In this episode, RJ Balde talked to Dr. Stephen Dahmer, board certified family doctor and Chief Medical Officer at the multi-state medical cannabis company, VireoHealth. They discuss his work at Vireo Health, his research in Ethnomedical systems, and much more.

The TRICHOMES Hash it Out podcast features conversations about trending cannabis topics. We also bring in Industry insiders and influencers to discuss their point of view.

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Podcast Transcription: 

RJ: Coming to you from Cheboygan, Michigan, that's Cheboygan with a C, I'm RJ Balde and this is the TRICHOMES Hash It Out podcast. On this show we feature conversations about trending cannabis topics. We also bring in industry insiders and influencers to discuss their point of view. In this episode I'll be talking to Dr. Stephen Dahmer, no relation, about his work at the medical cannabis distributor, Vireo Health. We’ll also talk about his research in ethnomedical systems and much more. Without further ado, it's time to hash it out.

Today I am joined by Dr. Stephen Dahmer, board certified family doctor and chief medical officer at the Multi-state Medical Cannabis Company, Vireo Health. Welcome to the show Doc, I'm stoked to have you.

Dr. Dahmer: RJ, such a pleasure to be here. I've enjoyed listening to your show and I'm excited to participate. 

RJ: Oh good! Right on, I'm glad to hear that. Where are you joining us virtually from today? 

Dr. Dahmer: I am from just a little bit north of the city, New York City in a little town called Piermont, which I call home. 

RJ: Okay, right on. Now has your year been so far? I know that's a loaded question but I like to start off each conversation with a wide question such as that.

Dr. Dahmer: Yeah, I mean what a year, right? What a tumultuous and guess the term everybody uses unprecedented but what a year and I think it's just, I keep coming back to gratitude, just keep coming back to that and then I'm here on this amazing podcast with you. We're going to talk about some fun things and I have my health and I'm helping others try to maintain or regain theirs.

RJ: I love that man. I love to hear that you are focusing on gratitude and practicing gratitude during this time because that's so important, you know, and it's a really great tool and resource to use to you know, look for the good out there. You know, it's a scary time. Like you said it’s a scary, unprecedented, tumultuous time but if anything it's a even more so a reason to be grateful for those around us that are you know, keeping us safe on a daily basis. Everyone out there that is essential man, shout out to them. 

Dr. Dahmer: Yeah absolutely. I think even a step further that you know, if you have you know have your wits about you and you are blessed with health or even a job to then support those that may not have been as lucky and that's you know, something that's one of my hopes as a physician to do but even now more than ever where communities are coming together, where you're supporting the neighbor, where everyone could just use a little bit more of a helping hand.

RJ: Hmm. Absolutely. Do you use like any sort of like gratitude practices? Do you like write down what you're grateful for? Do you like run it through your head maybe before you go to bed or when you wake up or anything like that? 

Dr. Dahmer: Yeah. I do. I like to run it through my head, I like to write things down and I'll be real with you I met, years ago in Cuba, I interpreted for Deepak Chopra and always been a fan. He was a young med student, he influenced me and I still almost on a daily basis listen to a gratitude meditation that he has a soothing calming voice for me. I don't know how you feel about kind of guided meditation, sometimes a voice I think can make it all or break it all and I listen to it regularly and it just puts me in that good state of mind.

RJ: I love that. Yeah, I love that. Um, I remember I don't know if he's still doing it, but for the past like few years ago, he was doing, Deepak Chopra was doing a like a 30-day guided meditation series like with Oprah and it was through his app and yeah, man, I used to love those series. I don't know if he's still doing it now but yeah, I used to love those 30 days series. 

Dr. Dahmer: Yeah, one other thing that really impacted me. You probably probably heard of Brother Steindlrast and he has a, it's the on YouTube, I think it's Good Day, just is one of those that's just you know, puts you in the right state of mind. 

RJ: I love that. I love that and it certainly you know, it's a constant conscious mental effort right to always find those places in which you can express a little gratitude or increase your levels of gratitude for something that you know, you might deal with or see on a day-to-day basis and you might start to, you know, take it for granted or you know, just think this is the way things are for me and so it's great to have those resources that can put you in that grateful mindset and remind you that there's so much around us to be grateful for even during a time like this.

Dr. Dahmer: Yeah! Now, I think now more than ever the, you know, the focus right now and for good reason is on physical illness and transmission and you know, sometimes ICU’s and vaccines and mental health is really what we all need to be discussing early on because we're already seeing a lot of the ramifications of what this is triggered for some people and they shoes that it's causing a mental health. 

RJ: Certainly, certainly. Now tell me about you, oh, I mentioned before that you are the Chief Medical Officer at Vireo Health, tell me about or first of all how long have you been with Vireo?

Dr. Dahmer: I'm coming right up on five years that I've been with Vireo and I do different things in cannabis industry that you multiply that by seven or ten to get a realest and just how intense the industry can be and wow, it's been a crazy ride the last five years.

RJ: Sure. Yeah, no doubt years in the cannabis industry mature almost as fast as dog years I want to say with you know, how nimble you have to be and how, you know, responsive and ready to make drastic changes, you know, you need to have those skills sets and you need to have that focus in the cannabis industry just because of how nebulous it still is, you know, the legal cannabis industry has been around for awhile few years now, but it is still in many ways in its infancy. Don't you think? 

Dr. Dahmer: Yeah. No, absolutely but also the flip side is a tremendous respect for those that might scoff at five years, that have been doing this for 20, 30, 40 and just realizing how we really stand and I see that over and over kind of standing on the backs of giants of those that paved the way for a physician like me to be discussing cannabis and so decided to talk more about that.

RJ: Totally totally. Now yeah, so you've been at Vireo for about five years now, tell me about what it was like for you and your team back in March when all of the, you know, initial lockdown procedure started taking place during the pandemic? What was it like over at Vireo? What were you guys thinking? You know, how did you guys implement plans into where to go from there?

Dr. Dahmer: Yeah, I think that one of the benefits I think you can be have drawbacks of a physician led company, but I think that was one of the benefits. We jumped very hard and very early and new. I've been reading all the literature and looked at, you know past epidemics that were similar and knew we had to actually get in front of that. So instituted across the board, across Vireo, you know, relatively strict protocol from masks, to even gloves, to hand-washing procedures, to even shifts within our staff to really ensure that we could continue to serve our patients and it was that call to action. We need to continue to serve our patients and we were very fortunate to be deemed essential which obviously all of us would agree with but it was nice to have that called out that we were essential and that we were ahead of the game in preparing our team to be able to continue that service and my protect our teammates so that they wouldn't fall sick at work. 

RJ: Totally. Now you are a graduate from what I understand of the University of Wisconsin, Madison. Is that right? 

Dr. Dahmer: Yeah, and I heard that you're from Michigan.

RJ: I am yeah. 

Dr. Dahmer: I was stalking you a little too RJ. From the midwest...

RJ: Yeah, we're midwest buddies. Yes, indeed. You know, I remember when I was a kid there was sort of like a rivalry between Michigan and Wisconsin over who was the MIT, like who was the actual Mitten State, like Mittens shaped State because you know obviously like Michigan has like a claim, a stake on being the Mitten State and Wisconsin was like I think were shaped like a Mitten and I just remember that was such a funny, that's like honestly the one thing I think about whenever I hear Wisconsin, is that like made up rivalry when I was a kid.

Dr. Dahmer: That doesn't give me going too much but what really did, I'll be honest with you RJ was I grew up in a small town called Sheboygan with an S and Michigan claims to have a Cheboygan with a C as well and yeah, the “S” side of the lake right and that's lake Michigan kind of looks across the lake and says let's just get your spelling right over there.

RJ: I love that man. That is so awesome. That is what's up. So you're originally, like you grew up in Wisconsin, you didn't just go to school there you grew up there. 

Dr. Dahmer: Absolutely grew up in Sheboygan, Wisconsin and went to Madison. Very proud fantastic school. I did three out of my four years of undergraduate at Madison, Wisconsin. I did one year in Madrid, Spain and then I took took a year off and was not only working in the Dominican Republic but traveled through South America and I came back and did, well two years of med school and then I did something very unconventional as well, I requested a one year leave of absence after my second year of medical school and not for any reason but I love to travel at that point and volunteered in the second largest slum in Brazil called Peetamboom on the northeast coast of Brazil and then came back to finish medical school.

RJ: Wow, you've really been all over the place. That is so rad. I've never been to Brazil. I hope to go one of these days but that work is so important that you did there.

Dr. Dahmer: Yeah, incredible experience and it just really shaped me to this day.

RJ: I love that. Now, how did you go from not only attending a school in the midwest but growing up in the midwest, you know, where even to this day apart from Illinois and Michigan are the only two states I believe in the midwest to embrace cannabis legalization. Overall in the midwest, it's not really widely embraced even to today so how did you go from growing up there to then working with medical cannabis?

Dr. Dahmer: Yeah. I think it's a long and winding road. I guess the short story of it is I always, you know through my travels was fascinated with diversity and which led me to do residency in New York and so I did a residency at an underserved clinic with Beth Israel Hospital and after residency, you know, went to travel a little bit more and then rekindled an old relationship, the founder of the Vireo Health, Dr. Kyle Kingsley, he and I had met on the medical exchange to Cuba about 20 years ago and he called me up while I was working in New York and he knew that I had an interest in plant medicine, had an interest in integrative medicine and that cannabis was kind of right up my alley and said listen, you know a lot about plants, what do you know about cannabis and I admittedly despite all my studies in plants knew very little and start to do some research and he offered me, if we would win one of the very competitive New York licenses to come on as Chief Medical Officer and that was five years ago RJ. 

RJ: Wow. Now, why do you think that your knowledge up until joining Vario, your knowledge on medical cannabis was limited? Do you think that that had at all to do with your upbringing in the midwest? Because I know it did for me. 

Dr. Dahmer: Yeah, I think up bringing in the midwest, but let's just be frank the tremendous amount of negative stigma surrounding this this plant is just, you know, we can't even grasp to what it to what extent that goes in our psyche, I think for all of us and even for me being a physician that is open to plant medicine and you know, there are thousands of plant medicines so I had many others to look into and to study and to learn more about but honestly, it was just truly the taboo and stigma surrounding the cannabis plant that kept me from investigating it more. 

RJ: Totally, yeah, I feel that. 

Dr. Dahmer: Just one more thing on that RJ there’s just so many layers to it than even you know for me, it probably took me a year to even learn the derogatory history of the term marijuana and why we really try to use cannabis a lot of our laws are written with marijuana so we're forced even in some states, we operate to still use the term but you know to really dig into those things was fascinating for me and eye-opening and then to look at you know, what is that stigma you bring to the table and I think I'm up to almost a hundred and sixty lectures I've been on medical cannabis and they always start out the same and even to Physicians, look let's strip away the stigma that we bring to the table and treat this like any other medicine or any other sub substance if you want to call it that and let's really look at it from an objective lungs and not one that's tainted by that stigma that we bring to the table.

RJ: Definitely. Yeah. Yeah it's so important especially in something like the medical field, it's so important to approach it as objectively as possible, right? Like I mean, I'm not in the medical field, I don't want to make assumptions. Now, what do you think this current state is in the broader medical field when it comes to cannabis education? Is there enough of it? Is it better than it was? You know and where does it need to go? 

Dr. Dahmer: Yeah, there's certainly not enough of it. It's certainly better than it was and we have a very very long ways to go but it just, even in a short period of five years, it's been fascinating for me to see the changes, you know early on I was even heckled by physicians to talk about cannabis five years ago and certainly watch lectures and you know, this is not FDA approved, how can you even talk about this being a medicine to really, you know seen much more acceptance that is accruing to, you know, spoke to students that are part of one of the first masters in cannabis at the University of Maryland this past week. So we're certainly seeing strides far more needs to happen. I just, you know part of gets me out of bed in the morning is the incredible potential of the endocannabinoid system and impacting disease and even health and how little we are utilizing not only vital medicines to impact that system but just even learning more about that system to harness it to improve our health and we're just scratching the surface again standing on the backs of some giants that have done some incredible work and research but have a long ways to go and every you know and studies reflect this as well, Physicians are yearning to learn more and they might not always openly admit it but even on a lot of the surveys done they want to know more about what's going on and it's obvious that patients are utilizing it so the more that we know the better we can counsel and even if that counsel is for harm reduction related to the plant, I certainly want to see more counseling related to harnessing the medical potential but I think the medical community there are certain subsets that are very hungry to learn more and I only see that crime with time.

RJ: So there is positive news there when it comes to the wider acceptance of cannabis as medicine, you know, because there's obviously, you know the war on drugs and and just years and years and years of this, the pushing of these negatives stigmas and stereotypes, you know, that's a big ship to turn like most things in this country, you know a shift in attitude or mentality, it's a big ship to turn man. 

Dr. Dahmer: It is. No it has been and will continue to be but I think you know, even Physicians we are moved by family members, by friends and even more so by patients and it's something I've observed very keenly over the last five years is a patient or a physician that may be reluctant and there are a thousand reasons for us Physicians to be reluctant. There's an uncertainty related to malpractice, it's not FDA approved, it's very different from other medicines that we’re used to, it's not a single biochemical agent but you know what I've seen over and over time and time again those that join a program and certify their first patient and do see a patient benefit, it’s just very is very moving for them and it's something that I continue to see over and over that is starting to move the needle in addition to you know education and so many of the other movements that are happening with cannabis.

RJ: Once you see the benefits in a person first hand, you know, that's almost all you need man if especially if you compare it to someone who you know might have been prescribed opiates before hand and just seeing the difference in you know, how the opiates sort of just mask the symptoms or the pain if we're talking specifically. I have, you know, had the opportunity to see that first hand in people and that was really what pushed my opinion over the edge, was when I saw the change in people around me. 

Dr. Dahmer: Yeah and again we don't have too many tools when it comes to chronic pain as Physicians and we would always benefit from more and I think that lack of tools is in part what led to the crisis that we have seen with opioids and I see cannabis as a tremendous tool in helping with chronic pain. Mmmmm, and there are patients that don't do well, you know not only death as a side effect of addiction but some patients that just, opioids don't help or is a very high percentage of them that will have constipation as a side effect or other side effects and just give other tools to treat something as challenging as chronic pain. I see tremendous potential for cannabis with that. 

RJ: Certainly, certainly. Love that. Only way to go is up, right? 

Dr. Dahmer: Yeah and again I’m not sure if we'll get into it RJ, I don't want to jump the gun a little bit but I do think a lot of your podcasts have been about research and…

RJ: Yeah!

Dr. Dahmer: And we respect that about your podcast and again a Vireo Physician, as a company we just really believe that science and medicine, we can pull some of that stigma and the emotions surrounding this plant and let's really start to look at some of the data and so we're very proud to support, you know, high quality research to help truly determine, you know, not only is this helpful in chronic pain. Can it help patients get off opioids? Is it safe to take? What kind of side effects do we see? And even more important for me which is, you know, the other big thing that gets me out of bed in the morning is to really help someone hone in you know, and right now across the United States across the world somebody walks in and I have chronic pain and they can be overwhelmed by the number of choices and most places will say start low, go slow and we don't really have more information for somebody that you know, maybe naive and hasn't used cannabis before to really hone in on that appropriate dose, appropriate product, appropriate ratio to help them alleviate their pain.

RJ: Yeah, totally that actually brings me to my question here, I was going to ask you so Vireo Health offers an array of products from CBD, THC, CBN ratios to THC, CBD ratios and then also THC or CBD dominant extract. So, can you tell me about the process toward pointing patients to the product that might work best for them for their unique condition. So if I'm a patient and I walk in and I'm trying to find the right product for me, how would you help me locate that product?

Dr. Dahmer: Yeah, I mean, I think that's the million-dollar question, right? 

RJ: Yeah.

Dr. Dahmer: And I think that you know, what we've done to date again starting off being a physician led company really looked at the research that existed. So you know there, it’s an amazing plant as well to look at the number of conditions that qualify a person for medical cannabis and the latest estimates I've seen are over 3.5 million Americans that are part of a state legal program. I've seen estimates over 60 different conditions. So it's very reasons why people are coming into a dispensary, but we could look at that literature that did exist, you know to try to at least gauge what might be a right dose specifically of their THC but then there's that complexity of the plant. There's a CBD, there's the ratio. You go into the next level of minor cannabinoids beyond that terpenoid levels and everyone will look at you know, some of the literature that exists and look at different chemo bars or strains and start to inch someone towards this based on other things that they would like to treat in an addition to their condition or things that they're trying to avoid, but truth be told it's just a lot of patient or a customer trying on their own. So like a trial and error for them. So one of the first things that we tried to do and we have two very large-scale studies that one is already enacted and the other one is coming up. The first one is an observational trial where we're looking at hundreds of patients with chronic pain and we can see exactly what it is that they're taking and then that compare that to the efficacy and this is the beauty of research as you start to get data points of you know, third-party tested products, which all Vireo products are. We know that they're safe. We know that the precise within that ten percent stated dose of the major cannabinoid and then we can start to correlate that to how effective it is for someone and we're going to more and more hone in on to you know, and that's the beauty of this plant is it's nuanced. Every person is incredibly different but at least they have some guidelines that here's kind of a medium dose for people with chronic pain. This is a great team of our that works for them for these reasons and the science backs that this is the direction that you want to go, you know kind of in this window that we're aiming for as opposed to you know, kind of right now it's just really not much guidance. 

RJ: Yeah. Yeah, you mentioned that it's at least for now, it's a lot of you know trial and error just trying to help a patient find you know, whichever product would work best for them but I would imagine that when it comes to medical cannabis over different types of medications a trial and error thing is a little less precarious in that medical cannabis, you know, the potential negative symptoms if you compare it to opiates or other pharmaceuticals aren't you know as scary. Am I right in guessing that? 

Dr. Dahmer: I absolutely agree in that, you know again, one of the big things that turn me on when you could imagine it was a very difficult decision for a physician to get involved in a schedule one substance, but with…

RJ: Sure.

Dr. Dahmer: Non existent LD50. So knowing how many patients can die from pharmaceutical medicines that doesn't exist with cannabis, you know, it was some sort of relief for me to explore it more. I do think that there are a lot of patients that either don't get relief or do get side effects. Side effects are very common with cannabis, they usually just you know, self-limiting but it's enough, you know, and I think what we've seen in a lot of states is that first wave is more cannabis savvy, you know people that were kind of waiting for the door to open walk through and yet you know what I hear from a lot of those that may not be as savvy as oh, I tried one, you know capsule or a tried one puff and it didn't really do anything and no one really coach them on well, you know you needed to increase or we needed to try to switch you to this or the opposite is no I tried 10 puffs and I almost ended up in the emergency room because of that lack of guidance unless you've had some experience before and you know and are able to really kind of teach yourself on how to go about finding that best does. 

RJ: Totally totally. Now where can you know, someone who may not know anything about cannabis say I'm in that group of people who you know, I have these symptoms that other medicines aren't working for me and I keep hearing about medical cannabis and I want to give it a try but I don't know much about it and I'm kind of scared, where do you think are the best resources for those people to go to whether they be at Vireo, in person or online or anywhere else?

Dr. Dahmer: Yeah, I'm a big big fan of our website. We touch on all conditions there. There are hints at the research that were participating in and that's Vireohealth.com and just really you know what I love, I've always considered myself a patient advocate and so I always encourage patients to be their own advocate as well and again standing on the backs of giants, this is a medicine, this is one of the only medicines that I have worked with in my career as a physician that was brought to the table by patients, you know, really patients advocating for this through politics, patients advocating for this medicine to be available for their child with seizure disorder fill in the blank that the patient's brought this to the table continue to advocate. There are great Facebook groups. Would really encourage you, you know reach out to your local dispensary, reach out to Vireo, you know, and we're accessible, you know in all the states where we do operate phone calls away oftentimes. You can sign up for a newsletter and email away. Really get hungry about learning more about that because it is a lot of information and it can feel overwhelming at times but to have a good partner, which you often times could be a dispensary or you know, some key players at that dispensary to help learn more and even recommend some great educational resources and vireohealth.com is a great place to start. 

RJ: That's so interesting, I had never thought of that until you brought it up that the many of the things that differentiate cannabis from other medicines is that like you said the patients brought it to the Physicians and to the doctors and advocated for that. I had never thought about that until you brought it up. That's fascinating to think about.

Dr. Dahmer: Yeah. I know it's really a testament to people that advocate for themselves and say hey I deserve access to this potential medicine and it's helped someone with a condition like mine or it has help to a child that has a condition similar to my child and I deserve access to that and it's been really amazing to watch that and as advocates really make this more and more available and more accessible and I think that now that we're starting to see it available accessibility is the next big frontier and that's one of the things that you know, kind of really irks me is that I interacted directly with patients that have seen tremendous benefits with cannabis of decreased our opioid or gone off at completely had to go back to the opioid because they couldn't afford the candidates and the opioid still is you know, I have a copay that's much cheaper or even patience I've had very specific examples where my the pain clinic that I go to does not allow for cannabis so I have to choose between those two and again because cannabis can be a little bit more challenging price, I've had to go back to opioids and those are things that were also fighting for at Vireo Health. We did a cost effective analysis with an NYU researcher at City University of New York to show that you know, there is cost effectiveness in cannabis specific to sickle cell disease and I think those are things that will turn the heads potentially even of insurance companies in the future. 

RJ: Certainly, now has that study been published yet,or is it still in the works? 

Dr. Dahmer: No that's published, its online is part of a dissertation. Dr. David Donor looked at that in terms of cost effectiveness. Certainly we hope we get to see even more of those and again in this going to fight I think evidence, research, you know, more science are the things that will push the needle on insurance coverage or other things that can make this more accessible to other patients.

RJ: Yeah, definitely and that's one of the things that I really love about what you're doing at Vireo is you're focusing on providing that data driven research in that you know, the science behind it all that, you know will really help in advocating for the accessibility like we said of this medicine for for patients that need it. Another thing that would, you know obviously really help facilitate the accessibility of medical cannabis for patients is legalization, you know, a bunch of states have legalized it. It’s still federally illegal though in the United States. You know, you're over in New York, what is the vibe like over there? I understand that, you know legalization was supposed to be on the table, it was, it wasn't. What is going on over in New York?

Dr. Dahmer: I think that I've given up on that a long time ago RJ just too sick to medicine over politics.

RJ: Forsure I get it!

Dr. Dahmer: My political glass ball was I think I lost it in a move along time ago. I see bipartisan support. I see it as inevitable. I also see, you know, pressure on economies from covid and this being a potential response to that and there are arguments for or against. I really see an inevitable movement in that direction and even as a physician, even when we talk about an adult use market to have to know that a product is third-party tested, to know that it's safe, especially having gone through the vaporizer scare and then evaluate instance, you know instances that have something third-party tested that is trusted, that is regulated is a step up from an illicit market.

RJ: Mmm. Certainly. I love your analogy about politics man. It's quicksand, it's hard to not fall into it though. So props to you!

Dr. Dahmer: I will still be out there voting though, so I’ve certainly given up on predictions, but I'm certainly going to vote for who I think is best suited to help run the country and to sit in office.

RJ: Props for that. I want to ask you about this also because in researching more about your history and your experience and your background, I understand that you are a fellow at the Arizona Center for Integrative Medicine and I also understand that for over a decade, you know, beyond medical cannabis you have been studying the relationship between plants and people and to better understand what is called the ethno-medical system. So for those who may not know what that is, can you explain what an ethno-medical system is? And what specifically you're trying to learn about them?

Dr. Dahmer: I think it's you know much deeper level of the context in which you know medicine is given and you know that involves, you know, if we think of like plant medicine which across the globe for many people still their first line of primary care. Many people still go to plant medicine and that's one of the things that really interested me and early in my travels is how accessible plant medicine is and how affordable it is for many people that grow that in their backyard and you know ethno-medicine kind of studies the relationship between people and that plant and and how that serves as a medicine and that includes everything from the growth of that plant and the preparation of that, the traditions surrounding that and how that's evolved over time. That relationship between those people and that plant and its use as a medicine.

RJ: Mmm and your work in that has taking you all over the world. You mentioned a little bit earlier in the show some of where it's taken you, such as you know to the second largest slum in Brazil that you mentioned. I understand also that you worked in Maori clinics in New Zealand. Is that right? 

Dr. Dahmer: That's true. Yeah, in Whanganui or Wanganui, I worked as a primary care physician so worked both at a clinic within, you know, kind of native culture the native Maori population and also urgent care as well and Wanganui is kind of the Southern coasts of the northern Island and really, you know, 85% Mahdian and so every you know, every almost every patient that I saw Mahdian origin and you know again in all of those travels and Wanganui in New Zealand included, I mean, it just was so fortunate and oftentimes come there and you think you're the doctor from the United States that's you know, sharing medicine or knowledge and I honestly learned so much from every culture that I ever interacted and touched including Ahmadi that on-site the clinic where I worked had traditional healers that would teach me kind of general knowledge about medicinal plants that they used and I would supplement that with my Western Medical knowledge, sometimes in working in Urgent Care we saw pretty extreme things from even melanoma skin cancer to broken bones to one night at Urgent Care, I had a patient with 42 lacerations. It took a little time to put together those lacerations but learned so much from the Maori culture and from all over the world from Sevilla in Brazil, Dominican Republic, Cuba and traditional healers, Hawaiian Islands, have done work there as well. Just so eye opening. 

RJ: Man, that's so awesome and I understand even here in the states, in Arizona you worked with the Navajo tribe.

Dr. Dahmer: Yeah! How could I neglect to mention that. I worked in Chinle, Arizona if you've ever been out to Arizona , RJ…

RJ: I've been out to Arizona not Chinle though.

Dr. Dahmer: Yeah. So the Canyon De Chelly was my backyard, I like to say and I worked as a hospitalist there and we had a four-bed ICU and took care, I remember one one week on the words, so I was a hospice working in the hospital, I had two code talkers in beds adjacent to one another which honestly before my you know, I'm really ashamed to say before, even working there I didn't know what a code talker was that you heard of code talkers?

RJ: I have! You just recently to actually so yeah.

Dr. Dahmer: So it was like the uncracked code that you know Navajo such a challenging language that none of our enemies in the world war were able to crack that code and again in Chinle, even on the hospital they had a native healing what's called Ogon on site where Native healers were present and available for those that you know want to traditional healing as well.

RJ: Wow, that's so fascinating and how long were you working there for? 

Dr. Dahmer: That was a shorter job, that was nine months of working there is locumtenens in Chinle, Arizona.

RJ: Wow, that is fascinating man. You know, how awesome is it that you know, your work has taken you all around the world man and you're able to bring this healing for people who really need it man. That must be so fulfilling. 

Dr. Dahmer: Yeah, it's really just a tremendous, I feel so fortunate and again coming back to gratitude, everyone reacted with and just was always amazed at so many of these cultures that I went to and if you ever see me I'm six foot four and very white and freckled, but just you know, the oftentimes the open arms and and you know, there's always everyone is always a little bit has their eye out for the foreigner that comes through but just so many cultures that I've worked in and I think it's somewhat, you know opening to being a doctor in a culture that there is even a little bit more opening but just we're so grateful and so gracious with lessons to me. I remember a quick story in New Zealand when I finished on my last day the tribe brought together a circle and hit a closing ceremony with music where each person in the circle sang something to me about how I had touched them and gave me a wheel hand-carved wheel bone on necklace as a departing gift and I can picture it even as I'm telling the story and again for a short period of time or what I'd consider a short period of time just such a gracious culture to share some with me.

RJ: Whoa dude, that is awesome. You do all this work with trying to better understand ethno medical systems and the relationship between plant medicine and people do you think at all this sends a shiver down the spines of those in the pharmaceutical industry who you know might see people embracing alternative medicines as a threat to their bottom line.

Dr. Dahmer: I don't see it as such. I'm just you know, the more you get to know me RJ, I have to be a kind of a rosy colored glasses, glass half-full type of person and you know, I think the pharmaceutical industry has really served us well in many regards, right there are some amazing medicines out there that I've used, you know for decades as a physician and I think you know again there are always exceptions to the rule but I you know, I do think that the best interest is really to bring products to market that serve people. I do think we've lost our ways and that's one of the things that all my travels have taught me is, you know, the respect that we should have for medicine, to really start low go slow with every medicine, to use them the minimal amount necessary and to really have that respect I think we'd become very relaxed with pharmaceuticals and that's one of the things I talked about quite a bit is polypharmacy and especially even in our elder population the number of us as we get over 65 that are on 5-7 even 10 medications is very daunting and scary because there's often times accumulative side effect profile and these can cause harm and I think that again like so many things we're looking for other ways to potentially improve health and in my lectures, I talked a lot about botanical and for a long time they've been considered dirty, you know multiple components hard to study, hard to make a precision product, hard to get through an FDA process. There's only been two botanical drugs that have gone through that process in the history of the FDA, but I have this hope and I think we're on the precipice of some changes especially in chronic medicine will see the benefit of these subtler plant chemicals used in combination that don't have such intense side effects as we talked about and I think we'll see more use of those hopefully even in mainstream medicine, which is one of the things I'm really working towards. 

RJ: Nice. Right on. I dig that. So that brings us to this now, what's next for you personally and then what is next, what's on slate over at Vireo Health? What have you got in the works over there?

Dr. Dahmer: We always, we have so many things on the works at Vireo Health. I couldn't possibly cover them all from new products, to new delivery forms. We have amazing R&D team just came out with a cannasafe, it's kind of a new container for a flower and bud that is going to retain or protect that terpenoid profile which is a big thing for me as a fishenado of plants. You want to try to maintain that plant and its original state as much as possible in this trepsafe can do that and actually published a study to that. One of the big things we are excited about and really credit goes to Dr. Cunningham at Montefiore and her team have put together and it's on clinicaltrials.gov. it's under Relief, we have a randomized control trial coming up where we will be randomizing patients to a voucher for either one of our three top products that we use for pain. One that has a higher THC content, one that has a one-to-one THC CBD, one that has a higher CBD content versus placebo. So the type of study that's been incredibly challenging to do here in the United States and really virtually impossible if you're not using bud and flower or a product from Ole Miss to initiate kind of the recruitment for patients for the study coming up here in October, which is very exciting and again giving honing in on that information patients with chronic pain, which of those products will help most and there's still even a debate is CBD dominant product, does that work in pain? What is that? What is that right ratio for a patient to help them with their pain. So you can check the Vireo website, it's also again on clinicaltrials.gov and it'll be an ongoing trial so these things don't happen quickly. It will be ongoing probably a good three years if not, even a little bit more. It takes time to get these great answers but again, Vireo, on top of making amazing products constantly pushing the envelope on new delivery forms, pushing the envelope on research and development we’re planting seeds early on these difficult questions that we can better advise all of our customers and patients in the future.

RJ: I love that and are you accepting applications from just a New York area or is this a nation wide thing? 

Dr. Dahmer: This will be a new york-based to begin with and again the once we do launch a recruitment, which will be in early October will be information on clinicaltrials.gov on our website, you know, you can call our dispensaries and certainly recruitments going to be a big thing and and getting patients that are interested in supporting research and participating in this really hasn't been a huge challenge for the most hard, you know people that do utilize medical cannabis or you know move to that direction are interested in getting more answers and I just hear it over and over we need more research, we need more research, we need more research. We're not sitting on the sidelines even with the many hurdles that exist to do that, Vireo is paving a path to get better answers for our customers and our patient's. 

RJ: I love that and I love the pursuit that the team over at Vireo is undertaking to bring this information and to conduct this vital research in order to help patients better understand cannabis as a medicine and how it can help them specifically for certain ailments that they might be experiencing or certain symptoms that they might be experiencing. That is so so rad man now...yeah, please!

Dr. Dahmer: Well I was just going to say and then the fun part about that is the you know, the side effects to doing something that is challenging like that, not only to get better answers right for the 3.5 million Americans, not to mention worldwide that are using this plant but also, you know put potential ramifications with industry or with the medical community or you know other circles that there has been this stigma to say, yeah, this has potential role in as a therapeutic agent for fill in the blank.

RJ: Love it. Love it. That is rad dude. Oh man. I'm inspired to hear that man. I hope it all goes well. I hope the application process runs smoothly and I hope that y'all are able to collect some important data. Before we go here first I want to thank you so much for taking the time to speak to me today and to you know, bring me up to date with everything that y'all are doing at Vireo, before we go where can our listeners find out again what you are up to personally? What Vireo is up to? And then also where are they can sign up through the government website for the clinical trial?

Dr. Dahmer: So I am active on Twitter, Instagram, Facebook and you can Google me for all of those. I'll give a shout out, Americans for safe access just started Leafwire, don't know if you heard about this, but it’s supposed to be a LinkedIn for cannabis. 

RJ: It's called Leafwire? 

Dr. Dahmer: Yeah LeafWire. I just joined that. I got it in my inbox. So it’s brand-new and I am a fan of Americans for safe access and amazing work that they do and then absolutely please come to our website vireohealth.com and before we wrap it up RJ, I do want to give a huge shout-out to, and you had her on the show as well Dr. Paloma. 

RJ: Yes, indeed.

Dr. Dahmer: Yeah, we're so proud that again where medical and science based, and RCT and you know getting these answers for patients and pushing delivery forms. She also heads up along with Amber Shupra, our diversity and equity initiative and just this past week held an awesome event at Maryland, Maine and Maryland and supported, you know expungement for 45 individuals and I just think that you know, again, we have such a duty to support those that have been wronged by the stigma surrounding cannabis and was very proud of our team to participate in that and to potentially right support those that have been negatively impacted by this and we all know, you know, what a negative impact that can have on family and individual, on unemployment which absolutely impacts health. 

RJ: Certainly. Definitely. I'm gonna look you up on Leafwire right now I just opened up a tab. So I'm going to look you up.

Dr. Dahmer: I'll meet you RJ. Absolutely. 

RJ: Right on.

Dr. Dahmer: Thanks for doing this. I'm excited about the TRICHOMES website and just real pleasure to be on your show. 

RJ: Absolutely man pleasure to have you hopefully maybe we can meet up across the lake one time in Michigan and Wisconsin and have an episode two. Socially distant. 

Dr. Dahmer: As long as you aren’t in Cheboygan with a C!

RJ: Right on we'll meet up on your side of the lake this time. How about that? 

Dr. Dahmer: Now you’re talking. Great! Thanks! 

RJ: My thanks again to Dr. Stephen Dahmer for joining me. If you are a member of the cannabis community and have a story you want to share with us, we would love to hear from you. You can reach the show at HashItOut@TRICHOMES.com. You can help others find the show by taking a moment to subscribe to the podcast and write a review. You can also join the discussion with industry insiders and get your voice heard by joining the community at TRICHOMES.com and following us on all social media. Hash It Out is produced by David Fortin and presented by TRICHOMES.com. I'm RJ Balde. Thanks for listening y'all.