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Ep. 429: Professor Gil Bar Sela, Rambam Academic Hospital

Cannabis Economy Podcast
Ep. 429: Professor Gil Bar Sela, Rambam Academic Hospital

Ep. 429: Professor Gil Bar Sela, Rambam Academic Hospital

Professor Gil Bar-Sela joins us and explains how cannabis is used to treat different illnesses and conditions: “For example, if we want to bring cannabis as cancer treatment, then of course, we need to do a specific study trying to answer this indication like every medicine that goes into the market. If you are dealing with symptom control, then it’s a different area of research.”

Transcript:

Seth Adler: Professor Gil Bar-Sela joins us. Welcome to Cannabis Economy. I'm your host Seth Adler. Download episodes on Caneconnomy.com, that's two n's in the word economy, or wherever you currently get your podcasts. Caneconnomy.com has a ton of direct insight from scientists, policy, and business luminaries in the space. First a word from Bedrocan, and then Professor Gil Bar-Sela.
Bedrocan is a patient-driven, global pharmaceutical-minded cannabis company. Their entire end-to-end process is GMP certified through Dutch and ultimately European authorities. Bedrocan is the market leader in Europe for medical cannabis, and has been the sole supplier to the Dutch government for 16 years. Through the Dutch government, Bedrocan provides product to 15 countries currently. As a science-based company Bedrocan invests in clinical research. The Leiden University conducted a double blind placebo controlled clinical trial on fibromyalgia with Bedrocan products which yielded promising results. They're now working on a follow-up to that study. Bedrocan is also working on the extent to which cannabis can reduce a reliability on opioids. Bedrocan believes that clinical research is key for the future of the company, standardized product, the industry, and the patient. Visit bedracan.com for more information.
Professor Gil Bar-Sela.

Gil Bar-Sel: Yeah.

Seth Adler: How do I pronounce it? It's okay?

Gil Bar-Sel: It's fine.

Seth Adler: Close enough type of thing.

Gil Bar-Sel: Yeah, you have the Israeli accent already.

Seth Adler: Well now we are here, we're at Can Attack right next to the Mediterranean sea, it's beautiful here. You laid out what you've been focused on, and I'm very excited to be talking about the science of cannabis with you. You say you've been focused on it for, how many years?

Gil Bar-Sel: I think it's around six to seven years that I'm doing research, and of course, giving cannabis to different indications, but for cancer patients, all of them. Almost all of my patients are cancers. During the year it's probably thousands of patients.

Seth Adler: What brought you to cannabis? Obviously you've been around it before that.

Gil Bar-Sel: I'm a specialist in oncology but also in palliative care. It's a different area. You can be a physician of palliative care not related to cancer, but it comes from cancer because many cancer patients need palliative care. And cannabis, it started as a palliative medication. I think it's still, in this area, regarding cancer, but it's trying to move to be a cancer treatment, to push it ahead.

Seth Adler: Or push it's way back through right? Because if it's basically, "Okay, nothing else works. Go ahead and try some cannabis.", that's where we are.

Gil Bar-Sel: Yeah, but usually in this position if you are trying cannabis it will not be helpful, because it's also the [inaudible 00:03:22] of the illness itself. When it's reaching a certain point, in most of the cases nothing will help. It's a kind of equilibrium between the ability of the body to strangle heart disease, and the disease itself that it's growing. So, if you are really trying in the end, and I allowed patients, when they have nothing to add, to try cannabis as much as they think it can be helpful, but I don't think it's helpful in this position.

Seth Adler: Will it at least easy pain at that point?

Gil Bar-Sel: Yeah, that's true. [crosstalk 00:04:02] It's important. It allows them to eat, sometimes gives them appetite, and most of the time you don't gain weight. It's very important in advanced cancer patients to gain weight. You don't gain it, but you really improve your appetite, and it's really improve your attitude to food. It's important enough, I think.

Seth Adler: So it's a quality of life improvement at the end there. But now let's talk about maybe how we can utilize it in a way that it can actually help.

Gil Bar-Sel: Well, I think first of all, regarding quality of life you can use it in ... You don't need to use it just in the end. Many cancer patients had sleep disorders, insomnia, and I find it very good indication. For old people cannabis i think work less than the younger. It's not a-

Seth Adler: Generalization.

Gil Bar-Sel: Research, it's just a general statement. But, it's really worked very good for sleep. In cannabis you have many sleep disorders, and it's not very specific. Sometimes it can be due to pain, sometimes due to thoughts, anxiety, and so on, and because cannabis give you some answers in every of those indications, so when it comes to an endpoint of insomnia it can be very helpful.

Seth Adler: Professor Gil Bar-Sela joins us. Welcome to Cannabis Economy. I'm your host Seth Adler. Download episodes on Caneconnomy.com, that's two n's in the word economy, or wherever you currently get your podcasts. Caneconnomy.com has a ton of direct insight from scientists, policy, and business luminaries in the space. First a word from Bedrocan, and then Professor Gil Bar-Sela.
Bedrocan is a patient-driven, global pharmaceutical-minded cannabis company. Their entire end-to-end process is GMP certified through Dutch and ultimately European authorities. Bedrocan is the market leader in Europe for medical cannabis, and has been the sole supplier to the Dutch government for 16 years. Through the Dutch government, Bedrocan provides product to 15 countries currently. As a science-based company Bedrocan invests in clinical research. The Leiden University conducted a double blind placebo controlled clinical trial on fibromyalgia with Bedrocan products which yielded promising results. They're now working on a follow-up to that study. Bedrocan is also working on the extent to which cannabis can reduce a reliability on opioids. Bedrocan believes that clinical research is key for the future of the company, standardized product, the industry, and the patient. Visit bedracan.com for more information.
Professor Gil Bar-Sela.

Gil Bar-Sel: Yeah.

Seth Adler: How do I pronounce it? It's okay?

Gil Bar-Sel: It's fine.

Seth Adler: Close enough type of thing.

Gil Bar-Sel: Yeah, you have the Israeli accent already.

Seth Adler: Well now we are here, we're at Can Attack right next to the Mediterranean sea, it's beautiful here. You laid out what you've been focused on, and I'm very excited to be talking about the science of cannabis with you. You say you've been focused on it for, how many years?

Gil Bar-Sel: I think it's around six to seven years that I'm doing research, and of course, giving cannabis to different indications, but for cancer patients, all of them. Almost all of my patients are cancers. During the year it's probably thousands of patients.

Seth Adler: What brought you to cannabis? Obviously you've been around it before that.

Gil Bar-Sel: I'm a specialist in oncology but also in palliative care. It's a different area. You can be a physician of palliative care not related to cancer, but it comes from cancer because many cancer patients need palliative care. And cannabis, it started as a palliative medication. I think it's still, in this area, regarding cancer, but it's trying to move to be a cancer treatment, to push it ahead.

Seth Adler: Or push it's way back through right? Because if it's basically, "Okay, nothing else works. Go ahead and try some cannabis.", that's where we are.

Gil Bar-Sel: Yeah, but usually in this position if you are trying cannabis it will not be helpful, because it's also the [inaudible 00:03:22] of the illness itself. When it's reaching a certain point, in most of the cases nothing will help. It's a kind of equilibrium between the ability of the body to strangle heart disease, and the disease itself that it's growing. So, if you are really trying in the end, and I allowed patients, when they have nothing to add, to try cannabis as much as they think it can be helpful, but I don't think it's helpful in this position.

Seth Adler: Will it at least easy pain at that point?

Gil Bar-Sel: Yeah, that's true. [crosstalk 00:04:02] It's important. It allows them to eat, sometimes gives them appetite, and most of the time you don't gain weight. It's very important in advanced cancer patients to gain weight. You don't gain it, but you really improve your appetite, and it's really improve your attitude to food. It's important enough, I think.

Seth Adler: So it's a quality of life improvement at the end there. But now let's talk about maybe how we can utilize it in a way that it can actually help.

Gil Bar-Sel: Well, I think first of all, regarding quality of life you can use it in ... You don't need to use it just in the end. Many cancer patients had sleep disorders, insomnia, and I find it very good indication. For old people cannabis i think work less than the younger. It's not a-

Seth Adler: Generalization.

Gil Bar-Sel: Research, it's just a general statement. But, it's really worked very good for sleep. In cannabis you have many sleep disorders, and it's not very specific. Sometimes it can be due to pain, sometimes due to thoughts, anxiety, and so on, and because cannabis give you some answers in every of those indications, so when it comes to an endpoint of insomnia it can be very helpful.

Seth Adler: Is that a general statement, or-

Gil Bar-Sel: It's still a general statement. You can see with the studies of Sativex that were actually studies for pain, but they used also questionnaires that were dedicated to insomnia, and they got positive results. But, it wasn't an endpoint in those studies. But they think it give you a hand, and they think it should be large clinical study on this point because it's almost every cancer patient.

Seth Adler: Sativex is synthetic, yeah?

Gil Bar-Sel: Sativex, it's not a synthetic. It's something equal that you get it from the plant, but it's a spray. CBD, TCH equal.

Seth Adler: So it's plant based?

Gil Bar-Sel: It's plant based, but it's a product, medical product.

Seth Adler: Okay, so now here we are in insomnia. You've go your six areas. What were the six areas that we saw?

Gil Bar-Sel: Well, five of them were actually palliative directions. It was chemotherapy induced nausea and vomiting, so we have the proof from the old synthetic drugs that it helped, but we don't have proof that it adds something to the new drugs, and very good drugs that we have for this indication.

Seth Adler: The plant-based drugs?

Gil Bar-Sel: No, I mean we have very good drugs, not cannabis based, it's just an [inaudible 00:06:57], anti-serotonin blocker agent and so on, that really improved the treatment in this indication. And does cannabis can add something above those indications? That's not for sure, but it's a good indication, it's already proven. And also cancer-associated pain, in somehow it's ... You have a good proof for it, not very good, but good one.

Seth Adler: And now that's research based, that's not a general statement.

Gil Bar-Sel: That is researched based but it's not too specific to cancer patients, that's the main problem. The pain is not much different from noncancerous to cancerous patients, but it's more complicated in cancer patients. You have other reason, or you have other symptoms that you need to do them in order to get improvement in pain. So, this proof is not completely but half done.

Seth Adler: Half done for cancer.

Gil Bar-Sel: For cancer pain, yeah.

Seth Adler: In terms of chronic pain generally then, where are you?

Gil Bar-Sel: I think it can be a good indication and I'm not sure it can be instead of opioids, but-

Seth Adler: Supplemental.

Gil Bar-Sel: A supplement for sure, and we don't have a good medication in between, and we have those side effects of the nonsteroidal, longstanding side effects that cannabis don't have, so in chronic pain I think you have more data. In cancer pain, the pain are usually in higher levels, but yeah.

Seth Adler: Is some of what we're talking about based on the fact that acute solutions, very intense pain, is not well solved by cannabis? Cannabis, if it's on a scale of one to ten at a ten, maybe that's not where cannabis goes. But if its a scale of one to ten and it's a four, but it's always a four, that's a good indication for cannabis?

Gil Bar-Sel: It's a good-

Seth Adler: I'm of course speaking like not a scientist, right?

Gil Bar-Sel: It depends when we are dealing with cancer pains we need to give the patient longterm medication that will change the level of the pian. That instead of running from two to eight or nine, it will be at the same level and the peaks will be lower-

Seth Adler: Threshold?

Gil Bar-Sel: Lower threshold. So cannabis until now, it's a short term medication. You can't use it for the longterm and that's one of the main problems that can be solved I think in the industry. It will have acute and chronic effects. So it will work for 10 or 12 hours, not just for three or four. So now it can be, instead of [inaudible 00:10:07] breakthrough medication, because when you are giving opioids, you're giving it for the longterm every 12 hours, and you have the breakthrough. When you have peaks of pain you use opioids above the ones you use regularly. So, when I advise patients I tell them, "First try the cannabis instead of the breakthrough. If it works and works good, you can try to lower the doses of the chronic opioids that you are taking.", but for a breakthrough it's working fine. It's really helpful, but still we need the research.

Seth Adler: We need the research. So this is what you are doing, right? What is on your desk or in your lab? What are you focused on most?

Gil Bar-Sel: I focus on different area. One of the area is really in pain, trying to focus on the neuropathic pain. Neuropathic pain is one of the different kinds of pain that we don't have a good solution for them. There are many medications, but none of them giving a good solution. And we have side effects to all of them. We have many chemotherapy drugs that use as adjuvant treatment, adjuvant treatment in oncology is something that came after you are during a surgery to prevent a recurrence. It lowers the percent of the recurrence, but it's a healthy person, you already removed his tumor. He probably will be fine, but because of the risk, high to intermediate risk for recurrence, we are giving chemotherapy four to six months in advance and make him ill for this time because of our drugs. One of the main side effects that's really [inaudible 00:12:00] was all his life for the future as well can be the drugs that cause neuropathic pain, and if we can improve there the situation and maybe prevent, we still didn't do the study so I can't say-

Seth Adler: No, I understood.

Gil Bar-Sel: But we try to find something to prevent the neuropathic pain from developed, that maybe will hold this situation for a long time and not just for a short time that he will need drugs during all his life after it.

Seth Adler: What I'm hearing is that there are a tremendous amount of side effects from the drugs that we have, and we haven't seen the same side effects when we use, plant based, not synthetic, but plant based cannabis.

Gil Bar-Sel: It's one of the good indication why to use plant based medication and not the ones that are regular used in medicine until now because of the side effects and the prolonged side effects that those medication also have. And of course, they are not giving a good answer as well, so it's both sides.

Seth Adler: When you say the research needs to be done, what do you need to see? Is it just a number of occurrences? Is it the length of time itself? Is it all of this?

Gil Bar-Sel: You are doing different studies for different indications. For example, if we want to bring cannabis as cancer treatment, then of course, we need to do a specific study trying to answer this indication like every medication that goes into the market. If you are dealing with symptom control, then it's a different area of research. It's really done with questionnaires for a longer time and you need to compare it to something because otherwise it's hard to go over the placebo effect.

Seth Adler: We go double blind placebo controlled right?

Gil Bar-Sel: Yeah, maybe. It's not all the time should be double blind. Sometimes you can give what is given in the market just to compare it, and just do it randomly. It's not should be all the time double blind. Of course it's the best, but it's very expensive and very large studies to do.

Seth Adler: There's fertile ground there as far as control, right? Of symptoms, symptom control.

Gil Bar-Sel: Now there is a different area of studies, what we call patients reporting outcome, that we are leaning not on the regular studies that focus on the product, but really asking many, many people what's improved their quality of life, ask them fill the questionnaires and so on, and this is used a lot for symptom control in cancer. The main problem with cannabis, that patients use a different product. So, it's hard to understand, do we have a specific product that's really good for pain, and another one that's good to insomnia. It's really hard to know because patients using many different things.

Seth Adler: But that approach, is that approach more towards treating the patient then treating the disease, or no?

Gil Bar-Sel: When you are dealing with supportive palliative care, the patient is in the focus. You're not asking how it can heal his illness, or his cancer. But, how can I improve his quality of life? So it's a different philosophy of treatment.

Seth Adler: I have an example that I would like to give, and I hope that you will stay with me in my example.

Gil Bar-Sel: Okay.

Seth Adler: It's a terrible example, but in college we used to have a joint and we would pass around the joint and everyone would take about the same amount, and every single person would have a different reaction. It would be personalized. What that same amount of the same medicine so to speak, the effect would be personalized. How are you seeing that in your research?

Gil Bar-Sel: Well, it's a different area of research that really needs still basic studies to do so, but I think we are different of course, in our genetics. So, it's also the endocannabinoid system, it's probably different in us-

Seth Adler: In each of us?

Gil Bar-Sel: Of course, in each of us, and of course, every cancer has it's own genetic as well, that's what we call personalized medicine. Now, in oncology it's more related to the cancer and less to the person. So, we have both sides, the person, that's regarding side effects or symptomatic effects, for example, of the cannabis. And if we want to deal with maybe anticancer drugs then we are dealing mainly with the genetic of the tumor itself. So, we need to do both studies to understand the endocannabinoid system in the tumor, and in the body, and what are the genetic differences in both of them.

Seth Adler: Yeah. Because we have you and your big brain, obviously we've talked the endocannabinoid system many times. We've got over 400 episodes and there are many opinions. So, I would love to hear how you explain the endocannabinoid system. What do you say when someone asks you, "What is the endocannabinoid system?", what is your answer for that?

Gil Bar-Sel: Well, it's a system that's really involved in many reaction, biological reaction in the body. Part of them related to the neurology system, but part of them also to the immune system, and both of them are probably important, but maybe not working on the same sides that we want them, can be differences. Can be a good neurotransmitter for many symptoms control and so on, but it can be also an immunoregulation that it's more suppressant of the immune system. So when we are dealing with different illness we need to know in what direction we want to focus. It's a good drug maybe to epilepsy, but also maybe a good drug if you want to depress the immune system, but if you want it to get higher maybe it's not a good drug, so it should be tested.

Seth Adler: And that gets into the cannabinoids and the compounds of cannabinoids, and maybe we want some of this and less of that.

Gil Bar-Sel: Okay, this is another direction. What I've been told in my lectures that we can use only the plant itself, and what it bring it will bring. But, if we really want to understand it we can see if we can create product from the plant, but are different from each other and that are more related to different illnesses that we want to focus on. On the different symptoms, in a different way to be active in the process, because it's a process. It's not stopping one point, it's all the times the body's changing, and in cancer, also the tumor is changing.

Seth Adler: Its' continuous essentially.

Gil Bar-Sel: Yeah. And we have all the target therapy in oncology that we know that are all the time are good for a certain time of a time, because after the tumor is changed, there is a different pathways that are taking part. And target therapies it was very good one year ago, is now not working at all. We have secondary mutations, and so on. So if we want the cannabis to be in this system as well, we need to understand if it goes with dose target indication, maybe it blocks some of them in the tumor, we really don't know. And some [inaudible 00:20:27] is needed when this is an indication of treatment.

Seth Adler: Did you say we also have to watch the endocannabinoid system within the tumor? Did I hear you say that?

Gil Bar-Sel: I think so, I think so.

Seth Adler: What could you ... I barely understand the endocannabinoid system in my body. Thank you, explained it again. What do we mean by the ECS in the tumor?

Gil Bar-Sel: Well, it's active. There are a lot of cancer cells models in the labs that we see that the endocannabinoid system is working as well into the oncogenic pathways. Sometimes blocks them, sometimes it's gets them a little bit higher. It's also some evidence that doing both sides it probably change from tumor to tumor, or from cell line to cell line. So, it's not the same in every tumor and if you want to be more personalized, and there are companies that are working on it, because some connections with them trying to see if they can be more specific and say, "Well, if you have this genetic of your tumor, then you can use cannabis or not.", or you can use cannabis X or cannabis Y. It's a new area of research, very interesting, but a lot to be answered. And they're all companies that try to jump very high jumps not really covered by science, but that's-

Seth Adler: That's where we are?

Gil Bar-Sel: Yeah, that's one of the problem of the markets, that it's very growing very fast.

Seth Adler: Because it's been prohibited, there was stigma attached, it was illegal. So, this is the problem with the fact that we are doing the research as we have an industry all at the same time. Of course, there's many years of research in Israel. You yourself have six or seven, and Raphi Mechoulam, and all of them have many years before.

Gil Bar-Sel: Yeah, but even dealing with clinical research in cancer, it's one seems to take it for symptoms, and it really can be very personalized. If it helps you, take it why not. It's only for symptoms. But taking it as a cancer treatment, sometimes people want it instead of their regular treatment, of the proven treatment. Sometimes they want to add it and you don't know if it's beneficial or not, so I think you should be more careful. And the industry is pushing them, but I don't think it's a good push.

Seth Adler: We have to be careful is I think your point. We have to be steady, we have to look, we have to make sure-

Gil Bar-Sel: This indication you need to go very slow and it should be research proven, and not use it by the website.

Seth Adler: Just to go, "Yeah, it says good. Okay, I go.". Now, some of your colleagues I've spoken to have said, "I have seen cannabis take down a tumor faster than chemotherapy.", the scientist says, "I've seen this with my own eyes.".

Gil Bar-Sel: Well, first if the [inaudible 00:23:43] fine. In my ways of thinking, I didn't see patients taking just cannabis. I have only one patient that she has basil cell carcinoma on her nose, and she use cannabis, but in local therapy. And it's improving slowly, not very fast, but it's improving. But, for advanced cancer patients the taking only cannabis and even in higher doses without regular treatment, I myself didn't see any patients that it was really helpful. Sometimes patients mix. The tumor was taken out, and they're taking it as unproven adjuvant treatment as I explained before. But in most of the patients the tumor will not recur anyway.
So, I don't believe the cannabis made something or not. And others took it with regular drugs, sometimes can be a hormonal therapies that you are even taking injections every three months, and you don't think, "Well this is my anticancer treatment.". So, it's very mixed. And you know that this RSO, what we call the Rick Simpson Oil, it's just how to make a product, but people are doing it at home or somebody helps them to do it. But the product itself, it's really quite different and if we try to check it we see that everybody has a different product, that they call it RSO. So even it was helpful for some person in the web that used it in Canada or in Australia, it doesn't mean that it will be helpful for you because it's completely be a different product.

Seth Adler: If I bake brownies and my sister bakes brownies I guarantee her brownies are going to taste better even if we do the same.

Gil Bar-Sel: Exactly. But people are looking at the web and think, "Well, it's good for me as well.", and leave the anticancer treatment and go for it, or ask for it. And it's really hard to explain them that this person, both of us we are not familiar with him, but maybe we take it for guarantees that it was very helpful for him. But we don't have information what he really used. So, I can't just give you 200mg [inaudible 00:26:06] make whatever you like and hopefully it will be helpful.

Seth Adler: Right. "Good luck. You'll be okay.", exactly. So, there are potentially answers here within cannabis. Is that a good way to say it?

Gil Bar-Sel: I think there is a lot to study.

Seth Adler: Of course.

Gil Bar-Sel: And there are some hints that it can be helpful in some indication, and i think for the science point of view, the clinical science point of view is trying to clarify this indication and people will know why they are taking it, they physician will know why he's giving it, and the patients will know why he's taking it.

Seth Adler: To get to that reality, based on the fact that you have been doing what you're doing outside of cannabis, how long ... And of course it's an unknowable, and it's almost unanswerable and maybe you won't answer it. But how long should we expect it will take for us to start to get more clear answers than just hins?

Gil Bar-Sel: Between five to ten years.

Seth Adler: That much time?

Gil Bar-Sel: I think so, to get a very good answer. People can use cannabis and maybe it will go through legalization in many countries and they'll use cannabis. But, probably they will not use the cannabis that it's good to their illness, if they're taking for medical purpose. So, if they wanted, as a medicine, you need the research. Even if everybody combines the shop cannabis, you still need the research to give the good indication why to take this cannabis or another, what amount, how to take it, and so on. So you will need the research anyway, even if everybody would take cannabis. And of course, it's not company want to sell cannabis, but government want to give solution for the citizens. So, it should not run just by the industry, the government should take part.

Seth Adler: 100%. I completely agree with you. I worry when I see Mark Zuckerberg from Facebook testify in front of Congress, I'm talking about the United States, and it's very clear that the legislators are not able to ask the right questions to the person that they are supposed to be regulating. It obviously is something that can't happen well. So, we have always looked for sensible regulations, so I think it is ... I'm glad to speaking with you, because it will be the scientists that will help not only industry, but with science help policy, help regulations come up and have those sensible regulations for patients. Because I agree with you it cannot just be industry. It must be science, and then it must be policy makers with open ears to science.

Gil Bar-Sel: I agree. I think in Israel it's a good background, but still we don't have the money from the science point of view, we don't have the money to do real studies. That's I think the main problem.

Seth Adler: You are as close as you can be though, because science has led these regulations as much as it can. Raphi Mechoulam name is on the regulation and [inaudible 00:29:27] name is on the regulations. We're doing pretty good. [crosstalk 00:29:33].

Gil Bar-Sel: We are doing pretty good, but the next step is really to reach to a specific product, to a specific indication, to understand why we are giving it, for what reason we are giving this and not the other. I think it's the next step.

Seth Adler: So I will have to keep talking to you as we go. [crosstalk 00:29:51].

Gil Bar-Sel: When we meet!

Seth Adler: Exactly. In the meantime I'll ask you three final questions, I'll tell you what they are, I'll ask you them in order. What's most surprised you in cannabis? What's most surprised you in life? And in the soundtrack of your life, one track, one song that's gotta be on there, but we'll get to that. I find it fascinating already what your answer would be no matter what you say, because of the fact that you actually study this. What has most surprised you in cannabis?

Gil Bar-Sel: I think what was known from the beginning, hopefully was known, that it can be very helpful in different kind of illnesses. I think it's very important that people can use it in a different age, in a different indication, and still it will be helpful for the quality of life. I find it every day very surprising and amazing. Even if it's not give the final solution to the diseases, we have very few diseases that we have them a good solution, and with most of our diseases we just live continual life with them. And I think cannabis in a large part of the diseases makes this continuation much better.

Seth Adler: So many different things. We didn't mention digestive, but also digestive as well.

Gil Bar-Sel: Yeah, many indication.

Seth Adler: What's most surprised you in life?

Gil Bar-Sel: The election next week in Israel.

Seth Adler: We'll see! Podcast land knows no time, but we are recording this right before the election, so we'll see what happens.

Gil Bar-Sel: I think life is surprising by itself. I'm coming to the age that my age are still people not with the good health so every day that I'm working the morning and in good health, I'm saying thanks.

Seth Adler: You're happy if you're healthy I understand, now that you're 30 right?

Gil Bar-Sel: Around.

Seth Adler: Give or take? On the soundtrack of your life, one track, one song that's gotta be on there. A song, a favorite song.

Gil Bar-Sel: A song one?

Seth Adler: Yeah.

Gil Bar-Sel: I very like Hotel California.

Seth Adler: We'll do that! Listen, you can check out but you can never leave. Professor, thank you so much. Appreciate it, and I look forward to checking in with you down the line.
And there you have Professor Gil Bar-Sela. Very much appreciate his time. Very much appreciate your time. Stay tuned.

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Cannabis Economy is a real-time history of legal cannabis. We chronicle how personal and industry histories have combined to provide our current reality.