How Medical Cannabis Could Transform ADHD Treatment: Insights from Dr. Niraj Singh
Did you know that medical cannabis could have therapeutic and anti-inflammatory benefits for people with ADHD?
In this week’s thought-provoking episode, consultant psychiatrist Dr Niraj Singh, a Consultant Psychiatrist specialising in Neurodevelopmental Psychiatry, joins me to explore its potential to ease anxiety, mood swings and sleeping issues as an alternative or alongside ADHD medication.
With over 20 years of experience as a clinician, Dr Singh has treated thousands of adults with neurodivergence and mental health challenges.
In this week's ADHD Women's Wellbeing Podcast, we discuss:
- How the endocannabinoid system regulates both health and ADHD
- The therapeutic benefits of medical cannabis for women with ADHD
- Why some patients self-medicate with cannabis – and the risks involved
- Cannabis as a medicinal plant throughout history
- How medical cannabis can complement or replace stimulant medication
- The challenges of accessing medical cannabis in the UK
Takeaways:
- The endocannabinoid system is crucial in regulating our overall health and well-being.
- Medical cannabis can serve as a holistic treatment option for women diagnosed with ADHD.
- Self-medication with cannabis is common among individuals with ADHD, autism, and anxiety disorders.
- Cannabis has historically been used as a medicinal plant for various health conditions.
- Patients may find that medical cannabis can complement or even replace traditional stimulant medications.
- The integration of medical cannabis into treatment plans can enhance lifestyle changes for better health.
Timestamps
02.07: How medical cannabis works for ADHD
12.17: Cannabis as a tool for mental health care
16.40: The future of cannabis in medicine
19.32: How medical cannabis is prescribed
28.00: The impact of lifestyle and social connection
Connect with Dr Singh on Instagram, or through his website.
Script Assist empowers eligible patients with private cannabis prescriptions in the UK alongside personalised care from doctors
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Kate Moryoussef is a women’s ADHD Lifestyle and wellbeing coach and EFT practitioner who helps overwhelmed and unfulfilled newly diagnosed ADHD women find more calm, balance, hope, health, compassion, creativity, and clarity.
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Transcript
Welcome to the ADHD Women's Wellbeing Podcast.
Kate Moore Youssef:I'm Kate Moore Youssef, and I'm a wellbeing and lifestyle coach, EFT practitioner, mum to four kids and passionate about helping more women to understand and accept their amazing ADHD brains.
Kate Moore Youssef:After speaking to many women just like me and probably you, I know there is a need for more health and lifestyle support for women newly diagnosed with adhd.
Kate Moore Youssef:In these conversations, you'll learn from insightful guests, hear new findings, and discover powerful perspectives and lifestyle tools to enable you to live your most fulfilled, calm and purposeful life wherever you are on your ADHD journey.
Kate Moore Youssef:Here's today's episode.
Kate Moore Youssef:Welcome back to another episode of the ADHD Women's Wellbeing Podcast.
Kate Moore Youssef:And I'm here today to discuss something really exciting and something I'm personally very interested in.
Kate Moore Youssef:I'm always doing these episodes so I can share this information and give you that empowerment so you can make choices, do your own research, and then hopefully, as things filter through the more holistic side of managing our adhd, you're able to make those choices further down the line.
Kate Moore Youssef:And today I'm absolutely delighted to welcome Dr.
Kate Moore Youssef:Neeraj Singh, and he is a and specializes in neurodevelopmental psychiatry, and he has extensive experience in treating adults with adhd, mental illness associated with autism, intellectual disabilities, as well as other mental illnesses.
Kate Moore Youssef:And he also specializes and has extensive experience in medical cannabis treatments, which is what we're going to be talking about today.
Kate Moore Youssef:He has a special interest in health, Spanish longevity and practices holistically focusing on nutrition, exercise, sleep and other areas to optimize mental health.
Kate Moore Youssef:This is all my language.
Kate Moore Youssef:I love it all.
Kate Moore Youssef:Anything that we can bring more holistic practices into helping our ADHD is what we're here for.
Kate Moore Youssef:So, Dr.
Kate Moore Youssef:Neeraj Singh, welcome to the podcast.
Dr. Neeraj Singh:Thank you, Kate, and a pleasure to be here.
Dr. Neeraj Singh:Thank you for inviting me.
Kate Moore Youssef:Yeah.
Kate Moore Youssef:So I'm really intrigued to talk about medical cannabis for the treatment of adhd.
Kate Moore Youssef:We're talking here.
Kate Moore Youssef:You know, we're both based in the UK and you're based in Leicester and in London.
Kate Moore Youssef:You have a consultancy that specializes in this and is prescribing medical cannabis.
Kate Moore Youssef:And I think a lot of people are going to be like, oh, okay, I'm interested, but cautious, and I've heard this and that, and maybe we can just demystify lots of things.
Kate Moore Youssef:And the fact that you are a psychiatrist, neurodevelopmental psychiatrist, this is something that we need to understand and know about because there are other options out There.
Kate Moore Youssef:So can you tell me a little bit about maybe your experience with delving into this side of psychiatry?
Dr. Neeraj Singh:So I've been a psychiatrist for about 20 odd years now and a consultant, I think, for the best part of 15.
Dr. Neeraj Singh:And the reason I got into this, Kate, was because I was reaching points where my patients weren't getting the outcomes that I wanted for them.
Dr. Neeraj Singh:And so I just researched and I found medical cannabis.
Dr. Neeraj Singh:It turned from a Schedule 1 drug with no medicinal value to Schedule 2.
Dr. Neeraj Singh:And actually realized that this was actually within the scriptures, you know, ancient scriptures, Chinese and Indian as well.
Dr. Neeraj Singh:And actually has always been in medicine, you know, in spite of that, we've been conditional, taught that actually it can cause a lot of problems.
Dr. Neeraj Singh:So in medical school, actually I was taught that cannabis is a really bad thing.
Dr. Neeraj Singh:It has no medicinal value, it actually causes schizophrenia and other things.
Dr. Neeraj Singh:Really what I found was actually, you know, this was a potential option for my patients to really benefit them.
Dr. Neeraj Singh:And also in a holistic sense as well, because it's a plant, ultimately, many medicines within one book.
Kate Moore Youssef:So what's interesting is that obviously you were trained traditionally in medical school and you're hearing the things growing up, you know, we were.
Kate Moore Youssef:There was apprehension.
Kate Moore Youssef:I grew up and knew quite a lot of people that smoked cannabis.
Kate Moore Youssef:Very often it was that gateway or it had detrimental impacts on mental health and it caused anxiety, depression, things like that.
Kate Moore Youssef:What we're talking about is very different and I just want to make that distinction.
Kate Moore Youssef:And what's very interesting is that you as a doctor are recognizing the sort of the natural benefits of medical cannabis and how we can harness it and use it.
Kate Moore Youssef:I know a lot of people also that were diagnosed late, later on in life with ADHD and used cannabis to self medicate because they recognized, despite the other things, they recognized that there was a calming impact.
Kate Moore Youssef:It helped them sleep, the restlessness, the hyperactivity, it helped calm things down.
Kate Moore Youssef:So are we harnessing that side of it to help our ADHD symptoms?
Dr. Neeraj Singh:Exactly.
Dr. Neeraj Singh:And a lot of people as you know, do self medicate with cannabis across full spectrum of mental health problems, ADHD with autism, who may be suffering from anxiety as well, a whole raft of problems, really.
Dr. Neeraj Singh:We term it self medication because literally that's what people are doing really, because they want help with their attentional control, they want help with emotional regulation and the inner restlessness they might be experiencing and also sleep as well.
Dr. Neeraj Singh:And how cannabis works is it works on our endocannabinoid system.
Dr. Neeraj Singh:So actually we all have cannabinoids inside of us already.
Dr. Neeraj Singh:A lot of people don't realize that actually we already have cannabis inside of us.
Dr. Neeraj Singh:These are called endocannabinoids.
Dr. Neeraj Singh:We have a system called the endocannabinoid system, and that's a fundamental neurotransmitter system which underpins all our other systems, be it our neurological, our guts, our immune system, our heart, our lungs, our hormones are all underpinned by the endocannabinoid system.
Dr. Neeraj Singh:So if you can influence the endocannabinoid system, you can bring term called homeostasis or equilibrium into your mind, body and spirit.
Dr. Neeraj Singh:And that's historically why cannabis has been used as a medication.
Dr. Neeraj Singh:And yes, absolutely, it can also be very detrimental for people who have access on the streets, principally because over the decades, that has been filtered out to be very high, what's called thc.
Dr. Neeraj Singh:So one of the major cannabinoids called thc.
Dr. Neeraj Singh:Now, literally, if you strip the plants off a lot of the balancing components and leave it as high THC without the other components, part of it, things like terpene flavonoids or cbd, et cetera, that could potentially be quite detrimental.
Dr. Neeraj Singh:As well, as he's rightly said, medical cannabis is different because it's produced under good manufacturing practice or gmp.
Dr. Neeraj Singh:So we know what our patients are getting when we're prescribed, and therefore we can, you know, accordingly titrate.
Dr. Neeraj Singh:We understand what the cannabinoid concentrations are, compounds called terpenes as well in there, which are really, really medicinal.
Dr. Neeraj Singh:These are things that we come across every day.
Dr. Neeraj Singh:So we understand through what's called certificates of analysis, which comes with these products, how this may potentially benefit our patients and accordingly make adjustments, as we do with any medicine, really.
Kate Moore Youssef:And it's so interesting, isn't it, that, you know, for historically, amphetamines have been part of the treatment for adhd.
Kate Moore Youssef:And that's always had a still, you know.
Kate Moore Youssef:Oh, gosh, you know, I don't know if I want to take that medication because it's.
Kate Moore Youssef:It's a drug, it's amphetamine, and it's essentially speed.
Kate Moore Youssef:And now we're going back, like you say, this historic, this ancient way of calming our nervous system, calming this.
Kate Moore Youssef:Endocannabinoid.
Kate Moore Youssef:Yeah, yeah, endocannabinoid system.
Kate Moore Youssef:And so am I right in saying that the endocannabinoid system, cortisol impacts it?
Kate Moore Youssef:And so if we are helping that we're reducing the cortisol levels, it helps.
Dr. Neeraj Singh:Regulate the whole system as well.
Dr. Neeraj Singh:So, like I said, you've got to think of it as like a foundational system, a foundational, what we call neuromodulator system.
Dr. Neeraj Singh:So we have the endocannabinoids, which are the internal cannabinoids, what the plant cannabinoids are, and we love technical jargon, it's called phytocannabinoids, it's the plant cannabinoids that we.
Dr. Neeraj Singh:And these are basically analogs, what we got, so similar to what we've got in our system.
Dr. Neeraj Singh:So by getting them into our system when we're unwell or suffering from physical or mental distress, we can bring that balance back, bring that regulation back, be it in our hormonal system, our gut, our immune system.
Dr. Neeraj Singh:So cannabis actually influences a whole host of systems.
Dr. Neeraj Singh:So typically what we have are medications which can be really helpful, but they're symptom specific.
Dr. Neeraj Singh:So if you have a symptom, you have a medication for that symptom.
Dr. Neeraj Singh:What cannabis does is, gets much more to the foundation and that's why it works for people.
Dr. Neeraj Singh:That's why people self medicate because actually they find it works well for them in that respect.
Kate Moore Youssef:Okay, so if someone's on, they've been prescribed ADHD medication and they're noticing that, yes, it's helping them with their focus while they're at work, they're keeping them on tasks, they can start tasks, finish tasks, organize.
Kate Moore Youssef:It helps with their executive functioning.
Kate Moore Youssef:But the side effects afterwards, there is a bit of a, kind of a weigh up and some people kind of think, you know what, I don't love that feeling afterwards.
Kate Moore Youssef:And is this a long term solution for me?
Kate Moore Youssef:Would you say this is an alternative or can you take it alongside the amphetamine sort of stimulant medication?
Dr. Neeraj Singh:It's a great question and the answer is yes to both, actually.
Dr. Neeraj Singh:So to qualify for medical cannabis, you need to have had at least two licensed treatments.
Dr. Neeraj Singh:Many patients that have come will have tried, you know, methylphenidate, short or long acting, maybe non stimulant medication as well, and then come to explore medical cannabis.
Dr. Neeraj Singh:When I mentioned about medical cannabis influencing the foundational of the system, so what it does is the endocannabinoid system has effects on the dopamine, the noradrenaline and the serotonin circuits, but much more to the foundation.
Dr. Neeraj Singh:Yeah.
Dr. Neeraj Singh:Whereas simplistically, amphetamines help with production of dopamine, noradrenaline and serotonin prefrontal cortex, hence they get benefits with executive functioning.
Dr. Neeraj Singh:Some patients want to substitute it and just change across altogether, but some people actually want to have both alongside and actually what I found in patients is that they can both work synergistically and work together, not necessarily taking it at the same time.
Dr. Neeraj Singh:Today, literally, people might have a gap, but use them, but actually find that they're mutually beneficial and it's not an either or and it can work in either way.
Dr. Neeraj Singh:Some people just want to move away from stimulants altogether and that's absolutely fine.
Dr. Neeraj Singh:So it's really to the discretion of the patient themselves and what they feel they want as an outcome.
Dr. Neeraj Singh:But certainly cannabis itself with caution, and we have to ask, generally works actually well with a lot of other medications and can work synergistically with minimal adverse effects.
Dr. Neeraj Singh:But obviously we need to obviously explain that actually no medication is side effect free.
Dr. Neeraj Singh:There's always potential for that.
Dr. Neeraj Singh:But when you compare it to a lot of other medicines, we're not having to do the vital observation checks, the blood pressure, the pulse rate and that sort of things that we would otherwise would have to do with stimulant titration on a regular basis as well.
Dr. Neeraj Singh:You know, dry mouth and dry eyes are very, very common side effects of cannabis.
Dr. Neeraj Singh:But that's a tolerable side effect when you compare it to potential advantages, if you see what I mean.
Kate Moore Youssef:Yeah, absolutely.
Dr. Neeraj Singh:And there are potentially other side effects as well, but you know, they, but they tend to be far, far, far rarer.
Dr. Neeraj Singh:You know, things like low blood pressure, nausea, headaches, faster heart rate, that sort of thing as well.
Dr. Neeraj Singh:So as a medicine, in my clinical experience, it's, it's very well tolerated as well and actually can be used with other medication too.
Dr. Neeraj Singh:So.
Kate Moore Youssef:Yeah, yeah.
Kate Moore Youssef:And what's interesting is obviously you're, you can prescribe as a psychiatrist, so you're able to say to your patients, right, I can see you're on this stimulant or in this medication and there's a way of like balancing the both and saying, right, you know, you can take that in the morning to get all your work done and then as that fades away a little bit, then you're able to then bring in the cannabis side and help.
Kate Moore Youssef:I mean, for me it's a no brainer that we should have this more holistic option for people.
Kate Moore Youssef:I'm guessing that a lot of people are using this for anxiety, for overwhelm, for low mood, for sleep.
Kate Moore Youssef:What other things are people coming to you and they're curious about the medical cannabis to help them.
Dr. Neeraj Singh:So I've used it for a whole host of different medications, health problems.
Dr. Neeraj Singh:So people struggling with anxiety mainly.
Dr. Neeraj Singh:So that's the main complaint that we tend to see, but it could be people suffering from ptsd.
Dr. Neeraj Singh:So post traumatic stress, complex PTSD as well, insomnia, ocd.
Dr. Neeraj Singh:I've also used it in people with Tourette's syndrome.
Dr. Neeraj Singh:People struggle with autism and anxiety and more recently actually people with dementia as well.
Kate Moore Youssef:Wow.
Dr. Neeraj Singh:Which is incredible.
Dr. Neeraj Singh:So that's mainly kind of high cbd.
Kate Moore Youssef:Yeah.
Dr. Neeraj Singh:Little bit of THC in there as well.
Dr. Neeraj Singh:But what I found is actually particularly for people who might be suffering with significant anxiety, you know, dementia is associated with quite significant anxiety.
Dr. Neeraj Singh:It can help bring that down quite significantly.
Kate Moore Youssef:What about things like Parkinson's or chronic pain, any autoimmune conditions?
Kate Moore Youssef:What kind of would that be something that they could use it for?
Dr. Neeraj Singh:So I don't, I mean my colleagues would see somebody might be suffering from chronic pain and Parkinson's.
Dr. Neeraj Singh:So they tend to be seen by Parkinson's.
Dr. Neeraj Singh:Something like a neurology colleague or something specialized in neurology.
Dr. Neeraj Singh:But yes, it works, it can be helpful.
Dr. Neeraj Singh:It does work with, you know, for chronic pain.
Dr. Neeraj Singh:It can, there is evidence to show that actually for Parkinson's symptoms, I think, you know, the cogwheel rigidity, the tremors, that side of things actually that can help alleviate it as well.
Dr. Neeraj Singh:And actually things like parking is associated with depression and anxiety as well.
Dr. Neeraj Singh:So it can help.
Dr. Neeraj Singh:And dementia too.
Dr. Neeraj Singh:So actually it can help across a whole raft of problems.
Dr. Neeraj Singh:Autoimmune, what is it is an interesting one.
Dr. Neeraj Singh:I'm not so sure about that one.
Kate Moore Youssef:But yeah, I'm thinking about inflammation because what I'm hearing a lot of, from, from a lot of people I see and speak to, there's always co occurring physical conditions and I'm sure obviously you know that.
Kate Moore Youssef:And sometimes it's like the pain or it's the fatigue or there's IBS or migraines, lots of hormonal issues for women especially.
Dr. Neeraj Singh:Yes, yes.
Kate Moore Youssef:And they're feeling a little bit like lost because there's not many options out there or they've been passed from pillar to post and the doctor says, well you need to do this and everything's separated.
Kate Moore Youssef:And you know, I'm very into the brain body connection.
Kate Moore Youssef:The amount of different doctors I've been speaking to now are like validating this, that this, it's all neurodevelopmental.
Kate Moore Youssef:It's this neurodivergence.
Kate Moore Youssef:We're going to understand further down the line that this is not just an executive functioning or a working memory issue.
Kate Moore Youssef:We're talking about a whole encompassing, you know, and this is what I'm interested About with the medical cannabis is that this could potentially help a host of different things.
Kate Moore Youssef:And so say we are struggling with anxiety.
Kate Moore Youssef:Well then if we're reducing the anxiety, maybe we're reducing the inflammation or the stress in our body, which then reduces the chronic pain and the gut issues.
Kate Moore Youssef:And just interested to hear your perspective.
Dr. Neeraj Singh:Absolutely.
Dr. Neeraj Singh:So cannabinoids themselves are actually very strong anti inflammatories.
Dr. Neeraj Singh:And I said before, you know, when you influence the endocannabinoid system, you influence the immune system and the gut.
Dr. Neeraj Singh:Yeah.
Dr. Neeraj Singh:So we know about the gut microbiome and the link and the brain.
Dr. Neeraj Singh:And as you said, okay, you know, the mind and body are one.
Dr. Neeraj Singh:Right.
Dr. Neeraj Singh:They're not separate.
Dr. Neeraj Singh:We think of, in sort of current practice we have distinctions between mind and body, but actually it's one ecosystem ultimately is one ecosystem and inflammation.
Dr. Neeraj Singh:And we're learning more about how inflammation is associated with disease itself, be it physical or mental.
Dr. Neeraj Singh:So depression, anxiety, etc.
Dr. Neeraj Singh:These are inflammatory conditions.
Dr. Neeraj Singh:Yeah.
Dr. Neeraj Singh:So what do we do with those?
Dr. Neeraj Singh:We need to have something which can bring down that inflammation.
Dr. Neeraj Singh:And that's where cannabis works in one way is actually THC and CBD are actually strong anti inflammatory compounds.
Kate Moore Youssef:Okay, so this is, I mean for me this sounds like this is the future to caring for a lot of these neurodevelopmental kind of conditions.
Kate Moore Youssef:Why is it only just coming out now, especially that this is like being used for thousands of years.
Kate Moore Youssef:What's the turn in the tide and what can people expect further down the line?
Dr. Neeraj Singh:Yeah, yeah.
Dr. Neeraj Singh: this is all sent back to the: Dr. Neeraj Singh:it came on the back of the lifting of alcohol prohibition.
Dr. Neeraj Singh:So cannabis became a big target.
Dr. Neeraj Singh:But prior to that, which used as a medicine, like I said, for thousands of years, brought to the UK by Dr.
Dr. Neeraj Singh: liam O'Shaughnessy in the mid-: Dr. Neeraj Singh:Queen Victoria famously used it I think for a menstrual cramps as well.
Dr. Neeraj Singh:And you know, it's been, you know, you know, hundreds of papers were published even before prohibition of it.
Dr. Neeraj Singh:And I'm not discounting the fact that actually people have suffered from what they've accessed in terms of cannabis on the streets or wherever the legacy market, because ultimately they don't know what they're getting and can potentially be poisonous.
Dr. Neeraj Singh:However, what's happened then is people have been taught that actually this is only a harmful drug and actually has no medicinal benefits at all.
Dr. Neeraj Singh:And that's indeed what we get taught as well.
Dr. Neeraj Singh:Throughout what I was taught in Medical school.
Dr. Neeraj Singh:But I think the tide is starting to shift now and there is certainly more openness.
Dr. Neeraj Singh:I think there is a reluctance for colleagues and some doctors to look at prescribing it because they're naturally worried.
Dr. Neeraj Singh:They're naturally worried about what might happen in terms of consequences.
Dr. Neeraj Singh:Are they going to cause any harm to the patient?
Dr. Neeraj Singh:The first rule is do no harm.
Dr. Neeraj Singh:Right?
Dr. Neeraj Singh:We don't want and cause that.
Dr. Neeraj Singh:But what I found, and I found it with trepidation, I was really worried about doing my first prescription when I first did it.
Dr. Neeraj Singh:And I.
Dr. Neeraj Singh:But I'm so glad I did and I had excellent support with me and all I can say to would be prescribers is that you will be supported throughout the process.
Dr. Neeraj Singh:It's trying to basically unlearn the stuff that we've already learned and been conditioned about keeping an open mind that actually this has been used as a medicine for so long.
Dr. Neeraj Singh:Always has been.
Dr. Neeraj Singh:It is a medicine, it always will be.
Dr. Neeraj Singh:And that remains is that we have the physiology within us is about the cannabinoids and the endocannabinoids in our system.
Dr. Neeraj Singh:You know, this plant is actually helping us replenish, helping us adjust the endocannabinoid system to get better health.
Dr. Neeraj Singh:We need more education and awareness really across professionals.
Dr. Neeraj Singh:But the public, you know, public as a whole too.
Kate Moore Youssef:If someone's listening right now and they're a doctor, how can they become a prescriber?
Kate Moore Youssef:And do they have to go on a course and they get a special license?
Kate Moore Youssef:Like how does that work?
Dr. Neeraj Singh:So I'm a committee member of the Medical Cannabis Clinician Society and on a monthly basis their courses run to help educate would be prescribers.
Dr. Neeraj Singh:It's really accessible several hours.
Dr. Neeraj Singh:And that society as well supports prescribers with anything they want really in terms of support for patient support for them when they're prescribing for patients as well.
Dr. Neeraj Singh:So it's a really good resource.
Dr. Neeraj Singh:We run regular webinars as well, grand rounds.
Dr. Neeraj Singh:So it's a great resource for education and very supportive to has like a.
Dr. Neeraj Singh:A Google group as well.
Dr. Neeraj Singh:So people can regularly access it.
Dr. Neeraj Singh:24 hours if needs be supposed to run 24 hours.
Dr. Neeraj Singh:I think because members across the globe, there's a lot of clinicians from other countries as well where medical cannabis has been legalized for many years, Australia and Canada, for example.
Dr. Neeraj Singh:So they're very much ahead of the curve.
Dr. Neeraj Singh:We're a little behind in the sense that we need GPs prescribing this but unfortunately GPs can't prescribe this medicine.
Dr. Neeraj Singh:It's only left to people with secondary care.
Dr. Neeraj Singh:I say they can't prescribe it, they can't initiate a prescription.
Dr. Neeraj Singh:So GPs can continue prescriptions but they can't initiate it, which in my mind is bonkers because if anybody's struggling, where's first port of call?
Dr. Neeraj Singh:Unless it's serious, really serious, then obviously the medicine.
Dr. Neeraj Singh:But otherwise they're going to primary care and gpc, whole host of things and they prescribe lots and lots of drugs.
Dr. Neeraj Singh:Drugs.
Dr. Neeraj Singh:However, at the moment they're unable to initiate cannabis.
Dr. Neeraj Singh:That's different to other countries.
Dr. Neeraj Singh:At the moment they should.
Kate Moore Youssef:Crazy.
Kate Moore Youssef:It's crazy.
Kate Moore Youssef:It frustrates me so much that the UK is behind in so many, you know, so many ways and I see this with adhd, you know, I speak to people from across the world who are, you know, been ahead of us and ahead of the curve.
Kate Moore Youssef:What's interesting is that, and again I'm not a doctor, so I don't know this for sure, but am I right that GPs could probably prescribe stronger and more addictive sort of opiate based medication than this and probably more detrimental medication and this could be a much safer option?
Dr. Neeraj Singh:Absolutely.
Dr. Neeraj Singh:So gps can prescribe opioid analgesics, they can prescribe benzodiazepines, that can prescribe many what we call psychotropic medications for mental health.
Dr. Neeraj Singh:So it really is unfortunate at this stage that we have a position where they're enabled to prescribe because one, I think we don't have enough people prescribing so they're not enough doctors.
Dr. Neeraj Singh:And all I can say is just reassure that actually it is a safe medicine.
Dr. Neeraj Singh:Like I said, we always want to keep people informed about potential disadvantages or side effects.
Dr. Neeraj Singh:But actually in my experience the potential advantages outstrip any disadvantages and we should be in a position and hope where GPs should be able to prescribe it as has happened in other countries, because I think that is reducing the number of potential prescribers that can be out there.
Kate Moore Youssef:What I'm wondering is that if we know again that addiction is very closely linked with adhd and so very often it's the addiction that's self medicating, the undiagnosed adhd, because we're looking for that dopamine hit or the self regulation or the calming.
Kate Moore Youssef:And so if people have had sort of addictions in the past, whether it has, you know, drink, alcohol, food, gambling, sex shopping, this can't, this is not addictive.
Kate Moore Youssef:Am I right in saying that's right?
Dr. Neeraj Singh:Yeah, yeah.
Dr. Neeraj Singh:So a lot of people get Worried that actually you can get addicted to it, but you can build like tolerance to it as well.
Dr. Neeraj Singh:But medically prescribed, actually, I've not observed those things happening.
Dr. Neeraj Singh:So I've not observed that people have become hooked on medical cannabis or indeed needing large amounts of increases of the medication as you develop tolerance, which is basically what that means, is that your body gets used to a certain amount of cannabis and you need more and more and more as time goes on.
Dr. Neeraj Singh:Ultimately, there is always the potential risk of people who are accessing it on the streets to get potentially dependent on that.
Dr. Neeraj Singh:Again, that is because we reach a position where potentially people are accessing high strength thc.
Dr. Neeraj Singh:Like I said, that can be potentially quite damaging and detrimental, particularly for people who, during the neurodevelopmental period as they're growing up, where your brain is much more sensitive.
Dr. Neeraj Singh:And so it's really, really important for people to be aware about potential for harm during the newer developmental period in time, because especially for products that are.
Dr. Neeraj Singh:That you don't know how they've been produced, come with any sort of vetted certificates and analysis or anything.
Dr. Neeraj Singh:So you don't exactly know what compounds are in there.
Kate Moore Youssef:Yeah, there are very few options, apart from just the holistic and the lifestyle and looking after our movement and nutrition and all.
Kate Moore Youssef:All these things are totally, you know, they're valid and we need to do that, especially alongside the medical cannabis.
Kate Moore Youssef:But we are feeling, we are hearing a lot that people are just kind of like lost in the system or that titration is not working and because of the way everything is and, and the expense of having to titrate and go back for more consultations, people just think, I can't be bothered, I can't be bothered to go through this whole process.
Kate Moore Youssef:It's actually making the diagnosis of my ADHD even more stressful.
Kate Moore Youssef:So I wonder if this is a hopefully a more simplistic option for people.
Dr. Neeraj Singh:Exactly, absolutely.
Dr. Neeraj Singh:And you know, the fat remains, as I mentioned, you know, you're not having to do the observation side of things as well, and it fits in nicely with that whole integrative approach.
Dr. Neeraj Singh:So I always say to patients that cannabis is not the beginning or the end.
Dr. Neeraj Singh:Yeah, it's a platform.
Dr. Neeraj Singh:Yeah.
Dr. Neeraj Singh:For then you to do other stuff.
Dr. Neeraj Singh:So what people can find is that they're eating better, they're reducing alcohol consumption as well.
Dr. Neeraj Singh:Obviously the sleep is better, so they can exercise more as well.
Dr. Neeraj Singh:And all these things actually influence the endocannabinoid system, so you're actually boosting it there.
Dr. Neeraj Singh:So any medication is Just there to act as a platform to help leverage you better lifestyle choices as well.
Dr. Neeraj Singh:And I think that that's what's really crucial for people to know is that actually it is helpful and it can do, but it's not just, it's not the full solution at the end of the day.
Dr. Neeraj Singh:Patients are accountable and responsible and it's their own health at the end of the day and they can actually help boost that by using cannabis can be helpful to help give them a boost to, to get on with other things day to day.
Dr. Neeraj Singh:I have workers included as well.
Dr. Neeraj Singh:So many of my patients have actually managed to access employment because they feel in a state that are able to get on with work.
Dr. Neeraj Singh:And I think that's such a fabulous outcome.
Dr. Neeraj Singh:It's a great barometer of quality of life when people are actually not being able to work for a long time, but actually then they find themselves in a position where they're able to do all those lifestyle things and actually get into employment as well.
Kate Moore Youssef:Yeah.
Kate Moore Youssef:And if you think about social anxiety, you know, if people are struggling to find a partner, relationships, friendships, community, like all of that, like so impactful on our health, all of this, and if we can't, we're struggling to leave the house and this can help with social anxiety.
Kate Moore Youssef:That is a massive health boost, isn't it?
Dr. Neeraj Singh:Exactly.
Dr. Neeraj Singh:I mean a lot of people do struggle with socialization.
Dr. Neeraj Singh:That's right.
Dr. Neeraj Singh:It could be for variable conditions.
Dr. Neeraj Singh:But the fact is that social interaction itself can be medicinal.
Dr. Neeraj Singh:We know about the interactions from one person to another, the mirror neurons, oxytocin, they connect, all that kind of things as well.
Dr. Neeraj Singh:But a lot of people are unwell, they're withdrawn, they're looking inwards, they don't have the capacity to go outside.
Dr. Neeraj Singh:And actually here is a potential.
Dr. Neeraj Singh:I've seen many people who have just stayed at home for months, even years and they've just not had the ability to get out.
Dr. Neeraj Singh:And now more and more these days we can, we can order stuff online so we're kind of, you know, we can get stuff in and all that.
Dr. Neeraj Singh:But with this potential to help reduce our social anxiety to extent where people are going out, they're starting to make friends, they're starting to build relationships.
Dr. Neeraj Singh:That's medicine ultimately, isn't it?
Kate Moore Youssef:Absolutely, yeah, absolutely.
Kate Moore Youssef:So what I'm hearing is that we can self refer but we need to have a diagnosis and we need to have tried medication that potentially hasn't quite worked to tick those boxes to come to you.
Kate Moore Youssef:What else?
Kate Moore Youssef:I mean, tell me if people are Listening to this now and they're like, yes, I would love to try this.
Kate Moore Youssef:I am always very sort of open and honest that, you know, this type of.
Kate Moore Youssef:We're still at the beginning stages, which means the affordability, the accessibility, unfortunately, is still quite expensive and I know that prohibits a lot of people and it's very frustrating when we're talking about this and going, yes, it sounds amazing, and then we realize what the cost is and it's beyond people's, you know, affordability.
Dr. Neeraj Singh:Yeah, well, a lot of clinics these days now offer discounted appointments, so initial appointments could be an accessible cost anyway.
Dr. Neeraj Singh:But yes, you're quite right, Kate, that actually it can be a costly process, really, in the sense that actually, on average people might be paying anywhere between 250 to 300 pound a month, and it can vary from person to person and how much they're using, et cetera.
Dr. Neeraj Singh:Actually, that's a lot of money.
Dr. Neeraj Singh:Prices have come down with ranges of products that are out there as well.
Dr. Neeraj Singh:And I'm hopeful that actually in time we'll see further price reductions as well.
Dr. Neeraj Singh:It's also the ability to.
Dr. Neeraj Singh:For people to access kind of smaller amounts of products which otherwise, you know, they might come in certain sizes or actually, you know, they're actually smaller, they could be more cost effective.
Dr. Neeraj Singh:Effective.
Dr. Neeraj Singh:So I think there is an awareness actually that actually this is.
Dr. Neeraj Singh:This can be quite cost prohibitive for many and needs to be ways for people to be able to access this medication.
Dr. Neeraj Singh:It should be on the NHS and I'd love to see a time when it will be accessible to people.
Dr. Neeraj Singh:There are medications which are produced for certain conditions, the Ms.
Dr. Neeraj Singh:Or epilepsy, which are cannabis for those specific conditions, but not for, not specifically for mental health and chronic pain.
Dr. Neeraj Singh:What we find is actually is that medical cannabis can possibly save the NHS billions.
Dr. Neeraj Singh:So there's a recent study done on chronic pain where they evaluated and said that actually with cost savings, it could be up to about, I think it was £4 billion a year could be saved just through preventable cannabis.
Dr. Neeraj Singh:Now, you think if somebody's been treated, actually they're getting to work, so they're contributing to the economy.
Dr. Neeraj Singh:It could potentially save the number of people going in for inpatient care, hospitalizations, be it to secondary care, the hospital hospitals or mental health hospitals as well.
Dr. Neeraj Singh:So there's a whole, whole potential of savings that can be made.
Kate Moore Youssef:Makes sense.
Kate Moore Youssef:We need some lobbyists.
Kate Moore Youssef:If there's anyone listening here and that you're interested in lobbying, then this is what we need.
Kate Moore Youssef:We need the pressure on we need people like you, who are obviously very reputable in being a doctor psychiatrist, to be able to say, this is the future.
Kate Moore Youssef:And unfortunately, the NHS is as amazing as it has been and a lot of the good work it does, it's still very much stuck in an archaic system that I don't think is working anymore.
Kate Moore Youssef:Especially what we're seeing with ADHD very specifically, is that the people who are thriving are the privileged people, are the people who can afford the private diagnoses, the medication, the continuous of care, and the people who aren't thriving who are waiting on these waiting lists for four to five, six years and then unable to continue the medication because of different things.
Kate Moore Youssef:And, you know, there's that disparity, which is what empowers me so much to do this podcast because I always think that awareness education is power.
Kate Moore Youssef:We can go and advocate for ourselves to our gp, to a psychiatrist and say, no, I'm not accepting that there's other options.
Kate Moore Youssef:And this is why, you know, this conversation is so, so important that hopefully the more of these conversations and they're shared, then there's more kind of ammunition to lobby the government to really take this seriously.
Dr. Neeraj Singh:100.
Dr. Neeraj Singh:100.
Dr. Neeraj Singh:And I think really what we need to do is dispel assumptions about this medicine.
Dr. Neeraj Singh:Like I said, people need to want to learn.
Dr. Neeraj Singh:We need to get the education out there and really continue to build on the research and the evidence base that we have.
Dr. Neeraj Singh:So Drug Science, which is a charity, is running what's called real world evidence studies to show the outcomes in various conditions, anxiety, even adhd, chronic pain, ptsd.
Dr. Neeraj Singh:And they're really, they put out some publications already which have shown some really favorable outcomes, outcomes again with very, very few adverse effects as well.
Dr. Neeraj Singh:So if anyone's interested, I would definitely urge you to look at the Drug Science T21 study.
Kate Moore Youssef:Okay, I'll link to that.
Kate Moore Youssef:Okay, so how can people get in touch with you?
Kate Moore Youssef:If you've got a website, tell me.
Kate Moore Youssef:If people are saying, right, I want to try this, where can I go?
Dr. Neeraj Singh:Yeah, yeah.
Dr. Neeraj Singh:So I have my own website, so that's Dr.
Dr. Neeraj Singh:Nerad singh.co.uk I also work with a couple of other medical cannabis clinics called Integro and biomedical as well.
Dr. Neeraj Singh:So people have got various ways in which they can get to see me as well.
Dr. Neeraj Singh:There are a lot of different clinics out there with different offers.
Dr. Neeraj Singh:What I do just urge patients do is have a look around, explore, do your research and just get educated on it.
Dr. Neeraj Singh:Have a look at what information is out there in relation to that particular condition that you, that you're struggling with as well.
Kate Moore Youssef:Amazing.
Dr. Neeraj Singh:There's also the Medical Cannabis Clinician Society website as well, which has got loads of fantastic information on there.
Dr. Neeraj Singh:So it will tell you information on accessing the medicine itself, the products, how it gets used, and also things like in relation to driving, travel and that sort of thing, you know, issues that people might be a little bit, you know, concerned about if they're medicine.
Dr. Neeraj Singh:So things like driving, pregnancy and travel, travel abroad can be things that unnerve people.
Dr. Neeraj Singh:But again, just to reassure everyone that actually this is, this is, this is the way we see it.
Dr. Neeraj Singh:And I always say to patients, because many of them are very, very worried about this and why wouldn't they be?
Dr. Neeraj Singh:Because of, you know, criminalization.
Dr. Neeraj Singh:Historically, it's a medicine and again, it always has been, it is and it always will be using it as a medicine.
Dr. Neeraj Singh:And if you're using it responsibly and you're using it in a way that augments your life in a way that you're accessing, you're doing other things that helps, that helps your health, then there's no greater thing really than that.
Kate Moore Youssef:Thank you, thank you for explaining all of that.
Kate Moore Youssef:And I'll make sure that everything you've just sort of said is, are all in the show notes so people can go there, really do their own research, check it out, like you say, really understand how it impacts all those different, those variables.
Kate Moore Youssef:But this has been absolutely fascinating and thank you so much for coming and explaining it all.
Kate Moore Youssef:And yeah, I really hope that, you know, in a few years we're going to look back in this conversation and go, oh, can't believe that's where we were and look at the progress now.
Kate Moore Youssef:So that's, that's what I believe.
Kate Moore Youssef:I believe this will be the future alongside lots of other more sort of holistic based practices as well.
Kate Moore Youssef:So, Dr.
Kate Moore Youssef:Neeraj Singh, thank you so much for being here.
Dr. Neeraj Singh:Oh, thank you very much, Kate.
Dr. Neeraj Singh:It's been a real pleasure.
Kate Moore Youssef:If you've enjoyed today's episode, I invite you to check out my brand new subscription podcast called the Toolkit.
Kate Moore Youssef:Now this is where I'm going to be opening up my entire library, my vault of information from over the years, my workshops, webinars and courses, my conversations with experts about hormones, nutrition, lifestyle and bringing brand new, up to date content from global experts.
Kate Moore Youssef:This is going to be an amazing resource for you to support you and guide you even more on more niche topics and conversations so you can really thrive and learn to live your best life with adhd.
Kate Moore Youssef:I'm so excited about this.
Kate Moore Youssef:Please just check out its toolkit on Apple podcast and you get a free trial.
Kate Moore Youssef:Really hope to see you there.
