Junella Chin, DO, was a patient first.
At 17, she was diagnosed with ankylosing spondylitis (AS), a condition that grew progressively worse during her college years, leaving her body stiff and painful. She tried a series of failed treatments—from physical therapy to muscle relaxers, epidurals to opioids—but nothing worked.
As a medical student at Touro University College of Osteopathic Medicine (TUCOM) in California, she was introduced to CBD, or cannabidiol, as a possible salve for her pain.
‘You’re not thinking marijuana’
“I freaked out! I was very, very resistant,” Dr. Chin says. “Because when you’re going through Ivy League pre-med (at Cornell University) and then med school, you’re not thinking marijuana.”
But Dr. Chin tried a few drops of the tincture under her tongue before bed one weekend. By Monday morning, she knew it was working. When she got her health back, Dr. Chin “made it a point to learn everything I could about this plant medicine,” she said in a video for Green Flower Media posted on her website.
Since then, Dr. Chin has been helping patients integrate medical cannabis into their treatment plans for nearly 15 years, first in California and now in New York City. She also treats patients with osteopathic manipulative medicine.
Taking CBD eventually allowed her to stop taking prescription medicine for AS. “But it’s not a cure-all,” Dr. Chin says. “I still have to exercise, eat an anti-inflammatory diet and practice yoga daily.”
A career in medical cannabis
Dr. Chin’s practice grew very quickly, with no need to market it. It included children with epilepsy, chronic pain sufferers and cancer patients. Patients appreciated that they could be honest with her about using cannabis or wanting to try it. And she helped integrate medical cannabis with her patients’ conventional treatment and prescription medications.
For years, Dr. Chin was concerned about the reactions of her fellow physicians. But what sets her apart, she says, is that among the limited number of physicians performing medical cannabis evaluations, she’s one of the few who doesn’t solely focus on medical cannabis.
“I practice traditional, neuromuscular osteopathic medicine and adjust patients with my hands,” she says. “People don’t necessarily come to me for medical cannabis alone.”
This balanced approach to care is what Dr. Chin teaches other medical practitioners as well. Prescribing medical cannabis is not an all-or-nothing proposition, she tells them.
Science vs opinion
When Dr. Chin speaks with her colleagues about medical cannabis, they often tell her that there isn’t enough research on the science behind cannabis.
She counters by pointing them to a webpage she’s compiled of hundreds of scientific articles on cannabis and the endocannabinoid system, spanning topics from addiction to inflammation, multiple sclerosis to pain management.
“Cannabinoid receptors are the most abundant receptors in the brain,” she says. “But we don’t learn about them in medical school.”
Patients who are looking for reliable information have very few trusted, health care provider resources available to them, which leaves them looking for advice from unconventional sources, Dr. Chin says.
With 32 states having passed medical cannabis laws, there are sweeping changes happening. Last year, Epidiolex became the first FDA-approved drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy.
“If the FDA approved CBD for children, you can extrapolate how safe it is,” Dr. Chin says.
The AOA supports well-controlled clinical studies on the use of cannabis and related cannabinoids for patients who have significant medical conditions for which current evidence suggests possible efficacy. It also supports a review of the classification of cannabis under the Controlled Substance Act of 1970 for the purpose of advancing public health and patient safety.
Proof is in the pudding
Dr. Chin has seen medical cannabis help many of her patients, some more than others. At Mount Sinai Epilepsy Program, she was on the care team of a young boy named Aidan who was having about 100 seizures a day. With the use of medical cannabis, he’s down to about four seizures a month.
“He wasn’t talking, he wore a helmet. His house was lined in foam. He was seizing all day long,” Dr. Chin says. “It took a while but we finally got the right strain that works for him. Now he’s in the public school system.”
Michael, a teenage patient of Dr. Chin’s, had been suffering from Crohn’s disease for years. His stomach pain, nausea, diarrhea, and constipation were so severe that they were keeping him from normal day-to-day activities. He had tried steroids, immunosuppressants, antibiotics, anti-diarrheal meds and anti-depressants. The next step would have been a bowel resection.
Michael did some online research of his own and discovered patients claiming they’d found relief from cannabis, so he began sourcing it on his own, on the black market. When it began making a big difference in his health, Michael told his parents, who then sought the counsel of Dr. Chin.
Today, Michael takes medical cannabis with immune-suppressant medications. He faces far fewer side effects and has better health and well-being, Dr. Chin says.
Despite these success stories, Dr. Chin is careful to share with her patients and health care practitioners that medical cannabis is not a silver bullet.
In her Green Flower presentation, Dr. Chin says, “The endocannabinoid system holds great promise, especially for improving our patients’ quality of life. And as practitioners, it is our responsibility to be capable of engaging in meaningful discussions with our patients regarding the potential harms and the potential benefits of medical cannabis.”