Finding the correct dosage and combination of cannabinoid products for medical treatment is almost universally a long and expensive process of trial and error. And for the most part, patients are undertaking this journey alone and often with little guidance.
This week on The Cannabis Enigma Podcast we get together with Otha Smith III, CEO, and Founder at Tetragram, a smart, digital platform that helps users get the most out of medical cannabis. We each have a unique endocannabinoid system, which makes finding the right dosage and combination of products a challenging process. There is also a lack of access to healthcare professionals, and experts in the field, to guide patients through this complicated process. There is still a long way to go in building a model that serves all patients, but in the meantime, Tetragram is providing an essential service for bridging that gap. The app helps patients make sense of their journey by simplifying the information and supplying data-driven insights into their regimen and its effects. It includes a space for journaling, an imperative aspect of improving your experience, as well as tools for determining the chemical profile of the cannabis you’re using and how that correlates with your experience with medical cannabis.
In our conversation with Otha, we talk about how Tetragram has been able to help its patients, how federal and state laws affect access to medical cannabis and what we can expect of government legislation in the coming years. We delve into how data can further our understanding of different types of cannabis and why standardization is desperately needed in the industry. For an eye-opening and informative conversation on federal laws, medical cannabis, and much more, tune in today!
The Cannabis Enigma is a co-production of The Cannigma and Americans for Safe Access. Music by Desca.
Elana Goldberg: Hey everyone. I’m Elana Goldberg and I’m here for season two of The Cannabis Enigma Podcast with our scientific advisor, Dr. Codi Peterson.
Codi Peterson: Hi Elana, new voice in the room. It’s so great to see you, yeah, and be part of this podcast, The Cannabis Enigma has been a listen of mine and it’s great to be on the other end of the microphone.
EG: Yeah, you’ve even been interviewed on the podcast before, in season one.
CP: Yeah, well, now the tides have turned.
EG: Indeed. Actually, that was one of our most popular episodes, you should know. Very happy to have you on this side of the microphone. Codi and I, were just recently in Las Vegas for MJBizCon. For those of you who don’t know, this is the event of the cannabis industry, a massive industry conference in the Las Vegas convention center, big is exactly what it is, like Las Vegas really.
CP: Yeah, there’s like a theme in Las Vegas, everything is just extra-large, even the blocks appear to be larger than regular blocks.
EG: Right, totally. It’s just one hotel to go and then it takes you 20 minutes to walk there.
CP: Yeah, there’s a lot to see along all of the walks, right? Lots of people watching in Las Vegas.
EG: Right, lots of people watching. Apart from people watching and trying to work out if we should get an Uber and where we can get it to stop and running around and getting samples of doob tubes and all sorts of different fun things at the conference.
Codi and I did a bunch of interviews on the sidelines of the conference and so that’s what we’re going to be presenting to you this season and what we kind of, chose as our theme for this season is people are doing it right when it comes to this space and what we’ve ended up here, which I think is really cool is a very varied selection of guests on the podcast.
I’d like Codi, for you to introduce our first guest today since you actually did this interview, I think this was your first official interview that you had for the podcast, right?
CP: I know, things are evolving so quickly, absolutely. My first interview was with Otha Smith from Tetragram and it was a really great first interview. I couldn’t have met a friendlier guy, just like so much of MJBizCon because I started in the cannabis industry, really, during the pandemic or just before, it’s the first time I met the guy.
Way taller than I expected, pretty stout man in general and so it was great to meet Otha, I was like, “You are a large man” but the conversation went really smoothly, we really conversed around what Tetragram is, which is something that’s aimed at serving patients and consumers so that they can really dial in cannabis because cannabis medicine is super complicated and you need to really reflect on the way cannabis is affecting you if you want to optimize.
Tetragram is an app that is available all over the states and it’s growing into a really useful tool to optimize cannabis therapy.
EG: Yeah, I was also very excited, we’ve done a number of different collaborations with Otha in the past year and a half, had him on webinars.
CP: With me, yeah, you meet him there.
EG: Yeah, right, exactly. Super cool to meet him in person. Tell us a bit more about the interview, what did you two talk about?
CP: Well, I think, we really kind of focused in on why the app is needed and how it can be challenging for patients to really figure out what part of their therapeutic regimen or cannabis regimen is giving them relief. Journaling is an imperative part of improving your experience and figuring out what the chemo type, the chemical profile of the cannabis that you’re using and how that correlates to your experience and Tetragram has integrated all of this. Gathering that can be really helpful for say, a patient like mine who I’ve been recently dealing with, who really is kind of struggling to figure out the right cannabis regimen for them and I’ve instituted a journaling method and actually recommended Tetragram as something for them to utilize.
It could just be a really valuable tool and we know this, there’s lots of competitors on the market coming out with similar tools but we really like Tetragram and we really like Otha, so it was a good fit.
[0:04:45.2] EG: Yeah, we do. For sure. It’s really so important, something that I find myself saying over and over again is that no tool, whether it’s the tools we are developing on Cannigma or an app like Tetragram, no tool is going to make it so that you press a button and you know exactly the right type of cannabis for you to use but maybe what it can do is kind of shorten the trial and error process and make it more effective and that’s what I think the real value is here.
CP: I think so and I think that the user interface being easy to access and it can help the user kind of log as they go along in their experience is super valuable. I think there’s a lot of value add for sure.
EG: For sure. All right, let’s get straight to the interview and make sure to stick around after the interview to listen to a special segment from our partners at ASA, Americans for Safe Access. Let’s listen.
CP: Here we are at The Cannabis Enigma Podcast. My name is Dr. Codi Peterson and I’m here with Otha Smith, the founder of Tetragram, which we’ll get into in a second. Nice to see you Otha.
Otha Smith: Nice to see you as well. Finally, we get to meet in person, we’ve talked online for such a long period of time so it’s great to meet you in the flesh.
CP: Well, I think that’s one of the coolest things that MJBizCon, that’s why we’re here, right? Is to finally engage with these peers that we’ve developed relationships with. It’s beautiful, you know? This is my first podcast that I’m recording for The Cannabis Enigma Podcast and it’s really overwhelming almost to be around all these people and people that you’ve met on the Internet and for you, for example, you walked up and I was like, “You are taller than I expected.”
OS: Exactly right. I was talking to Stanly Atkins form the Cannamedic out of Atlanta Georgia and I was like, “Oh my god, you’re so much smaller than I anticipated” you know? Because you really never get an idea of a person’s stature when they’re online and he’s like from the neck up, you know?
It’s really refreshing to see people for the first time in person. Yeah, it’s just fascinating, I mean, the energy just changes once you’re really in the realm of someone else, you know?
CP: It’s wonderful so that’s why here at MJBizCon and we are in a hallway right now so if you hear some background noise, definitely know that that’s someone having a great time networking with their cannabis industry peers so for our listeners out there, I wanted to let them know.
OS: Yeah, a little disclaimer.
CP: I guess, why I’m really interested in talking to you is I have a patient right now, I’m a practicing pediatric pharmacist and I also have some patients who come to me and wants some advice on medical cannabis. One of the things we’re struggling with right now is I’m not there, right? I’m not involved with this patient every day, when we’ve had some side effects, right? Some tachycardia and anxiety in our patient who is using medical cannabis.
They’re trying to fight cancer, sort of a last stitch effort, we’re not going to get into the weeds here, pun intended but really I guess what I’m getting at is I’ve really had a lot of trouble trying to figure out what part of the cannabis therapy that’s setting them off because they are using CBD, THC and a number of other pharmaceuticals, right? Including some opioids and some other medications. I guess, that’s the lead in to what your app can do. You’ve heard of this problem before, correct?
OS: Yeah, a 100%, I hear it all the time. Yeah, that’s really why we build Tetragram because people are utilizing so many different various cannabis products. All these cannabis products have what I call the T’s and C’s, the terpenes and cannabinoids associated with them and so it’s challenging as you navigate that landscape because you’re going to a dispensary, there’s hundreds of products to choose from, you don’t know what’s going to work right for you because getting that is federally illegal, no one has any type of guidance that they can rely on.
CP: It’s overwhelming, right? The product selection you describe is very real and it rotates, right?
OS: Yeah, to make it even worse, it goes batch by batch too. Even you buy to be the same cultivator. That’s why we really developed Tetragram, so people can start to document and not only the product but we’ve designed the UX to really stir people to pay attention to those terpenes and cannabinoids and then associated for medical conditions so that over time, even if they’re trying to say product by trying to use their product for different something, they could draw a conclusions on, “Okay, this might work for this or that might work for that” because you really need to provide that type of documentation in order to see what’s going to work for you because cannabis is a road that you travel alone. As we all know, we had different endocannabinoid systems so everything is unique to ourselves.
CP: Yeah, I think that’s a great point and right now, in particular, in cannabis, patients are traveling alone, they don’t have access to a lot of healthcare professionals or experts in this field. This is a new and emerging field so that we really haven’t provided patients with the model that serves them and I think it sounds like to me, Tetragram is one of the tools that patients can now use to bridge that gap.
OS: Yeah, I mean, I always display it like this, you know when you go to the doctor, you have a headache or you got into a bicycle accident and you’re like, “Oh my leg is like really screwed up.” He knows exactly what different products to recommend to you, right?
How does he do that? He says, “All right, try these two products, I’m going to write it down in your littler posture form and then come back to me in a month and then we’ll see what the diagnosis is, did it work for you?” In cannabis, we are essentially the patient is creating their own law that can say, “This is what I try because the doctor doesn’t have that ability to do so.”
Then you circle back in a month or a couple of days later after you try that product, document your experience with it in order to draw the same conclusion. We’re running in parallels as this is a little bit more cumbersome for us as we’re in this industry that is federally illegal.
CP: Makes everything more challenging every step of the way, right?
OS: A 100%. I mean, in this industry, I always like to equate myself to that newborn who is always fighting to stay awake because this industry, the minute you wake up the next morning, something has changed. It’s like, you always want to keep your finger on the dial to try to figure out what’s going on and what’s the next new exciting news. I read a lot of it, the reports that you publish on LinkedIn and it’s very insightful, so I appreciate your work as well.
CP: Thank you, it’s all about the endocannabinoid system for me and –
OS: A hundred percent.
CP: That’s why your app, Tetragram and apps like it, the tools and power and patience to try to figure out what’s going on with them, you mentioned everyone has a unique endocannabinoid system. It changes through the day. We know that your endocannabinoid system is different in the morning than it is in the afternoon, this is why the wake and bake feels very different than the night time session.
CP: Anyone who has done this can pretty much attest like, “Woah, there’s something different in the morning.”
OS: Yeah, because I’m one of those. I cannot get up and wake and bake, it completely just changed the trajectory of my entire day but to your point also it’s like, when you eat an edible, if you eat edible by itself, empty stomach, you’re only probably going to absorb, you know better than anyone, what, 12 to 14%. The minute you take that same edible and put it with like a fatty food, then you get double the exposure. There’s so many nuances associated with it and that’s why I was really excited to be here today.
CP: That’s why we need to write it down is potentially what you’re saying.
OS: A 100% We’re version two that we anticipate the launch in Q1, we’re going to include a lot more of those lifestyle aspects of it, people go paint a clear picture, not just about what product you’re using, what were those T’s and C’s, how did you consume the product but more importantly, what was your lifestyle about that day? I mean, we were talking about earlier, did you had breakfast, did you have lunch and then take the particular product
CP: Yeah, so much is going on with the endocannabinoid system and so much what we do can stimulate it and that stimulation causes are release of our own endocannabinoids, sometimes anyway, depends on what we’re doing and those interact. They cross over with their THC and CBD and all these other cannabinoids and it changes the effects.
CP: Right? Then you throw terpenes into the mix, right? There’s 30,00 of them, only 30 on cannabis but this is an incredibly difficult problem and eventually we’re going to have to basically leverage computers to solve in my humble opinion.
I guess that’s my question as I wanted to go. I think we’ve established to folks that Tetragram is an app that is helping patients record their cannabis experience, their symptoms, what cannabis variety they’re doing, if you haven’t downloaded it yet, do it right now, we have 20 minutes left to this podcast.
OS: Yeah, please do, at the Apple store or Google play, Tetragram app. Yeah, that’s the first version that we released which is just really sky rocketed, we just wanted to build with those MVP, with the essence of giving people the ability to document that information but in version two, a couple of things that I can share is definitely just like we talked about.
Incorporating other parts of their lifestyle, eventually getting to a point where we can include their medical records and so whatever prescription pills we’re on currently, we can have that correlation of data that say, “Okay, now they’re starting to use cannabis, what’s that mingling effect like?” Because as we know, these steps, they become legal, prescription pills and opioid uses drops dramatically. If we can capture that, I think that will be phenomenal.
CP: I think tracking that is so important for our progress in the cannabis movement, right? Both recreational and we need to prove on a recreational side that this isn’t heroine and it’s not killing people and creating an equivalent opioid epidemic. Which, I think it’s kind of ridiculous that we have to prove this considering cannabis use has been widespread for many years. Okay, we got to prove it.
[0:14:10.3] CP: Let’s at least, start to gather the data so we can leverage the law makers and say, “Look, shut up and legalize.” The flip side to that is we also need to start gathering big data around patient outcomes, diseases, medication interactions and also what cannabis can do to help reduce medication use because we know pharmaceuticals just generally carry a higher risk to benefit profile.
All of that is great but I guess my question and what I wanted to get to today is, what would you like to be your data and the data of other companies working in that space, what do you think that we can achieve with some of these big data like just a couple –
OS: Man, how much time do we got? I mean, a number of things –
CP: Give me the highlights.
OS: Yeah, I mean, first and foremost, with the data that we collect, I always say, it not only helps improve their process for the patient but also improves the general understanding for the industry so we look at the aggregate data that we collect.
We look at dispensaries for example, you know, some what they’re called to bud tenders are more knowledgeable than others but their practicing in medicine at the end of the day and so we could give them information that says, “You know you have 50 products on your shelf and there is 8,000 or 10,000 reviews associated and saying that his aggregate data is helping them with PTSD or fibromyalgia” then everybody changes the conversation.
You know, especially when federal legalization happens and you know, everyone is going to be selling the same cookies at some point. The more knowledge we have so that we can stir that person in the right direction is going to be huge because you know at the end of the day, cannabis isn’t cheap and if you try and try all of these different products, you still haven’t met the one that meets your profile, it could be challenging.
Also with the data is helping the cultivators, helping the CPG companies that produce these products but really have no understanding about what the actual effect of it is.
CP: Helping them narrowing on what their products are doing in the field.
OS: Exactly, yeah and you’ve seen it Cody like they’re out in the marketplace and they’re like, “Oh” that you know, from a marketing perspective like this is for being energized, this is for creativity. What data are you using to really say that?
CP: The answer is none, I am shaking my head over here.
OS: Exactly, right? Then lastly, I’ll say you know, the data can establish the first ranking system in this industry. There might be 20,000 people growing blue dream or these 20,000 are going to be inherently different. Some of those is not going to be blue dream, so the ones that people, consumers that said, “This has been very beneficial, let’s find out why” and then I will hope other people look at those terpenes and cannabinoids to understand that better.
CP: I love it, yeah. What are those challenges to getting that data? It sounds like we can do some really big things with it, so what have you seen is the challenges to acquiring that data and then maybe let’s touch on anonymity and so the interested parties who are considering downloading your app don’t feel like they’re about to sign up for a wiretap?
OS: Yeah, a hundred percent. First and foremost, when it comes to the privacy, you know I am a patient, my two business partners are patients, so we went through every length to make sure that our data stays secure for our consumer. When it comes to downloading the app, we’ll never ask for your first and last name and then it owes you unique identifiers. In version two, we will ask if you want to provide a sex or age, stuff like that just to gather more metric data.
CP: It builds the dataset, it really especially when we know there’s really strong sex base differences between how men and women react to cannabis, so clearly establish into scientific data. Having that piece of information really helps you kind of put your data in buckets.
OS: Exactly and what was the other question?
CP: What about anonymity and then what are your challenges in obtaining data?
OS: Yes, so the challenge really is like most people in this industry from a business perspective, how do you reach that end consumer because Instagram, Facebook, they’re very limiting in terms of what words you can use, what pictures you can use. I’m very grateful through the relationships that we have with dispensaries you were saying, you know, they use to promote paperback journals saying keep track of what you are using.
Now, they’re promoting tachogram and saying, “Hey, this is much easier for you to document your experiences” so that’s been really beneficial but the number one challenge in this industry and I am sure you can appreciate this is gathering the COA information. You know, understanding the lab results with every product that’s out there because that’s a big part of tachogram that we want to automate for the consumer.
They’re not sitting there and mailing and entering in all the terpenes and the cannabinoids if they have access to it.
CP: Did you mean this is crazy? Your some terpenes reports are coming out parts per million and now you’re expecting patients to convert parts per million to milligrams per gram and enter and calculate what their dose was if they put a little pinch in there like I can see that being a really big challenge, plus every state has different regulatory requirements on terpenes, right?
OS: Yeah, I mean I am very fortunate that I thought I’d never say it but Maryland did it right in the sense that it was legislated that all terpenes and cannabinoid information had to be on a product. One of the things that I’m also seeing is that cultivators, CPG companies are now including a QR code that takes that customer directly to the COA and so we really need to understand that life cycle of that product before it got entered into my hands, you know?
I want to know the clear picture so that we could release all these included more effectively, so standardization is something that we all need in this industry. It’s the biggest pain point.
CP: If we could standardize the way that which terpenoids are tested, which cannabinoids are tested, how they’re resulted now we could easily develop some sort of software to convert that and then associated with the product in your software or others and now all of a sudden, we can build that bigger, deeper, more robust data that’s really needed to drive forward the outcomes that we talked about before.
OS: Yeah because I’ll always say like the industry, these regulatory bodies with every state that’s legalized for medical or recreational is they put the test state labs as the police of the industry but it is a private institution, right? There’s always and as you know, some situations where test numbers are coming back wrong and you know, that’s a whole –
CP: Manipulated, falsified.
OS: Exactly, we won’t get into those specifics more but we understand the game is being played and so you know, who is testing the testing labs, right? I really think and what I started to see in Maryland is that Maryland is actually going to have their own state ran testing lab so that every testing facility that is utilized has to send that through them too, they get final approval.
I think that’s a step in the right direction because if you look at the privatization of jails, that never works, it never would. I mean, we’re kind of get that same similarity in cannabis when it comes to this testing labs.
CP: Right, we’ve got someone who we’ve let it unregulated market that’s incentivized by these manipulations or these higher THC numbers and they have no standards set for their baseline and no one’s enforcing any sort of regulation or standardization, so you’re spot on with that. I think that is a big challenge but I think that there is a lot of focus on fixing that so with cannabis reforms, California is doing something very similar.
I don’t know if they have announced this yet but I think that UCSD is teaming up with the Board of Cannabis Control and they’re going to do a joint venture to make sure once again, they can be testing these products that they find either in the elicit market or that they find and the state can have like an analytical lab dedicated and whose focused on these measures. That thing that Maryland is doing is spreading.
I think that brings me to the next question I have, which is cannabis reforms and this is something that I am writing about at The Cannigma or I just wrote about, there’s been a lot of talk on banking, there’s been the CEOAO, the Cannabis Administration and Opportunity Acts, something like that and then of course, we have these other bills that have come through in recent years.
What are you hopeful about in the next two years? Do you expect things to go full federally and how does that affect your business, your business model at Tetragram?
OS: Yeah. I mean, I’d like to say like federal reform probably isn’t going to happen for another six, seven years.
CP: Oh, not very helpful.
OS: Yeah, I don’t think it’s going to happen that soon because I mean, you just look at the timetable like if Biden get re-elected, there might be a possibility it will start to put some attention on that.
CP: Once he’s safe.
OS: Yeah, exactly but you know COVID is still a real thing. I think that’s a priority to a lot of people who run the country but it will be interesting to see what plays out. I also caution people to be very careful when they ask about federal legalization. I believe federal legalization needs to happen but more, it needs to be structured in a way that states continue to do it independently in my personal opinion.
OS: Just because cannabis is a commodity at the end of the day and so if you let interstate commerce happen where people can just transport tons of cannabis across the country –
CP: Quite literally tons, it could be.
OS: Yeah, exactly, you’re going to see a lot of these smaller companies aren’t well capitalized, how are they going to survive in that market when that commodity of 45 to $60 per ave drops to like 10 to 12 bucks, you know? I think it takes over, it streamlines it in a sense that it is going to be real corporate America like I don’t want to buy weed from Walmart, you know?
CP: I try not to buy anything from Walmart but definitely not my weed.
OS: Yeah, exactly right so I think it’s keep it state ran, where there’s let it be federally legal at that point.
CP: Interesting. Yeah and I am going to have to throw my own opinion here because I have a very strong opinion in this space. I agree cannabis is a commodity and can be treated like a commodity but I also think its medicine.
OS: A hundred percent.
CP: Yeah and I knew we agree on that so in my mind, in my ideal layout is we separate out that sort of medical market. We start using data like the data that you’re collecting and we start showing it to insurers and we say, “Look here, I’ve reduced your medication independence and we’ve improved patient outcomes, opioid deaths” by the way, 90,000 individuals still die from the opioid epidemic this year in America.
CP: We still have a very clear problem there, so I think if we can sort of separate out those markets and continue to use data like the ones that you’re gathering to do it then we’re going to serve the market better. Adults should freely use cannabis but patients should have their medical right protected, which includes access to consistent product so that they can get consistent outcomes.
OS: Exactly, a hundred percent. You know, the medical market, that’s something that scares me. You know with more states coming on the recreational, they were once medical, you know a lot of people are like, “Well, you know the medical” and medical take a hit initially but overtime through education, I have seen firsthand where people are coming to the dispensary. I’m an adult user and then you know, the first thing you ask is, “Okay, so what are you looking for cannabis? What do you want to do with it?” “I want to sleep” bingo, you are a patient.
CP: I got some knee pain, okay.
OS: Exactly, you are a patient and so like my personal perspective is anybody that uses cannabis is a patient in my eyes, which is why any of our marketing material, which I’ll never change, you know Tetragram was built for patients by patients and that’s the way we view it.
CP: Yeah, there is no doubt. I think my personal opinion again is not necessarily the view of The Cannigma is that’s true. We people use it but there’s a lot of both, right? People are definitely getting high, so I am totally with you that almost all patients or almost every user has a medical need that they’re also secondarily probably using cannabis for so not a disagreement I guess, probably semantics but although this has been absolutely amazing, we didn’t even get too many loud walker by.
OS: Yeah, I know, with that great. You know, I speak to bet your relocation.
CP: We got it very – we’re very deep in the corner. We went as deep into a corner as they have here in this giant convention center but where can people find you? What should they check out? What do they need to do?
OS: Download the Tetragram app at our website at tetragamapp.com. You can follow us on Instagram and LinkedIn @thetetragramapp and version two is on the way in early Q1, so I can’t spill the beans because you know, stealth is wealth in this industry but some really great things coming.
CP: I look forward to using it.
OS: Yeah, I look forward to talking further with you and getting your feedback on it as well.
CP: For sure, will do. Thanks Otha.
OS: All right, thank you.
EG: For our regulation segment today, I’m here with Debbie Churgai, who is the executive director of Americans for Safe Access. Hey Debbie.
DC: Hello, how are you?
EG: Good, great to chat with you as always. Today, we’re going to talk about federal medical cannabis access around the globe. What do you have to tell us and our listeners today?
DC: I think people are really surprised when I tell people that there are currently 44 countries across the globe that provide federal medical cannabis access and the United States is not one of them. The United States is really falling behind many other countries when it comes for providing access to medical cannabis to everyone. As you know, there are 37 states that have some form of access but federally, we’re still far behind in providing access to everyone.
EG: Yeah, definitely. I know that you would say, “You know, this is what you do. This is what you’re working towards” can you tell us a little bit about where we’re headed and what you’re working on at the moment in the space?
DC: Sure. What we’re doing a little bit of both, we’re trying to provide access, better access in the states that do have programs but at the same time, we’re also trying to get federal oversight so that people can travel across stateliness and so that they can use any type of medicine no matter where they live across the country and be able to access the same types of medicines that people have if you live in New York or California or Texas or Florida to be able to have that same access of medicine that’s available. We’re trying to provide standardized access for patients across the country, like other countries do.
EG: Okay, yeah super important. How far away do you think we up and we go?
DC: Well, a lot of people are talking about legalization and they’ve been talking about legalization for many, many years and everybody thinks that it’s right around the corner but we’ve been advocating for now 20 years and when we first started, we thought it would just take two years because it seems like something that people deserve to have safe access to cannabis but it’s been taking a lot longer and while a lot of people are talking about adult use legalization, ASA is really focused on medical cannabis legalization because we know that pediatric patients need access and we want doctor education. We want research and so for us, we are looking at federal medical cannabis access.
EG: Right, yeah, super important goal. Thanks for the update Debbie and we’ll talk to you again next week.
DC: Thank you.