Cannabinoids and Dementia Symptoms with Dr. Ryan Buck

Dr. Ryan Buck is an Internal Medicine physician with more than 12 years of experience. He received his MD from the Northwestern Feinberg School of Medicine and now works in Hospital medicine with a focus on Oncology. He is also the Research Director for Acute on Chronic. He has published research on blood transfusion, and cannabis science.

Dr. Buck co-presented at the Cannabis Science Conference on September 22, 2023, with his talk titled “Cannabinoids for the Treatment of Agitation in Dementia,” with Rebecca Abraham, RN, BSN, the CEO and Founder of Acute on Chronic, the first cannabis nurse clinic in the Midwest.

Read a transcription of the interview below.

Can you tell us a little bit about yourself and how you became involved with the cannabis industry?

Dr. Ryan Buck: My name is Ryan Buck. I am a physician, an oncology hospitalist, and assistant professor of medicine at Northwestern in Chicago. I got involved with Acute on Chronic about three or four years ago. So I've known Rebecca, who's the CEO and founder, since I was a resident and she was a nurse just starting off and when she started this company as she kind of transitioned from working in the ICU to doing cannabis nursing. I was like a lot of physicians are curious about how cannabis and medical cannabis might help patients, but, you know, very little education or training on it. I certainly don't know how to tell people how to use it. I saw the results that she and the nurses were getting and I got really, really interested in the science behind this and learning more about it. I came on board as one of the medical directors, another research director there trying to kind of advance both the education and science behind, you know, cannabis and you know, cannabinoid system as medicine.

What is neuropsychiatric symptoms (NPS) and how do cannabinoids benefit NPS related to Alzheimer’s Disease (AD)?

Dr. Buck: With dementia and especially Alzheimer's disease, there is the initial memory loss and cognitive impairment that comes with it. But especially in Alzheimer's disease, up to 80 to 90% of patients will also go on to develop what we call these neuropsychiatric symptoms. So that can be sleep, disruption, anxiety, depression, agitation–a lot of the behaviors that become really, really difficult distressing for the patient and extremely distressing for their kind of loved ones and caregivers to kind of help deal with. And unfortunately right now there are just not really in from the traditional pharmacologic treatments, there's not good treatments, they don't work well and they come with really significant risks such as falls, seizures, death–nothing that you that you want to do. And so it's been really challenging to treat these symptoms in this huge population of patients and there's just been this growing body of evidence that cannabinoids are definitely safe in this patient population and used correctly, I think they've it's been shown that they are effective in reducing and helping to manage these neuropsychiatric symptoms that can be so challenging.

Are there specific cannabinoids that work best?

Dr. Buck: From our experience, it seems like a like multimodal approach is best. I think that THC is certainly an important component. It definitely helps reduce some of the neuro excitability to reduce symptoms like agitation, anxiety and it helps with some of the sleep disruption and sleep disorders. But I think that also other cannabinoids, CBD, CBDA, CBG also have a very important role that obviously what happens with dementia and especially with Alzheimer's that there's a variety of changes that happen. There are these plaques that kind of that kind of develop in the brain and there's neuro inflammation that kind of goes along with that. And especially some of the cannabinoids like CBD and CBG help reduce some of that neuroinflammation and they help enhance the body’s own clean up process to help restore some of the more normal kind of neuronal development.