“I think medical schools will eventually begin to incorporate information about the ECS—it’s too vast a physiological system and too important to continue to ignore. In the meanwhile, healthcare professionals will need to continue getting this information through emerging programs and through self-study.”
It’s quite alarming that many doctors graduate from medical school without the faintest idea of medical cannabis or the endocannabinoid system (ECS). A survey that was conducted by Dr. David B. Allen in 2016 revealed that only 13% of medical schools “mention” the endocannabinoid system in their curricula. A 2022 survey showed that 71% of physicians belonging to the Society of Cannabis Clinicians obtained medical cannabis knowledge from conferences. Only 1 participant out of 37 participants learned about medical cannabis from medical school.
As Timothy Byars puts it, the ECS is “too vast a physiological system and too important to continue to ignore.” A few colleges are rising to the challenge to fill the gap in medical cannabis knowledge. Timothy Byars is spearheading this effort as the Director of Medical Cannabis Programs at Pacific College of Health and Science. In this brief interview, he discusses the need for medical cannabis education and what the cannabis program at the Pacific College of Health Sciences has to offer.
As an intro, how did your career path lead you to the cannabis industry?
In 2015, my wife Rebecca and I started the Agathist Collective, which was a non-profit cannabis consulting and delivery company that catered mostly to seniors. We worked with an adult geriatric nurse practitioner (my current business partner at Radicle Health, Eloise Theisen) and helped our members understand their treatment plans, their dosing instructions, how to use the devices or any new technologies, and so forth. We provided ongoing support for these members and, of course, delivered products to them, as well. In 2018, California passed Proposition 64, which legalized adult use but also allowed municipalities to completely ban commercial cannabis. Most cities and counties implemented bans, and the Agathist Collective no longer had a legal path forward. Rebecca and I were forced to close our business.
Shortly thereafter, we founded Radicle Health, which creates cannabis education for healthcare professionals (Eloise Theisen and I are the two remaining founding members of Radicle Health). My background (prior to cannabis) is in curriculum development, technical writing, and instructional systems design. Eloise has a clinical background and has treated over 7000 patients with cannabis. We brought these two areas of expertise together to create education for clinicians.
I also continued to design cannabis curricula for other organizations and schools, as well. In 2020, Pacific College hired me to develop a course for their Medical Cannabis Certificate program. Shortly thereafter, I was hired as adjunct faculty to teach in the program. In January 2022, I accepted the Director of Cannabis Programs position.
Briefly introduce the cannabis program at the Pacific College of Health Sciences. Who does the program target and what is offered in the program?
There are two cannabis programs at Pacific College: the Medical Cannabis Certificate Program and the Master of Science in Medical Cannabis Therapeutics program.
The Medical Cannabis Certificate Program is an 8-credit, 3-course program that can be completed in as few as 6 months. There are two tracks: one for healthcare professionals and one for non-healthcare professionals. The program courses are offered online, using a combination of synchronous and self-paced formats. For each seven-week course, two weeks are comprised of live classes, while the rest is asynchronous coursework with defined outcomes. Graduates of the certificate program will acquire foundational cannabis knowledge that they can incorporate into their clinical practice or healthcare organization, or to help advance their career in the cannabis space.
The Master of Science in Medical Cannabis Therapeutics program (MSMCT) is a 30-credit, 10-course master’s program that prepares students to thrive in the cannabis industry as healthcare providers, advocates, educators, coaches, or entrepreneurs. Students in this program learn to use cannabis science evidence and holistic approaches to educate, coach, and advocate for cannabis patient populations. Graduates of this program are prepared to be leaders in coaching and educating cannabis patients, the general public, policymakers, and the medical community.
You are one of the few people who hold a Master’s degree in Cannabis Therapeutics. What motivated you to pursue this kind of education?
The degree that I received from the University of Maryland is a Master of Science in Cannabis Science and Therapeutics. Because I’m not a healthcare provider, I used my time during the program to focus on cannabis science, specifically the anatomy and physiology of the endocannabinoid system, the pharmacology of cannabinoid medicines, and the design and implementation of cannabis education programs. I had already been studying cannabis for several years when Maryland’s program launched, and I thought it would be exciting to be a part of the first cohort to complete an advanced degree in cannabis sciences.
What does your role as Director of Cannabis Programs at the Pacific College of Health and Sciences entail?
Primarily, the role of the Director of Medical Cannabis Programs is to advance our holistic cannabis education for healthcare providers and industry stakeholders. Responsibilities include oversight and participation in comprehensive program and curriculum development, implementation, course delivery, maintaining WASC accreditation, and fiscal management of the Medical Cannabis Certificate Program and emerging degree programs. The Director also represents the department within the PCHS and other professional communities.
Currently, I am focused on the development and rollout of the new Master of Science in Medical Cannabis Therapeutics. Pacific College has an opportunity to create a program that is both special and unique, as our cannabis master’s program is targeted specifically to healthcare professionals. We want our graduates to have competency and confidence when they’re working with medical cannabis patients. Graduates will be able to take foundational knowledge and program concepts and apply them to their clinical practice. It’s very exciting to be part of the development of this program.
One of the greatest setbacks to medical cannabis is that the endocannabinoid system is not taught in medical schools. Are there any efforts that are being made toward including the ECS in medical textbooks?
The number that I see bounced around on the internet is that approximately 13% of medical schools mention the ECS in their curriculum. I don’t think this number is supported by a peer reviewed study, but rather is the outcome of independent research from Dr. David B. Allen. In 2016, Dr. Allen surveyed over 100 accredited U.S. medical schools, asking specific questions relating to the ECS in their curricula.
I think medical schools will eventually begin to incorporate information about the ECS—it’s too vast a physiological system and too important to continue to ignore. In the meanwhile, healthcare professionals will need to continue getting this information through the emerging programs and through self-study.
Last year Radicle Health released The Cannabinoid Protocol Guide (pre-release pdf). Such a guide is long overdue for the industry. Can you shed more light on this guide and what other measures are being made to standardize medical cannabis and make it easier for physicians to prescribe cannabis?
The Radicle Health Protocol Guide ™ is a reference manual and set of protocols for healthcare professionals who are treating cannabis patients, and includes reference material available in table format for quick access and review (for example, contraindications and considerations for special patient populations, cannabinoid onset and duration, routes of administration information, and so forth). Cannabinoid treatments are highly individualized (consider them n of 1, or single patient clinical trials). Healthcare professionals should make recommendations based on a patient’s symptoms, health history, and background and adjust that recommendation based on observed efficacy and side effects. The Protocol Guide ™ includes a comprehensive section on patient assessment, organized as a Review of Systems that is designed to reveal dysfunction and disease. Furthermore, the guide includes a comprehensive table with over 125 common prescriptions and how they interact with CBD, which the cannabinoid of main concern with respect to drug interactions. The first version of the Protocol Guide ™ includes five conditions: anxiety, migraine and headache, nausea and vomiting, neuropathic pain, and sleep disturbances. Each condition includes a brief introduction, a list of the cannabinoids and terpenes that seem to be most effective when treating the condition, the benefits and challenges of the routes of administration when treating the condition, dosing guidelines, specific drug-drug interaction considerations, best practice guidelines for using cannabis to treat that condition, and a procedure that facilitates effective patient interaction and treatment success.
Additionally, Radicle Health occasionally conducts Protocol Guide ™ coaching sessions. These are live events where we apply the Guide’s principles and concepts to clinical practice. Every coaching session includes a deep dive into the assessment of case studies and the review of a potential cannabinoid profile and route of administration most likely to benefit the condition. The sessions are recorded and later packaged for sale on the Radicle Health curriculum website: radiclehealth.thinkific.com.
Do you see cannabis becoming a mainstream medical specialty in the near future?
Yes. I think cannabinoid medicine is traveling a similar path as have other alternative and holistic modalities, such as chiropractic and acupuncture practices. That said, I think there will develop a bifurcated system, where pharmaceutical companies will develop single-compound cannabinoid medicines through the FDA, and cannabis manufacturers will continue to create whole-plant and herbal products.
30,000 studies later and medical cannabis research is still considered preliminary and “not yet enough evidence.” What do you think about this?
I think for some critics, no amount of evidence will ever be enough. Cannabis is one of most rigorously studied plants on the planet, and as more states adopt legal cannabis models, I think we will continue to see more research, especially after cannabis is removed from Schedule I (I’m cautiously optimistic that this might happen in 2022, but we’re already into July, so with each month passing I become less hopeful).
Part of the problem, I think, is that there multiple and various conditions and disease for which patients are using cannabis. For some of these conditions, there exist solid evidence in the literature demonstrating the safety and efficacy of cannabis. For example, in their comprehensive 2017 review of the literature, the National Academies of Sciences stated that there exists substantial or conclusive evidence in the literature that cannabinoids can effectively treat chronic pain in adults, chemotherapy-induced nausea and vomiting, and spasticity related to multiple sclerosis. For other conditions, the literature to support the use of cannabis is sparse. Yes, we will always want more research—cannabinoid medicines show promise in the treatment of neurological disorders, psychological disorders, gastrointestinal disease, infectious disease, and inflammatory disease. This is an incredibly wide range of conditions that cannabinoids can help treat. It only stands to reason that there remain gaps in the literature.
Finally, I want to add that when we discuss cannabis safety within the therapeutic context, it is not our burden to prove that cannabis is without risk whatsoever. Our burden is to assess how cannabis meets the societal standards against which all conventional drugs are held. And when we apply conventional drug safety standards to cannabis, we can confidently conclude that cannabis is as safe as many conventional medications, and clearly safer than many commonly prescribed medications, based on the objective metrics used to measure drug safety. Readers can find a great talk on YouTube by Paul Armentano (the Deputy Director of NORML) that addresses this issue specifically in great detail.
What’s next for Tim Byars and the cannabis program at Pacific College of Health and Science?
Our vision is to continue to create best-in-class Medical Cannabis programs and to improve lives exponentially by supporting health and well-being through our daily actions.
It was a great pleasure to have this one-on-one with Tim Byars. Readers who wish to learn more about formal cannabis education are more than welcome to visit their website.