Waching daily Feb 2 2017

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Software #BIM Diseño Arquitectónico 3D - #Edificius #008 - Duration: 1:02.

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Let's Play Lost Odyssey - Part 10 - Xbox One RPG [No Commentary] - Duration: 20:06.

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Top 10 ODI Batsman Ranking 2017 (ICC Rankings) - Duration: 2:01.

HI

Top 10 batsmen in icc odi cricket

10.Babar Azam

9.Martin Guptill

8.Steve Smith

7.Amla

6.Joe Root

5.Kane Willamson

4.de Kock

3.Virat Kohli

2.de Villiers

1.David Warner

THANK YOU

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1 Conferencia uso terapéutico del Cannabis - Figueres ( 2 de 4 ) - Duration: 26:21.

José Carlos, when you want...

Thanks Oscar, and thanks also to David and Ramon from Alchimia Foundation.

Since some years ago, the relationship has been fantastic, since thanks to them we at ICEERS Foundation

could start the first study being conducted today in Spain

in regard with what happens to people or patients who use cannabis.

Most studies are clinic trials, in laboratories, under very artificial conditions

and we want to conduct a more naturalistic study as we say in science, more focused on reality, on the reality of patients,

on their quality of life. That is some of the things that interests me most.

In medicine, many times we're worried about sthe ympthoms or the disease,

but a very important aspect of the disease is the quality of life of patients. In that sense I think cannabis does lots of interesting things,

but from my point of view, the most interesting one is improving the patient's quality of life.

Well, thanks to the Alchimia Foundation we could start this study,

then we also got funds from the Canna Foundation and some collectives, but thanks to them we could take the first step,

also other initiatives that we've proposed them, which they've always kindly accepted.

So...I'm also feeling at home...I know Oscar since many years ago. Before we worked together,

and Joan collaborates with us at the Spanish Observatory of Medicinal Cannabis (OECM), so I can say they're part of my catalan family,

despite they have failed to make me speak catalan in my talks...but I'll work on that and perhaps I can do something in the next one.

It is impossible to replace Dr. Mariano García de Palau,

I believe his knowledge is unrivalled, it is not that we know nothing, but he knows so much!

Anyway, Joan and myself will try to do our best, I'm pretty sure we'll do it with dignity...

Oscar pointed me to some subjects, and each of them could take us some seminars, so I'll try to synthesize

and explain the most important among these subjects.

Starting with the current knowledge we have. What do scientific publications say about medical cannabis.

Depending on who's talking, we can hear from almost miraculous virtues of cannabis to almost demonic properties.

In medicine, none of these ends exist and cannabis, as any other medicine, is usually between them.

Cannabis starts from a premise, it is not a panacea,

it does not work for everybody, it does not work for all diseases. It cures few of them but reduces the symptoms of many,

and that is a first knowledge that will be furtherly explained by Joan.

It is not a substance to cure everything, but it does work for some things.

And we certainly have many scientific studies, despite some times we hear that we don't have enough studies to start

and promote initiatives towards its prescription or sale at pharmacies.

Actually, well... in most presentations the slides are in English language,

but you just ignore them, they're a guide for my talk. A first review of all studies conducted between 2005 and 2009

listed 37 clinical trials. Trials conducted in hospitals with different groups of diseases:

neuropathic pain, experimental pain, multiple sclerosis, AIDS and HIV, glaucoma...

and we have 32 studies from 2010 to 2014. So, more than 5.000 patients have been

somehow involved in clinical trials conducted around the world in the last 10 years.

We then have sufficient evidence to take decisions on the benefits of cannabis.

Most studies have showed positive results. For example, in spasticity, we have two studies in which some patients have been treated

and only 3 out of 12 patients experienced negative effects. In nausea, which is the most studied subject,

and as consequence of certain anti-cancer medicines, a clinical trial obtained positive results in 40 patients and negative in just one.

We could continue disease after disease, I just wanted to mention some examples to transmit that

the evidence found with regard to cannabis derivatives shows that they're more efficient than other medicines.

Here I have a website, for anyone interested in accessing all the studies published up to date, in which they'll found more than 100.

When these studies have been observed as a whole and processed with sophisticated statistical analysis,

it has been observed a moderated quality of evidence. I mean, it is not solid enough, it's a moderated evidence,

which supports the use of medical cannabis for chronic pain and spasticity,

and a lesser degree of evidence for other types of symptoms like nausea

or vomiting caused by chemotherapy, weight loss or sleeping disorders.

This is speaking in merely statistical terms. When this review has been performed from the clinic point of view,

not only taking numbers into account, but also the actual improvement on patients health,

what we find is that this evidence becomes much stronger. Why do I say this?

Because many times it is said that the evidence degree is not strong enough, as I mentioned before, and that

is partly true , but it's also true that when speaking about efficiency degrees in clinical trials we're talking about cannabinoids, why?

Because most clinical trials don't use the plant. They're conducted with isolated products which, as we'll explain later,

do not work as well as the whole plant does, for the plant has different cannabinoids which cooperate with each other

to produce a more beneficial effect and also to reduce side effects.

In any case, as I was saying,

it's much more interesting the level of efficiency in relation to the patients quality of life than in relation to symptoms.

Another fact that clinical trials don't show, which we've already found in our current study

and has also been found in international studies,

is that while perhaps they (cannabinoids) don't have the level of efficiency required for medicines,

they do reduce the side effects of other medicines, and that

is, from my point of view, another major beneficial property of cannabis. Actually, many patients using medical marijuana

may not find the complete relief that they seek,

but are taking much less medicines with important side effects than people who don't use it.

With regard to side effects, there is also concern about the possible long-term effects of cannabis

in patients who use it for medicinal purposes.

Well, here I have a recently published study conducted not with medical patients but with recreational users,

adult users, in which the only difference found between long-term users (20 years) and non-users

are some oral problems...probably as a consequence of smoking,

which could be easily avoided by vaping or using another route of administration.

As I say, most side effects observed in these trials with cannabinoids are caused by this fact,

by using cannabinoids instead of the whole plant.

Isolated cannabinoids, like pure THC or synthetic analogs of THC,

have their tolerability profile, are worse tolerated than the plant.

For the reason that I explained before, it is something weird also in herbal therapies.

Normally, plants contain a series of therapeutic active principles,

but also some active principles which aren't therapeutic and which can produce some type of side effect.

That's why generally doctors prefer isolated products, pure products, efficient to reach their

objectives. In the case of using the whole plant this rule is somehow broken,

but as I'll explain later the cannabis plant breaks many rules.

And the rule broke is that the present compounds

actually cooperate to obtain a more efficient therapeutic effect while reducing negative side effects.

Of course, we still have few studies on side effects of long-term use, the more consistent ones made with Sativex,

which is the only cannabinoid-based pharmaceutical product available today and is only used,

as Oscar mentioned, in very specific conditions,

especially multiple sclerosis and in some other diseases as compassionate use.

The current data from the United Kingdom, Germany and Spain shows that these medicines are well tolerated

in the long term, so if Sativex is correctly tolerated there is no reason to think that the whole plant will not.

Well, I assume most of you already know this but, for those who don't, the cannabis plant contains different compounds.

It is actually said that cannabis is a true factory of chemical compounds.

It produces more than 800 different compounds, 100 or 105 of which

(new ones are discovered every day) being cannabinoids. And today, in humans,

only THC and CBD have been relatively well characterized...

Ok, for those who know a bit more about pharmacology, and this is one of the peculiarities of cannabis,

cannabis must be accurately adjusted to the patient's needs,

because the same dosage does not always produce the same effect...this is a graph of, for example, THC level in blood

at different dosages, and what we pharmacologists love is to find what we call

a dependant dose-response, so the increase in the dosage is proportional to the physiological response.

Cannabis breaks this rule somehow, that's why dosages must be very accurate.

For example in tasks involving psychomotor performance,

tasks dealing with, let's say, driving a car or performing certain complete activities,

the curve is not proportional according to the effect. Even at average dosages the psychomotor performance is improved

instead of being worse, and only with high dosages it is seriously reduced. And at very high dosages it is also reduced...

For example, in other effects like being thirsty, the feeling of being high is one of the graphs shown here,

the curve is not linear and upwards, it looks like a roller coaster. This means that according to dosages

we'll obtain one response or another, even the feeling of being high.

Dosages here of 60ml have milder psychoactive effect than 15 or 18ml dosages.

These are aspects that must be taken into account and that patients should know about, and which doctors should know

when practicing personalized medicine. Because if there is a medicine that requires personalized medicine is cannabis...

Perhaps in relation to arterial pressure is where we find the most consistent dose response curve.

Another interesting thing recently published is that cannabis is more viable when not exposed to heat

than when exposed. That means that more THC is absorbed,

so the therapeutic effect is more efficient if cannabis is not heated. Thus, as we'll see in a moment,

the performance of cannabis will be higher if it is vaped rather than smoked.

For example, in this graph we compare a vaping device with different temperatures with smoking a cigarette

or joint, and we see that despite smoking extracts higher amounts of all the products contained in the smoke,

vaping extracts more cannabinoids and less products which are not cannabinoids and don't influence in the therapeutic effect,

so that's one of the reasons why patients and those who use and smoke cannabis should think about start vaping it.

First, because you avoid all the risks derived from combustion and second, because you get the most out of your plant material.

I've also brought some...as well as curious effects, from studies conducted many years ago...because despite being a pharmacologist

I come from the psychology field, and I can't resist to talk about some of these interesting psychological effects.

For example, if you give people some marijuana to smoke

and let them speak out in a group, the amount of discourse decreases as the dosage is increased.

In other words, people become more quiet

in conversations or social situations as the dosage is increased...and there is also an important difference

between men and women. We can't see it here, I had to scan this article and it didn't work properly, but in the second part of the graph

for example when men and women smoke in social context, women show what we call positive reinforcement.

They are more prone to conversation than men and rely less on body language than men under the effects of cannabis.

Also, another curious effect from another study...I'll explain why it happens later...

in studies in which people are given marijuana in social contexts, if - when they're high -

the researcher tells them that there is an emergency and their help is needed,

all of a sudden is like if the high disappeared and they can concentrate on the task. These psychological effects

may seem of low importance...I'll explain their importance and how they can be translated into clinical practice.

Well... Mariano had to talk a little bit more about CBD...

I've brought some last-minute slides to help us approach this issue. First of all, THC and CBD act on different parts of the brain

which indicates us that they have different effects, both at psychological and therapeutic level.

I'm not excessively enthusiastic about the CBD issue, which is the trend today. CBD is one of the medicinal compounds of cannabis.

but to this day THC is the main medicinal compound.

What is interesting about CBD is that it allows us to counteract the psychological effects of THC, and those who don't tolerate THC,

who can't cope with being intoxicated or high, or can't be as efficient as they would in their normal life,

see the feeling of being high reduced. In my opinion, CBD has 4 major applications. The first of them is in the treatment of psychosis.

Psychosis is a chronic mental disease very difficult to treat, and we have seen in the studies conducted that CBD acts

as efficiently as last-generation anti-psychotic medications and without the side effects observed in the latter.

What does it all mean? That people with psychosis problems

will probably hold on their treatment, that is to say, we'll have less cases of people giving up on treatment than with traditional treatments.

Another psychological property is that is acts as excellent anxiolytic.

We're claiming that anxiety is at the basis of all diseases...all. Both mental and medical.

In the sense that anyone suffering from any medical condition is exposed to anxiety simply because they're suffering from a disease.

The possibility of getting a highly efficient medicine with almost no side effects

means that we can use this medication to treat a vast number of conditions, either medical or psychological...and

in one of these studies CBD has been observed to be particularly efficient in generalized anxiety disorder.

I'm rushing now because my time is almost over and I´m still halfway through my talk. But well, it always happens the same...

These are...in the studies conducted where isolated CBD and THC and placebo have been used,

it is clear that the feeling of being high is much stronger with THC

and there is hardly any difference between CBD and placebo.

This means that the intoxicating level of CBD does not produce psychological effects.

Also, as I said before and in regard to anxiety, while THC can be quite anxiogenic

CBD is quite anxiolytic, and the same happens with mental decline...one of the interesting things I wanted to tell you:

CBD is also becoming popular for its counteracting effect on THC. I've also said this before, but this depends on when it is administered.

Only if you take CBD before taking THC is it capable of counteracting this psychological effect,

so the feeling of being high will be present if they're administered at the same time.

About myths...there are countless graphs on the internet

where they tell you the diseases that can be treated with cannabinoids...well, to this day,

this is a chimera, it is more based on laboratory research and cell culture than on clinical trials.

What we can state is that marijuana has a level of efficiency to treat the aforementioned diseases,

but in no way it is as versatile as it may seem...

And it also has some side effects. As physical side effects we have tiredness, dizziness, tachicardia, hypotension, dry mouth...

It also develops tolerance to many side effects, which means that side effects disappear with constant use.

And that is also interesting: it does not develop tolerance to medicinal effects.

Tolerance is the need to raise the dosage to get the same effect...

what happens? Many times, when speaking about non-regulated medicines like cannabis, patients tend to identify

the beneficial therapeutic effect for their condition with the psychological effect that they're feeling.

But cannabis doesn't need...many times the psychological effect is not needed to get medicinal effect.

What does it mean? That we often overdose thinking that we need the high to get some beneficial effect.

But there's no need...to raise the dosage in many diseases

even if we have to raise the it to get psychological effect, it's not the same with medicinal effect.

Finally, at international level, which was the last point of my speech...how is regulation?

In Spain cannabis is only allowed for therapeutic , educational and scientific purposes

and international laws are allowing to conduct medical cannabis programmes.

The United Nations, which is the institution regulating these issues,

has set the stage, the rules which should be followed by countries implementing these programmes.

Spanish laws also allow it, because one of the requirements for starting these programmes is

that the plant must have a traditional medical use in the territory, and we know that back in the 40s and 50s

we had tens, hundreds of different products available at pharmacies.

Thus, cannabis has been proved to be a useful plant, traditionally used in Spain, which is proven by its sale at pharmacies.

With regard to the international reality, and although in Spain we dn't have any of this medical programmes yet,

in the USA we already have 25 states with these programmes, with more than 1 million people registered.

We have around 25.000 in Israel, 45.000 in Canada...

Other countries have also started medical cannabis programmes, like Chile, Colombia, Macedonia, Uruguay or Canada,

and some others are starting theirs now, so it's only a matter of political will before we also have these programmes in Spain.

Furthermore, these programmes are not only necessary bacause cannabis is a medicine that could help many people,

but also baacause it has been proved that when these programmes exist,

patients use cannabis more responsibly than when there is no regulation. Actually, the average consumption in the Netherlands,

which was the first country to implement these programmes, is around 0,68 grams, it doesn't even reach 1 gram per person and day,

while in the rest of Europe the average is around 3 grams.

That's not explained by major levels of stoicism from Dutch patients,

that's related to how it is regulated, since patients use it more rationally if they have proper information and the use is legit.

Finally, we still have so much to say, I invite you on the 16th and 17th December

to a congress at our Foundation, also sponsored by Alchimia Foundation.

It's exclusive for cannabis users, so we can have a dialogue between medical patients and health professionals,

we don't want this congress to be a place where experts talk unidirectionally to non-experts, but a place of coexistence. I'm done now.

I'm sorry if I extended myself too much, I'll give the floor to...

For more infomation >> 1 Conferencia uso terapéutico del Cannabis - Figueres ( 2 de 4 ) - Duration: 26:21.

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1 Conferencia uso terapéutico del Cannabis - Figueres ( 1 de 4 ) - Duration: 15:00.

Hello, hello...

Good night everybody. For those who don't know us, we are David Saulina and Ramon Camps,

president and vice president of the Alchimia Solidària Foundation...

First of all, we would like to thank you for being here and excuse Dr. Mariano García de Palau, who hasn't been able to join us.

He's ill today but perhaps he'll come to the second sessions, right?

This is the last event that we'll held in the framework of the celebration of Alchimia's 15 anniversary, and well,

lots of positive things have happened during the past 15 years with regard to medical cannabis...

Our shop...our shop has been visited by plenty of people who have found relief for their suffering and conditions.

Cannabis may not be a miracle, but it can work

better and with less side effects than the drugs prescribed by conventional medicine in some cases.

Back to our current reality, and after these 15 years, as Ramon was saying, things have changed drastically.

And the best of all is that cannabis is starting to

be on the place where it always should have been, which is the medicine cabinet of many people.

Despite cannabis is still illegal in some countries and it is difficult to access this medicine,

scientific evidence is showing that the therapeutic properties of cannabis are evident,

so it is clear that this should lead to a legalization of cannabis, in this case for medical purposes, but we hope also for recreational users.

So, we are pleased to present you Oscar Parés, assistant director of ICEERS Foundation in Barcelona, and thank him for moderating this event,

for volunteering to moderate the talks of Dr. Joan Parés and psychologist and Doctor in Pharmacology José Carlos Bouso...

Also tell you that the absence of Dr. Mariano García de Palau, who was going to talk about a hot topic in the cannabis scene, CBD,

will be covered by Dr. José Carlos Bouso, who is also an expert on pharmacology.

Well, thanks a lot for coming, thanks to all the doctors for accepting our invitation and for their talks,

and that's all, Oscar if you wish to take the floor...thanks.

Thanks David and Ramon. Let me start with a small confession, you know I'm feeling at home today, I've had the fortune of being asked to...

me and our Foundation, the Foundation where I'm working, to collaborate in this event and sometimes you see it as a responsibility,

but today I see it as a celebration and you'll soon understand why.

First, the person on my left, José Carlos Bouso, is a workmate and great friend for many years.

Next to him on his left is Dr. Joan Parés, who is my father...

and here at the first row I have my mother and my girlfriend, so I'm feeling at home.

Also, Ramon and David are like two cousins for us city people,

we've been collaborating for a long time and always with very good vibes.

Not only at personal level, but also through the institutions that each of us represent,

and that's why we're here today. Because both Alchimia Foundation and ICEERS Foundation share objectives,

specifically in the cannabis field, since it's been 3 years working together now,

and whenever they organize some event we try to assist and vice versa...

we know we can always count on their help and enthusiasm, which are highly appreciated.

So, today's event is not new in the sense that the debate on medical cannabis has concerned our society for a long time.

We have more visibility every day, we are performing more talks in more important and cool places every day, just as today.

But there is still some type of contradiction in this story, which is that even if our knowledge on the benefits and prejudices

of cannabis at scientific level increases, with more and more people using it, it seems like normalization at political and judicial level is not arriving.

And that fact makes people, either those interested on cannabis or users,

still feel stigmatized for using it, and that's why meeting, taking a look at it and discussing about it is so important.

Because, as you know, cannabis has been on the lists of international drug control treaties since 1961,

where substances are listed according to their level of hazard, cannabis is in two of these lists,

and one of them includes substances without medicinal value...that can't be used responsibly. It's still in those lists today so

there is persecution, stigma, plenty of unfair situations. So this type of events can help us reverse this situation

and play a part in achieving the desired political and institutional normalization of cannabis.

I'd like to focus on what has happened to cannabis users in Catalonia during last years,

because it seems like we have some meeting points today, some knowledge that can be shared,

it is still recent, right?...Somehow, the claim on the responsible use of cannabis, or adult use of cannabis, started back in the 70s.

We could actually say that in Barcelona it started in a small bookstore that some of you probably know, Makoki.

Makoki was a bookstore where people from the counter-culture met, people fighting against Franco,

with libertarian spirit, people who enjoyed the culture of comics, with "dark" cultural background...

so that was a meeting point for both medical and recreational users to share and gain knowledge on homegrown cannabis,

on the fact that cannabis is a plant with many properties and it wasn't until 1991, I mentioned the 70s before, but it was in 1991

when, also in Barcelona, the first association of cannabis users was founded, the Ramon Santos Cannabis Studies Association.

Some of the people who met at Makoki were the founders of this association,

and planted their first cannabis crop in 1994, a public crop. It was in Tarragona.

They went to the institutions, they notified it to the Mossos d'Esquadra, to the prosecutors office, to the courthouse...

They said: "we want an exit from the black market, we want to know the origin of our pot.

So they planted 200 plants.

When they were almost ripe, the Guardia Civil destroyed the crop without any warrant and these guys were taken to the judge.

They won the trial at first instance at Tarragona Provincial Court, but after the prosecutor's appeal the case moved up to the Supreme Court.

They were tried and found guilty by the Supreme Court in 1997.

They were fined and sentenced to prison terms, and even if the terms were not too long,

all these old-timer activists who had been fighting since years ago were suddenly unable to grow their own pot,

so they started to look at the different options available, especially in the private sector.

It was then that the first issue of Cáñamo magazine was published,

the first of many magazines about cannabis printed in Spain.

Actually, Spain is one of the places with more publications on cannabis. We have like 4 or 5 magazines...we had 7 or 8 once.

Some of them opened florist shops where cannabis seeds were sold...what we know today as Grow Shops.

The first one opened in 1999 in Barcelona's "Barrio Chino", today called Raval. It was called "El Interior"...Also, the first cannabis fair, Spannabis,

was held in 2004, with almost 20 editions at this moment.

Today, more than 30.000 people visit this event, which has become South Europe's greatest cannabis festival.

All this is somehow connected, and also in 2001 something significant happened; as you may know, in Spain we've had

a huge problem with heroin...a whole generation

was trapped in that situation without any help from the Administration.

Methadone treatments did not start until many years later, as well as needle exchange programmes, etc.

But during the 80s we had a large proportion of the population with HIV problems.

The Junta de Andalucía, the government of Andalucia, was worried about this sector of the population

so they requested a report from a group of Professors of Criminal Law at the University of Malaga. They told them:

how could we treat these AIDS patients with cannabis? To make a palliative treatment

for these people. And this group wrote a report where they explained a new way of accessing cannabis without committing any crime.

The Junta de Andalucía archived the document in a drawer, but these professors published it in a criminal law journal and some of those activists

who were busy with their Grow Shops, magazines, fairs, etc. said "damn!". We have another door open to collective crops here...

So this text, which was originally requested by the Junta de Andalucía,

ended up in the hands of activists and became the basis of Cannabis Social Clubs.

Already in 2001 the Barcelona Club of Cannabis Tasters was founded in Barcelona, in the city centre.

It was also formed by the same people involved in previous experiences that we've already mentioned,

and inaugurated the path of Cannabis Social Clubs.

As you know, these clubs are institutions that supply most patients looking for relief with cannabis...almost by accident,

cannabis activists were serving people who went to their clubs for therapeutic reasons.

I mean, all of a sudden that was the only option available for patients, although these are not places where patients should really...

Cannabis Social Clubs can't meet all the needs of these people. We can't require any more from them for the moment.

This caused that, in 2001, an association of breast cancer patients,

the Agatha Association from Barcelona, pushed - along with physicians like Dr. Laporte

who is an institution in Catalonia - the Government of Catalonia to raise a petition where all the political parties from Catalonia

requested a regulation of medical cannabis from the Government of Madrid.

This finally seemed a solution, or that the problems of patients were finally dignified...but if that happened in 2001

the reality is that today, 2016, the only progress made is that multiple sclerosis patients can access Sativex now, which is a medicine

only accessible by a very specific type of patients.

Most people using cannabis for medical purposes - we'll hear them next - can't access this medicine,

so they remain in a grey area, left on their own and being subject to contradictory information,

to people who want to sell them products that they don't even know if they should be taking...In any case, it is a situation of vulnerability.

That's why we're here. To continue reducing this vulnerability,

to educate, to give power to all these people, and to learn from the experts that we are lucky to see here today.

Well, without further delay, I'll give the floor to José Carlos. Dr. José Carlos Bouso comes from Madrid,

although he's been working in Barcelona during past years.

He works for the ICEERS Foundation...we're workmates as I already mentioned before.

He's Doctor in Pharmacology and one of the most experienced persons in Spain in regard with research on different psychoactive substances and...

Well, you have 20 minutes to teach us what you want.

After that Joan will talk, and then we'll have a little debate with all of you, which is a very interesting moment...

For more infomation >> 1 Conferencia uso terapéutico del Cannabis - Figueres ( 1 de 4 ) - Duration: 15:00.

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1 Conferencia uso terapéutico del Cannabis - Figueres ( 3 de 4 ) - Duration: 26:38.

Well, the next speaker will be Joan, Joan Parés...

he's a retired doctor who has been involved in different cannabis projects since 2008.

He started in a Club in Sants, the quarter where his family lived,

and then he started to advise different Clubs belonging to FAC (Federation of Cannabis Associations), to CAT-FAC...

As José Carlos, he also collaborates with the Spanish Observatory of Medical Cannabis

and more recently with the KALAPA Clinic. When you want Joan...

Thanks a lot. Good evening everyone. Can you hear me?

Well, I'm a newbie with regard to medical cannabis,

although I've used it recreationally since I was 20 years old.

I've managed my career as doctor without taking into account medical cannabis. I'm specialist in the respiratory system

and never thought about using it as medicine. I had my education and I have been practicing medicine,

but when I retired, about 8 years ago,

and in order to have the cannabis I liked to use, my son recommended me to go to a Cannabis Club.

And here starts my experience with medical cannabis. It all started at La MACA,

one of the first and most militant clubs in Barcelona, in Sants, where the former president told me: "Listen, you're a doctor,

and we have plenty of people looking for cannabis to treat their diseases. You could talk to them, advise them..."

And so I started to meet people in a small office and talk to them.

Soon after, a treatment team was formed in CAT-FAC, which is the Federation,

and we improved our structure and started to meet people who required medical cannabis, whether they were members of the club or not.

We interviewed them for about an hour and collected data, about which I'll talk a little later.

This lasted for 2 years, when this therapeutic service was closed, and since then I collaborate with the KALAPA Clinic (advising patients),

with Alchimia in our online doctor's office, with the Spanish Observatory of Medical Cannabis, an entity born about one year ago

in Madrid, which is very interesting because it gathers researchers with years of experience. I'm feeling like a newbie, a complete ignorant.

Because Manuel Guzmán, Cristina...they all have more than 20 years experience...

José Carlos Bouso is also a veteran...so I'm constantly learning.

So, I'd like to tell you what I've learned during these last 8 years in this field.

First thing I learned, about which I was completely ignorant, is about the endocannabinoid system.

I realized then that all animals, all types of animals and not only humans

have a system called endo (because it is internal) cannabinoid system.

We synthesize substances which are almost identical to those found in the plant. And these substances are called endocannabinoids.

We already know about 2 of them. One is called "anandamide" and the other one "2-AG".

What do these substances do? How do they work for normal people?

Well, these substances somehow modulate the metabolic systems of cells.

In technical words, it is said that they promote homeostasis, the proper functioning of our cells, of their metabolism.

And that was new to me. All this was discovered in the 90s,

so it was not only new for me, but for almost every person that I've met during these years looking for medical cannabis.

80 to 90% didn't know about the endocannabinoid system, which allows us to understand why cannabis works,

because it is acting on a system that we already have.

We can then find substances coming from the plant, called phytocannabinoids,

or coming from our own body, called endocannabinoids,

and we also have some obtained by artificial synthesis in a laboratory.

Which are synthetic cannabinoids. These can be found in some pharmacies

under names like nabilone, dronamidol, etc. These three sources can produce molecules that act on our endocannabinoid system.

And our endocannabinoid system has molecules and receptors.

It's the beautiful same example explained by Manuel Guzmán;

imagine that you have locks on your cells and phytocannabinoids come and BOOM...

they open the locks and generate a number of beneficial reactions for the cells, very beneficial indeed.

Well, I didn't know about all this, so something changed inside me and I said "what happens here", right?

We owe much to Professor Raphael Mechoulam, who was recently in Madrid telling us about this subject.

He's a brilliant researcher from Israel who discovered all this during the 90s and published his studies...which we have been reading about.

An interesting point is that when we take phytocannabinoids

we are interfering in the activity of our endocannabinoid system.

Our body is wise, and a bit lazy. If cannabinoids come from any external source, it will stop producing them,

so it will happen the same as with insulin or other things. If you give insulin every day to a normal person

after some time his pancreas will stop producing it, so this person will need insulin from external sources.

So all regular users be advised, it is good to stop from time to time and give our body a rest, a fast,

so that our endocannabinoid system doesn't lose its working capacity. These are things that I've learned and that I now explain you.

Cannabis is a great surprise, as José Carlos already told you, I'm only reminding you about it.

It has plenty of different strains, types and subtypes, and every single plant hosts a true pharmacy inside it.

As he said, more than 100 cannabinoids, terpenes, flavonoids...in total,

I'd say 400 and he said 800...I mean...it is a true factory of substances

and many of them have medicinal effects, psychosomatic effects.

Terpenes are also being studied, their effects and so, but the complete cocktail is in the plant.

And every single plant is different. Those who have tried different plants know it.

Some are relaxing, others stimulating, some enhance colors while others are sedative...

Because each plant has its own internal formula, and we also have what he mentioned, the recently discovered entourage effect...

so all substances entouraging the 2 main compounds, which are THC and CBD, are important.

So that's the reason, as he also mentioned, why plants are much more effective than isolated cannabinoids.

Another thing I learned is that marijuana can contain a large amount of contaminants.

We have a very curious anecdote. At first, some CBD capsules appeared on the market. Wow, CBD capsules coming from Czechoslovakia.

Hey, that's great, we have isolated CBD...they were studied, analyzed looking for their origin.

Well, it turned out that some of these plants came from China.

And what were these plants doing in China? Marijuana is capable of "cleaning" the land from heavy materials.

Plants absorb these materials from the land and clean it in that sense.

So, marijuana plants have been used to clean the land from industry waste materials,

which should had been incinerated in specialized treatment plants

so that all contaminants should had been trapped by the filters of these incineration plants,

and then these filters should had been treated in a specific way. But they didn't do this in China...

They simply harvested the plants and instead of incinerating them as special waste they sold them to Czechoslovakia.

And someone there processed the plants into capsules

and sold them as medical CBD. That's terrible. I mean, you may know what you take and if it is good or not,

but someone poisoning you without your knowledge is a whole different story. Well, cannabis can contain a vast number of contaminants.

Arsenic, lead, mercury, cupper, cadmium...and it can also host pathogenic microorganisms.

Cancer management. Cannabis grown with compost have a higher tendency since compost contains lots of microbes.

Normally, microbes present in the plant are not hazardous, and a normal person can easily deal with them,

but if you give this plant as medicine to someone with depressed immune system...FAIL!!

Then this person is exposed to these microbes, which can be really bad for him.

Another possible contaminants are fertilizers and pesticides. Some nutrients and pesticides contain phosphorous,

I remember when I purchased cannabis on the black market that my joints sizzled sometimes, as one match that doesn't light properly,

with a strange noise...you should discard things like that immediately.

That plant contained some type of phosphorous derivative, and phosphorous is a very toxic substance to the brain.

This is something that should be known. And that's why the origins of the plant, its source, is so important, as we'll see later.

Another thing that should be known is that when we make tinctures, oils, concentrates...all contaminants are also being concentrated.

In other words, perhaps smoking a joint with some Cadmium traces is not that dangerous,

but if you're smoking a concentrated oil then you'll taking much more contaminants,

and that should be known. Another thing I've learned in my cannabis training is to distinguish smoke from vapor.

José Carlos Bouso has also mentioned this. Smoking and vaping are very different things.

I've been only vaping for some time now. There are wonderful vaporizers

and you avoid all cardiovascular problems derived from tobacco, smoke, rolling paper and contaminants. Combustion is incomplete,

so it generates many improper products. I don't know if you noticed, but the smoke released from a joint is dark, almost black.

If you put a flame in the smoke you'll see it burning...that means it is carrying substances which haven't been properly burnt,

from the paper, the tobacco, which are harmful...and you get rid of all this when you vape.

I've also learned that. Therefore, your confidence in the person who supply you must be strong, either buds or oils. That is basic,

because otherwise...I remember when we didn't have clubs, I often went to Plaza Real (Barcelona) to buy something.

And there in Plaza Real I had to meet with that tall and skinny guy with a terrifying scar on his face,

"El Lejía" he was called, and I just couldn't trust that guy.

and I just couldn't trust that guy. Imagine I ask him for crop guarantee,

or quality guarantee...he'd have sent me to hell. He gave me what he had, no jokes. And I could only say "thanks".

Well, not anymore, now we know that this subject must be strictly controlled and monitored. The quality of the crop,

la concentración que tienen los diferentes productos que te dan en los diferentes cannabinoides...

It is not the same a high-THC plant with low CBD content than a CBD rich plant...that must be known.

Today we can have everything tested and analyzed easily and fast. We even have an NGO called "Energy Control"

that analyses for free the first sample that you bring them.

To know what we are taking is so important...because if we don't, we can fall into a trap.

Another important thing is the absence of toxic products, as I said before, make sure that it doesn't contain microbes or pathogens.

It's important that regular cannabis users know about all this.

What is good use? What is bad use? What have I learnt about good uses and bad uses of cannabis?

In the first place, good use implies that there are no contraindications to this use. Because there are some too...

A person suffering from tachycardia, a person suffering from hyperactivity,

a person suffering from certain mental diseases, a person taking many medicines...

Bear in mind that, I'll explain it later, we've had 70 and 80 year old people coming to us for chronic pains,

asking us if cannabis could help. And when we asked: "Well, are you taking any medicine?" they grabbed a list with perhaps 10.

Then, let's be cautious, giving someone a new medicine when he's already taking 10

is not recommended, especially if we don't know the possible interactions between most of them.

And that should also be known. I mean, there must be no contraindications.

What other contraindications can we find, apart from pathological ones? Obviously, age.

A 12 year old kid must not smoke cannabis because his brain is still not fully developed

and it could alter his endocannabinoid system, resulting in incorrect development. Therefore, it is another contraindication.

Being sick, and carrying out for example mechanical activity, handling heavy machinery which requires good reaction capacity.

There is a number of contraindications which should be studied. Each person is a different world and there is the importance

of being advised by a good therapist when taking the first steps in the world of cannabis.

Another important aspect is quality, as we already mentioned. Substances must be of good quality.

Poor-quality substances can make you fall...and this happens with any substance, with any addiction. Even sex, whatever...

The quality and dosage of the product must always be taken into account. At first, only dosages were important.

Yes, we already know that dosage is the difference between a toxic and a remedy.

But take caution, dosages must also be suited for each case.

It is not the same using marijuana for a person whose weight is 100kg than for someone weighing 40kg.

It is not the same for a person who is on his 60's than for someone who is 20 years old .

All this must be evaluated, each of these points must be evaluated.

Another important factor is obviously the place and company.

Depending on the circumstances surrounding the cannabis user the effects may vary,

whether we talk about recreational or medicinal use.

Then, let's talk about recreational use now.

The main character here is THC, that's why most products in Cannabis Clubs have high THC content.

It causes a distortion of time and space, of colors, of sounds,

of smells, flavors and touch. And that's something wonderful for those who enjoy it. But horrific for those who don't.

The other day someone told me "I don't know if I'm in Barcelona or Amsterdam"... that's great!

That's what I want, not caring much about time and all that, but there are people who cope very badly with that.

Feelings, colors, touch, caresses, music, concerts...everything changes with recreational cannabis if the person has empathy,

and if he doesn't is just the opposite...he vomits, he feels bad, he goes to the Hospital.

Another symptom is that it increases the feeling of being intoxicated...what is commonly called "being high"

and that is something enjoyed by some and hated by others. Well, everyone should know that all this will happen if they use cannabis.

Another effect of cannabis is to facilitate introspection when being used along with entheogens.

Entheogens provide a trip to other dimensions which is normally

better enjoyed with cannabis. Cannabis usually connects well with ayahuasca, psilocybes, LSD,

there are also cases in which...we even have religions or religious sects

which use some of these substances along with cannabis, like Santo Daime sects, it is also used there...

We can use it recreationally. But then we also have medicinal uses, which are different.

In my experience, we've told around 500 people that cannabis could help.

But we also told 120 pople not to use it. That we felt like cannabis was not going to help.

What diseases we had among these 500 cases?

Most of them...well not most but many, 57% were chronic pain. Chronic pain derived from long term anthritis,

fibromyalgia, diabetes with neuropatic pain, and other causes of chronic pain.

We're not talking about toothache, but a pain that has been there for a long time

...and why? Because we know about the antiinfammatory and antialgic properties of cannabinoids.

It is also suitable for other things like tremors and spasticity.

We'd really need the input from Dr. García de Palau now, since his experience in administering oils to kids with epileptic seizures is wide,

where classic anti-epileptic medicines don't work. Well, it turns out that CBD works great.

Normally, it must be used along with other anticonvulsant medicines,

but it has made things a lot easier for kids suffering from 30 seizures per day.

(I also ignored this. There are newborns that start suffering from seizures 2 days after being born, 30 or 40 seizures per day)

and all of a sudden they only have 1 or 2 seizures, even none, with cannabis. And that's fantastic...

The fact that cannabis can undermine their nervous development, well...we'll see about it, but the kid is doing well for the moment,

he smiles, he's hungry, he eats...something that he couldn't do.

These are exceptions to normal treatments for refractary epilepsy...

There are also diseases derived from treatments, symptoms derived from chemotherapy...nausea and vomiting.

In that sense I had a very close experience, and I could check that it does work.

Literally, nausea and vomiting are highly reduced, and from telling you:

"I don't want to eat because everything seems expanded polystyrene"

they go to "I can feel the taste of a strawberry, I can feel the taste of everything..." that's a major change.

The quality of life, as José Carlos said, of people using cannabis...the quality is improved.

People being treated with chemotherapy, I can assure you they go through very difficult moments,

not only for the taste of food, but also for the anxiety, fears, insufficient sleep, etc.

And cannabis is truly a wonderful coach back, in most cases, not always.

Other conditions, those called autoimmune diseases, can also be trated with cannabis. Multiple sclerosis, scleroderma, lupus

and others...why? Because it has been found that our endocannabinoid system,

where we have many receptors is also present in our immune system, so we should not be surprised.

In regard to medicinal uses, medical science is becoming a more accurate science...

which measures, analyzes...today, nobody practices without an analysis of 20 or 30 parameters.

Pharmacology also monitors the dosages, etc... These are medicinal uses.

When the patient needs to know the miligrams of cannabis he's taking, these are medicinal uses in my opinion,

while someone smoking a joint to feel better, to relax, it would not be so medicinal but "maintenance".

To me, there are three uses of cannabis: recreational, for partying, dancing, listening to music,

enjoying a good meal after smoking a joint...

Then we have maintenance uses. Planty of people who smoke a joint before going to bed. Beause it helps them to relax,

or because they've been in a stressing meeting, after the meeting one smokes a joint and feels better...

What's that? Medicinal? Recereational? None of them. I say it is "maintenance".

Just to avoid conflicts in certain situations. Sometimes, before a meeting,

you say: "hey, I'm going to argue with everyone. I'll smoke a joint and just chill...".

I don't know if you've seen it, but there's a very interesting study from England. Football hooligans, who are very aggressive with alcohol,

become much less aggressive if they take less alcohol and some cannabis. It's curious...but also a bit funny.

In short, it's just a matter of achieving well-being. Hey, I'm quite well, right?

And that's something well known for cannabis users.

After a joint I feel better, I'm not looking for some "party" effect or an extraordinary effect.

I just want to feel "normal", to feel my normality...

So, the word therapeutic is wonderful because it comes from the Greek, and is referred to the art of "caring".

The therapist was the person or technician that accompained someone to pave their way. For a therapist, that is his task.

Then, I always say that using marijuana correctly is always therapeutic.

Either if it is recreational, maintenance, medicinal...it accompanies, it helps.

The good use obviously requires the aforementioned conditions. No contraindications, quality, dosages, place and company.

If done like this, marijuana is always therapeutic, it always accompanies. Then, we doctors have the tendency to embrace noble words

and all physicians are called doctors, and we're all happy! And none of us is a doctorate,

but they call us doctors and it is ok to us...all right then, doctors.

Also with medicinal and therapeutic cannabis we say: medicinal and therapeutic.

Well, it may be therapeutic, but it can be therapeutic without being medicinal.

In this sense, the wideness of the therapeutic concept goes far beyond of that of medicinal,

and I'd love to have approved something that judges could not understand, and they'd approve therapeutic cannabis,

that'd mean that everything is approved. But they normally stick to medicinal. I repeat: it provides well-being...wellness. And that is crucial.

Forms of use are many and varied, but I'm most interested in vaporization. I discovered it 2 years ago...

I smoked joints but one day I had pneumonia. That day I stopped smoking and started vaping.

I haven't had a problem with my vaporizer, not a cough, nothing...and it's been some years now with my vaporizer without a problem.

Then, it also depends on the symptoms to treat...the pathologic antecedents of the person, as we said before,

if he has some experience with cannabis. It's not the same for a 60 year old person to start using cannabis than for a 20 year old person.

Age, corporal weight, concomitant medication, social and employment situation...it's not the same.

And then, precautions are: first, try not to smoke, as we said, to avoid cardiovascular problems,

and if the person is not an expert on medical cannabis, please, ask for help from a therapist.

It's not necessary to find a doctor, but at least a therapist. Someone who can advise him wisely,

who takes into account everything we've said and helps him. Because dosages must be varied, as José Carlos said,

You can't prescribe a dosage and that's all, everyday the same, done...no.

Depending on the evolution of the person you can vary things, but supervision is needed, external supervision. Not self-supervision.

Finally, to end my speech, it seems like addiction is a disease now.

Well, that's not something very old, you know? But today, to have an addiction is to have a disease.

I'm totally against that. Having addictions...addictions are good...are very good, if they're not harmful.

Furthermore, I recommend to have several addictions, not just one. The problem is to have just one.

And addiction...why is it addiction? The word itself explains it.

Addiction is a force that unites you with something. It is as real as the force of gravity.

The force of addiction...and I repeat, it's not bad to have addictions.

It is an exercise of personal freedom, and freedom is there to be exercised, not for being kept in a drawer.

Then, I want to be educated on the addictions that I want to have,

which is contrary to prohibitionism.

When some of my addictions are prohibited, I must break this prohibition and find the knowledge in it.

Life in this world without addictions is totally unthinkable and unbearable,

only those who are dead are free from addictions...all living ones are addicted to something.

Well, thanks...

Notice that we're addicts to certain foods. That is true. I love chocolate, that guy loves bread,

the other one loves sugar, and that other one loves I-don't-know-what...we're addict to music, to work, to sex, to cars, to money...

and to certain feelings, like emotions, vanity, love. All these things are addictions that all living persons have...

Another issue is incorrect management of these addictions. That's true.

If we don't manage our addictions properly, we can fall into compulsion, we can be in trouble.

But we won't if we manage our addictions correctly! Sorry, it happens the same with cars.

Cars are not dangerous. Drivers are dangerous.

Drivers are dangerous. Drivers, either for ignorance or imprudence, can do crazy things.

But the driver that knows how to properly drive his car enjoys it. It allows us to travel far away, on our own, and that's great!

It happens the same with drugs.

If we are educated, if we know how to deal with them, it brings well-being, will to live, and that is so important.

And those who say they have no addictions, they're simply lying, or are hypocrites,

or ignorants or living deads...and nothing else. I shall end here.