Dr Niraj Singh, a consultant psychiatrist and member of the Medical Cannabis Clinicians Society, shares his journey prescribing cannabis over the last 18 months.
For me medicine has been a calling since adolescence, when I took pride in helping people.
Not providing them with a treatment protocol or management plan as we call them in medical language, but just to be around to help, lend a hand or just listen to them about their troubles.
As a medical student I was fortunate to have access to an education of the wonderment of the human body, its functions, how things malfunction and how they get better.
What has always struck me though was the distinct separation of specialties. We have a heart doctor, a lung doctor, a bone doctor, a brain doctor and the list goes on and on.
Clearly the fall out of entrenched Descartian thinking, whilst the mind and body had its clear separations in service provision, the fact is that the two are united and inseparable.
Think of anxiety and the physiological effects on our body, with increased heart rate and blood pressure. Or even gut health and the effect of mental health through the gut brain axis.
Undeniably a doctor has to focus on both mental and physical health to truly assist the patient in healing.
The symbiotic relationship
Having realised I had two left hands and surgical practice was a non-starter, I set my mind on general practice.
But working on a stroke ward as a house officer (the first year of work following receipt of a medical degree) and spending large amounts of time just listening to patients, many struggling with depression and anxiety, I soon realised that psychiatry was my path.
I didn’t have an easy time and was met by opposition from several quarters suggesting I reconsider my choice.
Sticking to my guns though, I took up a psychiatry rotation and eventually higher training in neurodevelopmental disabilities treating people who struggle with conditions such as depression, anxiety, OCD, bipolar disorder, schizophrenia, ADHD and treating mental health problems in autistic patients.
I count my blessings every day that I have the opportunity to help others as well as learn from them.
Medicine in my view shouldn’t just be paternalistic or maternalistic, though this approach has its place. It’s symbiotic, because it is also aided by the patient’s understanding of what is going on with them, if they are able to express this.
Healing starts from the beginning of the interaction, not from the first prescription.
We are what we do
Another important saying I’ve always related to is the importance of having two ears and one mouth, so one can listen twice as much as they speak. We all have the innate capacity to heal and also have the capacity to help others heal. Nature is the primordial force.
In my practice, lifestyle is vitally important. The old saying ‘we are what we eat’ has relevance. I’d add ‘what we do’ also.
Giving attention to exercise, sleep hygiene, hobbies, work and recreation, has clear impact on the mind and body.
The use of plants for healing has been around for thousands of years. Many of us know the benefits of turmeric, nigella sativa, Echinacea and the list goes on.
Cannabis has been used for an uncountable number of years for healing. A plant in our natural environment, which works in synergy with our bodies to relieve illness, heal and even have health-promoting benefits.
It has multi-systemic effects through the endocannabinoid system, the system that underlies the entire major systemic and organ functioning as well as that of the autonomic nervous system.
It has the capacity therefore to transform health and lives through its effect on mind and body, working in synergy and getting to the foundation.
Conventional medical treatment has its place, however room should be permitted for other therapeutic options.
But cannabis has been demonised for decades.
When one looks at recreational misuse and the negative impact on mental health from uncontrolled elevated doses of THC in people who may be predisposed to psychosis, the concern is understandable.
Moreover lives can be impacted through uncertified products, resulting in physical and mental health detriment as well as possible criminal proceedings.
However, to box everything negatively to the expense of removing potential life- saving treatment options (and I don’t use these words lightly) for children and adults, is negligent and unethical in my opinion.
It’s the data that speaks
Building the evidence base is crucial and we must be able to progress quickly from only a handful of patients being able to access prescriptions on the NHS.
Project Twenty21 and the fantastic work being done will shed further light. As practitioners, we’re only too aware of the incredible benefits medical cannabis accords. However, ultimately it is data that speaks.
Mental health problems, neurological conditions, pain, cancer, gut disorders and the list continues. We are only just scratching the surface in relation to chemovar knowledge and the myriad of benefits that medical cannabis has on mind and body.
As we gain further information on cannabinoids, our knowledge of terpenes and effects of flavonoids will also increase. And what an exciting time it is.
Having prescribed medical cannabis for around 18 months now, I have seen first hand the incredible impact it has on mental and physical health, quality of life and the impact of lives around those who are being treated.
Speaking with patients, it is a privilege to learn from their experience for they often have a greater knowledge and understanding on what works for them and the reasons for this. It is truly a symbiotic relationship.
I leave with you a quote from Paracelsus (1493-1541), one of the first scientists who pioneered the use of minerals and other chemicals in medicine.
“The art of healing comes from nature, not from the physician. Therefore the physician must start from nature, with an open mind.”
Find out more about joining the MCCS here
If you’d like to share your experience as a medical cannabis prescriber or patient, we’d love to hear from you. Please email email@example.com
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