Guide to Holistic-Integrative Medicine

Dr. Scott

Dr. Hernberg has practiced medicine for over 35 years and is a leader in his field.  In 1976, Dr. Scott Hernberg received his Bachelor of Arts in Microbiology with Distinction as a Henry Rutgers Scholar from Rutgers College. Dr. Hernberg earned his Osteopathic Doctorate from the College of Osteopathic Medicine and Surgery in Des Moines, Iowa, in 1980, and completed his Anesthesiology Residency training at Washington University, Barnes Hospital, St. Louis, Missouri in 1983. His extensive postgraduate education included training with leading experts in the fields of Aesthetic Medicine, Anti-Aging Medicine, Addiction Therapy, Botanical Medicine, Bio-Identical Hormone Therapy, Functional Medicine, Hyperhidrosis, Integrative Medicine, Laser Medicine, Nutritional Medicine, Wound Care, and studied Traditional Chinese Medicine, at Chengdu University, China. Dr. Hernberg is Board Certified in Anesthesiology and a Diplomat of the American Board of Anesthesiologists. He is also a Fellow of the American Society for Laser Medicine and American Professional Wound Care Association. Dr. Hernberg has held clinical academic appointments at Washington University and Temple University. He is a past President of the New Jersey State Society of Anesthesiologists. Dr. Hernberg is an advisor to the New Jersey Board of Medical Examiners and the New Jersey Department of Health. Dr. Hernberg was the former Chairman of Anesthesia and Peri-Operative Medicine at several regional institutions.

Medical Marijuana Program at Tomorrow’s Wellness Center

As a part of our comprehensive treatment model we now offer medical marijuana evaluations to patients diagnosed with one or more of the state approved medical conditions Once you have completed your consultation and your medical condition meets the requirement of the State of NJ, as well of the other requirements, Dr. Hernberg will issue you a written certification that is recognized by the State of NJ, allowing for the therapeutic use of medical cannabis. You will then submit the certification to the state, and they will issue you a Medical Marijuana Program card whereby you can go to a local Medical Marijuana dispensary- known as Alternative Treatment Centers  to obtain your medical cannabis. Many patients find they can resume regular activities with less debilitating symptoms as a result of medical cannabis. We have a reasonable fee schedule and offer discounts to Veterans at Tomorrow’s Wellness Center so don’t hesitate any longer, give us a call 609-407-1119. Our knowledgeable staff are available to book your appointment.

History of Medical Marijuana

The cannabis plant debuted in current day Kazakhstan some 10,000 years ago. The plant evolved over thousands of years ago with three main varieties, Indica, Sativa, and Ruderalis. The Indica and Ruderalis varieties adapted to colder climates and the Sativa varieties flourished in warmer climates. The Indica’s species grow faster and are smaller plants, their psychoactivity incline to be more cerebral and sedating. The Sativa varieties grow slower and larger and tend to produce effects that are more stimulating. The Ruderalis variety has minimal psychoactivity and does not play a role in medical marijuana. Today, because of the hybridization of the various plant species the differences between the plants have become less definitive. Currently, medical marijuana products are best described by the amounts and ratios of, THC to CBD, as well as other plant components.

Marijuana was first used medicinally over 5,000 years ago in China for generalized healing. The ancient Romans, Egyptians and the Greeks used it for a variety of aliments including, pain, gout, and inflammation. In 1840’s it was widely used in the Western civilizations for menstrual cramps, headaches, appetite stimulation, and as an aide for sleep. Cannabis was added to the U.S. Pharmacopeia in 1850 and widely used in the USA. In 1937, against the advice of the AMA, the Marihuana Tax Act made the use of marijuana essentially illegal. By 1941, it was removed from the U.S. Pharmacopeia. In 1970, the U.S. federal government’s Drug Enforcement Agency (DEA) classified Marijuana as a Schedule 1 Controlled Substance, claiming it had “no medical value” and placed it in the same category as LSD and Heroin. A Senate Panel in 1972 recommended that cannabis had medicinal value and urged decriminalization however, President Nixon maintained the Schedule 1 Controlled Substance classification. An DEA administrative judge in 1988, recognized the use of cannabis as a medicinal product and the reentry of the medicinal recognition began. In 1990, scientists discovered the underlying chemistry and receptor system involved with the effects of cannabis and named it the Endogenous Cannaboid Receptor System. California became the first state to legalize medical cannabis in 1996. The US government filed its own patent for the therapeutic use of “cannabinoids as antioxidants and neuroprotectants.” Thirty-three states have legalized medical cannabis. Eleven states have approved legal use of marijuana for recreational use. Hemp is a variety of the Sativa cannabis plant and is refined into many commercial products including, paper, clothing, food, biofuel and many other items. It was declared legal by President Trump in the 2018 Farm Bill. Hemp is defined as cannabis with a THC concentration of less than 0.3% and is commercially available as CBD and many products. Worldwide, over 30 counties have approved marijuana for medical use. Unfortunately, because the USA has maintained the Schedule 1 Controlled Drug Classification, essentially no research is being done in the states. Israel, Canada the Netherlands and the Czech Republic have become the world leaders in research of medical marijuana.

Cannabis Chemical Mediators and Discovery of the Endocannabinoid Receptor System

In 1964, two scientists, Raphael Mechoulam, PhD and Yehiel Gaoni, PhD, identified the two most important compounds of the plant: cannabidiol, or CBD and the psychoactive molecule delta-9 tetrahydrocannabinol, or THC. Subsequently, it wasn’t until 1988 that an American scientist discovered a large group of receptors in the brain that responded to THC. Interesting the THC receptors were found throughout the central nervous system and NONE were found in the respiratory or cardiac centers. This is the physiologic reason why no one has ever died from a direct cannabis overdose and why it is a very safe medicine. Several years later, in 1992 Dr. Raphael Mechoulam, and his researchers identified a naturally occurring chemical that mirrored the effects of THC. He named the natural chemical Anandamide, after the Sanskrit word for “bliss.” Shortly afterward, researchers identified another natural chemical, 2-Arachidonoylglycerol (2-AG), which mimics the plant’s chemical – CBD. From these discoveries the galaxy of the ENDOCANNABINOID RECEPTORS SYSTEM(ECS) were found to extend to every organ, gland, immune cell and connective tissue in the body. ECS receptors in the brain are known as CB1 Receptors; those in the peripheral called CB2 receptors. Many tissues contain both CB1 and CB2 receptors, each responsible for different actions. The ECS has been called “the body’s supercomputer” because its role is to keep all other bodily systems in balance. When an injury occurs, naturally occurring cannabinoids are involved in reducing the effects of trauma and serve to maintain homeostasis. Despite the fact that the US government classifies cannabis as a Schedule 1 drug and having “no therapeutic value,” the USA has owned a patent on cannabinoids as, antioxidants and neuroprotectants since 2003. CBD can be extracted from industrial hemp, which was legalized in 2018 with passage of the Farm Bill.

How Cannabis Works

The cannabis plant contains over 600 chemicals and more are continuing to be discovered.

Biologically active chemicals contained in the cannabis plant are called cannabinoids and terpenes. The two most prevalent cannabinoids are, THC and CBD. These cannabinoids, have no odor, affect areas throughout the body including brain, CNS, airways, ovaries, testes, immune system, skin, GI tract, eye, heart, bone and other many other organs by activation of the CB1 and CB2 receptors.

THC – One of two main chemicals in cannabis that provides psychoactive properties is 9-tetrahydrocannabinol (THC). It is neuroprotective with analgesics properties. THC produces psychoactive and euphoric effects primarily by its affinity to CB1 receptors located mostly in the CNS. THC is believed to be neuroprotective and helpful in treating:

How CDB Works in the Human Body

CBD – Another significant chemical found in cannabis with medical benefits is CBD. Cannabidiol (CBD) is a phytocannabinoid found in the cannabis species of plants, and the most common phytocannabinoid produced by hemp varieties of cannabis. It has no intoxicating or euphoric effects and does not directly bind to CB1. Rather than direct binding it has an affinity to the receptors and influences how THC binds to the receptors. It can mitigate the psychoactive effects of THC by interfering with THC binding to CB1 receptors. Some researcher’s believe CBD interacts primarily with CB2.  There is evidence that CBD functions to raise the body’s natural ECS mediator, Anandamide, by preventing its re-uptake and breakdown. CBD is an incredible substance. It is 2X as potent as a steroidal anti-inflammatory, like cortisone, which is commonly used to treat arthritis, tendonitis, and bursitis. It is 10X stronger than salicylic acid.

CBD is used to treat symptoms of anxiety:

How CDB Works in the Human Body

The cannabis plant produces 113 cannabinoids but only a handful are produced in any significant quantity include Cannabigerol -CBG, Cannabichromenic Acid – CBC, Cannabinol – CBN, and Tetrahydrocannabiarinic Acid – THCVA.

CBG is the third most prevalent cannabinoid and commonly found in hemp varieties rather than cannabis varieties. CBG is analgesic, anti-inflammatory and not psychoactive.

CBC is rare and produced early in the plant’s flowering cycle. Like many cannabinoids it is anti-inflammatory, anti-bacterial and fungal properties and some anti-depressant effects.

CBN is NOT produced in the plant but is a THC breakdown product after the oils have dried. It is not psychoactive but does cause sedation when combined with THC. CBN is believed to have three times the affinity to CB2 than to CB1 receptors which is why it is thought to have a greater effect on the immune system than the nervous system. It is useful as a pain reliver, sleep aide, and as for anti-inflammation.

THCV is a bioactive neutral form of THC. It is controversial whether this compound has psychoactive properties however it is believed to be useful as an analgesic, appetite suppressant and anti-inflammatory.

Terpenes – are also a major constituent of the cannabis plant and many other plants. These molecules account for the plant’s odor and taste. They are found primarily in the plant’s trichomes.  Trichomes are fine hair like outgrowths on the plant and give it the frosty appearance. Cannabis has about 200 compounds and are believed to protect the plant from diseases, animals, insects and other plants. The most common terpenes found in cannabis are:

Dosing and Administration of Cannabinoids

Since the DEA has classified Cannabis as a scheduled 1 drug with “no medical value,” physicians are prohibited from discussing specifics of therapy with their patients. Several topics that can be discussed with Dr. Hernberg include: