“To understand the pain of others is to be in favour of the legalization of cannabis for medicinal use” – Interview with Albert Estrada

Albert Estrada is a fan of role-playing games, a genre in which he has published The Secret of the Nimblekins. But in addition, he specializes in Clinical Biochemistry. Professionally he dedicates himself to cryopreservation and endocannabiology, and is one of the few specialists in cannabis medicine in our country. YesWeSkunk have taken the opportunity to chat with him, on the occasion of the recent publication of his amazing book, El médico del cannabis (The Cannabis Doctor), published by Editorial El Ángel. Read on to learn more!

Laura Rueda- Cannabis is a worldwide trend, however you are considered to be one of the few specialists in cannabis medicine in our country, What point do you consider Spain to be at, in this field?

Albert Estrada: It depends. At a research level, I believe Spain may well be considered a world leader, thanks to the work of scientists such as Dr. Guzmán and Dr. Sánchez and the efforts of entities such as the Spanish Cannabinoid Research Society. At other levels, considering the politicians that we have chosen to represent us and the legal guarantees offered by our courts, capable of rejecting one thing today and ruling against the banks tomorrow, I believe that Spain is where it belongs, at the bottom of Europe and the world. At the level of patient care, thanks to the professionalism and dedication of many brave health professionals and also the work of patient organizations and cannabis users, we are better than we should expect, taking into account the circumstances in which we have to fight. A large part of the cannabis aid received by patients is received from regular health personnel who attend them, not from any specialist, if I can consider myself as such.

Laura Rueda- You’ve just published The Cannabis Doctor, a book that tells your experience treating patients with the plant. What can the reader find in this book? What can you tell us?

Albert Estrada: Well, the book has been constructed in a personal conversational tone. In fact, it is born from a series of interviews, and in it I explain what I would explain to any patient that came to my office in search of professional advice. I’ve also taken the opportunity to share some very personal reflections, that may not always be proven, about how this world works, which I think give an added value to the book. It is not an aseptic text, like other books that speak of medicinal cannabis, but I think that is positive, not negative.

I also think that the testimonies part is very interesting, of patients who tell their experience and with whom the reader can empathize due to the greater proximity. This human aspect is often neglected and I think that, although it is brief, the book gives an interesting insight into it.

Laura Rueda- For those who have never heard of it, what is endocannabiology?

Albert Estrada: I love that you use that term, because I think it highlights the value of a medical specialty that is emerging at the moment and that is based on the study of the endocannabinoid system, and by extension of the drugs and substances capable of interacting with it. Just as there are no “aspirinologists”, but cardiologists or neurologists, in the world of medical cannabis we should abandon the pre-eminence of substance, of cannabis itself, and focus on the human physiology on which it operates, which is the real medical field developing. The term was coined by my good friend, Dr. Raquel Peyraube, and I hope that it soon reaches the dissemination it deserves.

Laura Rueda- You are a specialist in Clinical Biochemistry. How did you come into contact with cannabis? And, what made you as a doctor decide to specialize in cannabis medicine?

Albert Estrada: Well, because of the cuts in the health system that we have been suffering  that have catapulted our medical service from one of the leading positions in the world to a much poorer position. It was a bit by chance, an acquaintance asked me for help offering medical advice in his smoking club, both to therapeutic users and to recreational users, in terms of risk reduction, and that’s how it all began. I have always considered myself a scientist, and cannabis has more than enough endorsements regarding clinical evidence, so at no time did I doubt the role I should adopt, even though I personally do not have any relationship with the plant. As I confess at the beginning of the book, I have never consumed it.

Laura Rueda- It is proven that cannabis is indicated for many medical cases, although you have also highlighted in some interviews that in others it is not the best alternative. Is there still a lack of knowledge about the plant and its therapeutic properties?

Albert Estrada: Absolutely, but just as I have no idea which is the best hip prosthesis for a particular patient, the best treatment available for a certain type of cancer, or let’s say how to fix the motor of a car. We doctors are obliged to specialize and subspecialize, and it is impossible for us to know everything. In this sense, what we need is not so much to increase the knowledge of the health community about endocannabinology (which wouldn’t hurt, it is true) as to train more specialists in this field to meet the demand that exists. In the same way, the more people know, the better, but it’s not essential, because that’s what doctors are for. Many patients do not know that some of the drugs they take are analogues of heroin, and honestly, they do not even need to. Unfortunately, contrary to the romantic idea that exists, knowledge does have a place, and it is impossible today to know everything about everything. The only ones who need to inform themselves a little more before making decisions are the politicians … or, at least, to delegate the decision making to those who know about the subjects that they do not understand.

Laura Rueda- Do you think we are wasting time delaying its full legalization? Do you trust that Spain will follow the world trend and regulate cannabis soon?

Albert Estrada: I think we are losing things much more valuable than time, and as they say time is money. I think we are missing the opportunity to improve the health of many patients, and health is worth more than all the gold in the world. I trust that Spain will follow the policies that come from Europe and the United States, as it has almost always done, and that it will legalize cannabis when these superpowers consider that they can take advantage of it. I am clear that our leaders have much more pressing concerns than those of defending their citizens. What is more surprising to me is that the voters do not care, but ultimately it is their decision and it is they who suffer the consequences.

Laura Rueda- Contrary to what everyone thinks about cannabis, you highlight its properties as a neuroprotector. Tell us more about this.

Albert Estrada: As Paracelsus said, everything is poison, according to measure. Cannabis can cause memory problems, but some of its components, mainly CBD, in the proper dose and form have an unparalleled neuroprotective effect. It is equivalent and synergistic to hypothermia, and is what explains why the plant is being used in neurological diseases such as epilepsy, multiple sclerosis, Parkinson’s, Alzheimer’s, etc. THC has also shown a neuroprotective effect at low doses. And, as we deepen our knowledge of the endogenous cannabinoid system, new doors will be opened to us regarding neuroprotection. The studies that are being carried out with pigs show that the CBD is effective in mitigating the damages caused by an hypoxic insult (lack of oxygen to the brain) and provides a therapeutic window of six hours post ischemia. That, of course, does not mean that by smoking cannabis you’re going to get smarter.

Laura Rueda- We would love you to share a patient anecdote that you have collected in your book with our readers.

Albert Estrada: Well I do not remember if it came to appear in the book, but on one occasion we helped a patient to vaporize, to see if a very intense joint pain that he suffered in his hands disappeared. The pain did not subside and the patient began to feel a little dizzy, so we decided to leave the smoking club to give him air. Just when we were on the other side of the block of houses, he became dizzy (an episode of orthostatic hypotension) and we were surrounded by people who, in good will, seeing an elderly man who was fainting, insisted that we call an ambulance. The truth is that I had a hard time explaining to the crowd that it was not necessary. In the end, I accompanied him home in a taxi, where he recovered completely thanks, in part, to the soup that his wife prepared for him. They both dealt with it matter-of-factly and without any problem, but I had a really bad time, not because of any real risk, which was evidently totally non-existent, but because of the anxiety generated by the curious onlookers

Laura Rueda- In one of the chapters you pose a very interesting question to do with the fact that curiously many groups that gather to plant cannabis and use it as treatment are made up entirely of women. Coincidence? What do you think is the relationship of women with this highly beneficial plant?

Albert Estrada: The truth is that this is pure speculation, but I get the feeling that man has always occupied positions of public and institutional power, and women have had to look for secondary alternatives, where they do not bother or call into question the male domain. I think that makes them more open to non-official alternatives. That, and the care vocation that they have always had. I am not questioning whether for genetic or cultural reasons, or a combination of both. I think that empathizing with the pain of others is something deeply rooted in women and almost unknown to politicians, and that explains the role of each in this conflict. Understanding the pain of others is to be in favour of the legalization of cannabis for medicinal use.

Laura Rueda- As there is a lot of ignorance, I would like you to briefly explain to our readers what would be the unofficial protocol that they would have to follow if they wanted to follow a cannabis treatment.

Albert Estrada: What I always tell people is that the main issue is the supply of the product. Not only to get it, but for it to be of quality. If there is no product, medical advice is of little value, so my main advice is to go to a reputable smoking club or to patient associations like Aflora, Dosemociones, etc. There are also specialized clinics such as Medcan or Kalapa … Today, with the internet, everything is at hand, you only need to ask Google. Then, there is no choice but to try and find what works best for each person.