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doctor focus
cannapatientcare.com july/augustl 2022
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cannabis patient care
family or personal economics? That includes the medications
they're on, and how they relate to their doctors. All those
things become so important, so that we can start to turn their
health picture around."
Even with a better understanding of the autoimmune sys-
tem, today's informed medical doctor sometimes still has to
watch and wait—and hope—for their patient to improve. "I tell
patients that none of us have that crystal ball to say how long
you're going to live, and when you're going to die," she said.
"But statistics tell us that cannabis has a higher success rate
with treating autoimmune issues than those of pharmaceuti-
cal drugs or the anti-cancer agents, and that those two work-
ing together—cannabis and pharmaceuticals—have a better
outcome than any one individually."
It's Not All Cannabis
The key to helping patients is to tell them that it's not cannabis
alone. "We can't just tell you to go out and buy these cannabi-
noids or these terpenes and it's going to be okay," Dr. Knox said.
"A patient has to buy into every last bit of what the therapy
is, including believing that they can heal. We're so focused
on illness and sickness and treating that sickness, and we're
not really focused on moving patients back to wellness. What
cannabis has taught us is we need to look in other places and
move patients back to wellness."
A Bigger Commitment
The American Cannabinoid Clinics (ACC) (6), which were
co-founded by Dr. Knox, her daughter Dr. Rachel Knox, and her
husband Dr. David Knox, along with the organization's CEO,
her other daughter, Dr. Jessica Knox, was a clinic where these
cannabinoid and endocannabinoid system specialists managed
patients' use of cannabinoid therapies, natural foods and sup-
plements, and cannabimimetic practices (such as detoxification,
oxygenation, yoga, meditation, and exercise) according to the un-
derlying function or dysfunction of the endocannabinoid system.
The ACC was closed and rebranded as Pivital Health (7) last
year, Dr. Knox said, which is an interactive education program in
cannabis, cannabinoid medicine, and endocannabinology devel-
oped by her and her daughters—the so-called Knox Docs. "Pa-
tients come to us to get a deeper consult, such as an hour-long
consult on occasion, instead of the 15-minute visit with a signa-
ture on a piece of paper so you can get your card, like we did at
the ACC," she said. "We will delve into what their health and their
lifestyle has been. We delve into their disease processes."
The patients can't be given cannabis, but the clinicians at Pivital
Edu can suggest certain terpene profiles or cannabinoid profiles.
More Education Is Needed
There needs to be a lot more education, Dr. Knox said, but med-
ical practitioners need providers to understand not just tetra-
hydrocannabinol (THC) and cannabidiol (CBD), but why they are
recommending it. "What do you hope to accomplish? And how
do you use it? I want them to feel comfortable," she said.
They must know the physiology that explains why cannabis
works and why clinicians should consider these other ways of
treating patients, whether it's for post-traumatic stress dis-
order (PTSD), depression, or suicidal ideation. "They need to
understand why we should be using cannabis perhaps in-
stead of the pharmaceuticals," Dr. Knox said. "I by no means
am putting pharmaceuticals down. There's a place for them.
But there's a place for botanicals as well, whether it's Chinese
medicine or Native American medicine. There are places in
our health toolbox for all of these things, and we just need to
be more open," Dr. Knox added (8-9).
She thinks that clinicians and providers of all types need to
feel like they're not threatened if they talk about these oth-
er alternative medicines to their patients. "Cannabis can even-
tually be an everyday medicine, prescribed like an aspirin, if
it's clinically appropriate for patients," she said. "I think clini-
cians and providers need to reset their brains as well, and con-
sider using alternative care. It shouldn't be at the end of life,
for example, because your doctor can do no more for you. Is
there a way we can incorporate plant medicine into our dai-
ly lives, so we even prevent getting or maybe stopping cancer?
We need to change patients on what's healthy, and how to stay
well, instead of how to recover from sickness or how to man-
age sickness."
Her advice for clinicians is to keep learning. "That's why we
have Pivital Edu. That's why we're cannabinologists. We're go-
ing to talk from the science first and the physiology first. We
want providers to at least know the rudimental stuff," she
said. "Be open to what really God gave us to use on Earth. Be
open to what the Earth can provide for us and look at those
things. Read about those things. Feel comfortable with those
things and take charge of your health. That's what I'd like pa-
tients to understand."
References
(1) https://alcoholpolicy.niaaa.nih.gov/about-cannabis-policy
(2) https://www.fda.gov/drugs/information-consumers-and-patients-
drugs/finding-and-learning-about-side-effects-adverse-reactions
(3) https://doctorsknox.com
(4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313508/
(5) https://www.hopkinsmedicine.org/health/wellness-and-prevention/
what-are-common-symptoms-of-autoimmune-disease
(6) http://veteranscannabiz.org/american-cannabinoid-clinics/
(7) https://www.pivitaledu.com/pages/cannabis-grand-rounds
(8) https://www.hopkinsmedicine.org/health/wellness-
and-prevention/chinese-medicine
(9) http://www.shermanindianmuseum.org/native-american-medicine.html
