Whether you have specific questions about cannabis and mental health or are simply curious, welcome to my home on the web. I’m often asked how I became Dr. B, the Cannabis Psychiatrist. It’s a big question. The simple answer is that I want to help people feel better and improve their mental health.
Over the past twenty years of practicing as a psychiatrist I’ve learned from listening to thousands of patients that cannabis helps them, often more than any of the other psychiatric medications I’ve prescribed. I became passionate about cannabis when I realized how much my patients were gaining by using it, not just in terms of their mental health, but in terms of their overall wellness. In the past 10 years, I’ve treated over 10,000 patients with medical cannabis, all the while asking questions, and reading the research. I’ve found that the research supports the positive and life changing results I’ve seen in clinical practice: stories told to me daily by patients describing how essential cannabis has been to their recovery because using it medicinally helps them to manage their symptoms with minimal side effects. What’s more, their use of cannabis has turned them on to a new way of living with mental illness, which is reflected in their healthier lifestyle choices, decreased use of other more harmful psychiatric medications, and a commitment to both personal and spiritual growth. Contrary to what I was taught in medical school, I now think of cannabis as a gateway to wellness, one of the many tools we can use to treat mental illness.
I was trained as an Osteopath, and osteopathic physicians generally think more holistically about disease and illness; we approach healing from a whole person perspective, looking at the mind, body, and spirit, not just the biological or physiological mechanism underlying disease.
When I began my psychiatric residency, I found that people (colleagues, patients, the field of psychiatry itself) weren’t/wasn’t interested in the whole person approach to mental health. This was in the late 1990s, and the predominant view of mental illness within the psychiatric community at that time was based on a misconception that persists in popular culture to this day: it is the view that all mental health problems can be solved by simply changing neuro-transmitters in the brain. So instead of approaching psychiatry from a holistic viewpoint, I based my practice on what was considered “gold standard” treatment at that time and I prescribed patients a lot of psychiatric medications, often in complicated combinations with the intention of addressing the biological basis of their problem.
I had a lot of success with this approach. These medications often helped patients initially, decreasing the severity of symptoms during the acute phase of illness. But after developing relationships with my patients and seeing them over a period of 10-20 years through the different phases of their lives and development, I noticed something: after the acute phase of the illness had passed, they were still dealing with the same problems. The medications I was prescribing weren’t helping them get well, beyond a short period of initial improvement. Many were just treading water, managing their most severe symptoms.
In 2006-2007 I began to question my whole approach to treating mental illness. I started practicing in a new area, wilderness psychiatry. I was still treating young adults and adolescents with addictions, substance abuse problems, and comorbid mental health problems, but the setting was completely different. Instead of a traditional rehab setting, these patients spent 3 months in a wilderness-based program.
Most entered the rehab on a complicated cocktail of psychiatric medications. I realized that if the medications were working for these kids, they wouldn’t need the wilderness treatment program! That was the crack in the proverbial ceiling that allowed the light of doubt to seep through, and I questioned the heavy use psychiatric drugs. At that point my focus shifted, and I began to take a different approach, one which involved reducing the number of meds my patients were taking and using the wilderness experience itself as a treatment modality. As I became more comfortable weaning medications in the wilderness setting, I noticed that 90% of the kids were leaving the wilderness rehab feeling great on little to no medication. This was in stark contrast to what was happening to patients in hospitals or other residential treatment centers. Additionally, their decreased use of psychiatric medications and overall improvement continued through their aftercare where they began to cultivate a healthy lifestyle through nutrition, exercise, and spirituality.
Not much later, cannabis was legalized here in Colorado where I have my private practice. My patients talked to me about their cannabis use and I listened to what they were telling me: that cannabis helped them sleep better and they no longer needed me to prescribe their sleeping medication. Or that they were using cannabis and not wanting to take their stimulants for ADHD because they felt less anxious using cannabis and it also helped them focus during the day. I had patients that I had treated since they were diagnosed with childhood onset bipolar disorder who had grown up on traditional psychiatric medications switching to cannabis in their twenties and thriving in ways none of us ever thought would be possible: managing full time employment, school, having successful relationships, and building families.
Cannabis became a medication I was comfortable prescribing, thanks to a knack for listening, some curiosity, and the desire to provide my patients with educated information so that they could make informed decisions about their own mental health.
Cannabis is much more accessible to people now, and for those who are curious about its benefits, it can be confusing to navigate the different streams of information, especially when it comes to treating mental health issues. My belief is that through education, advocacy, and research we can begin to reframe our misconceptions about the use of cannabis in mental health and begin to align our practices with what many physicians have observed in clinical practice, so that we can begin to treat cannabis like we would any other medication.