Many people dismiss the idea of cannabis as an alternative treatment simply because they don’t understand how it works. In this episode, Tony Frischknecht chats with Charlie Piermarini, CEO of Restorative CBD, to talk about the science of cannabis. Charlie is an experienced physician assistant and healthcare services provider with a hefty educational background. He has invested a lot of time studying cannabis and how it has helped his patients. He also talks about how he got into creating The CBD Education Series to teach more people, both patients and medical professionals, all about the science of cannabis and the benefits it holds.
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The Endocannabinoid System: Science Of Cannabis Explained With Charlie Piermarini
I’m getting close to my 100th episode so I’m super excited. Those that are new to the show, please read that. I’m going to do something that I think is cool for my 100th episode so be ready for that. I’ve got an exciting guest on the show with me. He was one of my guests here a little while ago, Episode 49. I had to look back and see where I was at on that but he’s doing some neat, unique stuff in the CBD industry. He’s the CEO and Cofounder of Restorative CBD. He’s got training that he’s created. He also has a book that he put out. Charlie Piermarini, welcome to the show. How are we doing, Charlie?
Thanks for having me back. I love your show. I love working with you. I’m glad to be back. It sounds like we’re coming back full circle.
The reason why I brought Charlie is he’s got a lot of experience in CBD and starting to uncover some stuff. Some of the stuff that he’s created has made it very easy. In our industry, it’s so convoluted when you’re trying to figure stuff out. Charlie, let people know a little bit about you before we go into this. I want to make sure everybody knows this is going to be an exciting episode. Charlie, go ahead and share with the audience a little bit about you and what brought you into the CBD world?
I’m a board-certified Physician Assistant. I have a Master’s degree in Physician Assistant Studies, Public Health and Physiology. I graduated in 2015. I’ve moved into family medicine for a year after graduation. I’ve moved into pain management, urgent care. Through my journey, based off on my first mentor and the first doctor I worked with, I had developed a liking and gravitation towards wellness and more alternative mixing, holistic and alternative medicine with a typical Western allopathic medicine. I got tired of writing scripts for opioids and stuff. There’s a baseline problem in some of these patients that can be fixed and addressed. I may never heal you but I can at least alleviate and augment some of your pain and ailments.
Basically, my story with CBDs, like any other medical professional, they don’t teach us about anything, endocannabinoid, CBD, nothing. I don’t even think I had a lecture about endocannabinoid in my three Master’s degree courses. It wasn’t after I saw patient after patient in my pain management clinic, CBD in the last couple of years has been getting bigger and bigger. It’s more readily available. Patients are trying it. I had a lot of patients trying it getting varied results. Some of them are coming back positive with THC even though the bottle specifically states THC-free product. Is the industry in trouble? I had no idea. Is this a bad product? Is the patient lying to me? I had no idea. It wasn’t until I had an encounter with a patient who had a central pain syndrome due to a stroke and went from not interacting or talking very much to me doing these appointments to having full conversations with me and her expressing to me, “I know something is different. I feel different.”
I started taking this seriously. I started looking up that I went home that night, did a PubMed search of the endocannabinoid system and lo and behold, there are thousands of papers that no one ever tells you about. I started educating myself. I’ve fallen to be my mission to educate other medical professionals and the public about CBD, cannabis, the endocannabinoid system. There’s still a lot of pushback. Even with the Hemp Bill legalizing CBD, there are still a lot of doctors. I had a patient in my clinic that her primary care physician from a very large primary care group here in Phoenix referred her to me because she wants CBD and talks about insomnia and sleep loss. “There’s a guy. Go see him,” which leaves a business opportunity for me. It leaves a void in education at the patient level when the patients first interact with the doctors and PAs.
One thing I want to share with the audience out there, I’ll give Charlie a lot of props because he’s got a lot of educational knowledge. Not only that, he’s got a drive for entrepreneurship. Knowing Charlie only in this short time, I’ve seen him move and he’s moving in some amazing directions. He’s moving like an entrepreneur. He’s thinking about things. That’s one of the other reasons why we have him on because he’s put some stuff together. It takes some foresight to see the future. He’s figured out some areas such as training the doctors and getting them comfortable. You brought up something here a little bit ago. You said endocannabinoid system. In a nutshell, can you share a quick overview of what that is and how that works in our bodies?
Endo means within anything cannabinoid is referring to receptors that are cannabis-like. We have a whole system in our body that is charged with keeping us in homeostasis. Homeostasis is we are fraught every day with outside stress, even inside stress that is trying to bring us away from a set point up or down. The endocannabinoid system is our supercomputer that is charged with trying to keep us at a certain set point, not too high, not too low. It’s an amazing diverse system that not only includes the CB1, CB2 receptors that are most commonly known. We’ve known for many years that our body produces products that are carbon copies of the CBD and THC molecule.
Our body produces these naturally. We have receptors that these bind to. That’s why when you take in cannabis or CBD, you have these effects because it’s binding the receptors that our body already has. This is our body’s system that works day in and day out to make sure that we are working at a level that keeps us alive. We’re finding that the system goes beyond the CB receptors that we already know about. It goes into other receptors that we are now discovering that are outside of what they call the endocannabinoid system. There are receptors all the way from your brain to your pancreas, spleen, reproductive organs, blood vessels, bone, eyes. It’s ubiquitous is what they say.
You can get some more information on this. We’ll tell you how you can find some of what Charlie is sharing with people. When it comes down to sharing this with professionals, which I think is awesome, starting at the problem and it’s the problem of knowledge and education for these guys. When you talk to any medical professional about endocannabinoids, does it even click at all?
From the entrepreneurial standpoint, it gives a void. That’s what entrepreneurs like you and I feel. We try and fill a void. You see a need and fill it. It leaves a good business opportunity but it leaves a sad state of affairs for patients. A lot of patients coming to providers, “What do you think about this CBD stuff?” “You just want to get high. Go away.” Now you’ve shut down someone that could use a plant to help them heal. It’s a dichotic relationship. It’s good for business because it leaves a void but it’s bad for patient care.
You’re also coming up in a reced state here. It’s starting to happen. Even though it goes legal, it takes some time for everything, regulations, to work their way out, to understand what’s going around you, for law enforcement to understand, for city officials to click. You’re dealing with that but you’re in this time in between medical and rec that I think you’re going to see some big moves out of it because people are going to want to see the differentiation between medical and rec. Are you seeing any of that? Has anything come out where there’s a lot of confusion of what is medical and rec? What does that mean?
I have a wellness clinic that I combined with my chiropractor business partner, myself, and another doctor. We have a different approach to medicine. We get a lot of patients that gravitate towards us. I’ve seen a lot of patients that are coming into the cannabis space, very inexperienced and have little knowledge, except for when they tried marijuana in the ‘60s. Who knows what it was in there? Nowadays, we’ve got scientists with PhDs growing plants, modifying phenotypes, and genetics. It’s down to a science. A lot of patients are coming in and they’re smoking something that they think, “I used this when I was in high school. Let’s try it again.”
They are getting extraordinarily stoned way too high. They’re scared. They put it away. They’re like, “I’m done with that. I’m never going to use that again.” It didn’t work for me. There is a void of education because there’s an influx of people coming in across the whole country that don’t know how to use these products because of lack of knowledge and lack of access to knowledge. The budtenders, the people behind the counter, dispensaries, their knowledge level is limited. There’s a legal aspect where they can’t say certain things. I see a lot of patients with back pain and a lot of them use this. They got to skirt the issue.
Are you able to get more in-depth with your patients on the level of that because of your stature and where you are in the community?
As a medical professional in Arizona, I’ll have in-depth conversations and disenfranchisement you and I talked about, my coaching business. I’m trying to get this cannabis coaching business up and going nationally because I’m seeing a lot of patients in a lot of states. I spoke at the CBD Expo in Indianapolis. It was me, two pharmacists, and a lawyer that has one of the biggest FDA-approved USDA organic grow in South America. He had a very high-level panel. One gentleman raised his hand, an older guy and he says, “How do I find people like you in my state? I don’t know where to go. I don’t know a doctor.” I was like, “Maybe this is an idea to start something where I can help people across state lines.”
One thing that I enjoy that you’re doing is you started this with a bigger vision of helping patients. The great part about where you’re at is you’re aligning yourself still to do that but you’re finding different business avenues along the way to accomplish that. That’s not an easy thing to do. It’s not an easy thing to figure out that focus. Where do I want to hit? Where do I want to land in 5 or 10 years and still stay on that path? How many shiny objects are you seeing on a daily basis?
When I started my CBD business, Restorative CBD, it was out of wanting to get legitimate products that I knew that were higher concentrations, that was a medical level, that I had control over where it was made and how it was made and testing and that was it. I wanted to give it to patients. I thought I’d have a line. I love speaking about this. I’m in five expos in 2021 speaking about CBD as an alternative to opioid medicine. What I’ve seen is how any entrepreneur goes, you think the goal is here but now the target has moved. It doesn’t mean it’s different. It’s changed forms. As an entrepreneur, that the path is never straight. It is as winding as anything could be.
Let’s get back to some of your training. I want to talk about the more in-depth knowledge for the patient. This is a course that you’ve developed. I was able to read a little bit for the medical professional side, which I enjoyed. How easy is this for the new patient to understand?
The CBD education series is my entrance into the education realm during COVID when my clinic hours got cut down and so I was bored. My wife’s like, “Why don’t you start a CBD course?” I was like, “Okay.” She needed me to be distracted by something. I created this course. I called it CBD 201. It’s more of an advanced knowledge course for patients that have some common idea of what the endocannabinoid system is, has heard about it and want a little bit more knowledge. From that, I created a 301 specifically for medical professionals that talked about drug interactions, dosing. At some point, I’ll have to go back and create a 101 that’s for your grandma that has no idea about any of this marijuana, hemp and CBD stuff and start at ground zero. I felt that was going to be a little bit more of a challenge for me rather than starting at a midpoint.
You brought up a couple of good points about dosing. Medical professions, when they prescribe something, they need to know the drug interaction. How’s that going to act? That’s the farthest in their mind if they’re going to prescribe anything. It’s like, “I don’t know anything about cannabis and how it’s going to react.” They’re going to say no because of fear.
The lack of knowledge leads to fear because as medical professionals, we love algorithms and knowing drug-drug interactions and starting doses. I have apps on my phone that show you every dose, where to start and possible titration schedules. I had a conversation with a patient. The beautiful and the most frustrating thing about the cannabis plant is everybody responds differently. This becomes a personal journey. That’s what makes it frustrating for me as a medical professional but also more fun and engaging for a patient because if you truly want to get relief with this, now it’s not me writing a prescription, putting the onus back on you, “Take two of these and call me in a week.” It’s like, “We’re going to start here. I want you to take a journal every day and I want you to slowly go up every couple of days. I want you to write, ‘How am I feeling? What’s my pain scale? How’s my activity level?’”The entrepreneur’s path is never straight. It is as winding as anything could be. Click To Tweet
It sounds like you’re doing it on more of a macro level than anything.
I start patients at a similar dose and I go up and down. I have the patient titrate themselves. You’re adults. The patients know what’s best for their bodies.
How much interaction are you having with your patients?
They sit next to me in my clinic. On my coaching business, that’ll be a Zoom or FaceTime thing. I do half-an-hour appointments and I sit down and ask a lot of open-ended questions.
Are you meeting with them 1 or 2 times a week? Are you on calls?
It’s based on the patients. For sure, once in the beginning and then I like to do once a week, depending on if they’re using a full cannabis product. CBD, every 2 to 3 weeks but if someone’s new to medical marijuana, once a week, get in with them, see them, look at their journal, talk with them. “How are you feeling? What did you experience?”
How are their families responding to their journey?
More and more are becoming supportive. The lady I saw was a retired lawyer. She’s probably in her 70s or 80s. She is anti-cannabis as you could be, growing in that era, lawyer. Her daughter-in-law started using cannabis to help her sleep. She gave it to her mother-in-law and she was like, “You need to try this.” She’s like, “This worked.” She went to her doctor and her doctor was like, “I don’t know anything about this. Go see Charlie.” She ends up in my chair. I think more and more families are becoming accepting of this because it’s becoming more mainstream. There are a couple of CBD companies that are publicly traded on the NASDAQ. You wrote a whole book about this. It’s gone from the days of the back of your van, in your basement, a bunch of hippy smoking stuff to we have medical professionals and scientists that are changing genetics in the plant and learning how to make this into a mainstream thing. A lot of athletes in the mainstream are using it and advocating for its change in sports. It’s way less taboo and it’s becoming more accepted. The overarching goal is a lot of people are searching for more holistic and natural approaches to their health than pharmaceutical agents. A lot of people are embracing cannabis and CBDs for that more than anything.
For those out there that are like the members of the audience said, “Where do I find people like you?” Where do you send them in other states at this point? Do you know very many other people?
My brain went to maybe I’ll create a Weedmaps for CBD professionals. I was like, “How do I monetize it?” I was like, “I’m going to take the bull by the horns. I’m going to start my own CBD and cannabis coaching business that can go across state lines.” My recommendation is if you’re not able to sign up on my program for whatever reason but if you want to go see someone in your area, if you have medical cannabis that’s legal in your state, there are those doctors that you could try and follow-up with them. I find a lot of those cannabis doctors are just writing the prescriptions. They don’t know much about cannabis. They’re taking the money in for writing the script or the recommendation for cannabis. There’s still another void. You got to do research. Project CBD is a good place to start. There’s a lot of good resources on there. There’s a big void of knowledgeable professionals in this area.
It depends on a lot. It depends on your regulations that are happening or the market whether or not marijuana or cannabis legalization has happened. Have you seen an increase in your business since recreation happened?
In my CBD business, it was pretty steady. I get more inquiries now. Even my dad, when they passed the proposition here in Arizona, he’s like, “Is that going to hurt your business?” I said, “No. CBD is different.” It may help it because more people are going to be, “It’s illegal.” Now it’s a little bit less taboo. My sister’s a nurse and she uses my CBD for her anxiety. She tells people about it and nurses are like, “I don’t want to use cannabis.” She’s like, “It’s not cannabis. It’s a hemp-derived product.” There’s still a lot of ground to make up in the medical profession.
I’m guessing another reason why you wrote your book, What is CBD?: CBD Education for Medical Professionals. I am assuming there’s going to play off of your CBD 301 here. Is it completely different? How is it laid out?
It’s completely different. It’s more of a Kindle version for the patients to learn about the basic level of CBD. My next book will be tailored towards medical professionals but I’m only one person. I’m trying to get more literature and education out there to get people educated. Even if they don’t ever want to use CBD or cannabis, at least they have an educated opinion about this. It’s not what they’re learning from their Uncle Joe in the back of his van that loves smoking doobies. It’s like, “There are medical professionals out there that are embracing this. I may not agree with what you’re taking but I understand it. That’s fine too.”
I got a question for you that I’ve been wanting to ask you because I was going through this. Why is the cannabis plant so misunderstood and misrepresented? That’s why you’re doing a lot of this I see. Why is that the case?
If you go all the way back to when cannabis started becoming into the medical community, in the 1800s, Dr. William O’Shaughnessy was an Irish doctor that was practicing in Calcutta, India. He started watching these Indian women using these teas and tinctures for menstrual pains, headaches, aches and pains. He’s like, “What is this?” He started observing it using it in animals. He noticed that it’s helping. He brought it back to England and the UK. It started making its way into medicine. It wasn’t until the 1900s when American physicians were using it. It was part of their repertoire.
They had marijuana tinctures in their office that they were giving to patients. Three things killed the medical marijuana cannabis stuff in America. One was the marijuana tax that I’m familiar with that put tax on people that were selling it. That brought a lot of stuff down. The second thing was Bayer invented aspirin. Patients then were able to take a pill instead of using it with a tincture, “How much do I take?” Every tincture is different from every batch. That killed it.
The delivery of systems, we see that in the evolution of cannabis. I can totally see how it was like, “This is so much easier.”
It’s way easier to pop a pill. What people forget is aspirin was made from the bark of a tree. It’s still a natural product too. The third is I think the government pinned a lot of the marijuana stuff on immigration and lower-level class society stuff. It got a stigma to it. That took off and then Asinger and all of his stuff. If you looked at Nixon’s war on drugs when he had the DEA look at all the stuff, we spent millions of dollars as a government and they came back and basically said, “This isn’t as bad as we think it is. It’s not that bad of a thing.”
They never publicized it.
They basically went and said, “It’s bad. It’s a Schedule 1,” when there’s never been a recorded overdose death of cannabis because there are no receptors on your brainstem. It doesn’t repress your breathing systems like opioids do. In order for you to overdose on cannabis, you have to smoke 45,000 pounds. It’s some abnormal amount of marijuana in order for you to potentially die. That’s my long-winded reason.
Before I let you go, I want to get an idea of what research and how you put this together. How much time did you invest in making something very easy to read but also factual?Lack of knowledge leads to fear. Click To Tweet
Probably a good part of 6 to 8 months of putting together like building websites, going through medical marijuana 411 is a national certification for providers to write medical scripts. I don’t recommend medical marijuana to certain states. Going through their training course, getting their book, PubMed, it took many months to make sure that the information I’m putting out. Still, even if you go on PubMed, one article and then an article two years later, there are differing opinions even on how many cannabinoids are in the cannabis plant. It could be 120. Some of them say 700 molecules, who knows? It’s trying to find the common denominator. At least if I’m saying something, there is some type of knowledge that’s backing this up in some type of literature.
Are you not just flying by the seat of your pants here?
No. I read almost all of the Cannabis Pharmacy that Dr. Andrew Weil wrote the foreword on. I’m trying to stay up to date on literature, which is I have a sticky note on my desk at home to remind me that this stuff doesn’t happen overnight. The amount of PubMed articles that were published going by decade. From 1970 to 1980, I think there were 60. 1980 to 1990, I don’t know the exact numbers but it went up incrementally. In the last several years, there have been thousands of published articles about this plant but yet it’s still Schedule 1. I don’t know for how much longer. They’re realizing that cat’s out of the bag and people are using it.
They’re figuring out how they’re going to tax it and then they’re going to put it together.
All the pharmaceutical companies can make their money out of it.
Charlie, where can people find your book?
It’s on Amazon Kindle. If you type in a CBD Education from a Medical Professional, that’s one way to find it.
How much is it?
It’s $9.99. I want people to learn from it and learn about this amazing molecule CBD. You can take my course, TheCBDEducationSeries.com. My Restorative CBD website has got a lot of knowledge on it. I try and do a podcast once a month but I get busy.
He’s got a ton of stuff on his website. If you’re semi-curious about if it could help my ailments, if it can make my life better, spend some time on his website and check it out. See what he’s got in there. I’m not bringing him on here to have him sell his stuff. He has stuff that’s available if you want to dig deeper into it and understand it. His mission is to truly help the patient in understanding this. One of the huge things that I noticed during our conversation here is he’s taking more care with his patients than 99% of the doctors out there. I visited hundreds of doctors in my life and most of the time it’s like, “What are you feeling? What’s this at?” They write a prescription and that’s the last you hear from them. They don’t spend any time with you. If anything, the evolution of creating that patient care is incredible.
That speaks a lot of the health coaching training that I’m going through that I’m trying to finish up. Also, getting burned out from typical medicine and seeing a patient every fifteen minutes, I work in an urgent care part-time. In my last shift, I saw 40 patients by myself in twelve hours. You physically can’t give good patient care.
You’re bringing up something too that as entrepreneurs that we have to do. You’ve had a second job for how long now?
I had a full-time job and between the days off, I’m building my new clinic. I went full-time, I quit my full-time job, branched out here and building the CBD stuff, my book, my education course, now building my coaching company. At the end of the day, I talked to my wife, Jessica. I’d come home. I’m like, “I’m so tired.” She goes, “You seem like you’re fulfilled.” I was like, “Every day here, I don’t care how tough it is because I room my own patients. I see my own patients. I don’t have an MA. It doesn’t matter how tough it is here because I know these patients are getting good quality care and I’m helping and listening to them. The biggest part of my business is doing dry needling and acupuncture on patients. We don’t teach that in school but I had two people come in that couldn’t even walk. Their back was in a spasm. Fifteen minutes with dry needling, they’re out fully walking.
I would love to talk to you about that sometime because it’s a very interesting process. I’ve experienced it a couple of times for some PT stuff. Thanks for being on the show. I want to thank you for reading. I hope you were able to get something. If anything, read up on CBD with your family members. If you’re interested, read up on it. You can go visit Charlie’s site but start doing some research and understanding what you’re doing.
One of the reasons Charlie started this company is the quality of products out there. There’s a lot of crap on the market. When you’re putting crap into you and you don’t know exactly what it is because they don’t share it on the label, it might not be anything that it says. It might be a very small active ingredient. You’ll see that in differences in pricing. Make sure you know what you’re getting into if you start buying this because there’s no need to spend $100 or $200 on some snake oil. That’s what it is a lot of the time.
You don’t have to buy my CBD. I tell patients, “There’s no pressure in buying my products. It’s as long as you’re buying a reputable company.” When I go to these expos, one of the first questions people ask, “How do you know a company is reputable?” Go to their website and look at the About Me page. If they don’t have an About Me page, that is number one. I would click off and go away. What’s their story? Even if it’s a mom and dad that started this because they got relief from their kid’s epilepsy, whatever it is, that’s at least a story and they believe in this. It’s not someone making money. Also, look at lab results. Everyone talks about that. Call the company, pick their brain, ask them. If they’re making outrageous claims, “Take our CBD, it’s going to cure your cancer. Take our CBD. It’s going to cure that.”
FDA is definitely keeping their eyes on those guys. There’s still a ton of that because they’re getting away. Go check out his book on Amazon and also check out his courses. If you’re a medical professional, check out CBD 301. If you’re a patient looking for more in-depth knowledge, check out CBD 201. Charlie, it’s been great having you on. I look forward to your continued growth and talking with you as you go through the process because you’re doing some amazing stuff. Please reach out to me. If you want me to ask Charlie some stuff about CBD, he’s got the knowledge.
We’ve got a good connection. I can introduce you guys directly if you want to talk to Charlie. If you feel comfortable with that, if you feel comfortable talking to him directly, that’s fine too. I want to leave that open for you out there reading. I hope you enjoyed the show. I had a blast. I will see you next time. Thank you so much for checking us out. Always visit PlantProblem.com. You can visit us any time and watch any episode there. See you in the next episode.
- Episode 49 – past episode
- Restorative CBD
- Project CBD
- What is CBD?: CBD Education for Medical Professionals?
- Cannabis Pharmacy
About Charlie Piermarini
Experienced Physician Assistant with a demonstrated history of working in the health care industry. Skilled in Medical Devices, Sales, healthcare, Speaking, consulting, Business, and Life Sciences. Strong healthcare services professional with a Masters of Physician Assistant Sciences (MSPAS), Masters of Science in Physiological Sciences (MS), and Masters of Public Health (MPH) focused on providing personalized healthcare to my patients. Also a Certified Health Coach (CHC) through the National Society of Health Coaches.
Restorative CBD was founded to give patients quality products that they can trust. Working with patients over the last couple of years, I have seen firsthand how CBD can really help patients. I want everyone to have access to quality hemp-based CBD and the necessary education that empowers them to improve their ECS.
I co-founded The Healing Joint and Integrative Medicine to give patients the type of health care that they deserve. Personalized healthcare is the future, we will be using targeted treatments that work best with the patients’ own DNA.
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