De-Prescribed with Lynn Bornfriend

We're sitting down with Psychiatrist, Thought-Leader, and Cannabis Advocate, Lynn Bornfriend, MD-PLLC.

In 2014, Lynn's mother was diagnosed with Stage 4 Cancer. After trying everything from standard and traditional medicine to various integrative processes and finding no relief, Lynn's sister recommended Cannabis - something she was adamantly against.

In this conversation we discuss Lynn's cannabis story, various delivery methods, poly-pharmacy, the stigma and shame surrounding this plant, the importance of evidence-backed research, and the promising research coming in regarding psychedelics.

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Interview with Lynn Bornfriend, MD-PLLC:

*This text has been edited for clarity.

Calla: I was telling Leanne how cool it was because we haven't had a perspective like yours yet on the show. We haven't had a psychiatrist come and speak cannabis with us and release. have spoken. I know you were a little apprehensive when it came to cannabis in general too. And so if if you want to kind of share your story from wherever learning point sounds good to start there enroll into it.

Lynn Bornfriend, MD-PLLC: Okay, well, basically, first of all, yes, I'm a psychiatrist. But for the past nine and a half years, I worked at a hospital for people with advanced and late-stage cancers. So unlike previous work, they weren't mentally ill. They were instead mentally traumatized, you know, depressed, anxious, post-traumatic stress disorder, complicated grief, but it was not a mental illness. Because of the nature of the hospital and the openness and inclusiveness of the public, other physicians, I had the opportunity to learn a tremendous amount about the medicine, parts of cancer care. And as I became the only physician talking about cannabis, I talked about many, many symptoms beyond just psychiatric ones. What would happen often is patients would come into the office, let's say a little lady would be coming in complaining about the set of circumstances and be expecting a prescription or a pill. I'm anxious, I'm expecting Xanax, I can't sleep, I'm expecting Ambien. And I would ask them if they had considered cannabis instead. And many people would say, "Oh, no, Honey, I'm not like you. I don't do that kind of stuff." At which point, I would have to say, hold on a minute. I just need to tell you, I was no fun growing up. I have never smoked a cigarette. I didn't touch anything. I was fully invested in what I was told by the authorities. And through medical school, I was told very clearly this is what's true, and I believed it.

Leanne: What was true?

Lynn Bornfriend, MD-PLLC: That cannabis was a gateway drug and it was a bad thing. It was terrible. In 2014, I was at the hospital for a few years already. And my mother, who was 84 was in perfect health. She had no medical condition, took no medicines, was suddenly diagnosed with stage four cancer. My older sister who has the bit of the hippie says, Let's use cannabis and my response. And I always quote this because I find it incredibly obnoxious, and I feel it's my penance to quote it. I said, "Absolutely not. I'm a licensed professional." My mother had been a high school teacher. My mother said, "I'm not gonna do that. That's what bad kids do." So she started treating at my hospital, which was a very wonderful place. Integrative therapies, not just chemotherapies, but acupuncture and massage and Reiki and naturopathic medicine and chiropractic, and we did and her tumors were shrinking, but the side effects we could not get ahold of, and for her, the side effects were not horrendous nausea. And then my mom was conscientious. So if the doctor said eat, she ate no matter what. After she would eat, gas, cramping, horrific pain, diarrhea. In addition, she couldn't sleep and she was anxious. We tried everything from standard and traditional medicine to these integrated processes and nothing helped her. And my mother had been very slim at the start of this. And about eight or nine months she was she had essentially she's starting today. And they said we cannot continue to treat her. It's time for hospice because she couldn't tolerate further treatment. At that point, my sister said the heck with both of you. And she came with the nanopore I heard about this and I raced to the house. I was mad. I'm like, No, no, I get to the apartment, my mother sitting up, she's not in pain. She's not nauseated, she's not anxious. She's not high. And she's eating a little. It was too late for my 84-year-old mother who had been through eight or nine months of this absolute torture suffering. But it was a game-changer for me. So that when I returned to work, I started asking some of my patients now the hospital I worked for was an interesting place because it was a destination place people came from around the country for cancer care. So they were coming from all different states and all different levels of legality.

And when I started asking, I started hearing from patients Oh my God, I was afraid to say anything but you know those medicines you give me for anxiety or insomnia, neither one of them. Furthermore, the medicines that my oncologist gives me for nausea and pain or apathy. I started doing more research learning more, and in April of 2017, cannabis was legalized in Pennsylvania. It was not available until February 2018. But when it was legalized, I started attending conferences and groups of former State Senator Daylin Leach was one of the people who had written the bill and pushed it through and he had this wonderful seminar and I met all these exciting people with cutting edge, and I got more and more involved. And I was working with patients from states that already were illegal. So I was finding about procedures and many other states. And I evolved from that time to what I would what has been called a thought leader. I have given speeches, I have been interviewed in newspaper videos, I've been, you know, all kinds of different things talking about cannabis, and the concept of getting away from toxic and ineffective treatments and how cannabis can step in and improve the outcome, the management of symptoms and side effects during cancer treatment. But in addition, beyond that, the evidence about cannabis helping to fight cancer.

Leanne: I was wondering, is there evidence about that as well?

Lynn Bornfriend, MD-PLLC: Yes, yes, there is quite a bit. Now. Interesting issues because in the US because cannabis is still a schedule one drug that is along with heroin, ecstasy, LSD. Off the top of my head, probably methamphetamine. Those are characterized as medications for which there is no medical purpose. What's interesting about that is in 1985, the FDA approved the use of Marinol for extreme nausea and lack of appetite in cancer patients and HIV patients. Marinol is synthetic THC. indistinguishable on a drug screen, from cannabis from the plants. Not very well tolerated because it is an opposed THC. And as you get to know more and more about the plant, you realize that Mother Nature is smarter than we ever were. So in the cannabis plant, there's THC but there's also CBD. And CBD moderates and decreases the psychoactive properties of THC. So it helps people feel less altered and uncomfortable. I was having difficulties with patients who I was giving teeny tiny amounts of THC, little old ladies and they couldn't handle it. It's way too strong for them. And ultimately the answer was to add CBD but way that back with my mom. When I finally fought and got her trial of Marinol, she took one pill, she was hallucinating, she never picked that up again. And this was months before the whole hospice and cannabis edible and relief.

So because of that, I began speaking and the patients educated each other. And they started coming to me for other issues. And then I started hearing back from patients reading more and giving talks and learning from the cannabis community things I didn't know. I was giving a talk one day and I was talking about how there are many different delivery methods, Cannabis, and how that can be very important in cancer patients. For example, some patients with lung disease can't inhale things. But there are sublingual and it's some people who have had neck cancer and they can't do that. The possibility of using things rectally in a suppository form and someone in the audience raised his hand and said and by the way, that doesn't make you high. What? Sure enough, I later discovered that in research that when you give cannabis oil suddenly Usually, about 40% are absorbed and about 10 to 15 minutes to go throughout the body. When you give cannabis oils or medications in general rectally, 80% are absorbed, the rectum is extremely vascular. That's why people get hemorrhoids. So 80% of them are absorbed, they go meet 10 to 15 minutes throughout the body, but they don't cause the psychoactive effects. So when I had cancer patients who had chronic extreme pain but wanted to have a life, and not be stoned out of their minds all the time, it was the delivery method. I wondered why, if this was so as wonderful as it looked, why it was still illegal?

Leanne: I think a lot of us are wondering that.

Lynn Bornfriend, MD-PLLC: Oh wow! The articles may blow you away. The reasons are the reasons originally, and the current reasons are racism and greed. So back in the 1920s, and 30s, the dawn of the Industrial Revolution, and people are making machines. And they don't want people to use home remedies and things that they grow in the garden. And because they want you to buy their shiny white pills rolling off the machine. So the word goes out that your grandmother's stuff was weak, it was dirty. It was no good. Don't use it. It's bad, use this instead. But in addition, there was this man I can't remember his first name, his last name was Anslinger. He has been in charge of the prohibition of alcohol. But that was over. And so the way I read it, he was looking for something new to do. Initially, they gave him heroin, but there wasn't enough there. And he was apparently a notorious bigot. And the conventional wisdom at that time had to do not only with racism and prejudice against African Americans but also against Mexicans. And so there were newspaper articles you can see that say marijuana and jazz music causes white women to have sex with black and brown men. And so to save our women. Interesting switch because cannabis is the Latin name for the plant. Marijuana sounds Mexican? It's not the name of the plant the plant is cannabis.

Leanne: They made up the name or was that what people called it in Mexico?

Calla: That's what gave it that stigma. The prohibition on all of it is so insane.

Lynn Bornfriend, MD-PLLC: So then we flash forward to currently and the only thing that I can find anywhere is: The reason it is currently federally illegal is that the four interest the four industries that lobby the hardest get the most money with the most money and senators, congressmen, governors, whoever's pockets against legalization are big pharma, big alcohol, tobacco, and the private prison industry. So big pharma. I'll talk a little bit about the incredible results I found them about, you're able to get off all kinds of medicines. So it cuts down their profits, big alcohol, and big tobacco in states where there's full accessibility and weed out legality. The statistics show that the illness and death from alcohol and tobacco are less the crime from alcohol, you know, motor vehicle accident is less. The sales of alcohol and tobacco are less. So money. You know, certainly, no one's going to say that they're lobbying to protect you. Alcohol and Tobacco. And the private prison industry twists me in a particular way. So all those people serving life in prison for just possession with an ounce of cannabis, largely people of color, because white kids didn't go to jail for that. Cannabis, prisoners are not violent. They're not psychotic, they're not gang members. They're kind of peaceful, whatever and you get paid $100 per body per day. And when you legalize, they get out of jail. So my mother who I adored, suffered and died because those people wanted money. And it was this racist agenda. Took me from my joke as "Sweet Polly Purebred" which I don't know if you guys are old enough to remember underdogs the commercials, a cartoon, but you know, I was this little sweet girl, too. I'm like a ramble. I cannot look at anyone else's mother, son, sister and say, Oh yes, sorry you got to die. I can't do it. It's outrageous. And it's really changed how I work and how I see the world. In addition, I have this old poster I'm looking at it. I don't know if I could show it. It was a Leafly post. And I unwrapped it so many times. It's kind of raggedy, but it's talking about different medical conditions and listing different cannabinoids in the plant and helping like useful for these different medical conditions.

And it includes arthritis, cramping, fibromyalgia, inflammation. Inflammation is the source pretty much of disease an agent headache, migraine, insomnia, pain, phantom limb, spinal cord injury, appetite loss to HIV/AIDS, which is that real extreme cancer, cancer, and Kaposi sarcoma that illness, Crohn's disease, GI disorders, nausea, and then ADHD, anorexia, anxiety, bipolar, depression, fatigue, PTSD, stress, Alzheimers, epilepsy, Parkinson's, multiple sclerosis, seizures, muscle spasticity, Tourette's disease, asthma, cancer, glaucoma, HIV AIDS, muscular dystrophy. In addition, there's documentation of cannabis improving lowering blood pressure and hypertension, stabilizing and lowering blood glucose and diabetes, treating peripheral neuropathy, which is a complication of diabetes, spinal cord injury, but also chemotherapies which is the starting numbness and tingling in the hands and feet. And here we have this plant that does all of these things. So one of the things I would say to patients was okay, you're in pain. So we give you an opiate. So everybody gets constipated from opiates. 95% of people and when you increase the dose, they get more and more constipated. So for constipation, we're going to give you maybe fiber or something, then we're going to give you a laxative and laxatives cause cramping so then we may give you a medicine for GI cramping and additional one or two medicines, but then, in addition, opiates cause nausea.

The primary nausea medicine we give cancer patients because they have nausea already is Zofran. Zofran causes constipation. Most of the other nausea medicines cause constipation like Compazine or Phenergan but they also cause respiratory suppression, I'll get there. Opiates also cause itching. So Benadryl or whatever for itching, respiratory suppression, sedation, constipation. Opiates are addictive, and opiates also kill you. The way they kill you is they send a message to your brain and say guess what you don't need to breathe. That's called respiratory suppression. As do the anti-nausea meds as do the sedation meds as to the Gabapentin, Lyrica used for nerve pain as so on and on and on all these other drugs causing respiratory suppression and the additive effect of those two is it's exponential rather than additive, So two plus two does not equal four it equals 10. So when a cancer patient who was already on opiates and was already on Compazine was sent to me for anxiety and I'm thinking I'm supposed to add Ativan or Benzodiazepine? It's going to kill them. Enter cannabis. Cannabis does not cause constipation. It's a painkiller. It does not cause constipation. It does not cause nausea. It's actually used to treat nausea. It does not cause itching. It's actually used in topical form for eczema, psoriasis, all kinds of inflammations.

Leanne: Is that the CBD in it that does that? ,

Lynn Bornfriend, MD-PLLC: Both. . It does not cause respiratory suppression. As a matter of fact, if you took a massive massive overdose, there is no lethal dose of cannabis. There isn't any.

Leanne: You might think you're gonna die.

Lynn Bornfriend, MD-PLLC: That's true. You'll wake up the next day. I have a case where the little old man from Central Pennsylvania and they were very country. And they're sitting in my office and I'm talking to them about cannabis and they're looking at me like waiting for, you know, some weird thing to happen or you know, the store. And so I'm getting to the point where I'm talking about different delivery methods and I'm talking to them about the concentrated oils, the RSO and I'm saying how when you start, we recommend a half a grain of rice size drop. I'm looking at this man and he's in his late 70s. He weighs about 70 pounds. And I said, you sir, I would start with a quarter of a grain of rice. And he's looking at his wife and she's looking at him and I said, What, what? Well, they knew nothing about cannabis. But the neighbor's grandson had come by and tossed a syringe at them said use this will help with this cancer. Oh, no, she took the RSO and she put about this much (Used hands to show half of the syringe)on a brownie and fed it to him. Because edibles don't work instantly. Two and a half hours. So two and a half, three hours later, she goes to check on him and she cannot arouse him. So she thinks he's dying. which is understandable because he's, you know, old and sick. Off to the ER, every examination, every test every lab study every scan. Finally, the doc comes back and says Well, I didn't find anything except an awful lot of THC. I said, Oh, what happened? She said, What do you mean when he woke up? What happened? Oh, nothing. Nothing. You drink too many beers. You wake up, you have a headache. your stomach's upset, like a bus ran you over. With cannabis, not thing. Nothing, nothing, nothing. So when I would educate people about it, I would tell them listen, it's an art. And there may be a time when you take too much. But here's the deal. See, remember those cartoons with the angel on your shoulder and the devil on the shoulder. I'm sitting on your shoulder and my little white coat. Oh, and I'm saying to remember. I told you this could happen. This cannot hurt you. The next time you see me, you can tell me to stick it where the sun doesn't shine. Although that might be a good thing. But this cannot hurt you. And the caregivers remember, this can't hurt them. It's not going to hurt their heart. It's not going to stop the breathing. It's not going to accept kill their livers can't do it. Take some straight CBD oil. Because Mother Nature knows best. Eat something drink something, take a warm shower, go lie down, you'll be fine. I am a child and adolescent psychiatrist as well. Tylenol is something that teenagers when they want to send a message had been known to pick a handful of Tylenol was safe. That's what your mom gave you. Seven and a half grams of Tylenol, which is 15. Extra Strength tablets with Tylenol is a lethal dose, it can kill your liver. You can end up needing a liver transplant or dying 15 tablets, I can tell you how many kids do that. Because they don't think it's a big deal. Benadryl, too much can kill you. Certainly opiates in heart medicine. There is no lethal dose of cannabis. So not only does it not have these toxic side effects, it can't hurt you. But then, when you think about all those different problems I've told you about, there's a phenomenon that we call polypharmacy. There's a drug for this drug, a drug for that. Then you take drugs for the side effects. No one has any idea what's happening at that point.

Calla: Yeah, it's a cocktail. A tornado of just garbage.

Lynn Bornfriend, MD-PLLC: We don't know one or two, maybe you can tell but 15 we don't know. We can't know. Cannabis cut out many of these drugs. Reducing polypharmacy, avoiding toxicities, and legalities. In addition, because it's so well received, I was telling Calla the other day about this patient of mine. her breast cancer had metastasized into her bone. She had fractures all over the place and tons of pain. So at this point, her cancer was kind of under control but the pain was chronic. When I met her she was on massive, massive quantities of long-acting Dilaudid. Dilaudid is one of the strongest opiates there is. And she was taking 32 milligrams of this long-acting formula. Plus every four hours through the day and night breakthrough 20 milligrams of oxycodone, Gabapentin, which is for nerve pain, and hundreds of hundreds of milligrams. Plus Ativan which is used for nausea and anxiety. One milligram four times a day. It was amazing that she was breathing but the other part of it is she would come into my office should be crying should be shaking should be in tears should be in pain. They weren't working. One day she came in she said, "I think I'm gonna get myself one of those marijuana cards", and I said "Absolutely". And the next time I saw her, she's completely off the Ativan. Taking no more breakthrough meds. The oxycodone was gone. No more Gabapentin and her long-acting opiate use was reduced to about a fifth of the dose of the original. But even more exciting to me. She was divorced. She had one child who lived in San Diego. She felt good enough. Confident, joyous, the opposite of how she used to feel. Enough that she got on an airplane and flew to San Diego. She needed a wheelchair. She needed bulkhead seating but she went and that was the change. And I hear story after story. Mr. Smith comes back and says, "Well I got the cannabis." And I say so what do you think of it? "Well, I no longer take the sleep medicine. I no longer take the nausea medicine". Next person, what do you think? Well, I don't need this for my irritable bowel and on and on and on. And it blows me away. And so as a psychiatrist but also as someone advising people treating cancer patients, I would tell them number one I believe cannabis should be available to everyone interested, and number two, I believe that it should be used first. This is where I differ from a lot of people. But if I need pain medicine, Please give cannabis to me first. I don't want opiates.

You know I don't want to die. I don't want to be addicted. Give it to me first and then if it doesn't quite cover it, okay maybe we can use a little bit of opiate.

Leanne: You mentioned earlier that they created that Marinol which is a synthetic THC, but then you said that nature works better than we do and the combination of the CBD with the THC is even better. Is it just because THC is illegal in a lot of places that why you see a lot of CBD-only products and the benefits of those or is CBD really beneficial on its own but THC not as much?

Lynn Bornfriend, MD-PLLC: Now that's not true. Okay, CBD CBD is not sold. Additionally, it is sold as a supplement. Anyone can sell anything and they can say it has CBD in it. So the problem is that number one, you don't know if what you're buying has any CBD in it, and number two. If it does have CBD in it, you don't know that it has what it says it has, because there's no lab testing on it. And number three and four is it's a plant. It can be grown, it's grown in fields. What if it's sprayed with pesticides? What if it's in soil that has heavy metals in it? What if the harvest molded? Those are things that you don't know you but certainly as a cancer patient or an ill person or anyone in general I don't want to take pesticide concentrated pesticides in the CBD oil. So there are formulations that are much higher quality are also really expensive. But I tell people please do not buy CBD from your neighbor who used to sell Avon. You have no idea what it is and if you can get it through a dispensary or a verified source, pay the money please do so.

Calla: Yes, you've got to see those lab results always.

Lynn Bornfriend, MD-PLLC: Oh yeah. CBD does its thing but THC is necessary also. When you think about THC is the chemical that makes you feel high. In addition, it's an anti-depressant. Depending on whether it comes from an Indica or Sativa it's either stimulating or sedating, which is kind of interesting. It decreases nausea and increases appetite. It's good for muscle spasms and anti-anxiety off the top of my head. In contrast, CBD does not make you high. It is good for nausea. It's good for anxiety and seizures. It doesn't do anything for appetite stimulation, it does some things for pain, but not the same. There's the anti-cancer activity for THC, CBA, CBD, and CBG. I want them all. You know, I'm not just going to take one, why wouldn't I take it all? Cancer is vicious. I know how vicious cancer is. I want to fight it with all of them. When you think about the fact that there is a dissociative kind of quality about THC, where, yeah, I have pain, I'm gonna leave it over there. I'm gonna sit over here. That's actually a pretty healthy coping mechanism. The joyousness and cheerfulness that people you know, the patient I was telling you about who flew to San Diego, she started chuckling and laughing again, she has a great sense of humor. But it's hard to access that when you're miserable all the time, and anxious and terrified and can't sleep and all that. And yet, I think there's more than just restoring sleep and helping with pain and nausea. I think it also enhances mood, there's evidence it's used on its own for depression, and mood instability, and post-traumatic stress and anxiety. So it does improve all of that. And so when you think about it in terms of the impact of stress and discomfort on your body where these talk, I'm sorry, your stress hormones are released. epinephrine, norepinephrine, cortisol, and they're really good. If you need to run from a saber-toothed tiger. They take energy from not unnecessary systems, they put it into your muscles, so you can run raise your blood pressure, breathing gets faster, that kind of focuses your vision, pinpoint it as your stare, my hair might stand on and you're ready to go sweating. But it takes that energy from systems like your immune system, your ability to absorb nutrients, and I would kiss people, the saber-toothed Tigers chasing you, it does not matter if you've been exposed to the flu. Or the saber-toothed Tiger gets you it doesn't matter if you finished digesting your chin on wheat. But chronic stress, chronic pain, chronic upset, chronically dumping those chemicals into your body. That's the very opposite of what we're trying to deal with cancer. So that was my explanation before I even was involved with cannabis in telling people why we must address your depression or anxiety or insomnia. You can't be under that level of stress and respond beautifully to cancer treatment because your body is not it's not going to respond. No room for it.

Leanne: A few weeks ago talk to a functional medicine doctor who talks all about the vagus nerve. Do you know anything about how cannabis affects that nerve?

Lynn Bornfriend, MD-PLLC: Not sure particularly about the vagus nerve. However, what I'm talking about more is the sympathetic nervous system, which is the fight or flight versus the parasympathetic nervous system. And that balance but when you think about it, it's all ebb and flow. It's you know, our bodies and Mother Nature, in general, are all about balance. You know, we have the THC, we have the CBD, we have the sympathetic when we need it, we have the parasympathetic when we need it. And balance is so important for and we've stepped so far away from that, to the idea of just fixing that thing, accepting it. One of the tragedies of medicine. That was sad because the hospital where I worked is no longer in existence. We had tremendous communication. I did not treat them apart. Everyone treated the whole patient. And you know, we communicate it but notoriously in medical centers all over the place and go to the cardiologist and he's like, tell me about your heart and doesn't want to hear about your lungs or your stomach or anything. My husband and I once when he had shoulder problems that he believed came from his neck. The orthopedic surgeon said, "I'm a shoulder guy, if you want to talk about your neck, you have to go see an Otolaryngologists".

But that's what we've come to. So a move towards cannabis and a move towards natural has seemed to me to be a move towards kind of a reset to what we came from. And a step away from all this dysfunctional foreignness. You know, in the hospital where I worked, I was a full-time psychiatrist, and people would say, I never saw a full-time psychiatrist in the cancer hospital. But, the whole theory behind this hospital system was we have to take care of your mind, body, and spirit and a very strong pastoral care department also. Without if you leave the body, I mean, the mind and spirit behind what good is taking care of the body, and vice versa, you know, if you only take care of one thing, so this whole balance and inclusiveness, and it just makes so much better sense to me, Barry, they also have really strong nutrition programs, strong naturopathic program, how can you give someone cancer treatment, not pay attention to what they're taking into their body?

Leanne: Say that again!

Lynn Bornfriend, MD-PLLC: Right. And yet, as physicians know, before I went to this hospital, I was working in a planned psychiatric hospital. And it was sort of the worst time of my life because I knew that I was not giving patients what they needed. And yet, I didn't have a choice. You know, I'm a child and adolescent psychiatrist and an adolescent girls unit, a kid would come into the hospital, depressed, I would start medicine and two days later, the utilization review nurse would say you have to change your medication dose. Let's see, but they just started, it now takes four to six months. If you don't change the dose, they're going to insist on discharge. So making changes make no sense. And then, after five days, the kid who had made a serious suicide attempt has to be discharged anyway. So the parent would be saying to me, what do you mean to discharging her? My insurance says I have 30 days. I said, No, ma'am, your insurance that you've had up to 30 days, they manage it, they're not gonna let you keep her here one more day. I understand what you're saying that it's not resolved in five days. But unless you're independently wealthy, I thought it was so disheartening to be proud of that system. I hated every moment of it, had I not had my own children at home, and I was a single parent, I would have walked out the door. It was switching to this other hospital where they really were, they got it. You know, the whole-body approach. And then they gave me the opportunity to educate and incorporate cannabis. Even though that the hospital was that way, I was the only one who was educated. The other doctors were like, yeah, that's cool. And yeah, maybe some of them tease me or you just want everyone to be high, but then they would start to see it's helping with, but they were still like you take care of it. The legality, the risks frighten them I guess.

Leanne: So why is that hospital not around anymore. It sounds like a wonderful and very rare occurrence where they're treating the whole body and whole patient.

Lynn Bornfriend, MD-PLLC: They had five hospitals, two of them close this spring. Insurance companies did not like to pay for this kind of care. Bottom line. They wanted to go cheaper. And it was really tragic. Really tragic. Because I now continue to follow some of the patients still. They can't get the care they have. They can't. And I know some of them are gonna die because of that. Because they're not having close monitoring. They're not having individualized attention. And it's tragic to watch. And it's terrifying to me to think, Oh, my God, what if I get sick? You know, it's just we as a society, I mean, I could go on and on, we don't care about we certainly don't care about mental health. And don't care much about health care compared to stadiums and war. I don't know. Why are we so messed up? Why is it more important? You know, why is it that drug companies have this ability to keep this to make my mother suffer and die?

Leanne: That's my question. How did it get this far? How'd they get so big? And are we able to change it at this stage?

Lynn Bornfriend, MD-PLLC: People don't? I don't know. I mean, I know I don't, why are we not able? Why are we not able to have people understand climate change and the nature of change? I don't get it. It doesn't seem to me like a question of opinion. It's just it is and Yeah, I guess the idea that it would be inconvenient to me, and if I believe this, so I'll just choose not to. I don't know. Like, it's more than that. I've had people not want to learn how to recycle properly. takes too much time. I don't know.

Calla: I have no room for complacency in my life. Leanne and I have been talking about this so much it's so alive and real for me.

Leanne: As the fire is coming out of your eyeballs.

Calla: I do, I get lit up. It's like, why would you be okay with saying this I can't take the time to do it right. But here, have this. Knowing XYZ. I mean, any commercial on TV for a prescription half of it is the disclaimer.

If that's not a wake-up call I don't know what is. I don't even know if cannabis is for everyone. I don't want to say that either. Because I know that while you may not be able to overdose, as you're saying there is an addiction component.

Lynn Bornfriend, MD-PLLC: Maybe for schizophrenics or for people who have psychotic disorders, I think it's probably not indicated. But when we're talking about you know, cancer patients. People would say to me before the cannabis when I'd say we need to treat your pain we need to treat your nausea. They said we don't want to get addicted. My grandmother was from Eastern Europe and have a heavy accent. I would think of her in the back of my mind saying "You should live so long." But people get stuck in these things that they're told and that shame and embarrassment. People would say, "I believe what you're saying, Honey, I'm still kind of embarrassed of what my family would think", and that's why telling them about my 84-year-old mother was so powerful. It breaks my heart but it makes me really angry. I've had to tell people there's a woman who I was called to the floor and she was very ill and she said, "Okay, I'm ready now. I'd like my cannabis." This was many years ago she came from Virginia, and I had to say, "Ma'am, you can't have it. It's legal in PA but not in Virginia."

"Well, I can get it here?" "No, I'm sorry. You can't. You have to have a PA address and you have this and that."

Leanne: Im in Texas, so I get it.

Lynn Bornfriend, MD-PLLC: Yeah, absolutely. And so you know, It breaks my heart and makes me angry. When I talk to my fellow colleagues about this some of them would say well there's no evidence-based medicine to prove your claims.

Calla: They won't do the research.

Lynn Bornfriend, MD-PLLC: Because it's scheduled one. The only cannabis research in our country is coming from Southern Mississippi University which was apparently this old weak dank whatever. But beyond that, evidence-based research has been done about what happens when you give opiates. We know what happens when you give opiates or benzos or opiates with you know, we know that.

Calla: Just be careful but here you go. I get so mad.

Lynn Bornfriend, MD-PLLC: I have a lot of experience I've seen person after person. I guess the thing I would get to but it was hard to do it in a civil way was kind of saying oh, okay, so that's okay for your mom. Because it wasn't okay for mine. Oh, you haven't thought about that yet? Because your mom hasn't gotten sick yet because my dad. Yeah. Let me share the pictures her before and right before she died. And not pretty. You know what happened to her. My best friend also that have cancer, you know, hideous what it did to her. You really want to go through that. But the safety of it and the ease of it because cannabis is much more complicated telling someone how to get it and access it and the cost of it is much more complicated than just writing a script and sending it electronically to CVS. And the other thing with cannabis, you know, when if I sent an electronic prescription for 1000 tablets of morphine to the CVS for you, anyone can go pick it up. Doesn't matter who it is. They don't care. They're this cannabis in Pennsylvania dispensaries, only the patient was allowed in and that the patient couldn't go forget you can't get the medicine boundary and to become a caregiver in pa you had to get fingerprinted, which was an additional cost. Plus you had to pay an additional fee to the state of Pennsylvania for the caregiver's card as well as the patient's card and the way the reception of the card. So where if you're just getting a card as a patient, it might take two weeks it might take six to get a caregiver started. And so therefore you're out of luck. If you are too ill to go to the dispensary. I remember initially at a woman she was very old and she couldn't see or hear well, I'm calling dispensary in New Jersey from I'm saying, I don't know what to tell you. She can't understand what you're saying. Can you please allow someone in? You know, No they can't. Where does that come from? That's got to be from lobbying. Why would anyone think hey, this is a good thing to do? This is better for people. They wouldn't if they stopped and thought about it, would they?

Calla: No, no one I know.

Lynn Bornfriend, MD-PLLC: When people would try the candidates even reluctantly, but desperately they would try it. And then they'd have the results. There is nothing like it, you know, and that was worth it to me to take them through the step by step by step and negotiating. And but it's somewhat complicated, and this is what you have to do. And this is what you might do and how to get around this. And that, because, God, it worked. And people were like, bless you. And thank you, and oh, my God, this is amazing. And why didn't I know about this, and I can't wait to tell people about it. And you know, when I met Ron, at that panel of veterans, and I was sitting on a panel with five veterans, and every single one of them had come out of the military with damage. And it wasn't a question of whether they had made suicide attempts or not. It was every single one of them was how many times And they described what the VA did for them after their medical and psychological damages. And it was pills and more pills and more pills and more pills. And they talked about their despair and their horrible quality of life and how many people they lost and, and we can do better? And we don't? Yeah, I just don't get it.

Leanne: Speaking of doing better, I did want to ask you, as a psychiatrist, what have you learned about psychedelic therapies and what they're doing for people?

Lynn Bornfriend, MD-PLLC: Not enough. I haven't learned enough. But I am going to. What's interesting about this one thing that's really interesting in comparison with cannabis. There's still a tremendous lack of real evidence-based research that cannabis, it's just not a lot being done. There's a lot of stuff coming out about psychedelics, PTSD. It's like, they're not evil to people. A lot of journals talking about ketamine, which is a pharmaceutical to psilocybin and mescaline, you know, absolute plant-based with enthusiasm. I just saw an article yesterday. I tried to print it out. I think it came out, right. But someone wrote, this was the most powerful thing I've ever seen. I can't help wondering if part of that is because it's not seen as a direct threat to the pharmaceutical industry.

Leanne: How?

Lynn Bornfriend, MD-PLLC: Because with cannabis, there are so many different drugs, but drugs you could get rid of. I was psychedelic. I see what you're saying. Yeah, you know, they're talking about PTSD. They're not talking about every darn thing.

Leanne: Because they don't have a prescription cure for PTSD anyways So It's not directly stepping on anyone?

Lynn Bornfriend, MD-PLLC: No, not at all. And also, the elusive I mean, psychedelics are not targeting pain. They're not well, they are some, but you know, not the wide, wide range. You know, cannabis has been used to treat autoimmune disorders. psychedelics aren't going in that direction. I don't know if that's in what I have read. And what I've heard is very exciting, about micro-dosing, about the impact on serious psychiatric situations, trauma, PTSD, the likes of which, you know, sometimes you see, I see videos, and I think, got the kids never going to be right. You know that you can't get over that kind of thing. You can't get past what happened. But it sounds like maybe psychedelics might open that door. I have to confess that they frighten me some. So I grew up in a time where they were talking about bad LSD trips and people trying to fly and jumping off buildings and people having psychotic episodes that never came back from.

Leanne: Oh, I heard about some guy when I was in middle school. Oh, you can't do that, because you'll think you're an orange peel and peel all your skin off. I'll never forget that.

Lynn Bornfriend, MD-PLLC: Was that the spice? The ones that were the people were eating... they became zombies?

Leanne: Bath salts?

Lynn Bornfriend, MD-PLLC: I gotta say that those things were scary. And they still kind of scare mine.

Calla: Terrifying. Absolutely.

Leanne: It's a healthy fear to have. It's a powerful drug or medicine, I guess.

Lynn Bornfriend, MD-PLLC: I think it's also impactful when you hear people with terrible traumas talk about their choice to use it and that relief from it. First of all, I understand what their level of suffering was before because I've worked with so many people with post-traumatic stress. Yeah, they're ready, just like these cancer patients who when we discuss the legality would say, "I don't care. Come arrest me", you know?

Calla: People are desperate to feel better.

Lynn Bornfriend, MD-PLLC: And they're desperate not to be suffering with all these medications and things that leave them feeling bad. And I had a patient I was talking with yesterday, she was talking about it was a surgical outcome that she wasn't happy with. She wanted her surgeon to reverse a colostomy. And she said, and I asked him, he just goes like, I happen to know our surgeon, I happen to know her. I think the reality is that she came so close to death. It was such a complicated, we cover it, I was shocked that she did recover at all. And I think he's a lovely caring man. But I don't think she's necessarily hearing the reality of it. She's kind of forgotten. And I don't think he feels comfortable in saying, Listen, I think if we did this, you would die. But you would suffer, you know, so he's not saying it. So I talked about it with her.

Calla: Shame on him though, he should. But, I get it though.

Lynn Bornfriend, MD-PLLC: Listen, he is a surgeon, I want him to have good hands. I want him to have great eyes. I'll do this part of it. But I said to her, I thought of this because I gotta tell you, I'm not an oncologist. But I thought that I knew I wanted to get better. I have to tell you, I'm stunned when you walked into my office after you've been in that wheelchair with an open wound that wouldn't heal for so long with your blood coming out. You know? I think you can't operate because I think if he did this, this was, you know, and I understand that it's hard for people and that we can't all do the same things, right, all entertain the same things. But I guess the thing I think is really important is to be able to say to someone, listen, I can't do better. But maybe there's someone out there who could or, you know, maybe you should talk to someone else. Or maybe I'd like to learn more. I don't know it yet. You know, so I can tell you with psychedelics, I don't know it yet. There are a million courses out there. And my current state is I don't quite know how to choose a course. They seem to be geared towards non-MD's. They're geared towards, counselors, therapists. And I could certainly learn from that, but I want to learn the next part of it as well,

Leanne: Is that because they think that MDs would be less open to taking a course anyway, so they're not even catering to that crowd yet?

Lynn Bornfriend, MD-PLLC: I did meet several years ago, a pain management doctor who was opening a practice near me and he was incorporating ketamine. Now, as I said, ketamine is a pharmaceutical but it's a second hallucinogen. So, actually, I was thinking now that I know that you guys mentioned it, maybe he's someone I can ask her to enforce this. He certainly knows more about it. I don't know, I guess. Yeah. Decisions tend to be a fairly conservative bunch, you know, take the response to my saying they patients should try cannabis. I had colleagues that called me Dr. Dubey. And Dr. weed.

Leanne: Can I ask Have you have you tried it yourself after seeing what it did to your mom and all your patients?

Lynn Bornfriend, MD-PLLC: Oh, yes. So I have come from a family who can't sleep. Neither of my parents were able to sleep well. My sister can't sleep. It goes throughout the family. At age 19 I stopped drinking caffeine because I couldn't sleep. So I went through finish college went through medical school and internship with no caffeine, I ran on anxiety. It's amazing how much anxiety will keep me awake. y

Leanne: My God, that gives me anxiety to think about.

Calla: I get that girl.

Lynn Bornfriend, MD-PLLC: So I couldn't sleep even without caffeine. And so I started with herbs, valerian root, hops, passionflower. It worked

for a while and then no and, and when Ambien was first released, it was marketed as you don't get habituated to it. This is great. In contrast, when I was in medical school and doing projects for my psych honors or whatever, I did a project on Halcion, which was asleep medicine were notoriously You know, there was rebound insomnia. In old people getting delirious and running down the halls naked. And all this stuff in here, Ambien was going to be the answer to this. And here it is, we've got it. And so I started taking it. And I took it, I took it, and then I needed a little more of it. And I took more of it took more of it. decades, I could not sleep at all without it. And I got to the point where I was on the highest prescriptions was a 12 and a half controlled release. Without it. I couldn't sleep at all. With it, I slept about two and a half hours. No caffeine.

Calla: That breaks my heart, Lynn.

Lynn Bornfriend, MD-PLLC: I had one point where my internist said, Well, why don't you try exercise? I was doing boot camp three days a week, you know, still didn't sleep. So when that happened was when I was stepping more into the cannabis thing. And it was in 2018 in May of 18. First of all, I had had a medical emergency in the summer of 17. That left me with clear PTSD. I almost died. That's the whole so I was like, I have PTSD. Here I am. My f 18 with the Ambien is not working. So I'm going to go get certified. I completely stopped. I have not had Ambien since that day. Don't take it at all. I use Indica cannabis at night.

My daughter is adopted from China. She has an autoimmune kidney disorder that is seen in Asian-born people. It's genetic and the treatment is steroids. Prednisone so when she was 10 when she was diagnosed, they gave her massive doses of steroids. And you know what happened? Yeah, no, she was eating chews up two o'clock in the morning shoving things in the face. You know, eating the weight. It helped. It took months and months and months to get that weight and people were staring at her and so then she's 14 we go to the doctor and he says, The numbers are starting to change. We may need to start medicine again. She burst into tears. Please don't do that to me. Please, please. I said to the doctor, why don't we try CBD first. She's been on CBD ever since, with no flare-ups. Which would you rather take CBD or prednisone?

So, yes, my dogs, my older dog. I've been older. He's 12 and a half and he's a big dog. And you know, big dogs don't live that long. When he was two and a half. He developed a doggy version of Crohn's disease. It's an autoimmune disorder. And he's my $6 million dog. He had the surgery. He had all three of those. And you know, we were giving him all these supplements. So now he's 12 and a half. But a couple of years ago, he started having arthritis pain. older dogs, big dogs. They traditionally give dogs, mega Motrin, for pain. I knew I couldn't give him that because if you look at him funny he gets colitis and diarrhea. I can't give them that. But CBD is useful for Crohn's disease and pain. So my dog takes CBD. And that's been a couple of years, he would have been dead if I tried to treat this pain with the nonsteroidal anti-inflammatory

Leanne: And the symptoms have gotten better since taking it?

Lynn Bornfriend, MD-PLLC: He is. He's old, but yeah, here he is. Here is my other dog was crazy PTSD kind of nuts. And I gave him CBD to calm this little butt down. You know, it's amazing when you start thinking of my parents are both gone but their best friends are still alive. 88 and 90. The 90-year-old had a knee replacement with high blood pressure. The 88-year-old you know has some anxiety and other things. Which are you gonna want to start with delicate people like that? Want to take give them drugs like Motrin and nonsteroidal that will take their kidneys out and their stomach lining or do we want to give them opiates?

Leanne: Yeah. So has your mission become just to kind of spread awareness about all the benefits of these drugs and get people more open to trying it for themselves?

Lynn Bornfriend, MD-PLLC: Yes. And in terms of marketing, the concept I have is de-prescribing me with your bag? Come in with your bag of 10 meds. Let's take a look and see what we can do with them. I have an appointment with my dearest friends, we're going to her internist on November 1. She's got a lot of different medical problems. I don't dare say stop those meds. But I will do it with the internist and see if we can back off some of them. You know, her medical problems include seizures, they include high blood pressure they, let's get on it. Let's back some of this out. And so translating this, I have a very different experience from most certifying physicians. I was on a Medical Advisory Panel for a local dispensary. And we met and all the doctors were saying, Oh, it's really nice, because I'm starting to see people back for their your research and hear how the cannabis helped them. And I'm looking at them like a year. I see him every week, every month, every whatever, talk to them on the phone in between. And so when this thing didn't work, I was involved with the manipulating or changing to that, or I have this amazing opportunity to share with people a wide, wide range of patients a wide range of conditions. It's not just cancer. Even the cancer patients, it wasn't just cancer. And because of my degree, I have the ability to be heard by people who maybe wouldn't hear it from other people.

Leanne: That's why I'm so excited for people to listen to this.

Calla: Yeah, I am too for that very reason.

Lynn Bornfriend, MD-PLLC: And also because of my not being someone open to it. I was hostile. I had dinner a couple of months ago, I was with a high school boyfriend. And I told him what I was doing. He started laughing, He said, "Lynn you are crazy. If I went and got high, I would have to go take a shower, wash my hair, brush my teeth, change my clothes, put in Visine if you saw any sign of it, you would have lost your mind and be like out of my sight!" I was crazy. I was really extreme with it. And I looked down on it. You know my sister, I would have at that time she's a hippie. She wants to use cannabis with my mom. That's how I believed. I have do