E3 Dr Tina Horsted - Medicinal Cannabis for Chronic Pain, Prescribing cannabis in Denmark

In this third episode of the Holistic medicine podcast, Dr Julie Moltke is interviewing Dr Tina Horsted, anesthesiologist, pain physician and owner of Clinic Horsted, the leading pain and medicinal cannabis clinic in the center of Copenhagen. Dr Horsted has prescribed medicinal cannabis for over 5000 pain patients. 
Content: 
00:13 - Introduction to Dr Tina Horsted, Pain physician and owner of Clinic Horsted 
1:16 - The Danish Pilot Study, Dr Horsted's medical experience and journey into medicinal cannabis 
2:52 - The first few years of prescribing Cesamet/Nabilone in Denmark 
4:22 - A Danish pharmacist starts to make medicinal cannabis from extract directly at Glostrup Pharmacy. 
4:58 - Resistance from other doctors in Denmark - stigmatization of cannabis
6:28 - Starting the pain clinics, the birth of Clinic Horsted
8.30 - Looking at the whole patient, taking a holistic view 
9:09 - A clinic for all nordic countries, a center for medicinal cannabis in the nordic countries 
10:05 - Making a prescribing guideline for clinicians 
10:35 - The typical pain patient is a female between 50-70 years old, fibromyalgia, chronic neuropathic pain, nausea, and vomiting. Male patients have mostly failed back surgery or muscle and joint pain, trigeminus neuralgia. 
11:59 - Medicinal cannabis can help people reduce their other drugs. We first stabilize patients on their other medicine and then they can reduce opioids. Many are addicted to opioid medications when they come. 
13:01 - Medicinal cannabis and addiction, cannabis can help people reduce their opioid medicine. Cannabis has an addictive potential of 8-10% for opioids it is 20-50%. 
14:25 - How to accept life as a chronic pain patient
15:14 - How good is medicinal cannabis at treating chronic pain, between 50-60% of patients in clinic Horsted has a good effect from medical cannabis and can reduce conventional medicine. 
16:26 - Side-effects from medicinal cannabis; most people become tolerant to the side-effects when dosing slowly. 
17:00 - What kind of pain does cannabis work on? Chronic neuropathic pain, arthritis and bone and joint pain, rheumatoid arthritis.   
18:10 - The other benefits of cannabinoids: improvement of sleep, mood, social interactions, cannabis can help improve mind, body, and spirit. 
19:18 - How to find the right dose (CBD has no side-effects). Start with THC 2,5 mg in the evening, increasing after 3 days to 2,5 morning and evening, and then increase after a week to 2,5 mg x 3 per day, depending on the patient. Nobody died from medical cannabis. 
22:30 - The difference between medical cannabis and cannabis-based-medicines
22:58 - The-effects of medical cannabis (dizziness, tiredness, euphoria is rare when taken in the right dose, dry-mouth, anxiety, quick pulse.   
24:17 - What to do if you overdose cannabis: Drink and eat sugar. 
24:42 - The stigma around cannabis. The difference between recreational and medical use of cannabis
25:50 - Dr Horsted has never seen a patient who got addicted to cannabis. She has neither seen withdrawal symptoms from THC. Tolerance is developed and then the dose needs to be increased
28:08 - Mindfulness for chronic pain patients. It can help patients deal with chronic pain on a daily basis, all chronic pain patients should learn MBSR and breathing techniques, acceptance is key. 
30:00 - The Danish Pilot Study for Medical cannabis. 2,5 years with the program, Dr Horsted's experience prescribing medical cannabis in Denmark, lack of products, the resistance from danish doctors is easing. 
33:10 - The future of cannabis medicine, it is here to stay 

www.clinichorsted.com 
https://www.drjuliemoltke.com/podcast
https://podcasts.apple.com/dk/podcast/the-holistic-medicine-podcast-by-dr-julie-moltke/id1519846556