0:00:01.083,0:00:03.518
Over the past 20 years

0:00:03.542,0:00:07.375
more than 800,000 people[br]have died in the United States

0:00:07.417,0:00:09.768
due do drug overdose.

0:00:09.792,0:00:12.934
Yes, more than all the lives lost

0:00:12.958,0:00:15.750
in all the wars[br]this country has fought in.

0:00:16.833,0:00:20.417
The majority of these cases[br]are due to opioid drugs.

0:00:21.917,0:00:24.976
Sadly, while we're having[br]this very conversation,

0:00:25.000,0:00:28.476
at least one person will die[br]from a drug overdose,

0:00:28.500,0:00:33.393
and a child will be born[br]experiencing severe withdrawals

0:00:33.417,0:00:36.684
due to in utero opioid exposure.

0:00:36.708,0:00:39.268
Only recently have some[br]pharmaceutical companies

0:00:39.292,0:00:42.601
been held legally responsible[br]for the opioid crisis.

0:00:42.625,0:00:46.184
And compared to their[br]multibillion-dollar revenues,

0:00:46.208,0:00:49.542
the economic penalties[br]they're paying seem minuscule.

0:00:51.292,0:00:53.083
So let me as a question:

0:00:54.208,0:00:57.476
why does addiction[br]and the stigma of addiction

0:00:57.500,0:01:00.042
make it OK to undervalue human lives?

0:01:01.458,0:01:04.726
Ironically, I'm often asked[br]the opposite question.

0:01:04.750,0:01:07.684
Why should we care about "addicts?"

0:01:07.708,0:01:09.684
Sometimes I'm even shouted at

0:01:09.708,0:01:13.559
by people who think that anyone[br]who suffers from a substance use disorder

0:01:13.583,0:01:15.101
brought it on themselves.

0:01:15.125,0:01:16.434
They must be weak,

0:01:16.458,0:01:17.851
they lack any moral compass

0:01:17.875,0:01:19.833
and therefore don't deserve any help.

0:01:20.708,0:01:24.726
But if you know anything[br]about opioid addiction,

0:01:24.750,0:01:28.351
you know that this population[br]does not fit that stereotype --

0:01:28.375,0:01:30.875
not that any addiction every really does.

0:01:31.875,0:01:35.143
These are mothers, fathers[br]and grandmothers.

0:01:35.167,0:01:37.768
They're teachers, business leaders,

0:01:37.792,0:01:39.059
cheerleaders, athletes,

0:01:39.083,0:01:41.101
nurses and bus drivers.

0:01:41.125,0:01:43.458
They're your brother or sister.

0:01:44.292,0:01:48.333
They represent every fiber[br]in the fabric of our society.

0:01:50.292,0:01:53.809
Yes, each person came to addiction[br]in a different way,

0:01:53.833,0:01:56.726
but a major cause of the current epidemic

0:01:56.750,0:02:00.059
is that medical overprescription[br]of opioid drugs

0:02:00.083,0:02:02.393
for the treatment of chronic pain.

0:02:02.417,0:02:05.559
And that is one thing[br]that makes this epidemic different.

0:02:05.583,0:02:09.708
This particular epidemic[br]was caused by doctors' prescriptions.

0:02:11.333,0:02:15.518
The cycle started when pharmaceutical[br]companies convinced physicians

0:02:15.542,0:02:17.833
that their patients[br]should not feel any pain.

0:02:18.875,0:02:20.393
Opioid makers claimed

0:02:20.417,0:02:23.643
that their very potent drugs[br]would not lead to addiction

0:02:23.667,0:02:26.518
unless individuals[br]were certain kinds of people

0:02:26.542,0:02:28.208
from certain kinds of communities.

0:02:29.083,0:02:30.934
Such disinformation,

0:02:30.958,0:02:33.184
compounded with clinicians'[br]limited education

0:02:33.208,0:02:35.351
and public ignorance about addiction,

0:02:35.375,0:02:37.208
is what created the epidemic.

0:02:38.042,0:02:39.833
So that's how we got here.

0:02:40.875,0:02:42.184
Now the question is:

0:02:42.208,0:02:45.333
how do you treat[br]a national opioid epidemic?

0:02:46.917,0:02:48.226
During an epidemic,

0:02:48.250,0:02:51.476
normally governments, clinicians[br]and scientists are brought together

0:02:51.500,0:02:53.184
to help the afflicted.

0:02:53.208,0:02:56.768
They develop new and even[br]unconventional treatment strategies

0:02:56.792,0:02:59.458
to rapidly address the condition.

0:03:00.167,0:03:03.351
That has not been the case[br]for the opioid epidemic.

0:03:03.375,0:03:05.601
However, the picture is changing.

0:03:05.625,0:03:08.976
We're beginning to see[br]more aggressive government actions.

0:03:09.000,0:03:14.143
For example, the NIH recently started[br]a new initiative called HEAL.

0:03:14.167,0:03:17.059
HEAL stands for Helping[br]End Addiction Long-term,

0:03:17.083,0:03:21.476
and it's designed to accelerate research[br]for pain management and addiction

0:03:21.500,0:03:25.059
through funding new treatment strategies.

0:03:25.083,0:03:28.643
The current treatment strategy[br]for opioid addiction

0:03:28.667,0:03:32.167
is the use of other opioids[br]such as methadone.

0:03:33.292,0:03:38.268
These few medications have been used[br]during the past 50 years.

0:03:38.292,0:03:40.893
They're considered substitution therapy --

0:03:40.917,0:03:43.500
basically fighting fire with fire.

0:03:44.708,0:03:47.601
They have saved numerous lives,

0:03:47.625,0:03:51.250
yet they're not used[br]by many who still need them.

0:03:52.208,0:03:53.893
Why?

0:03:53.917,0:03:56.434
These medications[br]are themselves addictive,

0:03:56.458,0:04:00.143
and therefore come[br]with many governmental regulations.

0:04:00.167,0:04:04.208
Hundreds of thousands of people[br]must be strictly monitored each day.

0:04:05.000,0:04:06.851
They must find an opioid clinic --

0:04:06.875,0:04:08.518
often far from home --

0:04:08.542,0:04:10.917
take their meds and then[br]try to make it into work.

0:04:11.917,0:04:16.750
Obviously, that is not the most effective[br]treatment strategy for an epidemic.

0:04:17.833,0:04:20.542
And it raises obvious questions as well.

0:04:21.708,0:04:24.934
For example: why is the treatment[br]of addiction disorders different

0:04:24.958,0:04:27.101
from other medical disorders?

0:04:27.125,0:04:28.893
With most other medical disorders,

0:04:28.917,0:04:32.500
a nonaddictive, prescribed medication[br]is picked up at the pharmacy.

0:04:33.542,0:04:37.059
Why do physicians treating their patients[br]with a substance use disorder

0:04:37.083,0:04:39.601
have limited treatment options?

0:04:39.625,0:04:40.893
No one ever says

0:04:40.917,0:04:43.393
that two to three treatments[br]are enough for cancer,

0:04:43.417,0:04:45.417
especially when it's not a cure.

0:04:47.875,0:04:51.958
And that brings us[br]to that 200 billion-dollar problem.

0:04:54.500,0:04:58.476
Fighting fire with fire[br]is a reasonable strategy,

0:04:58.500,0:05:01.184
but what about using[br]a different form of fire --

0:05:01.208,0:05:03.559
a safer form of fire?

0:05:03.583,0:05:07.018
What about actually developing[br]a nonaddictive treatment

0:05:07.042,0:05:08.542
derived from another drug?

0:05:10.125,0:05:11.643
That has been my journey

0:05:11.667,0:05:15.226
towards trying to develop[br]a treatment for opioid addiction,

0:05:15.250,0:05:18.000
and it's taken me in some[br]really surprising directions.

0:05:18.958,0:05:22.226
My journey started with studying cannabis,

0:05:22.250,0:05:25.434
the drug most people call marijuana.

0:05:25.458,0:05:26.851
In order to understand

0:05:26.875,0:05:30.351
how cannabis may connect[br]to combating the opioid epidemic,

0:05:30.375,0:05:35.059
first it helps to understand a little bit[br]about the science behind the drug

0:05:35.083,0:05:36.667
and the politics.

0:05:38.333,0:05:40.309
Cannabis is a complex plant.

0:05:40.333,0:05:43.768
It's actually made up[br]of over 140 cannabinoids.

0:05:43.792,0:05:46.101
Cannabinoids are[br]active chemicals from the plant

0:05:46.125,0:05:49.268
that binds to cannabinoid[br]receptors in our bodies.

0:05:49.292,0:05:53.143
The potent psychoactive cannabinoid[br]that leads to the reward -- the high --

0:05:53.167,0:05:54.809
is THC,

0:05:54.833,0:05:57.809
which we scientists call[br]tetrahydrocannabinol.

0:05:57.833,0:05:59.125
Pretty simple, right?

0:06:00.083,0:06:03.250
But the politics[br]is a lot more complicated.

0:06:04.333,0:06:05.893
Attitudes towards cannabis

0:06:05.917,0:06:08.893
and the amount of THC[br]that's considered safe to consume

0:06:08.917,0:06:11.726
have dramatically changed over the years.

0:06:11.750,0:06:15.643
In fact, this country's had[br]a roller-coaster relationship

0:06:15.667,0:06:16.976
with the drug.

0:06:17.000,0:06:20.476
Cannabis is either[br]highly demonized or glorified.

0:06:20.500,0:06:22.101
On the demonized side,

0:06:22.125,0:06:25.184
cannabis was deemed[br]a Schedule I drug by the DEA --

0:06:25.208,0:06:27.143
the Drug Enforcement Agency --

0:06:27.167,0:06:29.601
meaning that cannabis is considered

0:06:29.625,0:06:32.893
to be a drug of the highest[br]abuse potential

0:06:32.917,0:06:35.208
and to have no medicinal value.

0:06:36.083,0:06:40.518
Moreover, the Schedule I label[br]led to the mass, biased arrest

0:06:40.542,0:06:42.018
for the use of cannabis,

0:06:42.042,0:06:45.059
particularly among[br]young Black and brown men.

0:06:45.083,0:06:46.934
However, things are changing.

0:06:46.958,0:06:49.726
The pendulum is shifting[br]in the opposite direction.

0:06:49.750,0:06:55.684
Today, cannabis is legal for medical[br]or recreational use in most states.

0:06:55.708,0:06:58.893
And a bill is even being considered[br]in Congress to remove cannabis

0:06:58.917,0:07:00.792
from the list of schedule drugs.

0:07:01.708,0:07:05.167
We've also seen a great increase[br]in cannabis research.

0:07:06.125,0:07:09.101
Most research studies,[br]including some of my own,

0:07:09.125,0:07:11.000
focus on THC.

0:07:11.833,0:07:15.768
In fact, our animal research[br]has shown a negative relationship

0:07:15.792,0:07:17.833
between THC and opioid addiction.

0:07:19.083,0:07:20.625
However, as I mentioned,

0:07:21.917,0:07:24.726
the cannabis plant[br]has over 100 cannabinoids.

0:07:24.750,0:07:27.250
So THC was not the only one to study.

0:07:28.083,0:07:30.684
In examining another cannabinoid,

0:07:30.708,0:07:32.018
cannabidiol --

0:07:32.042,0:07:33.809
that is, CBD --

0:07:33.833,0:07:36.393
we were actually surprised[br]to see features relevant

0:07:36.417,0:07:40.000
to alleviating opioid[br]addiction-related behaviors.

0:07:40.708,0:07:43.958
So there my journey turned to CBD.

0:07:45.875,0:07:49.434
So what's this CBD that has moved[br]from virtual obscurity

0:07:49.458,0:07:50.726
only a few years ago

0:07:50.750,0:07:52.559
to everywhere in society --

0:07:52.583,0:07:54.018
in your coffee in the morning,

0:07:54.042,0:07:55.518
your water at lunch

0:07:55.542,0:07:57.125
and your beer at dinner?

0:07:58.625,0:08:01.268
CBD comes from the cannabis plant,

0:08:01.292,0:08:05.518
but in contrast to THC that has the high,

0:08:05.542,0:08:08.875
CBD has no addictive properties.

0:08:09.792,0:08:12.851
We're still trying to figure out[br]how CBD fully works,

0:08:12.875,0:08:15.934
but it is known that CBD[br]alters chemicals in the brain

0:08:15.958,0:08:19.042
that regulate emotions and anxiety.

0:08:20.250,0:08:23.268
Interestingly, giving CBD[br]to our animal models

0:08:23.292,0:08:25.934
that had a history[br]of self-administering heroin,

0:08:25.958,0:08:28.333
reduced their heroin-seeking behavior.

0:08:29.250,0:08:34.559
Specifically, CBD reduced heroin-seeking[br]triggered by environmental cues

0:08:34.583,0:08:36.875
that were previously[br]associated with the drug.

0:08:37.917,0:08:39.393
Let me say that again.

0:08:39.417,0:08:44.309
CBD reduced heroin-seeking[br]triggered by drug cues.

0:08:44.333,0:08:45.851
This is significant,

0:08:45.875,0:08:49.643
because craving is often triggered[br]by the memories of the cues

0:08:49.667,0:08:52.018
previously associated with drug use.

0:08:52.042,0:08:55.851
And craving is a matter[br]of life or death daily

0:08:55.875,0:08:58.684
for people with an opioid use disorder.

0:08:58.708,0:09:00.184
Simply put,

0:09:00.208,0:09:02.309
craving can lead to relapse

0:09:02.333,0:09:04.167
and death from overdose.

0:09:05.125,0:09:08.958
So reducing craving[br]is an important treatment strategy.

0:09:11.125,0:09:13.643
Getting results[br]from animal models like this

0:09:13.667,0:09:17.018
is actually the first critical step[br]in the FDA process

0:09:17.042,0:09:19.250
for developing new medications.

0:09:20.292,0:09:22.184
The next step:

0:09:22.208,0:09:23.500
human studies.

0:09:24.542,0:09:26.101
In our first human study,

0:09:26.125,0:09:28.518
we demonstrated that CBD is safe,

0:09:28.542,0:09:32.500
even though individuals taking it[br]had also consumed a potent opioid.

0:09:33.458,0:09:36.726
Next, to determine efficacy,

0:09:36.750,0:09:38.226
we conducted clinical trials

0:09:38.250,0:09:41.018
and made sure that both[br]the study investigators

0:09:41.042,0:09:42.684
and the study participants

0:09:42.708,0:09:46.708
were blind to the CBD[br]or the placebo substances.

0:09:47.750,0:09:51.559
The results from those studies[br]replicated the findings that we had

0:09:51.583,0:09:53.518
in the animal experiments.

0:09:53.542,0:09:59.434
So now we know that CBD can reduce[br]craving triggered by environmental cues

0:09:59.458,0:10:01.917
in human heroin users.

0:10:02.417,0:10:04.643
What's more, our results demonstrated

0:10:04.667,0:10:09.042
that CBD reduced anxiety[br]associated with the drug use.

0:10:10.542,0:10:14.893
This is also significant because anxiety[br]is another critical factor

0:10:14.917,0:10:16.458
that triggers craving.

0:10:18.208,0:10:22.976
Importantly, CBD also reduced[br]the levels of the stress hormone cortisol

0:10:23.000,0:10:27.458
that is often elevated when addicted[br]individuals are exposed to drug use.

0:10:29.375,0:10:30.684
Another intriguing finding

0:10:30.708,0:10:34.893
was the CBD continued to decrease[br]craving and anxiety

0:10:34.917,0:10:37.500
even a week following its final use.

0:10:38.167,0:10:42.268
This aspect of prolonged efficacy[br]is very beneficial

0:10:42.292,0:10:45.476
for people taking any medication.

0:10:45.500,0:10:48.851
So the evidence is mounting.

0:10:48.875,0:10:53.018
CBD does show potential to reduce[br]critical features for opioid addiction

0:10:53.042,0:10:54.792
such as craving and anxiety.

0:10:56.708,0:11:00.309
But we're still not at the end of the road[br]for medication development.

0:11:00.333,0:11:04.601
The gold standard for medicine[br]established by the FDA

0:11:04.625,0:11:06.583
is large, clinical trials.

0:11:07.708,0:11:11.934
Recently, I was fortunate enough[br]to be given that rare opportunity

0:11:11.958,0:11:14.184
to conduct a large,[br]clinical trial with CBD

0:11:14.208,0:11:16.167
in people with an opioid use disorder.

0:11:17.167,0:11:21.292
And that study is expected to continue[br]for at least another two years.

0:11:21.875,0:11:26.208
CBD is now being investigated[br]for numerous medical conditions.

0:11:26.708,0:11:28.351
Also, during the past decade,

0:11:28.375,0:11:31.518
our society has seen an explosion of CBD.

0:11:31.542,0:11:35.583
It's being put into drink, food,[br]wellness and skincare products.

0:11:36.667,0:11:38.833
They're even giving CBD to pets.

0:11:40.667,0:11:44.375
So is CBD a wonder drug[br]as now touted by many?

0:11:45.292,0:11:47.059
No.

0:11:47.083,0:11:50.143
Does it have potential medicinal benefits?

0:11:50.167,0:11:51.518
It does.

0:11:51.542,0:11:54.143
But the only way[br]to get definitive information

0:11:54.167,0:11:56.726
about CBD's full safety and efficacy

0:11:56.750,0:11:58.792
is through large, clinical trials.

0:12:01.625,0:12:04.976
So is it possible

0:12:05.000,0:12:07.893
that we could actually change the game

0:12:07.917,0:12:10.768
by taking this very familiar plant

0:12:10.792,0:12:15.143
and developing a nonaddictive,[br]FDA-approved medication

0:12:15.167,0:12:17.375
for opioid use disorder?

0:12:19.000,0:12:20.809
Absolutely.

0:12:20.833,0:12:22.893
That is why we're working[br]so hard right now

0:12:22.917,0:12:24.958
to develop a solution based on CBD.

0:12:26.125,0:12:27.417
For me,

0:12:28.833,0:12:32.708
the potential benefits[br]are obvious and also overwhelming.

0:12:33.750,0:12:38.375
It means helping to give families[br]back their mother or father.

0:12:39.333,0:12:43.458
It means having your child[br]graduate from high school or college.

0:12:44.292,0:12:46.101
But most of all,

0:12:46.125,0:12:50.934
it means helping to save many[br]of the hundreds of thousands of lives

0:12:50.958,0:12:53.559
that will otherwise be lost to opioids

0:12:53.583,0:12:55.184
in the next decade.

0:12:55.208,0:12:56.476
Thank you.

0:12:56.500,0:12:59.125
(Applause)