. To understand (and help overcome) these disorders, I highly recommend "The Emotional Brain" by Dr. Joseph LeDoux. Published in 1996, physicians will also benefit by reading this excellent text.
A Wonderful Book for Patients Suffering with Anxiety Disorders
The Medical Use of Cannabis
There is uncertainty regarding how cannabis fits into medical practice. There is a lack of knowledge among physicians, which is understandable, as medical schools have, until recently, paid little attention to cannabis and its potential as a medical treatment.
The human body contains an endocannabinoid system consisting of receptors (including CB1 & CB2) and agonists (anandamide and 2-AG) which fit into these receptors. This system has many functions including modulation of neurotransmitters (e.g. dopamine, serotonin). Scientists are clarifying the role of this system and how it is affected by exogenous cannabinoids (e.g. THC and CBD).
Exogenous cannabinoids include cannabis plant material (phytocannabinoids) and man-made cannabinoid medications developed in laboratories (synthetic cannabinoids).
Synthetic cannabinoids include the pharmaceuticals Drabinol, Nabilone, Nabixmols and Epidiolex. Nabilone (aka Cesamet) and Nabixmols (aka Sativex) are available in Canada.
Synthetic cannabinoids have been approved for very few medical conditions. The approved conditions are (1) nausea & vomiting associated with cancer chemotherapy, (2) muscle spasms associated with multiple sclerosis, (3) anorexia in wasting disorders such as HIV/Aids and (4) neuropathic pain which has failed to respond to more conventional therapies.
In June 2018, the U.S. Food & Drug Administration (FDA) approved Epidiolex (CBD) oral solution for the treatment of seizures associated with 2 rare and severe forms of childhood epilepsy.
Beyond these 5 conditions there are insufficient studies to warrant a role for physicians in authorizing cannabinoids.
Further studies with cannabinoids will, no doubt, result in new treatments for medical conditions but, for now, those studies are significantly lacking.
Physicians should be guided, as they have always been, by results from randomized and placebo controlled trials and should resist requests to authorize cannabis for conditions for which evidence is lacking. Furthermore, physicians, when supporting the role of cannabis, should prescribe cannabinoids such as Sativex, Nabilone and Epidiolex rather than agents whose compositions, dosages and modes of administration are very unreliable.
Cannabis Use Disorder is not uncommon and significantly impairs one's quality of life. Now that cannabis is legal in Canada, patients may be more willing to admit to the use or abuse of this substance. The "Cannabis Use Disorder Identification Test" is a simple screening tool used to detect problematic cannabis use. The test can be downloaded here.