Transcription

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Hello, my name is Rane and this is the flow artists podcast - every episode my co-host Jo Stewart and I speak with inspiring movers, thinkers and teachers about how they find their flow and much much more.
I would like to start by honouring the traditional owners of the unceded land on which this episode was recorded, the Wurunderi people of the Kulin nation. Jo and I pay our respects to elders past, present and emerging.
In this episode we speak with
Bee Mohamed, head of patient advocacy at Astrid Dispensary.
Astrid is a specialty pharmacy, pioneering in cannabinoid medicine and plant-based therapies, located at the heart of South Yarra in Melbourne.
With a focus on patient centred care, Astrid is the first female-led dispensary in Australia, founded by a clinical pharmacist with extensive experience in the medicinal cannabis industry.
Bee was also the first CEO of ScriptWise, a non-profit patient advocacy organisation dedicated to prevent the harms associated with prescription medication overdose and addiction, so she has a long history in the field of harm minimisation. Please be advised that we do talk about mental health and addiction in our conversation, so just wanted to give you a content warning for those topics. As a couple who genuinely believe in the benefits of plant medicine, and reducing the stigma that is sometimes attached to it, Jo and I were super excited to speak with Bee for this episode. Let’s get into our conversation with Bee!

flowartists
All right, Hello Bee, it's so good to finally get the chance to talk with you. Perhaps we could start with you telling us a little bit about what you do at Astrid both day to day and perhaps your broader mission...

Bee
Yeah, for sure. Thanks for having me. So my role at Astrid is I'm the head of patient advocacy and engagement and I have to say it's it's quite unique for a pharmacy as such to have I guess a role dedicated. So my day today is obviously helping patients navigate through the system when they actually want to access plant-based medicines, obviously medicinal cannabis in this situation but also beyond that when they've already accessed medicinal cannabis. My role is actually to help them if they were to have any issues around employment, drug driving or workers' compensation. I guess the list goes on, so I'm sort of that person that comes in when a patient is discriminated because of the choice that they've made to use medicinal cannabis as their medication and I guess for Astrid. The reason why?
I guess we felt the need to have such a role as we saw so many barriers in the system when it comes to progressive medicines and so we want to make sure that not just at an individual level, but also at a systemic level we're hopefully able to make a change as well.

flowartists
And I must say as a customer client I really noticed that difference in care like it's usually if you go to a pharmacy and get a new medicine. They'll check in to see if you've had it before, but no one calls you a week later just to see how you're going and it really feels like you treat people as whole people rather than just oh, you've got this symptom take this.

Bee
Yeah, Absolutely I think I have to say you know. I mean we've It's only been over a year that we've we've been around but I guess why why we so value the importance of that care is because when patients come to us they've been through so much within the Healthcare system so you know they've they've either been on medications for so long and it hasn't worked or they have healthcare practitioners that don't really trust them when they say "hey this is not working for me".
Patients go through so much to get to medicinal Cannabis. So when they come to us we want to make sure a they feel like they're being trusted and obviously they have hope that you know things will actually get better in terms of their quality of life.
So I think it's it's more because patients, yeah, we we want to create a space and we're able to create that space for patients to feel like okay I finally landed somewhere where um, you know it's sort of something where it's not just treating with medication. But also we try to help in I guess a more holistic approach if if there's an opportunity to as well. I'm really glad that you know you've you've sort of had a really positive experience.

flowartists
And I'm not someone who's come from a really traumatic medical history either and I still appreciated that extra care and I'd like to go a little bit more into like what are the current laws around medical cannabis use. In Australia because it's all pretty new right.

Bee
Yeah, so it is pretty new obviously compared to you know Canada's been legalized medicinal cannabis for like 20 years now, in North America probably about 15 and most of the states we're about 5 years of having a legal framework here in Australia. The system is still quite confusing and hard for patients like I said at the start to navigate through. So um, you know it's it's still considered almost as - not the first option of treatment. So what that means is patients really would have had to exhaust other medications before they even get to trial medicinal cannabis. So most of our typical patients are patients who've been on pain medications or antidepressants for but some time I have to say, and suffer I guess side effects and realize that it hasn't worked and then that's how the regulation I guess permits the doctor to prescribe medicinal cannabis for them. It is still a private medication here in Australia as well so what that means is the patient bears the entire cost of the medication which can be quite challenging for patients on pension or patients who aren't able to work full time because of their conditions. So so we're a very long way to making sure that it works for all patients at the end of the day.

flowartists
And that's also something that you're advocating for right? Like getting it added to the pharmaceutical benefits benefits scheme or getting a little bit more subsidy support for people who are struggling financially, especially if that's because of the health condition that they're getting this medication for?

Bee
Yeah, absolutely I mean we try our best, I think, I mean the PBS side of thing will probably take a very long time. I almost feel from our point of view there needs to be a separate regulatory framework for medicinal cannabis. What it has been for pharmaceutical medications here in Australia because you know to get a PBS registered medication. It means companies have to invest millions and millions of dollars to get even the product registered.
What we try to do in small ways at the moment you know if a patient is for example on a pension or they have a healthcare card then you know we work with some clinics that offer a concession rate just to make the consults a little bit more affordable, and they are a couple of companies that also offer concession rates for patients but you know when you're on a pension and you're only getting $800 a fortnight and if your medications are costing you about $200 or $300 a month. It's it's a huge is a huge decision to make between you know, do I spend my money on my medication versus you know whether I can get groceries. So I think that's been the biggest challenge for us, the patients who always really it are the ones who aren't able to afford it as well.

flowartists
Yeah, because they would be the ones who would be the most debilitated by the health issues that they're seeking the medication for I guess?

Bee
Yeah, absolutely. So it's been hard, and even, you know, I mentioned workers compensation before, like patients patients who've been injured at work and they're not working because of the injury and if they've gone through all that medications that previously taken and they want to try medicinal Cannabis. Even the workers compensation companies are refusing to acknowledge medicinal Cannabis as a valid treatment. So what happens is while they were happy to remunerate patients for other medications, they weren't cover for this. So yeah, it's very...I would have to say I never have a boring day at work. It's very frustrating because you're literally like how is it so backwards? But...

flowartists
mmmm

Bee
You know, it's yeah, hopefully we'll get there and hopefully we can get more awareness around it as well.

flowartists
And go more into that awareness area, we've mentioned pain and depression. What are some of the other health conditions that could benefit from Medical cannabis?

Bee
Yes, so the main, I would say, conditions that the TGA approves medicinal cannabis for is the chronic pain, sleep and anxiety. So just to give you an idea like 70% of the approvals that come from the TGA. Medicinal cannabis is for chronic pain. So we see a lot of chronic pain patients coming through. Um I think the more recently because of the pandemic. We've really um, seen a huge increase of patients obviously taking medicinal cannabis for the anxiety just because they've realized their anti-anxiety or antidepressants doesn't work. There's a whole lot of you know, obviously inflammatory conditions as well. Um, like arthritis that's really helpful and we're really starting to see a lot of research and a lot of benefit to other conditions like Polycystic ovary syndrome as well as endometriosis. So um, you know it's I have to say it's getting better in terms of what conditions the government allow for medicinal cannabis to be prescribed for it. So they've definitely sort of opened that criteria a little bit more than what it used to be when it was first legalized. I think which was pretty much just you know, sort of terminal illnesses and epilepsy.

flowartists
Yeah I remember reading an article about children with epilepsy and how much of a powerful medicine. It was in terms of their daily experience in terms of how much their seizures went down. And I really felt so terrible for those parents and for those kids that they were dealing with all of that before that time and then before cannabis became legal as a treatment in Australia, they were kind of maybe trying to get some from overseas and facing some legal fears around that as well?

Bee
Yeah, no absolutely and I think it's you know, it's it's sort of what I find. I'm so humbled by being able to work in this sector. Medicinal Cannabis is, I guess it's a sector that was sort of created because of patients. So like all over the world when you see how Medicinal cannabis was actually legalized. It was all patient driven, so you know people were sort of realizing that this is a plant medicine that have existed for you know, was around in 3000 bc and it's really really benefited a lot of people but it became an illicit drugs because governments around the world decided it was. To be that in the 60s to the early 90s, and it was pretty much patients who, Mums of kids with Epilepsy, like you said, but also patients who were suffering from cancer. Who you know obviously through some of the heavy medications and realized that cannabis really allowed them, to I guess feel a little bit better compared to some of the medications and there was actually these patients that were the one that advocated for this medication to be legalized. Um, so it's pretty I think it's pretty what's wonderful about it. It's like a testament to I guess, people powered change. It still exists so I have hope.

flowartists
Yeah, and I guess the cancer example is a really good one because that's people, taking medical cannabis to like help them manage their chemotherapy symptoms so they feel okay enough to eat and maybe even have a little bit more of an appetite and

Bee
So.

flowartists
If You aren't working with a doctor or you aren't working with a dispensary knowing how your cannabis medication might interact with your other medications I think could be a really scary issue and a big fear for a lot of people. So I see that as also being a really powerful aspect of what you do. Like being the bridge between the plant medicine and the conventional medicine and knowing about both.

Bee
Yeah, absolutely and that's such an important point I think you know while a lot of patients you know have had you know cannabis even before it was legalized. The importance of having a relationship obviously with a prescribing doctor who's trained and knowledgeable around the issue as well as our pharmacists like you said knowing the interactions with any other medications, but also just understanding dosing titrations of other medications that they're trying to come off as well. So it makes a huge difference and then beyond that as well. I think a lot of patients now while they've realized you know Cannabis have really helped them and they've used it through I guess, you know, other channels. They now want to understand how it works in their body as well as what strains work for their condition. So people I think are now trying to seek that information themselves because I think as a society we're somewhat becoming more conscious of what we're putting into our body as medicines.

flowartists
Especially if it's something you might have to take ongoing for a chronic condition.

Bee
Well. Absolutely yeah, so I think it's great because you know, um, you know I think a lot of patients because of the medications. They've been previously on they weren't aware of side effects. So when they come to medicinal cannabis they really want to I guess empower themselves and have all the information around, you know, how it works in your body and everything and I guess that's when Astrid is about, really.
We're really passionate about is providing as much support and information to that patient when they're being prescribed like we literally take 20 minutes to sit down and talk through a patient. "This is your medication. This is what your endocannabinoid system is and how it works in your body, what foods to have it with". So we really take that time and like you said you know we also, allow patients to always ring us and ask any questions when they start on their medication.

flowartists
Actually would be really great to go through that now. Would you mind giving us a brief description of the endocannabinoid system and how it works in the body?

Bee
Well.

Bee
Yeah, sure so I have to declare I'm not a healthcare practitioner but you know, I've worked in the kind of is industry long enough that I'm comfortable talking about it. I guess in really plain english terms that I normally would explain to patients as you know your endocannabinoid system is pretty much a biological system that exists that regulates and balances key bodily functions. So, you know plays a central role in both our central nervous system and immune systems. So that's sort of the 2 systems I normally use to describe to a patient when they're asked, you know, what's an endocannbinoid system?
So you know sort of looking from that point of view. That's why kind of is as a plan because it works with receptors in our central and immune systems. That's why you can see the benefit. It's really brought to regulating functions such as how body controls inflammation, like how it helps with mood and sleep. So um, you know, it sort of works naturally with receptors that already exists within our body. So there's an amazing media on how the endocannabinoid system works by one of the doctors that we worked with. Many more um on Honahlee's website and he you know he explains it really well and um, yeah, it's it's sort of you know is a natural way of how the plant medicine works biological biologically within our system.

flowartists
I'll put a link to that in our notes it sounds great and I think um, a lot of people might be hesitant to try medical cannabis because like they need to feel clearheaded through the day so they might want pain relief but not the psychoactive effects. Could you explain a little bit the difference between THC and CBD?

Bee
Yes, I would say that's the most asked question because you know while there is a huge stigma on medicinal cannabis is an even bigger stigma around THC. So CBD and THC are like the 2 most prominent cannabinoids found in the cannabis plant. So. THC is the psychoactive component and CBD obviously is the nonpsychactive. Um, and I guess a lot of you know because of what the media and a lot of our drug laws of are always focus around THC. Um, it has a really bad reputation as ah, you know as a molecule. So um, a lot of patients when they come to us even if they suffer from chronic pain. For example, they always say, "hey, can I can I just be prescribed CBD because I don't want to feel that psychoactive effect or I don't want to feel drowsy the next day". The huge difference again coming back to the point of taking medicinal cannabis and having your prescribing doctor and the pharmacist is a taking medicinal cannabis.
How the plant is being manufactured and not having you know pesticides or chemicals used on the plant and it's a regulated product so you understand the level of THC that's in it as well as what strains that you're using and then of course having the support of the doctor and the pharmacist with your dosing.
It's always like sort of, you know if you're taking it medicinally and you're taking it as prescribed in terms of your dosing and the right strain that works for you. It's really rare that a patient would feel I guess really groggy the next day or sort of feel like you know some patients always ask would it well I get really stoned and um, it's it's just you know these sort of questions are because we've how do it set in perception around medicinal cannabis really but the difference is when you use it medicinally and like I said having healthcare practitioners around you I guess working with you to to understand what dosing works for you to obviously a help with the symptom but also making sure that you don't feel I guess sort of that euphoric effect when you're actually taking it is is the importance again to why accessing it legally is so important too.

flowartists
I've got a question you might not be able to help with this one because it's actually from another doctor but a friend of mine just wanted to have CBD for all of those reasons and her doctor actually recommended she get a CBD oil that did have some THC in it because. He feel like they worked in synergy with each other, is that a common point of view?

Bee
Yeah, so definitely, so like you know, um, for example with sleep majority of our patients will be given a predominantly CBD product with like a 3% sort of THC in it and what that really helps is the THC does at times work complimentary to the CBD so it helps to activate the CBD a little bit better as well. So there's that definitely, and even like some of the balance oil you see like a fifty fifty CBD to THC again that works really well for a lot of patients as well. So I think it's like both of these molecules together does actually work your endocannabinoid system pretty well and as well as like in isolate. So like when it's just CBD on its own it also has it benefits but more towards the central nervous system. So um, again, it goes back to like how you know I guess we've had such a huge. Stigma on the plant itself and then again when we talk about herec that's sort of what people have always, sort of associate with like you know I guess what marijuana is and it's like all the bad stuff about it as THC, whereas again when you actually use it medicinally there's benefits to these compounds.

flowartists
And I think another common concern that people might have as well is the potential to be dependent on this medication which of course is a huge issue with opioid-based pain killers, is this also a concern with cannabis?

Bee
Um, yeah, and that's another question, a lot of patients ask and so it goes back to what your doctor has prescribed you for in the dosing that is actually recommended for your medication. So. You know, most patients when they have, you know, we definitely see patients where you know because they abuse it from a recreational point of view or source. They come to us because they've started because initially they're like, "hey I've started using Cannabis because it really helped me. But now I'm using more and more" and that's why it goes back to that whole situation where we always say look it. It provides that benefit but having a doctor and having a pharmacist that actually makes you understand and sort of control your dosing and stick to the dosing. Ultimately so your body does not build that tolerance like everything else then that's the most important thing because you know, thats when that's always when it sort of goes out of control, between what you and your Healthcare practitioners sort of advising, is when I guess the dependency part of it may come in as well. Psychologicaly.

flowartists
And would you like to share a bit about the work that you do with scriptwise because I know this is like a big area of interest for you.

Bee
Yes, so yeah I mean that felt like ages ago now. But um, yes, the scrictwise was a not-for-profit organization that was started by a you know whole bunch of families in Australia and it was sort of spearheaded by the late Heath Ledger's Dad and I was very very blessed to have um, been the CEO to start the organization with him. The reason why that organization started was in Australia we were starting to see a lot of, I guess, people developing opioid dependency as well as um, long-term use of even like benzodiazepines and what was happening was the number of accidental prescription medication overdose was really high. So I think when I left five years ago we were talking about, you know, 1900 australians a year that die from a prescription medication overdose so it was a huge issue. Um, we were definitely going through a face in the Australian medical system where patients were just given tons and tons of medications. There was overprescribing. There was also a lack of care to its patients in terms of managing their pain. So the list goes on and it's something that's really close to me and that's how I guess was transition into the kind of the sector was um, seeing the devastating effects of some of these medications that ended up in an overdose was so um, was so hard because you're almost like "how can I change the system?" when you know it's sort of when they get to you for help at that stage.
It's almost like they get put into a rehab system with sort of more illicit drug use and they just fail within the system they come out and it's like back to square one again. So um, while I achieved some great changes in terms of regulations, I wanted to move a little bit sooner in the patient journey where I guess they don't end up as a statistic, because it was really hard every single day, seeing Coroner reports on my table and stuff um and that's why I got into the kind of this industry because that was it was way before cannabis was legalized and I started to hear from some patients going "Hey, you know the rehab didn't work I'm actually now um, taking kind of this illegally to help manage my pain" and that was what sparked my interest. Um, and yeah, it was very lucky to be to have been given an opportunity three years ago, to like work in the industry.

flowartists
Yeah, because that's a big thing like if someone developed their addiction because they were taking medication for their pain and they still have the pain after the Rehab it's like what are the other options?

Bee
Um, yeah, it's really hard and managing pain within, ah for example within a family clinic is so hard. Your consultations are 15 minutes it's really hard for a patient to be like, hey, this is what's not working. So then it sort of it puts that pressure in the doctor, like, well, what's the easiest solution to this? And obviously the pharmaceutical drug is what is the solution is. Then the other problem we have within the medical system is even if patients wants to go see a pain specialist, I remember, when we were sort of giving talks in regional parts of Australia. It was up to about a 9 to ten month wait for patients to see a pain specialist. Um, so it's pretty much the system that's broken. We just don't really um, see it until you obviously end up in that system and you sort of go wow! This is actually really hard to navigate and and I guess that's why like I said even at the start when patients come to us for medicinal kind of cannabis it's like it's it's it's sort of familiar to the work I did at scriptwise because when they tell the stories. It's like. Yes, that's what I used to hear every day so it's a bit better that we get to help them a little bit earlier and sooner in the journey but still, it takes a long time for them to get to us. It's really challenging for them.

flowartists
And are you finding that GPs even know about this as an option or is it more people doing their own research who find their way to you?

Bee
Yeah, look you know if I'm being honest, GPs do know it's an option. You know it's been legalized for a very long time now and it's very clear to the TGA that any doctors can prescribe, like pretty much any GP can log into the portal can actually write a script for medicinal cannabis.
So the TGA makes it really clear that you can just log into a portal and actually write the script. The issue here is you know. Your everyday GP is quite hesitant to actually upskill or sort of get that information or knowledge around medicinal cannabis as a progressive medicine. So the problem here is also when patients finally go to their, you know, usual doctor and they say hey you know all these medications that you've prescribed for the last four to five years it's not really helped me I want to trial medicipinal cannabis. Some doctors are really supportive and they just go "yup I'll support you but I'll write you a referral". Ah, referral letter so they just refer them on to a specialist or doctor that does some doctors even go to our patients and say "well actually if you go down that route I probably can't see you again". So there is this stigma of like, oh if you're going to consider...

flowartists
Whoa.

Bee
Marijuana and they always say that, "if you to consider that, well then I'm not sure if we can have this continuing relationship". You know so that's when I guess I live in my little Astrid bubble sometimes and I when patients come to me and their gynocoligist or their pain specialist or anyone says "I will no longer treat you or have a you know relationship with you if you go down this route.." That's when I go "Wow. We've got so much more work ahead of us". You know.

flowartists
So do do you think there's situations where people might be getting this treatment but not actually telling their um, their normal Gp or or primary caregiver?

Bee
Yeah, so there are patients that do that. But then when they come to us as well and they I guess say you know "hey my gp is not supportive or whatever". We also do have the ability to say to them. "You know the doctor that prescribes your medicinal cannabis. They are also a gp. You can also go to them continuously as your doctor like if your if your gp if your regular gp is not supporting this, you know", because I think everything when it comes to your health is trust. Like you need to have the trusting relationship with your doctor or your pharmacist, with your psychologists, like everyone, and I think you know if the gp or the patient does not trust you know, which way or the other. It's like, well then that's I feel always very important to your start of getting better as well is having someone that supports you. And gives you all the resources so that you can actually get better, so we normally then say to patients like "look you know all our doctors are actually Gps so if you just want to see them. You know outside of your medicinal cannabis just for your day-to-day stuff like they're happy to do that as well". So. We do help to, I guess in a way, empower patients to make that choice too.

flowartists
Yes, so you want your health care people to be on your team and supporting you.

Bee
Yeah I think, you know, this is why some days I get so frustrated because some of the stories that I hear. Um I Just go what? Like where where is that duty of care?
Where is that duty of care?
Like when you finish your Uni and you study medicine, like, you know, do you do some sort of oath that you'll do duty to care of patients?
No matter what, like when you get, you know, when you get admitted to the college?
That's sort of what you're supposed to do so sometimes and again, that's why it goes back to how at Astrid we really really spend the time to making sure that we care for patients because unfortunately more often than not they have been mistreated within the system as well.

flowartists
Yeah, we've had a bit of a medical system journey when Rane had cancer about five years ago and um, one of the things that we heard which I think really helped shift our perception is to treat your medical team like they're your consultants, like they work for you.

Bee
So yes.

flowartists
And you can also get some other opinions from other specialists if you feel like what they're suggesting isn't the best outcome for you because we like we heard quite a few stories from other people who didn't actually think that the course of treatment their doctor was suggesting was right for them but they were kind of too afraid to say so or they didn't want to hurt their doctor's feelings.

Bee
Yeah, absolutely and I think you know one thing I realized through script was is our our system is very much interventional. So a lot of practitioners are very much trained to like ah, what's the first intervention being medications for surgery. So. whole issue of pain and why the whole like opioid medication thing sort of became massive in terms of prescribing was a lot of patients would have surgery as a first point of, you know, it's sort of like even if they're pretty young. It's like surgery is like what's best for you. For your lower back pain and then they leave the hospital with tons of medications or same as a lot of our patients with endometriosis. So. It's like they see a gynecologist and you know after trying contraception. It's like next solution is "hey, let's let's do a surgery" and sort of you know treat that. So. We sort of take a step back because the whole idea of plant medicine. Anyways, it's almost like going back to you know your early days where your body does have the ability to heal. So um. So that's also part of what we do is like when we do the screening process and a patient comes to us and say well, my gynaecologist is suggesting for me to have a hysterectomy at 26 and I normally go well, you know, maybe seek a second opinion. It would have never occurred to them that that's even something they should do you know?
So we normally go take a step back. You know there are holistic doctors can really help to treat your endometriosis from a holistic whole of person approach before surgeries and options or we say go get a second opinion and then we help them. Potentially find a right gyno that's able to support them and everything so it's yeah it's so it's so sort of like yeah interesting to sort of you know and especially with what we've gone through in the last two years with the pandemic and how the medical system has been really focused on that. You know it's always, I feel, patients continue to just suffer because they're not able to get the right support most of the times.

flowartists
Yeah I've even heard the opposite on patients who actually have done a lot of research and have decided that they do want to have a hysterectomy or another treatment that would make them sterile and their male doctors will just.

Bee
Yes.

flowartists
Deny that option because they're too young and it's just assumed that oh if you don't want kids now you might later when you know they've come to that decision. And yeah, it's really, um, especially in the women's health world. It's so. Frustrating reading about the disparity of like how women's pain is treated compared to men's pain. And yeah I think what is it like it's an average of 7 years to even get diagnosed with endometriosis and then...

Bee
Yeah, yeah, it's crazy and even adhd were starting to see a lot of female patients in their late 30 s who've recently been diagnosed with Adhd as well and and so yeah, but you're right, the journey somehow for women it like a lot more convoluted and it's longer for them to get a diagnosis and that's why sometimes I'm like man. It's you know I'm always blessed when they come to us because we're like let us you know, help you and find a right support around you because. Because medicinal cannabis is just one part of their life one tool that we can give them as a medicine that helps them but where we encourage them. It's like, holistically, what other support do you need to get better?
Because that's the thing. It's like. You know we want patients to get better and they've in they've they're no longer on medicinal cannabis in the next five years that's fine but if they have a quality of life and they're happy like that's us like that's our job done at the end of the day.

flowartists
That's awesome. Thanks your good work! On your web website you mentioned as well that there's like a really big gender disparity within the cannabis industry and Astrid as a female lead dispensary with a diverse team is a bit of a rarity.

Bee
Um.

flowartists
Would you like to speak a bit more about how this might affect like both the individual customer experience but also the industry as a whole as it grows here in Australia?

Bee
Yeah sure I mean like it's it's sort of pretty much the case I guess everywhere even in Canada and North America you're only starting to see like for example, North America a huge rise of I guess um, sort of. Businesses and initiatives around the cannabis space that are owned by like black people. So it's sort of something that you know, um Lisa who's the founder of Astrid when we were both working at Canopy. We were like, "wow, there's a lot of men in the industry..."

flowartists
Ah.

Bee
Considering like the flower, you know the medicinal like benefits of the flower, come from only the female plant. It's the complete opposite when you work in the industry, and it was it was sort of I mean our office was probably the most diverse, like, even at Canopy we were very diverse group of people. But. I think Lisa wanted to take a step further because like every meeting we went. It's it's almost like you're the only female and sometimes, like, my role was the advocacy manager for Asia Pacific at Canopy and a lot of people thought I was um, my boss's PA um. It's just like it was so male dominated that we're like,"hey, we want to you know the plant is like beneficial when it's female". Um, it's an industry that's new so we have that opportunity to change it at the very start rather than wait like 10 years after the industry's been done then we're like oh. "Where's where's all the women in the industry?"
So um, so Lisa did really well and make you show that you know we are about being female led so the entire like management team are all females and and I think I you know we were sort of obviously like people. A lot of patients ask us "So do you have men working there?" like of course you know it's female led that doesn't mean like we don't actually sort of have any male employees. Um, and then obviously for Lisa coming from. Um I guess a diversity point of view was very important to just sort of make sure that. The industry was sort of you know, open to everyone of different backgrounds. Um, and I guess for the patient um, funny enough a lot of our female patients. They come to us because they were like "wow this is a female lead business I really want to come here and I think they already feel. Sort of safe and comfortable knowing that it's sort of a female led business as well". So um, so yeah, it was really cool to sort of I guess be the first one sort of making sure that we emphasise on the sort of identity that was sort of missing I guess within the industry as well.

flowartists
And I could imagine as well... at a lot of those meetings where they thought you were the P A, were there a lot of white guys in those meetings?

Bee
Yeah, yes I mean yeah, like there's definitely a lot more sort of whiteness in the industry as well. But look I think you'll get better and I think you know, um, just even within some of the company seeing, you know women get into really sort of executive positions. It always like makes me and Lisa really happy because you know sort of we need to always have that sort of opportunity to sort of make sure it's not an industry that ends up being very male dominated too. So um.

flowartists
And just kind of further along that kind of marginalised experience I know that Indigenous Australians are way overrepresented it when it comes to being arrested and charged with like low level Cannabis drug offences and also very overrepresented when it comes to mental Health statistics and.

Bee
So yeah.

flowartists
Physical health statistics and that also cannabis is a problem in some remote communities. Do you know anyone or is there anyone kind of doing advocacy work with a First Nation's focus?

Bee
Yeah, I definitely am aware of that and I guess when I was working with Canopy that was probably 1 of my main um projects or interests that I really wanted to do here. Um. Because in Canada the company that I worked for um, canopy grove, you know, I guess were doing a bit of work around First Nations and how you know 20 years after cannabis was legalized. The first nations were never engaged and. My then boss Hilary Black did some amazing work in Canada and making sure that, you know, it wasn't even like oh "let's make them a part of the conversation but like how can they benefit?"
Um, you know in terms of the industry because they've been very incarcerated as well in Australia unfortunately, again, it's probably a topic, Um, that's not even on discussion within the medicinal cannabis sector if I'm being really honest, um I have been in the sector only for two and a half for years I've not even once heard anyone sort of speaking about it.
While medicinal cannabis sector is projected to make billions of dollars in the next couple years I've not really heard of anyone sort of coming out and going "we need to do more for the Indigenous community".
So look I'm not gonna speak and in terms of what Astrid might do. But I think for myself if there's a way to work with ah you know I guess numerous organizations or companies where we can actually do something around the space I think it's really really important considering not just the incarceration but like you said you know the the use of cannabis amongst Indigenous communities is really really high and if there's a way for them to be, you know, sort of I guess be educated around the plan in terms of like using a medicine and how we can sort of find a way to work with them I think that would be great. One of the cool sort of initiatives that I had, um, the opportunity to see in New Zealand was up the East Coast of New Zealand there was a um company called Hikrangi and they're actually employed Maori who've been incarcerated by um, you know, small possession of cannabis and they employed them. They um, educate them around cannabis they were the growers and then eventually they had a sort of...

Bee
Ah, pathway to being in the industry and having some sort of, you know, ability to sort of change a lot of the policies that affected their community as well. So it was really cool that in New Zealand it happened really quickly. Um, and how there were companies that were focusing on that. So I really. Ah, really really do hope that in Australia we get to do something like that very soon.

flowartists
Well one awesome thing that is happening in Australia right now is um, the greens, one of their platforms is cannabis legalization and the greens are running an all First Nations senate ticket this year and I know that um Celeste Liddle and Lydia Thorpe are really pushing for change within this area. So um, there is definitely hope in Australia and hope for like Indigenous lead change as well.

Bee
Ah, absolutely and you know I definitely would love, there is a responsibility for the industry... You know we can't be making the amount of profits and money and reporting all these amazing financial outcomes, you know, to the world and how the industry in Australia is going and and sort of not talk about this, I think it's absolutely crucial that we do and the industry has to be responsible.

flowartists
And like you've said in some other areas. It's like this is a really new industry. So Let's grow it the way that we want to rather than just kind of have all of this baggage of like past patriarchal systems and discrimination baked in, it's like you can start fresh and work towards a better future...

Bee
Yeah, absolutely and you know I think why I'm so passionate about these industries because I always have seen medicinal cannabis as like a breakthrough medicine. So like patients when they come to us like you know. For example, Veterans who come to us and they've suffered so, so, much and they've been through all that medication. They've really struggled and they've in a way, been ostracized by the society when it comes to their healthcare and then they have medicinal cannabis and they have the right support and it's their breakthrough medicine. They finally - alright I'm conscious. I can finally see, you know, I can feel hope I can get better. So for me, it's biased but like I do genuinely feel that medicinal cannabis as a progressive medicine will really change certain policies especially within the drug reform, like I used to work, in the harm reduction space, and we think we're progressive here with our drug reforms. We're definitely not. You know. So I'm very, I guess I hope that medicinal cannabis becomes that platform where a lot of policies that have been, you know, taken so long to change will we eventually change that.

flowartists
And kind of with that future hope, are there any new developments or new clinical trials that have had really encouraging results like I don't have details but I've read a couple of studies that it can be helpful for long Covid and even as a preventative medication along with vaccination, like people are less likely get covid if they're using Medical CBD.

Bee
Yeah I think there was a lot of research around that overseas I've definitely read publications around that me personally are I'm not aware of what were the outcomes of that I'm more aware of I guess clinical trials and studies that are done locally. I think the biggest, well, the 2 biggest ones that we're really starting to see with medicinal cannabis is definitely within providing the scientific evidence around endometrosis like there's a couple of great studies around that as well as um. Like IBS, so any sort of gut health and irritable bowel syndrome that there was actually a study that was sort of you know, um, providing clinical trials to patients who obviously were able to benefit from cannabis for their gut health so those were the two ones happening locally the one with covid I'm not sure. Um you know because that that was done overseas so I'm not really sure to what the outcome actually presented. Um. But I think in terms of progressive medicine one of the biggest movement we're starting to see as well is obviously into um psilocybin as well. Um, and and that's definitely I guess one that may potentially change a lot within the mental health sector and how, you know, the traditional antidepressants and anti-anxiety are being used.

flowartists
And so what's um, what's the current state of those types of studies like have they had positive results with people?

Bee
Yeah I think Monash University was one that did a really you know had really positive effects with mental health you know and then St Vincent's hospital in Melbourne I think I think they're still going on with that trial. They did one for patients who I guess were suffering from terminal illness and it obviously with psilocybin it really helped them grasp, you know, I guess, the concept of death and it really allowed patients to sort of be at peace in that regard. So there were really positive studies and obviously on top of that you know when you see what's happening in Canada as well with psilocybin especially amongst the veteran community I think that's going to be a huge one especially with ptsd. Um, so again, you know I always say. You know patients always asking you when are we going to get prescribed psilocybin and and always say you know obviously hopefully soon. But again it goes back to if we don't have a framework that works for something like medicinal cannabis. You know it's going to be very challenging for the government to regulate like things like psilocybin or mdma.

flowartists
And so um, it's really interesting that you know all of this is um, starting to become more and more at the forefront of like actual medical research because I guess that's how we get some systemic change. Um, but I know that, Cannabis, like it's got a really long history in traditional Chinese Medicine and Ayurveda. Do you know if there are any studies going on that involve collaboration with traditional practitioners from those backgrounds, like do you think they'll be able to prescribe in the future?

Bee
Yeah I think there's definitely a bigger shift in that in Canada and North America for example that there is the huge push um sort of you know within that sort of more traditional like you said Chinese Medicine, Traditional Chinese medicine and Ayurveda. Sort of herbalist sort of like they're able to sort of work with with cannabis or medicinal cannabis it such again in Australia. It's been very very medical. So it's sort of like it's sort of almost I feel a lot of decision makers want it to sit within a more sort of pharmaceutical framework. So it's it's going to be really interesting again in New Zealand, they they seem to always be you know ahead of us in New Zealand, when I was there the last time two years ago before Astrid. There was a huge push from herbilists for example, to sort of be able to, sort of use medicinal cannabis as part of their integrative medicine. So you know when they treat patients with Chinese medicine they're able to potentially even use medicinal cannabis so there was already that push from associations there for that. So again in in Australia I think there was at least a start to, to consider CBD as a novel food, so to have it as a supplement so that you know a lot of these practitioners are able to use it. Of course my personal views, you know obviously I've been growing up with um Ayurvedic medicine because I'm half Indian as well like it's something that I do feel it needs to be integrated. So. Um, you know patients when when they normally come to this, they actually want a more natural approach. So so I do personally see there would be benefit if there was a way to integrate this into the more sort of holistic or traditional practices.

flowartists
Yeah, and also just to like honor the wisdom traditions of those practices, because otherwise it's just colonization right? To take this thing that's been used for thousands of years and like deny that people who actually know how to use it...

Bee
Oh.

Bee
Absolutely Don't get me started in that topic, and I do agree, I do agree, but you know it's always I don't know it's It's a very hard one because you know so much needs to be shifted in the medical system before we even get to that place and sometimes I get excited sometimes I get sad sometimes I'm just confused. Um, so it's yeah, it's sort of something that you know how do we pay respect, when you know, we we talk so much about this being a plant medicine but I think what's more important is paying that respect and honoring the origins of the plant and how it was used and where it came from um, but again, that's that's probably just me dreaming.

flowartists
I share that dream and so I guess the next question is for people who might have listened to all of this who maybe live in a remote community or who don't have a nice gp who lets them take charge of their health.. What's the best way to access Medical Cannabis and I'm thinking, especially for people who might not live in a big city where there's a lot of choice in terms of your medical practitioners.

Bee
Yeah, for sure. So you know with Astrid most of our doctors actually work by telehealth anyways because it's a private medication so most doctors do their consults, you know, either via phone or via the video so the best way you know. If someone's listening and they're in a regional rural area is definitely to head to our website. Um, there is that screening process to make sure that before we even book you through a doctor you actually are eligible but beyond that we also do ask questions around - just your health, like where your current journey is at the moment. What else we can offer outside of medicinal cannabis. Um, and then like I said you know we all our doctors sort are able to do their consults to pretty much anyone anywhere in Australia obviously um at Astrid we are on Chapel street, but we ship to every part of Australia as well. Um, so in that regards, you know it's sort of easier to access. But like I said it's just finding the right place you know a lot of patients. They have either been through cannabis clinics and they haven't had a good experience or they literally like you know heard about us from a friend because the regulations do not allow us to sort of say or promote that we are you know, providing medicinal cannabis like we always have to say it's plant medicine or progressive medicines and and that makes it hard for patient I guess to to sort of know how to get to that first point of contact when they want to actually access medicinal cannabis. But you know majority of our referrals at Astrid has been word of mouth and always feel that's a testament to the fact that we're actually doing all the right things.

flowartists
Beautiful. Well I guess we've just got one more question. Um that we ask at the end of all of our episodes. So um, if you could distill everything that you've learned and everything that you share down to one core essence. What do you think that one thing would be?

Bee
Oh Wow Ah I was not expecting...

flowartists
Yeah, yeah, oh we save the best for last feel free to take your time to think about it.

Bee
Ah, yeah, wow, That's a very big question. So so that's in relation to professional?

flowartists
Oh just whatever comes to mind and personal and professional.

Bee
Well, um I think the core essence I think for me because of when I think about all the work I've done like you know I've worked in Canberra, I've done work in the minister for health office and with script wise and even with Astrid, now I think the core essence is sort of like people actually have the ability to change systems. You know I think with the last couple of years we we sort of feel like you know at times we're not able to I guess gain that power back or sort of able to sort of feel empowered even ourselves.
But I think people really underestimate what they're able to do either like as an individual like you know through the experience to change like systems. So. You know I think the core essence of like what I've seen and witnessed and when regulations have passed is all it really took was like one family or one person who went I know this needs to change and you know they're just fearless and they're just going to be that person that changes everything. So I think that's sort of probably in reflection of like this big question is what comes to mind.

flowartists
Beautiful, Yeah, awesome. Well thank you for everything that you're doing to create change and helping so many people with their health struggles and also to create systemic change as well. If you get a bit ground down. We're all cheering for you.

Bee
Thank you I Definitely knew that that especially the last week I've had so and even that question I was like Wow that's Big. You know and sometimes I do think about what's ahead for us. Um, but I really hope we're able to make a bigger impact. You know, not just around. You know, just medicinal canbis but hopefully were able to yeah just sort of of create a system beyond medicinal cannabis, a healthcare system that really allows like that is really about health ,like I know it sounds so simple. But I think a lot of our patients would understand where I'm coming from.

flowartists
Yeah I definitely get it, beautiful.

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We do touch on some mental health and addiction themes within this episode, and if you are personally struggling we urge you to reach out for help. We’ve included the contact numbers for Lifeline and Beyond Blue in our show notes.
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