Living in the Weeds: Your ECS as a Thermostat with Simi Burn, PharmD, and Megan Hollingsworth, PharmD

Welcome to Living in the Weeds, a series that explores the experiences of neurodivergent people who consume cannabis.

Today we have two guests on the show: Simi Burn, PharmD, and Megan Hollingsworth, PharmD. Both women are pharmacists and medical writers with a deep understanding of cannabis and neurodivergence.

We talk about:

• The complexity of the endocannabinoid system (ECS)
• How your ECS can act as a thermostat for inner-wellness
• Cannabis as a teacher through the Ayurvedic lens of medicine
• How neurodivergence manifests outside of the brain
• How you can learn to understand your symptoms as an inner dialect
• The pharmacokinetics of how the different consumption methods work (AKA how it works and how long it lasts)
• Misconceptions around the therapeutic effects of cannabis being in the “high” feeling
• A holistic approach to symptom management
• Why potent THC products aren’t always better
• The importance of whole plant medicine and minor cannabinoids

Why I Love This Episode

The Endocannabinoid System As a Thermostat

Simi describes the ECS as a complex homeostasis system that touches all of our systems. Fascinated by the fact that we create our own cannabinoids. With her Southeast Asian heritage, she views cannabis through the lens of traditional Ayurvedic medicine. She notes that the ECS is affected by our environment throughout our lives, as well as other factors like nutrition. She calls cannabis her teacher and explains how cannabis can help us know ourselves. Finding ECS balance is more than “lock and key” – it’s the entirety of your inner ecosystem.

Megan describes the ECS as a thermostat or a Goldilocks system. It can bring you into balance. Through the lens of neurodivergence, early research has shown symptoms can be linked to low cannabinoid levels and may in fact be a clinical endocannabinoid deficiency, which can impact mental health and inflammation. Our ECS controls brain functions like energy, metabolism, stress, and more so it’s important to be in alignment. In Megan’s opinion, cannabis can fill in what we’re lacking. She calls neurodiversity not just a brain health issue – it’s across our whole system: sensitive brains, sensitive bodies. Cannabis is not a fix, but it is a tool to navigate the neurotypical world we live in, especially from a holistic aspect.

Neurodivergence Outside the Brain

Simi shares that Western medicine treats the body as a separate system, but we’re whole people and our neurodivergence is how we move in the world. Neurodiversity does not mean something is wrong with us. Simi describes symptoms as a signal to a complex inner dialect. We can learn to understand our own languages and our bodies because emotions are body feelings. The stressor may leave but the stress is still in the body, presenting. Western medicine is finally catching up to what ancient medicines know – we are whole people. Simi said something I found particularly powerful: that she doesn’t want to pursue medical treatment for her symptoms – her whispers became screams when she ignores them. It is only an illusion of separateness between our thoughts and our bodies. Neurodivergence can be a superpower once you understand it.

Pharmacokinetics of Cannabis Consumption Methods

Megan took us through different forms of consumption and how to figure out what works with your lifestyle. With smoking and inhalation, there’s a rapid absorption of cannabinoids into the lungs – you feel it quickly and it fades quickly within a few hours, but overall there’s quick symptom relief. But as a pharmacist, she has to consider the downsides of smoking – you can’t light up at at work, events, or places similar. There is also Oral ingestion with pills, capsules, and various forms of edibles. These cannabinoids are absorbed through the digestive system and have a longer onset and longer symptom relief. This works well for people with chronic pain, sleep issues, and other ailments that can keep you awake. We also touched on tinctures. These are typically absorbed both sublingually and orally and make a middle ground between smoking and edibles. Lastly, she touched on topical application, including oils, balms, and creams that have localized absorption.

Simi shared a powerful success story for transdermal patches with an adult autistic man. This patch had a 12-hour delivery and may have combined CBD and THC. Because the patch had a much slower delivery rate, he enjoyed the benefits of the cannabinoids for longer. His caregivers said it completely changed his life. Simi emphasized that while transdermal patches are rare in the recreational market, they are underrated for neurodivergent people, chronic pain patients, and people living an otherwise busy life.

THC Potency, Neurodivergence, & The Entourage Effect

Both Simi and Megan agreed: Cannabis is a pharmacy in a plant. All of the compounds matter and are conducive to a positive experience. It’s not just about THC potency. There are many misconceptions about CBD at medicinal dispensaries, and patients often think the therapeutic value of cannabis is in the “high” feeling.

Megan emphasized that only looking at one molecule like THC is shortchanging ourselves because there are so many compounds in cannabis and they all interact in unique ways that we still don’t fully understand. Cannabis has a pharmacy of compounds means they will work together and produce a more significant effect together than isolated. The entourage effect gives you more bang for your buck with more cannabinoids, terpenes, and other compounds.

Simi dialed in on our instance from a pharmaceutical mindset to a living medicine. The cannabis plant is alive, it’s not a single molecule. We want to distill it down to one molecule and one receptor, but plant medicine has co-evolved with us. Every animal has ECS – we would die without it. Therefore it makes intuitive sense that it’s not just one molecule or receptor that’s important- we evolved with the entire plant. Healthy practices that also help ECS tone – sleep quality, pain tolerance, and immune function – all of these things work in tandem. It’s a symphony of what’s in the plant, how you’re feeling, your intention, your set, and your setting.

Holistic Approach to Symptom Management

Simi sees cannabis as a gateway to holistic health. She shares that in her journey, she has seen cannabis act as a gateway to yoga, meditation, and plant-based eating. She also shared how cannabis helps her as a neurodivergent person to dial into her emotions and identify feelings.

Megan reminded us that when we exercise, when we move, we stimulate ECS and produce endocannabinoids like anandamide, which helps us feel better and reduce stress. Stimulating the ECS is a self-perpetuating cycle, a 2-for-1 deal. When you add in a nutrient-rich diet, which is essential for the synthesis of endocannabinoids, you create a new internal environment.