Q&A: Cannabis scientist responds to COVID-19 research, shares what practitioners should know

Photo Cred: Jeff W/Unsplash

By Liz Gold

Earlier this year, a new study revealed cannabis compounds could prevent novel coronavirus (COVID-19) infection from entering human cells. While the study made national media headlines, Matthew Elmes, PhD, a cannabis scientist and consultant, spoke out about the research, saying that the results were weak in clinical evidence.

Elmes has a doctoral degree in Molecular and Cellular Biology from Stony Brook University in New York and focused on endocannabinoid and phytocannabinoid cellular transport mechanisms for his dissertation. Since 2018, he has been part of a team developing a novel class of endocannabinoid transport inhibitors that are able to modulate endocannabinoid system signaling and may eventually become non-addictive, anti-inflammatory, and pain-killing drugs. He is the former Director of New Product Development at CannaCraft, a cannabis manufacturer in California and sits on the medical advisory committee of the Wholistic Research & Education Foundation. We spoke with Elmes about his opinion on the study and how cannabis is impacting integrative healthcare.

Integrative Practitioner: How did you first get into the cannabis industry and decide you wanted to study cannabis? 

Matthew Elmes: I was always a science nerd. I went into a biochemistry PhD program out of pure interest of the subject, and I fell into a lab that was studying the endocannabinoid system. I wanted to learn more about how cannabis works in our bodies and that is what drew me. I started in this lab studying the cannabinoid system When I started my PhD in 2012, there wasn’t much of a cannabis industry to speak of yet, but by the time I finished in 2018, I had the word “cannabinoid” in my dissertation title and the whole industry just blossomed around me. Right place, right time kind of thing.

Integrative Practitioner: Why did you decide to become a cannabis scientist?

Matthew Elmes: I always had a deep fascination with cannabis and cannabinoids. There is so little known about it still because research has been so challenging to perform historically due to federal prohibition. There’s so many low-hanging research questions to be addressed. It’s just a fascinating field. We didn’t even know there was an endocannabinoid system until the early ‘90s. Within my lifetime, this whole integral system that is present in literally every animal on the entire planet, we didn’t even discover until 20 years ago. There is so much to learn about it and that is really exciting to me.

Integrative Practitioner: What are some of the questions that haven’t been answered yet and some of the research that you would like to see take place?

Matthew Elmes: There is so much on the endocannabinoid system side we are still trying to figure out. We haven’t even identified all the endocannabinoids yet, there are others that are probably working in our bodies. There might even be other cannabinoid receptors, there’s a potential CB3 receptor out there. On the plant side, learning the pharmacology of other bioactive compounds in the plant, like terpenes, I think are having a real therapeutic effect. People are consuming these terpenes but there’s next to no clinical research on this. We had some rodent model data that points toward efficacy—some terpenes have analgesic or sedative properties, but it’s never been shown in a human and that’s really interesting to me. I think these have a lot of therapeutic potential. 

Integrative Practitioner: Why haven’t there been more cannabis studies on humans?

Matthew Elmes: Researching cannabinoids in general is very challenging just because they are a Drug Enforcement Administration (DEA) Schedule 1 drug. There is a huge amount of regulatory red tape to jump through to do any type of cannabis research. Triply so for clinical cannabis research when you are working on humans.

Integrative Practitioner: Speaking of research, let’s address the study that came out that said cannabis could prevent infection from COVID-19. What were your thoughts reading the study and why did you feel the need to speak out?

Matthew Elmes: The media sees a headline about a study and runs a mile with it and people will read a headline and take it at face value. This study was strictly preclinical; it was strictly done in test tubes and cultured petri dishes of cells. People don’t sometimes appreciate how little a preclinical study means in the grand scheme of things. Almost always there is going to be a huge caveat when you try to translate the finding into a human. It almost never works that way.

Even the preclinical data itself, I had problems with. I don’t think it seems that promising for a covid prevention mechanism. The thing is, they incubated… very high concentrations of CBDA and CBGA with the virus before trying to infect into a plate of cells. The basic finding is that the cannabinoids can attach onto the virus and by being attached on it partially, prevents their ability to infect new cells. They really encourage the formation of these complexes by incubating massively high concentrations of the cannabinoid with the pseudo virus before giving it to a cell. But in real life it would not work like that. In real life, the virus is traveling basically through the air, it hits your cell, and it’s going to get in. You don’t have this hour long, preincubation of massive doses of cannabinoids. I wouldn’t expect this to do much in the clinic.

I’m not saying it’s bogus research or anything like that. It is an interesting finding, and it warrants more study. But personally, I don’t find it particularly exciting.

Integrative Practitioner: Our audience is comprised of a variety of integrative practitioners, some of whom are recommending cannabis to their patients. How are you seeing cannabis being used in clinical settings?

Matthew Elmes: It’s great as a complementary treatment. THC [Tetrahydrocannabinol] is fantastic for pain; CBD [Cannabidiol] is fantastic for anxiety and anxious feelings. In a lot of cases, we can forgo traditional medication, like maybe you don’t need the opioids, and instead take cannabis, something with less addiction potential. Or in some cases you are using both products. It’s been shown people who are prescribed both cannabis and opioids tend to take less opioids when they have cannabis, too. The opioid crisis alone is such a huge problem. If cannabis can put a dent in that, that’s worth doing. 

Integrative Practitioner: What do you think integrative practitioners should know about cannabis as part of treatment?

Matthew Elmes: It’s not a cure-all. I’m sure practitioners know this. Some laypeople see this as a cure-all for everything. It’s going to cure their cancer. Cannabis is great for a lot of things, but not everything.

Also, dosing can be very challenging. People perceive the effect of cannabis wildly differently. I can take 50 milligrams and be fine and my wife can take 5 milligrams and she’ll have a psychedelic experience. You really have to take dosing into consideration. Somebody might need 30 milligrams of THC to feel a good effect they are looking for. Another person might only be able to take 2 milligrams to get that same effect. It’s more challenging than most typical pharmaceuticals, there is another layer of complexity to dosing cannabis. 

Integrative Practitioner: What types of misconceptions do you hear among practitioners around cannabis? 

Matthew Elmes: I work with some practitioners but for the most part they specialize in cannabis. I have seen misconceptions out there. The harms of smoking cannabis are not as great as some might guess. There have been a number of studies where there is no correlation found between throat, neck, or lung cancers. That is good to know and there has always been speculation when you are combusting plant matter and inhaling. There is always a big cancer risk there but it’s almost a surprise to find [that in] these very large population-level studies there’s not going to be that correlation drawn. Another one is dosing just based on THC alone. THC and CBD work great together. CBD really helps to mellow out the anxiety that THC induces in a lot of people. When you are thinking about cannabis, try to think about the whole plant approach because there are real benefits there.

Integrative Practitioner: How do you see cannabis impacting the integrative healthcare industry over the next five years?

Matthew Elmes: There will be a lot more cannabis. Even looking at the past five years, its massively grown. [There’s more] acceptance and destigmatization of cannabis and I think in another five years that trend will continue. There will be more people who are willing to incorporate this into their wellness routines maybe using it as complementary medication to whatever else they are taking. I believe integrative medicine looks at the whole body – exercise, diet, and everything, all one. Cannabis can play one piece of that multifaceted puzzle.