Feb. 13, 2019 - The Joe Rogan Experience
02:48:16
Participants
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| Speaker | Time | Text |
|---|---|---|
| Three, two, one, and we're live, ladies and gentlemen, or gentlemen, you two. | ||
| Ladies and gentlemen listening, but you two, unless you have some non-binary handle that you enjoy. | ||
| It's a new world. | ||
| Please, please introduce yourself. | ||
| Sure, so I'm Dr. Mike Hart, originally from St. John's, Newfoundland. | ||
| Now I'm residing in London, Ontario, and I'm a family doctor, and I've been practicing cannabis medicine for just over five years. | ||
| And use her. | ||
| My name is Alex Berenson. | ||
| I used to be a New York Times reporter. | ||
| Then I became a spy novelist. | ||
| And most recently, I wrote the book Tell Your Children, The Truth About Marijuana, Mental Illness, and Violence, which came out last month and has not endeared me to the cannabis advocacy community, I'd say. | ||
| Have they attacked you mercilessly for this book? | ||
| Yes, they have. | ||
| And that's okay. | ||
| I've also heard from a lot of parents, you know, some users, but parents who've told me that the book really encapsulates their family's problems in the last couple of years. | ||
| I suspect my real thoughts here, before we even get started, is that we're going to find that the truth is somewhere in the middle here. | ||
| I don't think marijuana is 100% safe. | ||
| Honestly, for everybody. | ||
| I really don't. | ||
| I know too many people that have had experiences where they took too much, particularly edibles, and I don't want to say I know anybody who had psychotic breaks, but I know some people that freaked out for weeks In fact, we just had a comedian here from Brazil a couple days ago, Rafi Bastos, who said he took a couple of hits of a vape pen. | ||
| He was high for 14 days. | ||
| Went to a psychiatrist, and he's a big guy. | ||
| He's like 6'5", 6'6". | ||
| And they told him to keep taking it, because he's like, you're so big, just keep smoking. | ||
| And so he doesn't smoke, so he just kept hitting his vape pen. | ||
| He said, I was high for fucking two weeks. | ||
| Yeah. | ||
| Yeah, so you need to do it properly, right? | ||
| It needs to be held to the same standard as any other medicine. | ||
| So we need to identify that there's risks and there's benefits to it. | ||
| And some people are definitely going to be more susceptible to those risks. | ||
| And we need to kind of tease out those people and make sure that those people don't put themselves at risk. | ||
| Yeah, I think so as well. | ||
| And this is one of the reasons why I want to state this because I'm a well-known marijuana advocate. | ||
| But I believe absolutely there are great benefits to it. | ||
| I think there's great benefits in terms of relieving pressure, ocular pressure for people that have glaucoma, people with AIDS who are on medication, people with cancer. | ||
| They're going through chemotherapy, find great benefit in terms of helping them. | ||
| And then there's also some people with autism. | ||
| I know people that they're children of autism and they give them small amounts of edible marijuana and stop seizures. | ||
| It's incredibly beneficial in the form of CBD for a lot of different ailments. | ||
| But I think with all things, and this is a stance that I've kind of like really come to accept over the last few years, with all things that affect the mind, they affect everyone slightly differently. | ||
| Absolutely. | ||
| Yeah. | ||
| Alex, you want to say something? | ||
| No, no. | ||
| Well, first of all, I suspect, you know, there are people who said, don't go on with Joe. | ||
| He's just going to, you know, he's going to try to eat you alive. | ||
| And especially, it'll be two on one. | ||
| I told them the truth. | ||
| First of all, I'll go on with anybody. | ||
| And I'm glad you had me on, or you're having me on, because, you know, Bill Maher, he won't have me on. | ||
| He's afraid to talk to me about this. | ||
|
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Why? | |
| Well, his people told the Simon& Schuster PR people, we just don't want to have him on. | ||
| And NPR had a national NPR show had an interview scheduled with me, an hour-long segment, and they canceled it. | ||
| They said, we don't believe in the conclusions of the book. | ||
| Okay, you don't believe in the conclusions of the book? | ||
| Have me on. | ||
| Ask me anything. | ||
| And that's why I'm so happy to... | ||
| That you're not afraid to have me on. | ||
| That we can have a conversation. | ||
| That we can have a conversation. | ||
| Come at me with any question you want about the science. | ||
| I'll say right off the top, I don't think marijuana is medicine. | ||
| It has a few medical uses. | ||
| CBD has been shown to reduce seizures in kids. | ||
| That's great. | ||
| THC has been shown to reduce the nausea associated with chemotherapy. | ||
| That's nice. | ||
| But for the most part, people use THC and cannabis as recreational intoxicants. | ||
| They use them to get high the same way they use alcohol, the same way they use other drugs. | ||
| And the sooner we accept that reality, the better off we'll all be that this is a drug and it has risks and benefits. | ||
| And the risks and benefits are different than alcohol. | ||
| They're different than other drugs. | ||
| But I don't think if you look sort of on a population level basis, they're less than alcohol. | ||
| I don't think you can even say that. | ||
| I really strongly disagree with that. | ||
| I mean, you just have to look at the death rate, right? | ||
| More people die from alcohol than almost all drugs combined. | ||
| But when we're looking at cannabis, there's zero deaths attributed to the use of cannabis itself. | ||
| Sure, you could say, you know, someone could use cannabis and jump off a cliff or something like that, but we're talking about the lethal dose. | ||
| You cannot die from cannabis. | ||
| And just based upon that alone, it makes it much, much safer than alcohol. | ||
| Yeah, how could you say that if that is the case? | ||
| So, okay, so that's a really good question. | ||
| The normal number that's used for U.S. deaths from alcohol is about 90,000. | ||
| Now, about 30,000 to 40,000 of those deaths are deaths from the physical effects of alcohol, right? | ||
| Essentially liver damage, either chronic liver damage, you get cirrhosis, you die. | ||
| In some cases, you can drink so much that you kill yourself in a night. | ||
| So that's about 30,000 to 40,000 deaths. | ||
| The other deaths are generally associated with alcohol, meaning... | ||
| Violence. | ||
| Exactly. | ||
| Violence, suicide, car accidents. | ||
| And all those numbers are basically based on studies from the 90s and before where people looked at traffic accidents and there were a certain number of those accidents where people had a blood alcohol content of higher than 0.1%. | ||
| They said, okay, that's an alcohol-associated death. | ||
| That's a fine way to count as far as I'm concerned. | ||
| Nobody has ever done that count for cannabis, and I can tell you based on the talk screens that I've seen from Colorado where people had cannabis in their blood and committed suicide, people had cannabis in their, I should say THC in their blood, and got into fatal confrontations with police officers. | ||
| If and when we do this number for cannabis, which we need to do as soon as possible, the number's going to be a lot higher than zero. | ||
| I suspect it will be in the 10,000 to 20,000 range. | ||
| We won't know until we actually do it. | ||
| Okay, but let's eliminate, let's go even over the alcohol. | ||
| Let's eliminate all things like violence, and let's eliminate suicide, and let's assume those people would have committed violence and committed suicide without it. | ||
| You're still looking at a giant number of people who drink themselves to death. | ||
| Thousands and thousands and thousands of people every year versus zero with marijuana. | ||
| And you're aware, I'm sure, that correlation does not equal causation and that, especially in a place like Colorado, where you're dealing with cannabis, something that stays in the system for many, many weeks, if you're testing people and they test positive for marijuana and they wind up committing suicide or they wind up committing violence, they don't even necessarily have to have been under the influence of it. | ||
| Well, as you know, when you test the blood, you can test both the active metabolite and the inactive metabolite of THC. So the test, when you do a blood test on somebody who's committed suicide, it's sophisticated enough to tease that out. | ||
| So there's a lot of people who have the active metabolite in their blood. | ||
| I agree. | ||
| Alcohol is a physically toxic substance. | ||
| Cannabis is a neurotoxin for a lot of people. | ||
| But in addition to the deaths, there's also just the morbidity that's associated with alcohol. | ||
| I mean, it ruins people's lives. | ||
| It ruins marriages. | ||
| It leads to weight gain. | ||
| It leads to a lot of metabolic disturbances. | ||
| I think you could say that for some people with marijuana, too. | ||
| I think you could say some people, especially weight gain, that some people smoke a lot of pot and they get lazy and they start eating Cheetos all day. | ||
| And you could also say that... | ||
| With some people, you know, the waking bakers that, you know, seem to be wasting their lives away, and that's like the stereotypical negative, you know, when you're talking about a negative description of a marijuana user, it's the waking baker, right? | ||
| The person who's high all the time. | ||
| You could absolutely say that that could ruin relationships. | ||
| You could absolutely say that it would ruin your job. | ||
| You could, but again, too, we're using the term marijuana, and really, we should be using THC, or high THC, when we're saying that. | ||
| Because people who use high CBD every day, as we know, or most people listening to this, CBD is non-psychoactive. | ||
| It does not get you high. | ||
| Super beneficial. | ||
| That can be extremely beneficial for a variety of different disorders that people have. | ||
| So we need to be careful about using cannabis versus using THC because it's really the THC that can do that. | ||
| And to your point, you say THC can cause the munchies and of course that's not good for someone who doesn't want to gain weight. | ||
| And just so people know, the way that it does do that is when THC attaches to the CB1 receptor, you get an increase in a hormone called ghrelin and ghrelin can actually induce hunger and that's why people get the munchies. | ||
| But that is not necessarily a bad thing if you're someone who has cancer or if you're someone who's wasting away from a terrible illness. | ||
| So sometimes having the munchies is definitely a good thing. | ||
| And I know a lot of people have said to me, it's not available, so you should probably not talk about it as much, but there is another cannabinoid called THCV. So there's over 100 cannabinoids in cannabis. | ||
| THC and CBD are only two of them. | ||
| Those are the main ones that people know about. | ||
| So THCV has been shown to actually reduce appetite. | ||
| So if we can get that out there in the market, you know, like we have with CBD, then we can almost, you know, eliminate or potentially, you know, substantially reduce the problem that people have with THC by using it with THCV. Dr. Hart, I have a question for you. | ||
| When people come into your practice, do they Do they want high CBD products, or do they want to get intoxicated? | ||
| No, absolutely. | ||
| Well, in Canada, it's fully legal. | ||
| Sure, of course. | ||
| Yeah, so it's like, they don't need to go to him to get intoxicated. | ||
| Right, so you're seeing a population that is genuinely interested in the health benefits. | ||
| Absolutely, because I mean, I'm glad that that's legalized in Canada, because it does make my job a little bit easier. | ||
| Basically, everyone who's coming to me now, I know that they want to use it medically. | ||
| Because if they want to use it recreationally, they just go to the store, right? | ||
| Because it's kind of a pain to get in to see me, come in and have the discussion, all that type of stuff. | ||
| So the people who see me now, they're all using it medically. | ||
| And then to answer your question, Alex, almost all my patients, as soon as they come in, they say, I don't want to get high. | ||
| I don't want to get high. | ||
| That's almost what everyone says. | ||
| So I think the word is out there that CBD is non-psychoactive and it doesn't get you high. | ||
| And I think that a lot of people are really interested in that compound. | ||
| And, you know, if the people didn't have the success that they've had over the past few years, you know, it wouldn't be as popular as it is. | ||
| So, you know, I think that, you know, we do need to look at the scientific evidence, but we do need to listen to others. | ||
| And the anecdotal evidence is, you know, something that we should consider because it is so strong. | ||
| Alex, let me ask you this. | ||
| Why don't you consider it medicine when it has proven medical benefits? | ||
| Well, it obviously can be medicine for these narrow things that the FDA has approved it for. | ||
| But as you know, I'm sure, when people talk about it as medicine, when the... | ||
| The ballot initiatives that have gotten it approved as medicine have really essentially deceived voters about the process, right? | ||
| So you go to a pot doctor, you get an authorization. | ||
| That authorization essentially enables you to buy as much cannabis as you want for the next year. | ||
| Most of the time, in reality, these doctors are not giving you a real medical examination. | ||
| They're saying to you, hey, do you have pain? | ||
| Do you have anxiety? | ||
| Here's your authorization. | ||
| I don't think you should speak for every single doctor. | ||
| We don't do that at my clinic, and I know that a lot of the clinics in Canada anyway, we definitely do not do that. | ||
| We provide a lot of education at my clinic, and there's other clinics in Canada that also provide a lot of education. | ||
| And I imagine there's a spectrum. | ||
| But in the U.S., this was a – and I spoke to advocates for my book. | ||
| I spoke to Rob Campia, who ran the Marijuana Policy Project for a long time, for the book. | ||
| And he acknowledged – advocates knew that this was a backdoor route to legalization in the U.S. Yeah, I used to joke around about it. | ||
| My doctor said, why do you need pot? | ||
| I said, I get headaches. | ||
| He said, when you get headaches? | ||
| I said, whenever I think about the fact that pot's illegal. | ||
| Yeah. | ||
| I mean, let's be honest about it. | ||
| I'm not – look, I say in the book at the end, I don't think this should be – this substance should be legal. | ||
| I favor decriminalization. | ||
| We're sort of jumping ahead here. | ||
| But if it's going to be legal, I'd rather have it be legal for recreational use. | ||
| I'd rather that we don't pretend that THC-high cannabis is a medicine. | ||
| And I'd rather separate out doctors like Dr. Holmes. | ||
| But THC is a medicine, though. | ||
| Yeah, but why are you saying don't pretend? | ||
| Because there's many medicines that have horrific side effects. | ||
| The medicine THC in regards to children's autism is pretty significant and well-documented. | ||
| Epilepsy, autism, those are two huge things that happen with children that they've been shown to severely mitigate with edible marijuana. | ||
| So I have to push back on you a little bit. | ||
| CBD has been shown to reduce seizures in children with epilepsy. | ||
| It's FDA-approved for that. | ||
| Okay, this may be anecdotal, but I have a good friend who has a child who, he uses it on, and he shows, I mean, it's been a game-changer. | ||
| Yeah, I mean, Just let me interrupt for a sec. | ||
| I had a patient four or five years ago, and she was 20 years old. | ||
| She couldn't drive a car because she had seizures, right? | ||
| So you can imagine being 20 years old, not being able to drive a car. | ||
| All your friends are driving around. | ||
| So she uses a little bit of CBD, not even every day. | ||
| She's never had a seizure since. | ||
| And now she's able to drive her car. | ||
| But this is, we're talking about CBD. He's talking about THC. So you're talking about a case. | ||
| And I'm not saying that your friend's situation didn't happen. | ||
| I'm not saying it's not real. | ||
| What I'm saying is that the reason we have clinical trials is because Science, the way you know whether a medicine works or not, whether a chemical compound works, whatever that compound is, the best way to know is you give the real medicine to one group of people and you give a placebo to the other group. | ||
| And you see the changes in those two groups over time. | ||
| And you find out whether or not your theory about whether this works on a population level basis is real or not. | ||
| That is at the core of medical science. | ||
| And we've basically thrown that rule out for THC. Well, that's not entirely correct. | ||
| You do know that there were studies that were run during the Nixon administration that showed the efficacy of marijuana and the safety of it, and those were all squashed. | ||
| And you also, I'm sure you know, like when we're talking about marijuana, you're talking about something that's federally illegal. | ||
| It's not something that's easy to run these FDA studies on. | ||
| Yes, and I say at the end of the book, I think we should drop that. | ||
| I think anybody who's got a legitimate interest in researching either THC or cannabis or any of the compounds for a medical condition, let them run phase one, phase two, phase three trials. | ||
| Let's see if this plant is good for these things. | ||
| I think that's a great idea, but still, why are you saying that you don't think it is medicine when all these people find benefit in it? | ||
| Do you think they're getting it from just the CBD, the minimal amount of CBD in marijuana? | ||
| No, I think that, again, there's been a lot of research done on THC and cannabis to see whether or not those... | ||
| Whether THC is a compound and whether smoke cannabis can treat these conditions. | ||
| And for the most part, the studies have been negative. | ||
| Negative in what way? | ||
| Meaning they haven't shown any actual... | ||
| Can you cite these studies? | ||
| I mention them in my book. | ||
| Okay. | ||
| Well, what were the conclusions of these studies when you're saying that they're not positive? | ||
| That they... | ||
| Again, that they... | ||
| Didn't work, that the drug didn't work. | ||
| Didn't work on what? | ||
| On cancer, on Alzheimer's disease, on irritable bowel syndrome, on all kinds of things. | ||
| So, Alex, I mean, you're throwing a few different things out there, and I appreciate the fact that we can't be going around saying things like, you know, cannabis cures cancer, right? | ||
| Right. | ||
| And I've done videos on this even recently stating that. | ||
| But if you look at the research, I mean, specifically, if you look at specific cancers, there are studies that have shown that THC and CBD can help. | ||
| Say if we're talking about breast cancer, and I did a video on this recently. | ||
| If you are HER2 positive, And you see CBD, it can in fact reduce tumor size and it can reduce tumor growth. | ||
| Now, if you have... | ||
| I'm sorry, can I interrupt you? | ||
| What does that mean? | ||
| It's a subset of breast cancer. | ||
| Right, so there's different types of breast cancer and that's just one subset of breast cancer. | ||
| So there are other breast cancers which do not express cannabinoid receptors. | ||
| And I've seen one study, at least. | ||
| Again, it's only one study that showed that when they gave CHC in that animal model, it actually caused a proliferation of tumors. | ||
| So it worsened them. | ||
| So I do agree with you, Alex, in the fact that we have to be careful about using terms like that. | ||
| But that just doesn't mean that we can't say that cannabis is no good for cancer at all. | ||
| And I mean, even in the National Mechanics of Science and Engineering report, they said that cancer was great for chemotherapy-induced nausea and vomiting, right? | ||
| So it's definitely a really good medicine for a lot of different things. | ||
| And when we're talking about THC, I said earlier, of course, we need to be careful about THC. But it definitely is still a medicine. | ||
| And to your point with regards to not being a medicine, say, for something like PTSD, I come from it from a clinician's point of view. | ||
| So I'm not a researcher. | ||
| So I need to make sure that my patients are getting better. | ||
| It's very frustrating for me just to say to someone, oh, there's nothing I can do for you. | ||
| There's nothing I can do for you. | ||
| And I understand that doing something sometimes is not going to be beneficial just because you're doing something. | ||
| You have to do something that actually works. | ||
| But we do have epidemiological studies and we have other studies that have shown that when patients are given cannabis, it can reduce their symptoms of PTSD. There's also another study, I don't use this drug too often, called Nabilone. | ||
| So Nabilone is just pure THC. Nabalone was shown to reduce nightmares in people who have PTSD. So just because THC is psychoactive doesn't mean that it's not a medicine. | ||
| And just to keep on the topic of PTSD, in addition to that, we've identified mechanisms of action. | ||
| I know there's one study, I think Matt Hill was one of the authors of that study, and he noted that in people who have PTSD, there's an over 50% decrease in levels of anandamide. | ||
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Which is the naturally occurring cannabinoid in your brain. | |
| Yes, which is the naturally occurring endocannabinoid, correct. | ||
| So you can get that through exercise, which is one excellent way to do it. | ||
| And that's part of the high that you get after you exercise. | ||
| But the other way that you can get it is by using cannabis. | ||
| So when THC attaches to those CB1 receptors, you can get a release of anandamide. | ||
| And cannabidiol can actually increase anandamide by another mechanism of action as well. | ||
| So, you know, there's different ways where we can, you know, raise a level of deficiency. | ||
| So, you know, to me, as a clinician, you know, if I have someone who is not doing very well, you know, they've been on a bunch of different medications, I've identified that, you know, they have PTSD, we have a mechanism of action, we have studies, and then again, too, you know, don't discount my clinical experience, right? | ||
| I've been working for over five years just with cannabis. | ||
| I mean, I do other medicines. | ||
| I prescribe other medicines as well, but I've been doing cannabis medicine for over five years. | ||
| And there's a lot that I've learned, right? | ||
| So as much as I've learned through reading studies and through going to conferences and things like that, for sure, the best resource as a clinician is to learn from your patients and to hear what your patients tell me. | ||
| And the things that my patients tell me is that THC is really effective for their sleep at night. | ||
| And a lot of my patients, especially my veteran patients, have done really, really well with that. | ||
| And just one further point, too. | ||
| I know it was in 2015, I believe it was. | ||
| There was a meta-analysis done. | ||
| I can pull it up if we need to. | ||
| That indicated that a lot of the medicines that are being used now for PTSD are just simply ineffective. | ||
| And the other thing, too, is that there's never been a medicine made specifically for PTSD. So all the medicines that people are using are for anxiety, or they're for depression, or they're for insomnia, or they're for something else. | ||
| But when we look at a study that says people with PTSD have a lower level of anandamide, and if you can increase that level of anandamide, that's a good way to treat someone. | ||
| It doesn't matter whether it's a vitamin, whether it's a hormone. | ||
| As long as you are correcting a deficiency, you're generally going to get excellent clinical results. | ||
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Right. | |
| So let me sort of try to frame this a different way. | ||
| Alcohol reduces blood pressure. | ||
| Alcohol generally tends to reduce cardiovascular events for people. | ||
| And during prohibition, you could actually get a doctor's note for alcohol as a medicine. | ||
| But alcohol is not a medicine. | ||
| It's a recreational intoxicant. | ||
| It has some positive biological qualities and some negative biological qualities. | ||
| And there was an argument, I think, 10 to 20 years ago, should we recommend that people drink moderately, one to two drinks a day? | ||
| And I think for the most part, the medical profession has come down on the side of saying, let's not do that. | ||
| There's too many non-cardiac negative side effects with alcohol. | ||
| Just on that note though, Alex, in Canada right now, I know the safe alcohol drinking guidelines are 14 drinks a week for men and 9 drinks a week for women. | ||
| So, you know, basically two a day for men, one and a half for women. | ||
| So you're saying, okay, like, we don't see huge negative consequences at that level. | ||
| Okay. | ||
| That's fine. | ||
| That's a totally reasonable way to think about alcohol. | ||
| But what we're not saying to people is, this is a medicine. | ||
| And I think that's where the confusion really around high THC cannabis lies. | ||
| And again, I don't mean to say that your friend's child is not benefiting. | ||
| If you say he or she's benefiting, I believe you. | ||
| What I'm saying is that that's not good enough for science. | ||
| We need randomized controlled trials. | ||
| And when those trials have been done, and a lot of them have been done, Joe, a lot of them have been done, they've almost unequivocally shown that cannabis doesn't work as a medicine. | ||
| The only actual place where, beyond these sort of very limited conditions, like chemotherapy-associated nausea, which obviously is terrible for people who have it, but isn't that common, fortunately, Cannabis has been shown to work as a pain reliever. | ||
| Probably for the same reasons that alcohol works as a pain reliever. | ||
| It dulls your awareness of your pain. | ||
| But even in that study, or even in those studies, they're mostly done against placebo, not against opioids or against NSAIDs like ibuprofen. | ||
| And there was a very big study for cannabis use in chronic pain over a multi-year period in Australia that came out last year that showed that people who used cannabis had more pain and used more opiates at the end of four years than people who didn't. | ||
| So we're almost arguing about what medicine is. | ||
| Yeah, that study, though, had a lot of flaws in it. | ||
| And the other thing is that you need to look at someone who is already using cannabis versus someone who is just using opioids. | ||
| So if someone is just using opioids and they want to come off cannabis, you know, there's multiple... | ||
| Come off opiates? | ||
| Sorry, come off of opiates with cannabis. | ||
| You know, multiple studies have shown that that can be effective. | ||
| And that's not what was done in the Australian study that you're referring to. | ||
| Right, it's a more naturalistic approach. | ||
| And also, too, they didn't have access to medical marijuana during that whole time. | ||
| Those are all self-reported, and they were getting it from recreational sources. | ||
| That's a big distinction, though, Alex. | ||
| They weren't getting it from a doctor who prescribed it to them. | ||
| This was a self-reported study, and people were getting cannabis that they didn't really know what they were getting. | ||
| It wasn't They weren't given any information from a doctor. | ||
| And that's why it's a medicine, Alex, because you can tell someone, you can tell a patient to take a certain amount of CBD every single day. | ||
| And when you take a certain amount every single day, it can reduce your symptoms. | ||
| And sometimes you need to increase that, and sometimes you need to decrease that. | ||
| We do that with all medicines. | ||
| We should be really clear about the distinction, though, between CBD and marijuana. | ||
| I mean, we're really talking about the psychoactive version of it, and this is where you're saying it's negative. | ||
| You're not really arguing that CBD is negative. | ||
| And I think, you know, Dr. Hart is talking about... | ||
| He's talking about using this as a medicine, certainly using the CBD. He's titrating his patients. | ||
| He's monitoring them. | ||
| He's not writing them an authorization and saying, come back in a year when it's up. | ||
| He's being a physician. | ||
| And, you know, and I think... | ||
| To the extent that marijuana is medicine, we want people like him... | ||
| So you admit it's medicine? | ||
| No, no, no. | ||
| I don't admit that. | ||
| But you just said that. | ||
| I don't think I just said that. | ||
| I think I said to the extent, I'm trying to meet you halfway, but I'll stop doing that. | ||
| But, you know, I think you said something else that was really interesting to me, and this came up in the book, too. | ||
| So you're a clinician. | ||
| You see sick people. | ||
| And, you know, it's funny, my wife's a doctor, too. | ||
| She's a psychiatrist. | ||
| That's how I sort of got in this. | ||
| But my wife is a forensic psychiatrist less than a clinician these days. | ||
| Her job is to evaluate people, not so much to treat people. | ||
| Your job is to treat people. | ||
| You see sick people. | ||
| You want to help them feel better. | ||
| And you don't want to tell them, there's nothing I can do for you. | ||
| There's no hope for your pain. | ||
| There's no hope for your PTSD. You want to help them. | ||
| And I totally get that. | ||
| But if you're an epidemiologist or a researcher who's trying to guide the views and the medical practice of hundreds of thousands of doctors, that's not good enough. | ||
| So you need to step back. | ||
| And I think, you know, this epidemiologist in Britain who I talked to, he said to me, he said, you know, I try not to draw conclusions because so often when I try to draw them, I'm wrong. | ||
| Yeah, and we need to be, you know, careful about that, right? | ||
| And Alex, you know, one thing that was mentioned in your book, you know, is that, you know, you often cited the National Academies of Science and Engineering, right? | ||
| But, you know, Ziva Cooper, you know, she's a member of that committee. | ||
| I mean, she put out on her Twitter, I mean, you can go to it, it's from January 9th of 2019. She says, in response in the recent New York Times editorial on cannabis and as a committee member of Which, by the way, that came out of something that I wrote that came out of the book. | ||
| Hold on, let me finish. | ||
| No, no, I'm just trying to give people context of where it came from. | ||
| Right, but this is someone you cited, right? | ||
| No, I didn't cite her, I cited the report. | ||
| Okay, you cited the report, and she's a member of that, okay? | ||
| So she said, in response to the recent New York Times editorial on Canada, says a committee member on NASM, which is that committee, And Cannabinoid's report, we did not conclude that cannabis causes schizophrenia. | ||
| Then, the Drug Alliance policy also said the report did not reach that conclusion. | ||
| So, you know, those are pretty two authoritative sources that are saying that, you know, in your book, you didn't cite the research properly, right? | ||
| And then also, they're saying that you left a lot out, right? | ||
| They said that They have found an association between marijuana use and improved cognitive outcomes in individuals with psychotic disorders. | ||
| That's straight from the same report. | ||
| And you failed to mention that. | ||
| So I think that when we're writing books or when we're giving out information, you want to do it from a balanced approach and you don't want to just... | ||
| Select the small amount of material that's just going to support your study. | ||
| We want to be truthful here. | ||
| Joe's show has always been very truthful. | ||
| I mean, Joe said right at the beginning, he doesn't think that cannabis is perfect for everyone. | ||
| And I don't think that either. | ||
| And in Canada, we have really strict guidelines to follow. | ||
| Basically, no one prescribes cheat seed to anyone under the age of 25. And, you know, all the conferences and stuff that I go to, you know, we don't really have too many discussions about that. | ||
| Like, the doctors don't really have much of a backlash about that. | ||
| Why is the distinction the age of 25? | ||
| Why do they decide that age? | ||
| So, 25 basically is when your brain is fully developed. | ||
| And when you do look at the studies that do show an association between cannabis and psychosis, it's almost all in adolescence. | ||
| I think that Alex only has one study in his book that shows an extremely weak correlation between an adult using cannabis and then developing any type of mental illness later. | ||
| So, you know, 25 is a good age, but it's definitely a, you know, kind of a conservative-ish age. | ||
| But, you know, it's something that we follow, and I think that, you know, we've done well with that in Canada. | ||
| So, Alex, why did you leave those conclusions? | ||
| So, I need to push back here. | ||
| So the National Academy of Medicine report was drawn up by a committee of 16 researchers. | ||
| Ziva Cooper is the one who's publicly said, the report said this, but I think that we should have emphasized that it also said this. | ||
| What I wrote in that New York Times op-ed, what I wrote in the book, is the plain language of the report. | ||
| And the plain language is this. | ||
| Cannabis use is associated with a risk of developing schizophrenia and other psychoses. | ||
| The higher the use, the greater the risk. | ||
| I may have a word or two wrong in that because I'm doing it from memory, but that's what it said. | ||
| And by the way, the committee was very clear. | ||
| They separated depression. | ||
| They said we don't see nearly as high risk for depression as psychosis. | ||
| Even though, by the way, today, just today, JAMA Psychiatry, the Journal of the American Medical Association of Psychiatry, I put out a meta-analysis showing that cannabis is associated with depression and suicidal thinking, and actually suicide attempts at a 3.5 to 1 rate. | ||
| This literally was released today. | ||
| But to go back, Ziva is one of 16 members of that committee. | ||
| So if you're going to say that I misquoted the report, which I didn't, I quoted it entirely accurately, you need to say, well, why aren't the other 15 members of that committee saying that I misquoted? | ||
| Why is one person who works for the Cannabis Research Initiative at UCLA, which takes money from cannabis investors and users, she's the one who said that I misquoted it? | ||
| Maybe we should ask why the other members of the committee are not speaking out against my book. | ||
| Well, I think that she was just one of the 16 members that came out, but you can't really expect all the other members to potentially come out with that as well. | ||
| Why not? | ||
| Why not? | ||
|
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If I did something wrong, if I misquoted them. | |
| Well, some people will and some people won't. | ||
| Some people have the personality. | ||
| Some people have the platform. | ||
| Ziva has a bunch of followers on her Twitter. | ||
| People know who she is. | ||
| A lot of people who do research actually are not into social media at all. | ||
| I don't think you were at all before you had your book, were you? | ||
| Yeah. | ||
| I mean, I was a novelist, so I was promoted. | ||
| Yeah, so you weren't into social media at all. | ||
| So, you know, I don't think that most people on that committee are into social media. | ||
| You know, Ziva just happens to be. | ||
| And, you know, I even spoke to Ziva on the phone about this. | ||
| And, you know, she said that, yeah, you know, I don't – that she agrees with everything that was in the report, but she doesn't agree with your conclusions. | ||
| My conclusions are – Quoted from the report. | ||
| But you're only quoting the parts that back your opinions. | ||
| You're not quoting the entire part. | ||
| Why did you leave out the part that said they have found an association between marijuana use and improved cognitive outcomes in individuals with psychotic disorders? | ||
| So you're leaving out that part. | ||
| So why did you leave that part out? | ||
| If you can Find me a psychiatrist who thinks that it's a good idea for somebody with an active psychotic disorder to use CGC. Why'd you leave out that part? | ||
| Well, my book presents, it makes a case, right? | ||
| It makes a case that this is a big issue that we have not heard about at all, and the reasons that we haven't heard about it have a lot to do with the advocacy community and the way they've presented this data for 25 years. | ||
| I wrote a book that is trying to break through a lot of noise. | ||
| So, but still, to get a balanced approach, did you decide that you were only going to write about things that confirm the belief that you held when you were writing this and what you were trying to push in the title of the book and in the conclusion of the book? | ||
| I think that's a really great question. | ||
| I say in the introduction of the book, this book is not balanced. | ||
| There's not a lot of evidence in there. | ||
| If you want to read about how indica and sativa strains are different, you're not going to read that in this book. | ||
| But I also want to say this. | ||
| I didn't come at this, and I say this in the introduction of the book, too, as an anti-cannabis crusader. | ||
| In fact, when my wife said to me, as she said to me over and over again in 2014 and 15 and 16, these are the cases that I'm seeing. | ||
| These are the terrible things that people are doing after cannabis use. | ||
| I sort of said to her, first of all, why do I always have to hear about this at the dinner table? | ||
| But more importantly, you know, why... | ||
| Why is it that maybe these people are using other drugs? | ||
| Maybe you're seeing a slice of the population that's not representative. | ||
| Why is it that I should believe this? | ||
| This sounds like reefer madness to me. | ||
| And, you know, ultimately my wife, who's the one who went to, you know, she actually, as I was talking to Dr. Hart about this, she grew up in Newfoundland too. | ||
| She went to the Memorial University of Newfoundland Medical School. | ||
| And she went to Harvard and Columbia for her postgraduate training. | ||
| You know, eventually she got tired of me yapping back at her and she said, why don't you go read the studies yourself? | ||
| And it was that that led me to write this book because when I read the studies, I could not believe the strength of the evidence, Joe. | ||
|
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Right. | |
| But you're still, even in saying that, you're still seeing positive results that you're excluding from your book. | ||
| Again, there's this one sentence, I mean it's not just one sentence, but there are a few sentences about how it may be that cannabis helps people's positive, it helps cognition in people with psychosis. | ||
| Maybe, maybe not. | ||
| Wouldn't that qualify as medicine? | ||
| No, it wouldn't be approved as medicine if it's causing them to have other psychotic episodes. | ||
| But if these people have psychotic breaks and improves cognitive function in people with psychotic breaks, wouldn't that be something that you would prescribe to someone? | ||
|
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No. | |
| No, again, you need to think about how the FDA is looking at medicine. | ||
| No, I understand the FDA's position, but I mean, looking at it as medicine, I mean, if we could prove this through studies and through some sort of clinical trials. | ||
| If it is improving your IQ to points on a test, I'm not saying it is. | ||
| Is that all it is? | ||
| I think we'd have to look it up. | ||
| I'd have to look at that. | ||
| I'm not sure what the exact outcomes are. | ||
| But at the same time, it's making you florally... | ||
| No, no, it's true. | ||
| But at the same time, it's making you floridly psychotic. | ||
| That's not medicine. | ||
| Well, it's not necessarily at the same time. | ||
| One of the things that I read about schizophrenia was that people were trying to make a correlation between marijuana use and schizophrenia, but the problem with that correlation, and what I read, and maybe you could help me on this... | ||
| Was that it's the exact same number that you find the general population. | ||
| Essentially 1% of the general population has schizophrenia, which is 1 out of 100 people. | ||
| And when you have marijuana users, you see essentially that same number mirrored, and so they're saying a small number of people... | ||
| That's not true, Joe. | ||
| Hold on, but let me get... | ||
| In a small number of people, what they were saying essentially in what I read was that marijuana use was associated with the onset of schizophrenia. | ||
| They were disputing this in this study because the same number is mirrored in the general population. | ||
| Again, correlation does not equal causation, right? | ||
| Dr. Hart, I think you've got to tell them that's not true. | ||
| Tell me. | ||
| Tell me what that means. | ||
| So traditionally, yes, when you look at the stats, you'll see that the people who use cannabis versus the people who don't use cannabis have very similar rates. | ||
| But getting to the exact rates, so in the U.S., they say that the range for schizophrenia is between 0.25% to 0.64%. | ||
| Globally, they say it's 0.33% to 0.75%. | ||
| So, right there, it's apparently lower in the US. And the US has the highest percentage of cannabis consumption in the world. | ||
| And the US also has a lot of people that are using high-potency THC. I think that we really need to be careful about throwing out stats like that because when you do look at the stats that we have, it shows that even though there's a lot of cannabis use in the United States, schizophrenia rates have remained the same. | ||
| So I have to push back really hard on this. | ||
| This is one of the great myths of legalization. | ||
| No one knows what the schizophrenia or psychosis rate is in the US. Suddenly, changed its estimate for the percentage of people with schizophrenia in the US from 1.1% to 0.3%. | ||
| They did it with no public notice, and then this researcher said, hey, this is a miracle. | ||
| They just cured 2 million people with schizophrenia. | ||
| And then, in response to that, the director of the NIMH said, well, we actually don't know how many people have schizophrenia in the United States. | ||
| Nobody knows. | ||
| Nobody knows if the rate is increasing. | ||
| Nobody knows if it's decreasing. | ||
| The only countries where they can count noses on this With any accuracy are in Northern Europe, because they have good healthcare, because they have slightly, you know, less protections around sort of individual privacy and mental health privacy, and so they are able to count cases. | ||
| And in Denmark and Finland, Which are the two places where they've actually done this research in the last 20 years. | ||
| They've shown increasing rates of schizophrenia between about 1995 and about 2010. And that goes side by side with increasing rates of cannabis use in the 90s. | ||
| So the people who are saying that there's no evidence of population-wide increases in psychosis are just wrong. | ||
| But isn't it possible that there's other factors? | ||
| Absolutely. | ||
| I mean, environmental factors, there's a bunch of other different things that you can consider. | ||
| Let me be clear on this. | ||
| We absolutely don't have the evidence at this point to say that cannabis use in the U.S. is causing a population-level increase in psychosis and schizophrenia, which are, by the way, those are sort of different illnesses, and we can talk about that, too. | ||
| So we don't have the evidence to say there's a definite increase. | ||
| But what I'm saying is that what you have been told is That there is no increase in schizophrenia or psychosis rates in the U.S. We don't know if that's true or not. | ||
| We just don't know. | ||
| Let me ask you this. | ||
| There has been proven that there's an increase in marijuana use. | ||
| Is that correct? | ||
|
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Yes. | |
| Absolutely. | ||
| When did the increase begin and what percentage is that increase? | ||
| So there was a... | ||
| Increase in the 90s, an increase in use and in potency. | ||
| Use sort of bottomed out around 1991. And then there was sort of a flat... | ||
| Bottomed out? | ||
| Meaning it hasn't increased since 91 to 2019? | ||
| No, no, no. | ||
| It's gone up to 50% since 92, roughly. | ||
| That's a lot. | ||
| That's a lot. | ||
| Wouldn't you expect a corresponding increase in schizophrenia if there was any sort of correlation? | ||
| Hold on. | ||
| Let me walk you through. | ||
| It bottomed out in the early 90s, increased again, increased in the 90s, flattened out between about 2000, 2006, and since then has been going up again, especially in, let's say, the last three, four years. | ||
| And the other thing is that potency in the last 15 years has gone way up. | ||
| I don't think anybody would dispute that. | ||
| But has schizophrenia gone up? | ||
| So what I'm saying to you is we don't know. | ||
| There is evidence. | ||
| There is now evidence on a population level basis in those other countries that schizophrenia and psychosis has gone up. | ||
| And there's for the first time in 2017, there's data showing that serious mental illness, which is not the same as psychosis or schizophrenia, in the U.S., Doubled between 2008 and 2017 in people aged 18 to 25. And those are the people who are most likely to be using. | ||
| So for the first time, there's actually evidence of what you're talking about, which is a population-wide increase. | ||
| Can I get you to clarify? | ||
| Can you say serious mental health? | ||
| So serious mental illness, so this was defined, there's a study called the National Survey on Drug Use and Health. | ||
| It's done every year, covers 70,000 people, federal government funds it. | ||
| It's sort of the best data source we have on all this stuff. | ||
| It showed that, and they're not counting cases either. | ||
| Let me just be as clear as I can on this. | ||
| Nobody's counting schizophrenia cases on a national or even state-level basis in the U.S., But you say to people, did you have depression so bad that you couldn't get out of bed? | ||
| Were you hospitalized this year for any inpatient psychiatric reason? | ||
| And if you look at those numbers, in 2008, 3.8% of Americans, 18 to 25, reported at least one symptom. | ||
| So they were categorized as having serious mental illness that year. | ||
| In 2017, that number was 7.5%. | ||
| So that's a doubling. | ||
| So again, I am not going to say that proves that the increase in cannabis use has caused this population level increase. | ||
| But something bad has happened. | ||
| And if you look at kids 12 to 17, interestingly, they, over that time period, didn't have a big increase in cannabis use. | ||
| In general, teenagers are actually... | ||
| Are pretty healthy now, although Juul and vaping may be undoing that. | ||
| And those kids didn't have a population level increase in serious mental illness. | ||
| Can I stop you for a second there? | ||
| Because there's other factors. | ||
| Oh, sure. | ||
| One of the big ones is Yuval Noah Harati has a great book, 21 Lessons for the 21st Century. | ||
| I read that. | ||
| It's great. | ||
| And one of the things they talk about is the onset of social media. | ||
| Jonathan Haidt talked about that as well. | ||
| And the onset of social media is actually more hate than Yuval Harati. | ||
| But Jonathan Haidt talks about it with young people. | ||
| I think it's the coddling of the American mind. | ||
| I think that social media and the pressures of social media have led an incredible amount of young people to serious mental distress and, you know, serious anxiety, serious depression, and suicide amongst young girls has increased some 50% according to Haight over the period of 2007 to, I think, 2000, whenever his book was written. | ||
| I think they're directly correlating that to the pressures of social media and to anonymous online bullying and all these different factors that are affecting kids. | ||
| So I think that could be considered a far more significant new form of distress to children and young people than even marijuana. | ||
| I think it does it twofold. | ||
| Because I think that what makes people really depressed, maybe more so than anxious, but definitely both, is that when you compare yourself to someone else. | ||
| And people, obviously we've done that, all humans have done that since history began. | ||
| But now, everything is online. | ||
| You can compare your life to everyone. | ||
| And people are doing it all the time. | ||
| And even worse than that, and we should talk about this too, is that the income gap is getting wider. | ||
| So it's like people's lives, not only are they getting better than other people's lives, but now it's on display so everyone can see it. | ||
| Whereas before, maybe you wouldn't have seen it because it wasn't on social media. | ||
| But now it's on social media. | ||
| So you have this huge income gap that just keeps getting bigger and bigger and bigger. | ||
| And then you have people going on social media and they're comparing themselves. | ||
| And you're absolutely right, especially in that age population. | ||
| I mean, people under the age of 30, you know, they're definitely, you know, they're being bullied online. | ||
| Like I see it every day in my office. | ||
| Like literally every day people are being bullied online. | ||
| And that's, you know, something that I never had, you know, to deal with growing up. | ||
| Yeah. | ||
| And a lot of kids do have to deal with that. | ||
| Just one more note, too. | ||
| Since Colorado has legalized cannabis, this is important for this subject and this topic, they've actually seen marijuana rates decrease. | ||
| So it's important for people to know that... | ||
| No, no, no. | ||
| Are you talking about teen use or overall use? | ||
| Overall use has gone up. | ||
| Teen use is flat. | ||
| Overall use is up. | ||
| Okay, yeah, I'm talking about teen use. | ||
| That's the category that we're talking about, under 30. So teen use would classify as part of that category. | ||
| So in Colorado, we have seen a decrease. | ||
| Do you think that's because of the lack of, because it's not illegal, it's not as exciting to them? | ||
| Part of it, for sure. | ||
| Part of it, one worry I had, I haven't looked into the statistics yet, was when you're growing up and when you're in high school, if you want to be part of the cool crowd, so to say, you usually drink or you smoke pot. | ||
| That's what people do. | ||
| I hope that that doesn't change because pot's seen as medicine. | ||
| I hope that people don't move on to or do something harsher because they don't see pot as cool anymore. | ||
|
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Right. | |
| There's no stigma attached to it because it's legal? | ||
|
unidentified
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Yeah. | |
| So I've got to push back on a couple of things. | ||
| Okay, please. | ||
| So everything you say about social media, it sort of intuitively sounds correct, right? | ||
| The problem is the data doesn't support this at all. | ||
| The data shows that teenagers, 12 to 17, those kids are healthier than they were 10 or 20 or 30 years ago. | ||
| They drink less, they smoke less, they have sex later, they have fewer abortions, they are healthier. | ||
| Okay. | ||
| And their mental health doesn't seem to have changed that much based on the NSDUH data, okay? | ||
| The data shows a big change in kids 18 to 25. They go to college, something goes wrong for a lot of those kids, at least in the last few years. | ||
| But wait a minute, when you're talking about suicide rates, suicide rates, especially with young girls, who are apparently more affected by social media, they've gone up significantly since the rise of social media. | ||
| That is the big factor. | ||
| Hold on a second. | ||
| More so than cannabis use, and that's a fact. | ||
| So you're talking about a tiny, tiny number. | ||
| No, no, it's not a tiny number. | ||
| It's a 50% increase of people that commit suicide that are young girls. | ||
| The people who commit suicide in the United States are middle-aged white men. | ||
| Okay, but you're discounting these young girls that are committing suicide to fit your statistics or to fit your conclusions. | ||
| No, what I'm saying is that's a tiny, tiny number. | ||
| But a 50% increase is not a tiny amount. | ||
| This is something we can look up. | ||
| Well, let's find out what the numbers are. | ||
| Because when Jonathan Haidt was on the podcast and he discussed it, he showed this chart and it's an alarming increase directly correlating with the increase in use of social media. | ||
| Sure. | ||
| Why would you push back against that? | ||
| That seems to be a factor. | ||
| What I'm pushing back against is the idea that kids 12 to 17 generally are less healthy than they were 10 or 20 years ago. | ||
| No one's saying they're less healthy. | ||
| You just said they're more healthy. | ||
| Yeah, I'm saying they're more healthy. | ||
| We're saying mental health has nothing to do with cardiovascular fitness. | ||
|
unidentified
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No, no, no. | |
| I mean mentally healthy. | ||
| I mean, they're less likely to use drugs, they're less likely to have sex. | ||
| But they're more likely to commit suicide. | ||
| That is a tiny, tiny number. | ||
| What are you talking about? | ||
| If it's a 50% increase, that's a huge difference. | ||
| We should look up the number. | ||
| Look, Jonathan Haidt's work is very well respected. | ||
| What I'm saying to you is that there's a clear increase in psychological distress in kids and young adults 18 to 25. There's a clear increase. | ||
| And those are the people who are most likely to be using cannabis right now. | ||
| Those are the people that are most likely on social media as well. | ||
| Sure. | ||
| And that's a stressful period of your life. | ||
| But I don't understand. | ||
| Like, 12 to 17, you're usually living at home. | ||
| Like, 18 to 25, then you've got to go to university. | ||
| You've got to deal with all these courses and stuff. | ||
|
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I'm willing to concede. | |
| I'm willing to concede. | ||
| And I've said at the beginning of the program that I think that marijuana, with some people, is not beneficial and, in fact, could be negative. | ||
| But I don't understand why you're not willing to admit that social media has a significant and unprecedented impact on young people that we've never seen before. | ||
| I would totally agree with that. | ||
| But I don't think that you can say, based on the population-level data, that the impact is all negative. | ||
| It may be... | ||
| Who's saying that the impact is all negative? | ||
| What we're saying is a 50% increase in suicide with young girls. | ||
| That's huge. | ||
| Let me give you an example. | ||
| When you were 15, or I was 15, maybe you got really drunk and wound up in a bathtub. | ||
| Maybe kids today are less likely to do that because of social media because they know it's going to be on Instagram forever. | ||
| I don't think that's true. | ||
| I don't think that's proven. | ||
| I don't think there's anything that would point to that. | ||
| Well, what I can tell you is proven is that kids today, I'm talking about teens, 12 to 17, have less psychological distress by all these measures. | ||
| I'm talking about their actual behaviors are better, or better or worse, that's a moral judgment, but they're healthier than they were 10 or 20 or 30 years ago. | ||
| They're less likely to have sex when they're 14, which I think most people say is a good thing. | ||
| They're less likely to be drinking. | ||
| They're less likely to be smoking. | ||
| Those are good things. | ||
| Well, less likely to be drinking, less likely to be smoking, less likely to have sex does not correlate to positive mental outlook and less suicide. | ||
| Well, yes, I agree. | ||
| Let's look at the numbers. | ||
| But depression and suicide are very difficult things to measure, right? | ||
| Well, suicide is actually pretty easy to measure. | ||
| It's a hard number. | ||
| Depression is more complicated. | ||
| The bottom number is in females. | ||
| So, okay, I mean, this is what I'm saying. | ||
| The death rate, first of all, this is, okay, the death rate for girls age 15 to 19 is 4 per 100,000, Joe. | ||
|
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It's at a 40-year high. | |
| Right. | ||
| So, I mean, you'd be hard put to say that's a huge spike. | ||
| It was 3 per 100,000 in 1975, and it's a little bit over 4 in 2015. That's not, that's one case per 100,000 girls. | ||
| Right. | ||
| Yeah, I don't know what the actual facts are. | ||
| I'm looking at this right now. | ||
| Suicide rates for teens, 15 to 19 years old. | ||
| This is something that we'd have to study to have this discussion. | ||
| We've got a giant spike for boys in the 1990s. | ||
| What the fuck is that about? | ||
| 95. An enormous spike. | ||
| What I'm telling you is if you put middle-aged men on this chart, you'd have to blow out the ceiling. | ||
| The suicide crisis is unfortunately a crisis of age. | ||
| Okay, I would agree with that. | ||
| I think we actually talked about that yesterday with Andrew Yang, that suicide amongst men in their 50s, and then they start to feel useless. | ||
|
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Yeah. | |
| Yeah, and especially if they lose their jobs. | ||
| But what Jonathan Haidt is pointing to is a direct correlation between social media use, depression, and suicide amongst young girls. | ||
| Thank you for finding it. | ||
| What is it? | ||
|
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This is the article it's from. | |
| Suicide rate for teen girls, the highest it's been in 40 years is social media to blame. | ||
| Right. | ||
| Okay. | ||
| New data released Thursday by the Atlanta-based Centers for Disease Control and Prevention. | ||
| Suicide rates amongst 15 to 19-year-old girls doubled between 2007 and 2015, reaching a 40-year high. | ||
| I would say that's significant. | ||
| Again, and it's obviously a terrible thing when anybody commits suicide, but we're talking about two per 100,000. | ||
| I understand. | ||
| Actually, it's five. | ||
| Well, it went from two to four. | ||
| Okay, that means for every 100,000 American girls in 2015, five committed suicide. | ||
| That's not a very high number, but I mean, that's also someone who's pushed to the extreme of taking their life. | ||
| How many girls are experiencing severe depression but don't commit suicide? | ||
| That's the real factor, because this is what hate directly connects to social media. | ||
| Again, the 50% increase, you're talking about a relatively small number because not as many girls commit suicide as men. | ||
| But still, you were talking about depression, and you were talking about these significant factors that would lead people to have poor mental health. | ||
| This could be a huge factor in this, right? | ||
| And I think that, too, it leads people to suicidal ideations and depression and anxiety. | ||
| I mean, right here we're just looking at suicide, which is the worst endpoint possible. | ||
| Which is very rare amongst girls, period. | ||
| Yes, absolutely. | ||
| Or less common, I should say. | ||
| It is, yes. | ||
| Men do commit suicide more than women do. | ||
| But we really have to be careful about that because, again, suicide is the end. | ||
| It's the worst thing that could possibly happen. | ||
| So what about all the things leading up to it? | ||
| Are there people who don't commit suicide but suffer from terrible depression, suffer from terrible anxiety, suffer from terrible insomnia? | ||
| Those people are not accounted for in that graph. | ||
| I agree. | ||
| And what I'm saying is that cannabis use has spiked in the United States in the last 15 years. | ||
| And teens notwithstanding, we've seen a large degradation in a number of these social outcomes. | ||
| And now just today, we have a JAMA psychiatry paper that looked at a bunch of other studies that said cannabis use in teenagers is associated with depression, suicidal ideation, and suicide attempts in people once they get to 18 to 30. It could possibly be a factor. | ||
| What's that? | ||
| It could possibly be a factor. | ||
| Sure. | ||
| Yes, but it might also be that these kids are depressed because of social media and they're using cannabis. | ||
| Or they're depressed because their friends died from opioid overdose. | ||
| There's a lot of potential. | ||
| There's a lot of factors. | ||
| You know, we are conceding the fact that, you know, you just said again that study was done on adolescence. | ||
| You know, Joe and I have both conceded multiple times that, you know, we do not think high THC cannabis is good for people in that age category. | ||
| But, you know, just to back up just a little bit again, you know, I don't, like I said earlier that I don't prescribe THC generally to anyone under the age of 25, and most other doctors in Canada don't. | ||
| But I think that we should be prescribing CBD to these kids. | ||
| Like a lot of those kids who have suicidal ideations, depression, I mean, you could never do a study on it, but how many of those kids wouldn't have committed suicide or wouldn't be feeling this way if they were using CBD? Because we know SSRI, selective serotonin reuptake inhibitors, You know, which are the most commonly prescribed medication for depression and anxiety, even in adolescence. | ||
| We know that they can increase suicidal ideation. | ||
| That's been shown. | ||
| I mean, it's written right on the package. | ||
| So again, as a clinician, you have to treat your patients. | ||
| If you're just... | ||
| Treating people with something that's not effective or that has horrible side effects, you're going to look at other alternative treatments. | ||
| A lot of people have had excellent results with CBD in that age category. | ||
| I've had it done in my practice and lots of other physicians have had it done in their practice. | ||
| So it's really important that when we're talking about teenagers and when you're talking about that study, you're talking about high potency... | ||
| THC in adolescence. | ||
| That's where Joe and I both can see that THC is not a good medicine. | ||
| Look, if GW Pharma or somebody else can do a study with CBD and depression or some other cannabinoids, a non-intoxicating cannabinoid and depression and get it approved for that, that'd be great. | ||
| We need all the treatments for depression and boy do we need treatments for psychosis that we can get. | ||
| I totally agree with that. | ||
| And I'm really glad to hear you say you don't think that adolescents should be using high potency or any hard drugs. | ||
| Especially alcohol. | ||
| No, and they should try to also stay away from the other medications. | ||
| So I want to push back on this, on the alcohol versus cannabis for teens thing. | ||
| And I know that this is a common feeling among people in Brooklyn, among people in LA, and sort of right, when I mean right thinking, I mean sort of the general center left to left view everywhere is that cannabis is better for teens than alcohol. | ||
| I totally disagree with that. | ||
| Cannabis, alcohol... | ||
| But no one's saying that. | ||
| I'm just saying alcohol is bad too. | ||
| We agree. | ||
| But you have heard this, right? | ||
| Oh, I'd rather have my kid smoking pot. | ||
| My 16-year-old, I think that's crazy. | ||
| I think you have to really be careful with anything that severely perturbs your sense of reality. | ||
| When you're a young kid and you're trying to form your vision of the world. | ||
| I think to unpack what we're saying here is that there is an increase in mental health disorders amongst young kids that corresponds to the increased use of social media and may correspond to the use of cannabis, but that's not necessarily proven. | ||
| What we guarantee, almost universally, is these kids are on social media. | ||
| I think much more likely that they're on social media than use cannabis. | ||
| I think a lot of them use cannabis. | ||
| I don't think all of them do. | ||
| I think all of them are on social media. | ||
| Absolutely. | ||
| I think that almost every single kid these days has a cell phone and they have some type of social media account. | ||
| I'm worried about kids using everything. | ||
| I'm worried about them using Valium. | ||
| I'm worried about them using Xanax. | ||
| They get prescribed benzos. | ||
| Yes. | ||
| I'm worried about them using Adderall. | ||
| Yes. | ||
| Prozac. | ||
| I think psychiatrists give out ADD medicine more. | ||
|
unidentified
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Yes. | |
| Much too frequently. | ||
| I 100% agree, and I think that it has a severe impact on kids when they're trying to study for tests, when they're trying to take their SATs, when they're trying to get into a good college. | ||
| I know so many people that are on that shit. | ||
| I know so many people, whether they're journalists, I know comedians, I know a lot of fucking people who are on Adderall. | ||
| And you need to develop that toughness when you're young. | ||
| You shouldn't just be 14 years old and then you run into your first bit of trouble in your life and then you reach for a pill. | ||
| That's terrible, right? | ||
| That's a terrible coping mechanism. | ||
| So, when you teach that to kids at an early age, and when you tell them, it's such a terrible thing to tell someone, oh, you're 14 years old, you have major depressive disorder, you're going to take this pill, you need it for the rest of your life. | ||
| And that's said to people all the time. | ||
| They say, oh, you have a biochemical deficiency and this is what you need. | ||
| We need kids to be tougher, right? | ||
| So you need them to build up some resiliency so that when they do go through hard times, they have better coping mechanisms. | ||
| Like Joe talks about diet and exercise all the time. | ||
| I talk about diet and exercise all the time. | ||
| Well, clearly you guys live it. | ||
| And that's kind of how I got my start on social media, is through diet and exercise. | ||
| Yeah, I think exercise is a big one for young kids. | ||
| I mean, it was a gigantic factor for me, personally. | ||
| When I was 15 years old, I really got into martial arts, and it changed my life. | ||
| It changed my life by alleviating so much anxiety, giving me so much more relaxation. | ||
| My parents talk about it. | ||
| They're like, there's two yous. | ||
| There's you before martial arts, and there's you after martial arts. | ||
| But you have relatively young kids, I know. | ||
| And so do I. And boy, they love the devices. | ||
| I mean, we have to fight. | ||
| And our kids, fortunately, they're three and six at this point. | ||
| They don't have their own iPad or iPhone or any of that stuff. | ||
| But you give it to them for five minutes. | ||
| It's like crack. | ||
| It's like you've got to tear it out of their hands. | ||
| Oh, yeah, my kid will just turn their shoulder when I try to get the iPad from her. | ||
| They're like, no, no, no, one more, one more. | ||
| It's crazy. | ||
| It's very fun and exciting for them. | ||
| And look, it's not entirely negative. | ||
| We have this TV set up with this dance game that they play, and they're sweating and dancing, and after it's over, they're giggling and laughing. | ||
| It's a massive alleviator of physical stress because they're constantly got to follow this thing, and it's an exercise routine. | ||
| I mean, their cardiovascular rate gets up, and they really feel good afterwards. | ||
| So it's not entirely negative, but it's mostly negative. | ||
| Yeah, but if you have, I don't know, is it Nintendo Wii or whatever it is? | ||
| Yeah, you can do some exercises. | ||
| It's an Xbox with this little thing that scans it, or you actually can use your phone. | ||
| And if you hold a phone, I'll give them my phone, my wife will give the other one her phone, and the phone shows how you're moving. | ||
| It's very weird. | ||
| So, like, you mimic this thing that the person on the screen is doing. | ||
| But, I mean, that's one thing that could be considered positive. | ||
| I think, for the most part, the real issue is social pressure and anxiety that comes from kids talking shit about each other, and they push buttons. | ||
| They push buttons on each other because they know that they can. | ||
| But do you think that's always been part of high school? | ||
| Don't you? | ||
| It has, but you would get free from it when you went home. | ||
| You're not free from it ever now. | ||
| These kids are waking up in the middle of the night and checking their Twitter account and finding that their friends are talking shit about them, whether it's on Facebook or whatever, and this girl from school, that fucking bitch, and she commented on my YouTube video. | ||
| This is what they're dealing with. | ||
| You know, look at her with her fat face, LOL. And then this little 12-year-old is like, oh! | ||
| That's a severe, severe factor that no one had to consider before. | ||
| And it makes you almost not want to go to school. | ||
| Like, there's kids who don't go to school because of that because they don't want to have to deal with, you know, someone said something. | ||
| I see it in my office all the time. | ||
| Someone said something to them last night on social media, so I didn't go to school today because they don't want to have to face that. | ||
| Like, that's something that, you know, my generation never, ever had to face. | ||
| But I do, I mean, I do, I think we're a little bit off topic here in terms of, so we're talking about depression and anxiety. | ||
| Right, but we're talking about a factor that could be considered as big, if not bigger, than marijuana. | ||
| But social media does not cause people to get psychotic. | ||
| Okay. | ||
| I don't know about that. | ||
| Well, I don't listen, this is why I don't know about that. | ||
| Severe anxiety, lack of sleep, depression, absolutely are correlated with altercations on social media. | ||
| Sure. | ||
| Sure, but... | ||
| Social interactions that are severely negative. | ||
| They're correlated with poor mental health. | ||
| The good news is the brain is a relatively strong and powerful organ. | ||
| For some people. | ||
| And if you look at sort of worldwide... | ||
| It's not for everybody. | ||
| Some people are in a really bad situation, right? | ||
| If you look at worldwide levels of psychosis, okay? | ||
| Again, it's less than 1% for schizophrenia, which is the most severe version. | ||
| You add bipolar disorder with psychosis, depressive psychosis, other kinds of psychosis. | ||
| Maybe you get to about 3% to 4% of the population is going to be diagnosed clinically with one of these illnesses over the course of their life. | ||
| So, okay, on the one hand, that's a lot of people. | ||
| On the other hand, most people are not going to get psychotic. | ||
| And most of the time, if they do, there's either a genetic component that's obvious, because psychosis and schizophrenia often do run in families, or there's an environmental component that's pretty obvious. | ||
| I mean, people can get psychotic. | ||
| They can get a brain tumor that can make them psychotic. | ||
| They can, you know, late in life, they can get dementia that makes them psychotic. | ||
| There's oftentimes a pretty clear organic cause, okay? | ||
| So, when we're talking... | ||
| The brain is a relatively strong and healthy organ, and it takes a lot to break it. | ||
| And that's why... | ||
| Boy, that's a bold statement. | ||
| It is a bold statement, but again... | ||
| I would not agree with that at all. | ||
| Really, you think? | ||
| No. | ||
| Okay. | ||
| I'm not saying that people don't get depressed or anxious. | ||
| It takes a lot to break. | ||
| People are depressed all over the place. | ||
|
unidentified
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Depressed, yes. | |
| I'm talking about the kind of... | ||
| Do you know that fucking antipsychotic medication was the number one prescribed medication in the country? | ||
| It's crazy. | ||
| People used to say, oh, I'm on antidepressants, I'm on anti-anxiety medication. | ||
| Now people, I hear them at parties and stuff saying, oh, I'm on Seroquel. | ||
| I'm just thinking, did that person just tell a bunch of people that they're on antipsychotic? | ||
| It's weird that people don't know that Seroquel and Atombilify are antipsychotics, right? | ||
| Because they've been sort of marketed as outside the class when in reality they're part of the class. | ||
| But I got to push back on you a little bit. | ||
| Sales numbers for those drugs, those are expensive drugs. | ||
| They're not the most prescribed drugs in the country. | ||
| Hold on. | ||
| Abilify was the most prescribed drug in the United States. | ||
| We should look that up. | ||
| No, we have looked that up. | ||
| We've talked about it on the podcast because it's insane. | ||
| That is insane. | ||
| And we do know, too, this is a good time, too, to talk a little bit about genetics after we kind of look at this. | ||
| Because we can tease out a few things by looking at genetics. | ||
| Antipsychotic Abilify is the biggest selling prescription drug in the U.S. To be a top seller drug has to be expensive and also widely used Abilify is both. | ||
| It's the 14th most prescribed brand name medication. | ||
| So it's 14th. | ||
| But fucking, that's crazy. | ||
| Right, I agree. | ||
| Out of all the people with actual diseases, this is the 14th most prescribed brand name medication that retails for about $30 a pill. | ||
| Well, Dr. Hart can probably tell you, this is getting prescribed as an add-on antidepressant for some people. | ||
| What that means, though, too, is that people are struggling, man. | ||
| Like, life is hard for a lot of people. | ||
| Like, very hard, Alex. | ||
| Very difficult, okay? | ||
| So, a lot of people need something sometimes at the end of the day or during the day to help them get through the day. | ||
| Cannabis, especially the CBD component, and also the THC component, when used properly, is okay. | ||
| I tell people all the time, I've made social media posts about it, that if you need to use a little bit of cannabis at the end of the day, just to help you sleep, man, you're doing great, and you're staying away from drugs, and prostitution, gambling, and all these other brutal habits that people have. | ||
|
unidentified
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Let's back off on prostitution, bro. | |
| If you're doing all that, then you're doing pretty good overall, right? | ||
| Some gambling's not bad, bro. | ||
| A little bit of gambling. | ||
| You want to bet on some fights, you know what's good. | ||
| Absolutely. | ||
| By the way, I think giving people handheld devices that are inherently addictive where they can bet on sports every 15 seconds is a super bad idea. | ||
| I 100% agree. | ||
| Look, man, you know what's one thing that's benefited me with social media is my eyesight is going. | ||
| As I've gotten older, I can't even read my Twitter feed. | ||
| Ah, fuck these people. | ||
| I don't read it. | ||
| If I don't put my glasses on, I don't know what the fuck they're saying. | ||
| Oh, my God. | ||
| So good. | ||
| But I'm not saying people don't get depressed and get anxious. | ||
| I'm saying psychosis is a different thing. | ||
|
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Yes. | |
| I think we are, though, discussing overall mental health. | ||
| Yes. | ||
| I mean, look, I'm saying this because I really think that this is something that I've made a big turn over the last few years with myself. | ||
| I'll take a quick bathroom break. | ||
| Yeah, please go. | ||
| I don't think marijuana is as safe as I used to think it is. | ||
| I used to think it was benign. | ||
| I really used to think there was no big deal. | ||
| But I have a friend that I discussed the other day who is a really confident, fucking muscular, handsome man that never did anything. | ||
| And he took a marijuana edible to go to sleep. | ||
| And for two weeks, this guy was – this is a different guy, not the guy I was talking about. | ||
| Oh, it's not the guy? | ||
| Not Rafi. | ||
| No, a different guy. | ||
| He took it and he experienced suicidal thoughts and all these, he had like severe consequences. | ||
| I think that human beings, we vary so much biologically that to just make this overall blanket statement, what's good for you is good for me, is irresponsible and I've been irresponsible saying that before. | ||
| Well, one reason, it's interesting, one reason I think that alcohol is so widely accepted, despite all the problems it causes and Again, alcohol can certainly cause problems. | ||
| Is that alcohol affects most people pretty much the same way? | ||
| And you sort of know what somebody looks like when they have one drink, when they have five drinks, if they have ten drinks. | ||
| I've got some friends that get those gerbilized. | ||
| You ever see when people get shark eyes? | ||
| They're just gone. | ||
|
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Yeah. | |
| And then they start talking crazy and like, whoa! | ||
| But you sort of know that. | ||
| And you sort of know how long it's going to take to clear your body. | ||
| Cannabis is so different. | ||
| It's a really complicated drug. | ||
| And it does affect different people in different ways. | ||
| And also the tolerance has changed radically. | ||
| Yeah. | ||
| So, you know, people say, well, two and a half milligrams of THC, you vape it, that's like one drink for somebody who doesn't use. | ||
| But then, if you're a tolerant user, you can use 200 milligrams in a day. | ||
| That's 80 drinks. | ||
| It's a weird drug. | ||
| And then there's the issue of eating it. | ||
| Yes. | ||
| When you eat it, your body produces something called 11-hydroxymetabolite. | ||
| It's far more psychoactive. | ||
| Yeah, you are all long for the ride when that happens. | ||
| Yes, you are. | ||
| Yes, and it can take days for it to get out of your system. | ||
| I know many people have eaten marijuana edibles, and then they call me up the next day like, dude, I'm still hot. | ||
| Yeah. | ||
| Yeah. | ||
| So I think the legalization community has sort of said for years, like, oh, there's basically no downsides to this. | ||
| There's only upsides. | ||
| The cops will bust smokers. | ||
| There'll be tax revenue. | ||
| All these people have a way to get high that's clearly safer than alcohol. | ||
| And unfortunately, that's just not true. | ||
| I think you're right, and I think the issue that people, from what I've read, are having with your book are people that are marijuana advocates that think that your position is unbalanced and that you've ignored the positive aspects of THC in terms of, like, what he was talking about, cognitive benefits for people with psychotic episodes, and that you're only focusing on the negative. | ||
| I guess I will plead guilty to that. | ||
| Because I think that for 20 years people have only heard the positives. | ||
| Right. | ||
| I think that's also, I'll plead guilty to that myself because I think that I've only been discussing the positives. | ||
| And one of the things that I've tried very hard to do and one of the things I've learned how to do from doing this podcast and experiencing criticism and communicating with a bunch of different people with a lot of different viewpoints is Is examine my own positions and try to figure out, am I coming at this from a truly balanced position or am I trying to support a conclusion that I started out with and I'm trying to, you know, somehow or another back up my own work or back up my own statements and sort of prop them up instead of being really honest and objective. | ||
| It's very difficult to do. | ||
| Listen, I wrote a book called Tell Your Children the Truth About Marijuana Mental Illness and Violence. | ||
| I don't think you can think that that book is going to be a compendium of the pros and cons of marijuana. | ||
| Well, if you want to tell your children the truth, though, you really do want to tell them the pros and cons. | ||
| And you did indicate, Alex, you said we should tell people the truth in the book, right? | ||
| So I think that when you're telling, and you're saying that you're telling the truth, and Alex, I'm agreeing with you that you're telling part of the truth, but part of the truth is... | ||
| It's a little bit deceiving and deceptive in some ways, right? | ||
| You want to tell the whole truth. | ||
| When you tell the whole truth, then you give the whole story, and then people can actually make a good, informed decision based upon that. | ||
| If people are going to just read one part of the story, then, of course, they're going to make a decision just based upon that one part. | ||
| They're not going to make an informed decision based upon all of the parts. | ||
| And because of that, people are going to make some very poor choices. | ||
| I completely agree with that. | ||
| But to me, the last 20 years have been an exercise in the other side, in the legalization side, doing a very, very good job talking up its arguments. | ||
| And essentially, there's almost nobody on the other side. | ||
| There's this one guy, Kevin Sabet, who's gotten killed. | ||
| What about Jeff Sessions? | ||
| I mean, you had the fucking goddamn attorney general who's telling people that good people don't smoke marijuana. | ||
| And that's literally a quote that he says. | ||
| Thank God that little moron's not in office anymore. | ||
| But that's a terrible thing to say. | ||
| Good people don't smoke marijuana. | ||
| There's a lot of wonderful people who smoke marijuana. | ||
| That's just not true. | ||
| And by the way, I think this is a personal choice, especially for adults. | ||
| And you can make bad personal choices. | ||
| Look, I play cards. | ||
| I love to play poker. | ||
| I'm sad that on this trip to LA I didn't get to go to a poker room. | ||
| But you can go into a casino and you can see people who've lost. | ||
| You can change your flight. | ||
| My friend Ari, he used to make a living doing that when he was struggling with comedy. | ||
| Don't encourage me. | ||
| But you can go to a casino and see people who've lost their houses. | ||
| It doesn't mean that gambling should be illegal. | ||
| It also means that there's less and more dangerous forms. | ||
| That device in your hand where you can bet on what the next pitch is going to be, if it's going to be a ball or a strike, That's more dangerous than my having to drive to the commerce and play there. | ||
| And 100% or 98% THC that an 18-year-old vapes is a lot more dangerous than a 5% CBD, 15% THC product that Dr. Hart might suggest his patient uses once a night to go to sleep. | ||
|
unidentified
|
Agreed. | |
| But that's the message that we should be putting out there, right? | ||
| We shouldn't just be focusing on one side of the story. | ||
| That part should also be included in the book. | ||
| And your book, in some ways, has made me rethink the way that I write. | ||
| Because my first book was co-authored with Jeremy Koston called Friendly Fire. | ||
| My second book that I'm writing now is called Cannabis for PTG. So it's how to transform post-traumatic stress into post-traumatic growth. | ||
| Because I feel that and we all know examples of people that have encountered really difficult obstacles in their life and some people have succumbed to that stress and they've gone down the wrong path kind of thing and then other people have used that stress to their advantage and they've actually become better because of it. | ||
| And, you know, CBD and THC can both help facilitate that process. | ||
| You know, when you're looking at someone like a veteran, for example, you know, the hallmark of someone with PTSD is someone who doesn't leave their home and they can't sleep at night. | ||
| So like when I see a vet in my office, a lot of the times they'll be leaving their home like five to ten days a month. | ||
| When you give them CBD, and this is really important for people to understand, CBD has been shown to decrease learned fear. | ||
| That's incredible. | ||
| If you can get people outside of their home, because I'm not talking about, again, someone who's too nervous to go to the bar with their friends or something like that. | ||
| I'm talking to people who it's difficult for them to go to the grocery store, just pick up a few things. | ||
| Those are the type of people that I see in my practice. | ||
| CBD is really excellent for that. | ||
| Then when you look at the nighttime component, THC, again, is excellent for reducing nightmares. | ||
| That's been shown in studies. | ||
| And it was even shown with one pharmaceutical drug, Nablon. | ||
| Again, I don't really... | ||
| I don't use Nabilone very much because it's only one cannabinoid and I do believe in the entourage effect and using all of the cannabinoids so I don't use that that much but that shows that THC can reduce nightmares and you know if you have PTSD I mean, if you talk to someone who has PTSD, and again, this comes from a clinician's point of view, they will tell you, I will try anything. | ||
| And that's the same way when you get with the parents of kids who have seizures all day. | ||
| Nobody wants to see that. | ||
| And like, Alex, if your kids ever started getting seizures, which I hope they don't because it's terrible what it can do to people. | ||
| But, you know, if that ever happened, you know, I would hope that you would consider, you know, CBD as a potential treatment option. | ||
| Yeah, I think he's not against that. | ||
| I think we have to be really clear on this distinction. | ||
| Like, CBD, you're not against CBD at all. | ||
| And I don't think anybody is. | ||
| I think no one really is arguing, except maybe the federal government in certain levels is arguing against CBD. That's probably some pushback from the pharmaceutical industry. | ||
| The reality is CBD has proven to be... | ||
| At least as far as I've read, very safe and very effective for a bunch of different disorders, especially those that have something to do with inflammation. | ||
| Or seizures. | ||
| Yeah, one of my good friends, his son, has developed seizures and CBD knocked it out. | ||
| Just killed it entirely. | ||
| This is very recently. | ||
| You're somebody who's a cannabis user. | ||
| You obviously know a lot of users. | ||
| Why do you think it is that people in legal states where they can really express a preference, they can go into a dispensary and know exactly what they're buying, Why is it that they want such high-potency THC product? | ||
| Because they get used to it. | ||
| Your tolerance develops. | ||
| It builds up. | ||
| Every year we do this thing called Sober October where we don't do no drinking, no pot, and we do some sort of crazy challenge, me and three of my buddies. | ||
| When we do it, it's very interesting how your tolerance is radically reduced. | ||
| Like, I'll smoke pot at the end of that month, and I'm like, holy shit! | ||
| Like, I don't even know what I'm talking about in the mid-sentence, and I'm just blitzkrieged. | ||
| Whereas, you know, now, like, I smoked a little weed last night, did some stand-up, had a great old time. | ||
| There was no issues with it at all, but I'm used to it. | ||
| And if the weed that I smoked last night, I assume you don't smoke marijuana. | ||
| I do not. | ||
| Okay, if you and me were together last night and I gave you a hit of my joint, you'd be still there in the corner in the fetal position going, what in the fuck is going on? | ||
| Because the marijuana is ridiculously powerful, but once you're accustomed to it, once your body acclimates, it's really not that big of a deal. | ||
| The problem is you're dealing with a lot of habitual daily users, and for those people, like my friend Joey Diaz, there's a video of him giving this other comedian, how many milligrams of those stars of death? | ||
|
unidentified
|
Oh, Tilly? | |
| When we give Owen, what did he give Owen? | ||
|
unidentified
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Oh, I think just one. | |
| He ruined his life. | ||
|
unidentified
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It would have been about $200 to $250 million. | |
| Yeah, I've heard that podcast. | ||
| You're saying like $250 million. | ||
| The guy opened the door and went out. | ||
| Joey made a video, but the day changed Owen's life. | ||
| Like, literally, he fucked the guy's head up. | ||
| Like, he went outside and he vanished. | ||
| He's gone. | ||
| That's cannabis psychosis. | ||
| Well, I think there's a real argument to be made, particularly with him. | ||
| Well, I was going to make two points on that. | ||
| So you definitely can develop a tolerance. | ||
| And I tell people all the time, try and take at least one three-week break. | ||
| But the evidence does show that if you stop for four weeks, generally all your receptors return and it'll be like you've never used cannabis before. | ||
| Yeah, that's my experience. | ||
| And that's even with people who are really, really heavy users. | ||
| I can go back and get the study, but I mean, these people are using, I'm pretty sure it was close to seven joints a day. | ||
| So really heavy users. | ||
| Snoop Dogg's a good example of that. | ||
| My friend Tony Hitchcliffe is good buddies with Snoop Dogg, and he said Snoop Dogg just smokes all day. | ||
| And he's just like, he's always high. | ||
| And you're like, well, what do you do when you're not high? | ||
| He's like, what? | ||
|
unidentified
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Yeah. | |
| He's like, I'm never not high. | ||
| So everything he does, he is high as fuck. | ||
| Literally everything he does. | ||
| For that guy, it's not that big of a deal. | ||
| And for the way he lives his life, he's just a relaxed, easy-going guy. | ||
| It's no problem. | ||
| You can be high all day and live his life. | ||
| And he's obviously wildly successful with this strategy. | ||
| Yeah, wildly successful. | ||
| And the second point I was going to make on that, too, though, was... | ||
| There does not appear to be any tolerance at the CB2 receptor. | ||
| So THC attaches to the CB1 receptor, and that's where we know we can get tolerance. | ||
| Some people, they have some pain, they use some THC, and sometimes they need a little bit more, sometimes asleep. | ||
| You know, they use THC, it'll work, and then it'll stop working. | ||
| With CBD, too, we haven't seen that. | ||
| Meaning, like, the people who, you know, get seizure control, generally, they don't need to increase their dose. | ||
| Like, the girl I was talking about earlier, you know, I first described her, I think when she was 20, when she was about 20, she's 25 now. | ||
| She's never increased her dose. | ||
| She's just used the same amount of CBD for the last five years. | ||
| That's a medicine, right? | ||
| Like, it works for you. | ||
| I think we should really stop talking about CBD. I just wanted to make a note on the tolerance of the CB1. I just wanted to make a note that CB2, there doesn't appear to be tolerance. | ||
| There's just such a significant impact when it comes to especially edible THC. There's a significant impact on people's state of mind. | ||
| And it's not always good. | ||
| That's just a fact. | ||
| I mean, we were talking about this when you were out, but, you know, so I had an interview. | ||
| I was that guy. | ||
| I was doing the radio interview on the Acela from D.C. to New York last month, and this woman came in, and it was Baltimore. | ||
| She sat down next to me, and I finished the interview, and she said, I couldn't help overhearing. | ||
| I thought, oh, Jesus, like, she's a pothead, or she's just annoyed that I was doing this. | ||
| But no, she said, you know, I was in Seattle last month, This woman was in her early 30s. | ||
| She was a lawyer, married. | ||
| She said, and a friend of mine said to me, let's do an edible. | ||
| She said, we bought a small dose. | ||
| We asked them for a small dose. | ||
| I took half of it. | ||
| So I think she took like five milligrams, if that. | ||
| And she said, I got so paranoid. | ||
| She said, I couldn't sleep all night. | ||
| Fortunately, my friend took and didn't have any problem and sort of watched over me. | ||
| But she said, the worst part was it took me weeks, weeks for the anxiety to fade. | ||
| And I said, do you have a history of mental health problems? | ||
| And she said, no, I don't. | ||
| She said, and I'd used, you know, I'd smoked in college. | ||
| But this was just a totally different experience for her. | ||
| I think there's a big problem with education. | ||
| A big problem with the education that edible marijuana, as we talked about before, I think you were in the bathroom, the 11-hydroxymetabolite as it's processed by the liver, it's a radically different drug. | ||
| Radically different. | ||
| And it's really a psychedelic. | ||
| For me, personally, edible marijuana and flotation tanks, I might as well be taking a fucking bucket of acid. | ||
| Because it is a crazy goddamn experience. | ||
| Now, I personally enjoy being paranoid. | ||
| And I know this sounds crazy, but I think with me, it gives me... | ||
| I think I live a pretty blessed life. | ||
| And I like the feeling of paranoia because it allows me to explore maybe some areas... | ||
| Is it a specific paranoia that you have? | ||
| It's a freak out, man. | ||
| I think... | ||
| I have maybe an abundance of confidence. | ||
| Maybe I have too much. | ||
| Maybe I'm too successful. | ||
| What I like about the paranoia that comes with edible marijuana is it allows me to check myself. | ||
| It allows me to put myself, examine all of my behavior in the darkest recesses of my mind, my thoughts, and gives me a And it makes me a nicer person. | ||
| It might knock down the ego just a little tiny bit. | ||
| Just like the other psychedelics. | ||
| I think it just, it gives you just a little, it knocks down the ego just a little. | ||
| I mean, some people use it at the end of the day and then, like Joe said, I think it makes you reflect sometimes better and more objectively. | ||
| Meaning that, like, you know, maybe you had an encounter with someone earlier in the day, and then, you know, late at night, you talk up a bit, and you're like, oh, man, I probably should have done things a little bit differently. | ||
| You know, like, that happens to people all the time. | ||
| It forces you to reflect in a different state, and sometimes when you reflect in that state, you come up with thoughts that you just wouldn't have come up with before. | ||
| My patients say to me all the time, it just kind of breaks this negative state that I have. | ||
| I'm just able to break out of a negative state and think logically. | ||
| People say that to me all the time. | ||
| But see, to me, you're talking about something different, and it works for you, right? | ||
| Your paranoia, it sounds more almost existential. | ||
| It's, how can I be a better person? | ||
| What am I doing wrong in my life? | ||
| It's not, my wife is poisoning me. | ||
| No, no, no joke! | ||
| No joke! | ||
| Like, this is funny. | ||
| When you're schizophrenic and you use... | ||
| Yeah, no, I understand. | ||
| Or, you know, or the cops are going to bust through the fucking door and shoot me. | ||
| Yes, no, you're right. | ||
| Okay, that's a different thing, and that's why... | ||
| That's a different kind of paranoia. | ||
| That's why marijuana drives this extreme violence in some people. | ||
| Or, those people need to get their fucking shit together. | ||
| That's possible, too. | ||
| Well, I mean... | ||
| The aliens aren't really coming, bro. | ||
| But they may need to be intervened before. | ||
| And to Joe's point, though, they have shown in studies that if you make an intervention outside of the psychotic symptoms, you can actually reduce the incidence of violence. | ||
|
unidentified
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Yeah. | |
| And also, too, I think it's a good point. | ||
| I was going to mention earlier to bring up genetics because we are teasing out genetics for people and we are discovering that certain people do have certain genetics that do predispose them to certain cannabis disorders, right? | ||
| So, you know, I'm involved with a company that's doing that right now. | ||
| We're trying to create... | ||
| Cannabis genetic test for people, right? | ||
| And there's three genes that we've identified so far. | ||
| You know, one of them is the MAPK14 genotype, and that has been shown to be associated with a deficit in brain volume when you do use cannabis. | ||
| And then there's two other genes, the AKT1 and the CADM2 genotype. | ||
| Both of those have also been shown to be associated with cannabis. | ||
| But again, how many people have them? | ||
| The MAPK14 is roughly about 8% is what we're seeing. | ||
| The AKT1 is around 4%. | ||
| And the CADM2 is around 5%. | ||
| But you add that up, that's almost 20% of the population. | ||
| But if we can identify... | ||
| I love that stuff, Lion's Mane. | ||
| Yeah, it's great. | ||
| Yeah, it's wicked. | ||
| So if we can identify the people who are at risk, then we can maybe potentially use the medicine in a way where only the people who don't have these genetics are using the medicine. | ||
| And then for the people who do have these genetics, they stick mostly to... | ||
| CBD. I just think that's a better approach than just prohibiting cannabis or saying that we shouldn't use it at all or saying that it's not medicine. | ||
| I think that it should be held to the same standard as any other medicine. | ||
| And I think that if we had an incredible medicine that worked for some people and that didn't work for others, then what we would do is we would try to figure out why. | ||
| And, you know, I've been doing that. | ||
| My company's been doing that. | ||
| It's called Enant Life. | ||
| You know, full disclosure, I am on the board, enantlife.com. | ||
| And, you know, when we use these different strategies, you know, then we can actually reduce the overall harm. | ||
| And that should be another thing that we can add into the mix because, for sure, there's people who are definitely more predisposed to mental illness and definitely more predisposed to psychosis. | ||
| I mean, there do seem to be some people who just – it breaks really fast, and I'm not sure why. | ||
| I mean, again, it's probably genetic. | ||
| Yeah, I think most likely it is. | ||
| But it's funny. | ||
| You mentioned your friend whose child has autism, and you said, well, you know – If that were my child, of course, I would want to do anything possible. | ||
| But I have to tell you, in the last month since the book came out, I've heard the other side of this. | ||
| I've heard from so many parents whose children, and in many cases, high-functioning children, college graduates, because by the way, those are the people who've read the book or heard about the book and who have the resources to stay involved with their kids when they have these terrible breaks, who have gone completely It's completely off the rails. | ||
| And the worst story that I've heard so far came from a woman in Connecticut whose son graduated from Haverford. | ||
| It's a college in the East. | ||
| And sounds like a really good guy. | ||
| He wanted to teach disadvantaged kids. | ||
| He had a girlfriend who was going to med or was a pre-med trying to go to med school. | ||
| They moved to New Mexico. | ||
| And for some reason, the guy decided to start smoking. | ||
| This was 2012, and within a few months, he'd lost everything, okay? | ||
| The girlfriend had left. | ||
| He'd lost his job. | ||
| He had his first inpatient hospitalization. | ||
| Now, this is a family with money, okay? | ||
| This is Connecticut, suburban, and they have spent the last six years trying to save their son, and they have failed. | ||
| She told me that they've spent more than half a million dollars. | ||
| He was hospitalized at Harvard. | ||
| You know, he had the best treatment. | ||
| None of it's made a difference to him. | ||
| And what are the symptoms like? | ||
| So he's completely schizophrenic now, and he's completely paranoid, and he believes, and this is the, so his girlfriend is long gone. | ||
| Has he tried CBD? That's a good question. | ||
| I think he's continued to use cannabis. | ||
| I don't know if he's used CBD. But let me just tell you where he is now, okay? | ||
| So he's one of these guys who has a really bad delusion. | ||
| His delusion is that his girlfriend has died and been replaced by a robot. | ||
| So that's the kind of delusion that leads you to kill people. | ||
| And so this guy's been now hospitalized 17 times. | ||
| He's gone. | ||
| He's on the streets of Houston. | ||
| She doesn't know where he is. | ||
| And I'll tell you, you know, you read Beautiful Boy, you see the movie, and you think, well, the worst— I'm not familiar. | ||
| Oh, Beautiful Boy is about— A Beautiful Mind, isn't it? | ||
| No, no. | ||
| Beautiful Boy is a book that came out, I think, a couple years ago and got turned into a movie. | ||
| You should have them on. | ||
| Nick Sheff and David Sheff, father and son. | ||
| And the son became a meth addict and essentially almost died. | ||
| He started smoking cannabis when he was 12, and within a couple of years it had all gone completely downhill for him. | ||
| I'm surprised. | ||
| It's a pretty popular book. | ||
| But anyway... | ||
| Have you heard of it? | ||
| No. | ||
| Jamie? | ||
| And I've heard the movie, yeah. | ||
| So you think, well, okay, the worst thing that can happen to you as a parent, the worst thing is your child becomes an opioid addict and you wait for the call that he overdosed and died. | ||
| It turns out that that's the second worst thing. | ||
| The worst thing that can happen is... | ||
| Your son, the college graduate, the want-to-be do-gooder, becomes a schizophrenic living on the streets, and then you're waiting for the call that he killed himself or he killed somebody else. | ||
| And so my view of this is in a couple more years, probably, I mean, this book has taken over my life, obviously, but in a couple years, I'm going to be back to writing novels. | ||
| This will still be part of my life. | ||
| But this woman, these parents, They are going to spend their lives trying to destroy the cannabis industry, and that is real. | ||
| Well, I think that would be a foolish thing to do, but I think there is a real possibility that some people who have a tendency to schizophrenia could be triggered by cannabis. | ||
| There's no question about that. | ||
| But I think it's also possible that guy would have gotten schizophrenia anyway. | ||
| Look, it's possible, but he was sort of at the outer edge of the window, and he had no... | ||
| Out of the other edge of the window? | ||
| Meaning it's usually, for boys, it's sort of 17 to 23, 24. Was he showing any issues before at all? | ||
| No, according to her. | ||
| I mean, this is from her. | ||
| So she's the mother, but... | ||
| Well, I'm sure she'd be the one who knows the most, right? | ||
| There are people, though, too, who just kind of have a decline with or without cannabis. | ||
| You do hear of people with schizophrenia. | ||
| It's just a breakup. | ||
| They just can't handle life. | ||
| I mean, I know people that have gone to medical school and then one semester they just can't handle the course load and then Their life just goes to shit. | ||
| They drop out of school. | ||
| No one ever hears from them again. | ||
| They don't get back into school. | ||
| That's it. | ||
| That does happen all the time. | ||
| That speaks to the fragility of the human mind. | ||
| This is a terrible disease. | ||
| It's a terrible disease to have. | ||
| It is. | ||
| And it affects a certain percentage of the population regardless of cannabis use. | ||
| There's a lot of people out there that have schizophrenia that have never used cannabis ever, and they've gone completely off the edge. | ||
| I don't know if you can necessarily blame cannabis for that. | ||
| And it would be really interesting to find out if there was some form of a treatment, like you were saying with CBD, that could counteract that. | ||
| So CBD has been shown in early stage studies to have some moderate impact on psychosis. | ||
| I don't think from the numbers that I've seen suggest it really isn't that strong as an antipsychotic. | ||
| But I do think that if I were a researcher in schizophrenia, I would be looking at the endocannabinoid system. | ||
| Yeah, you have to look at this from a clinical perspective. | ||
| The antipsychotics that we have out there are not good. | ||
| They have terrible side effects. | ||
| They have terrible side effects, and most of them do have some initial benefit, but after two to three years, there's almost no benefit. | ||
| And they have, as you said, really bad side effects. | ||
| Weight gain, metabolic disturbances. | ||
| People want to get off of them. | ||
| So, if you have something like CBD that doesn't have any of those side effects, of course, as a clinician, you're going to want to try it. | ||
| Because you know that the other tools that you have are not really that effective. | ||
| So, CBD should definitely be utilized for people who have psychosis and schizophrenia. | ||
| Well, I think, you know, we talked about life changes, like things that happen badly in your life, losing your job, losing your girlfriend, deaths in the family can trigger these breaks with some folks, but psychedelic drugs can as well. | ||
| I mean, it's a fact. | ||
| For some people, psychedelic drugs have tremendous benefits for PTSD, quitting alcohol, quitting hard drugs. | ||
| There's a lot of people that have used mushrooms, MDMA for PTSD is a huge thing that MAPS is studying right now. | ||
| But you can't deny that there's other people, well-documented, that have taken LSD, that have taken psilocybin, and taken them in large doses, and gone. | ||
| And never recovered. | ||
| And that's why, too, I forget who it was, maybe it was McKenna who was on, and you guys were saying that, like, you know, we need to use psychedelic medicines, but we need to use them properly, right? | ||
| And that's the same way with cannabis, as well. | ||
| I consider cannabis a psychedelic, particularly when you eat it. | ||
| Absolutely. | ||
| It is a mild psychedelic. | ||
| And so there's risks and benefits to that. | ||
| And we need to tease out the risks and tease out the benefits and make sure that people are... | ||
| But Alex, we need to make sure that people are informed and they get the entire picture. | ||
| Right? | ||
| So, you know... | ||
| Does your book have some truth in it? | ||
| Yes, of course it does. | ||
| But does it tell the whole truth? | ||
| Absolutely not, right? | ||
| And that's the message that I think people should be hearing. | ||
| People shouldn't be hearing just part of the truth. | ||
| They should be hearing the whole truth. | ||
| And again, in your book, you compared Mexico and India, right? | ||
| And, you know, I talked to German Lopez on the phone about this, you know, who talked to Isaac Campos, right? | ||
| And he said that, so Isaac Campos, you know, he's the guy who basically, you know, told the story of how in Mexico, you know, people were blaming marijuana, people were blaming marijuana on causing psychosis during kind of like the early 1900s. | ||
| And then there was some evidence as well in India at that time. | ||
| So Alex kind of made the connection, 9,000 miles apart. | ||
| They're both saying the same thing. | ||
| But he said that you did misinterpret the evidence on it, right? | ||
| And German told me that on the phone. | ||
| And I mean, all the cannabis that was used in Mexico at that time was in really marginalized environments. | ||
| And then when you look at the India study, And I know that you addressed this in your book, because I did read your book. | ||
| Sounds like you did. | ||
| I bought your book, so in some ways I did support you. | ||
| So I read your book, and like I said, you did address in the part on India that... | ||
| Yeah, you know, some of the report was wrong. | ||
| But I mean, the fact is that almost a lot of those cases in India were actually attributed to alcohol or opiates or other things. | ||
| And then the other thing in Mexico is that it was in those environments. | ||
| So, you know, basically what I'm kind of getting at here is like, you know, the National Academy of Sciences and Engineering, you know, they... | ||
| You know, disagree with how you interpreted their findings and then these people disagree with how you interpreted their findings. | ||
| Okay, but Ziva is only one of the 16 members. | ||
| I get that. | ||
| But if we asked other members, I think that they would all say the same thing because Alex, wouldn't you be upset? | ||
| If someone just quoted one part of your book and then left out all the other parts. | ||
| I mean, I would think that would be a huge disservice to my work. | ||
| I would not have put in a ton of effort into something, and then for someone to only have, you know, just to pick out the part that, you know... | ||
| Well, that really depends on what it ignores nuance. | ||
| Honestly, if I had written the NASEM report, the NAM report... | ||
| And it came out in 2017 and nobody had paid any attention to it, which nobody did, and nobody did for two years. | ||
| And suddenly people were paying attention to it. | ||
| I'd be pretty happy about that. | ||
| But what Dr. Hart is talking about is in the first chapter of the book, which I guess you haven't read, and I really should have a copy for you. | ||
| Stupid of me. | ||
| I got a copy in my bag. | ||
| So this is fascinating to me. | ||
| The British, you know, they colonized India and they set up what they call lunatic asylums, really psychiatric hospitals, sort of very primitive psychiatric hospitals. | ||
| And they were really initially for soldiers in the Indian army and they were run by British doctors. | ||
| And what these doctors really as early as like the late 1850s, 1860s noticed was that a lot of the people who showed up in these hospitals were showing up with what they called ganja actually. | ||
| In India it's called ganja. | ||
| Or bong, which is a very weak preparation of basically Indian hemp, just sort of low-grade cannabis. | ||
| And so they started counting, and they realized that 20 to 30 percent of the people who were coming to asylums... | ||
| were heavy cannabis users. | ||
| And that was way more than alcohol. | ||
| It was more than opium. | ||
| And this really fascinating doctor named George Francis William Ewens wrote a book in 1908, and he looked at the evidence. | ||
| And it is amazing to hear how he describes schizophrenia, how he describes cannabis, how he describes the cases of violence around cannabis. | ||
| It's like any psychiatrist today, certainly any forensic psychiatrist like my wife, would like everything in the book would ring completely true And it was so fascinating to me to stumble on this and realize this is something people have been talking about for more than 100 years. | ||
| So – Could we agree that there are some people where cannabis is not a good idea? | ||
| Absolutely. | ||
| Oh, yeah. | ||
|
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Right. | |
| We could agree that. | ||
| I think we all agree. | ||
| We also agree that some people can't eat peanuts. | ||
| Absolutely. | ||
| Yeah. | ||
| Yeah. | ||
| Right? | ||
| Yeah, it's not the same thing, though. | ||
| Yeah. | ||
| You know why? | ||
| Peanuts kill you. | ||
| That's true. | ||
| Yeah, it's more dangerous. | ||
| At least like 7,600 a year people die from peanuts. | ||
| Again, I think more people die from cannabis as a result of the homicide and the suicide. | ||
| Okay, well there's no correlation that you can prove on paper that... | ||
| I know! | ||
| Somebody's got to do the work! | ||
| Wait a minute, but why are you saying that then? | ||
| Because I've looked at enough data to tell me... | ||
| You think marijuana's causing homicides? | ||
| Oh yeah! | ||
| This is what the book is about! | ||
| But how so? | ||
| Because it causes paranoia and psychosis in people. | ||
| And paranoia and psychosis are huge risks for homicide. | ||
| And schizophrenia is a huge risk for homicide. | ||
| But there's multiple studies that refute that. | ||
| There are no studies that refute that paranoia and psychosis are huge risks for homicide. | ||
| Schizophrenia is a 20x. | ||
| 20 times, Joe. | ||
| Jamie, I sent you a document yesterday. | ||
| I mean, there's multiple studies that show that marijuana laws are not associated with any type of violence. | ||
| Okay, but let's forget about marijuana laws. | ||
| Let's just talk about marijuana use. | ||
| The use of the drug, yes. | ||
| So the use of the drug, which could possibly trigger psychosis and schizophrenia, which are correlated with murder, is that what you're saying? | ||
| They're not correlated, they're triggers. | ||
| That's an absolute fact. | ||
| Triggers. | ||
| Because of the paranoia and delusions and you think that someone's out to get you and they're not. | ||
| Absolutely. | ||
| What are the numbers? | ||
| Okay, so the numbers are if you have a diagnosis of schizophrenia, you are 20 times as likely to commit homicide as somebody who's healthy. | ||
| Now, it's actually worse than that for cannabis, okay? | ||
| And here's why. | ||
| So the National Alliance for Mental Illness and the Mental Illness Advocacy Groups hate talking about this. | ||
| Why do they hate talking about it? | ||
| Obviously because it stigmatizes people with mental illness. | ||
| So what they say, and this is true, is if you have a diagnosis but you're taking your antipsychotics, even though the side effects might be unpleasant, you're in treatment... | ||
| You're not using recreational drugs. | ||
| Your risk for violence isn't that high. | ||
| It's not that much higher than a healthy person. | ||
| Fortunately, healthy people don't commit murder that often. | ||
| The problem is, if you think about the math for half a second, if there's this one group of people who don't have a very high risk for murder or serious violence, because they're not using, because they're on antipsychotics, it means that the excess risk in the people who are using and whose psychosis is untreated, it must be spectacularly high. | ||
| And the numbers bear that out. | ||
| So there's a really good study from last year, 2018, a small group of patients in Switzerland. | ||
| Now, Switzerland is a safe country. | ||
| It's a low base crime rate. | ||
| But 50% of the people who were using cannabis and had psychosis over a three-year period committed violence in that group of people. | ||
| That's mostly 20-something men. | ||
| Well, you know, there's a study here, and I just sent it to you, Jamie, and it's titled Risk Factors for Violence in Psychosis, a Systemic Review and Matter Analysis of 110 Studies. | ||
| So, you know, it's quite a few studies, okay? | ||
| So, you know, let me just read part of it out to you. | ||
| So violence was strongly associated with a history of polysubstance abuse, strongly associated with a diagnosis of co-related substance use disorder, and recent substance misuse, and moderately associated with a history of alcohol misuse, a history of substance misuse, recent alcohol misuse, recent drug misuse, and a history of drug misuse. | ||
| It was unclear if there was an association between violence and a history of cannabis misuse. | ||
| So again, this is 110 studies. | ||
| They very carefully looked at all of the different risk factors as to what could trigger violence. | ||
| Just let me finish, Alex. | ||
| And what they said, again, it was unclear if there was an association between violence and a history of cannabis misuse. | ||
| So that's 110 studies. | ||
| So, cannabis use in there is going to get locked in with polysubstance use, because a lot of people who use are going to be using other drugs. | ||
| Polysubstance means multiple substances, alcohol, cannabis. | ||
| Exactly. | ||
| But everything else was found to have significant statistical significance. | ||
| And I have not, I do not know the study that Dr. Hart is talking about. | ||
| I'd like to look at it. | ||
| Without looking at it, I can't push back as hard as I would like. | ||
| What I can tell you is that I have Many studies in the book that show that cannabis use is associated with violence in people with psychosis. | ||
| And more broadly, it's associated with violence in the general population in large studies, in studies of high school students and bullying, in studies of people who were vacationing in Ibiza, in studies of young men in China and the UK. There are big studies out there that show cannabis use is associated with violence. | ||
| Ibiza. | ||
| Ibiza? | ||
| I've been to Ibiza twice. | ||
| I know, wouldn't you like to be the guy doing it? | ||
| Are you supposed to say Ibiza? | ||
| You aren't supposed to say Ibiza. | ||
| I got grilled over there for that. | ||
| They get mad at you. | ||
| I can't believe I just said it. | ||
| Yeah, some dignitary or royal person had a lisp, right? | ||
| Isn't that how it all started? | ||
| Is that true? | ||
| Yeah, I believe so. | ||
| Noted. | ||
| Yeah, the way the people in Spain pronounce words was directly affected by this one person, apparently. | ||
| So this correlation between people that have schizophrenia and using cannabis, is schizophrenia a diagnosis that's purely based on behavior? | ||
| Basically, yes. | ||
| There's no blood test. | ||
| You can't do a brain scan. | ||
| It's basically how you behave. | ||
| And what you tell the doctor about how you're feeling. | ||
| And what about fMRIs? | ||
| It's very subjective. | ||
| Because you're asking someone basically a series of questions. | ||
| I mean, it's no different than depression, really. | ||
| I mean, you're just asking someone a series of questions, and then based upon that, which is very subjective, then you're going to make a clinical decision. | ||
| Whereas when it's like a blood test, like if someone passes a certain amount of hemoglobin A1C, depending on which chart you're looking at, Then you're going to call that person pre-diabetic or diabetic. | ||
| But unfortunately, we just don't have those objective measurements. | ||
| And again, that's why Alex was saying earlier that they couldn't really figure out how many people in the United States had schizophrenia. | ||
| And I understand that. | ||
| At the same time, too, it's okay to adjust the way that you diagnose someone over the course of the years and you learn things because you could easily say that almost everyone has some type of mental illness. | ||
| People should understand that there's seven different basic human emotions. | ||
| I've talked about this before. | ||
| There's anger, there's contempt, there's disgust, there's fear, sadness, surprise, and happiness. | ||
| That's seven. | ||
| You know, depending on which way surprise goes, I mean, six out of those seven are negative, right? | ||
| Because we're wired to basically detect threats. | ||
| So, you know, when we're making all these diagnoses, I think we have to be careful because... | ||
| Some people are calling themselves depressed and some people are calling themselves anxious when really they're just not dealing with basic human emotions that they need to understand and need to deal with. | ||
| People are getting angry about being angry or depressed about being depressed. | ||
| If you feel one of these emotions, just kind of sit with it and just kind of reflect on it. | ||
| And I think that's a much, much better way to tease things out. | ||
| But to come back to my original point, I think that more people are understanding that we don't just need to give out a pill for everything and that everyone shouldn't just be labeled as having a mental health diagnosis because if things just keep going the way they are, By 2040, it's going to be like 50% of people are going to have a mental health disorder. | ||
| People just need to understand that life is hard. | ||
| You've got to deal with these emotions sometimes. | ||
| It's not that big of a deal. | ||
| For some folks. | ||
| For some folks. | ||
| Yeah, for some folks. | ||
| And that's why I'm such a big fan of Jordan Peterson because he's kind of tough on people and he said that. | ||
| Okay, but let me stop you there because Jordan Peterson was on... | ||
| That's interesting. | ||
| Yeah, he was. | ||
| For a long, long time. | ||
| I mean, like, for a long, long time. | ||
| As was his family. | ||
| And what's crazy about him is what got him off is a carnivore diet. | ||
| I know. | ||
| I know. | ||
| Which is an elimination diet where he only eats meat with salt and drinks water. | ||
| And he's healthier than he's ever been in his life. | ||
| And that is another massively controversial subject. | ||
| So, let me... | ||
| I want to push back a little bit. | ||
| Because I think people, you know, as controversial as the book has been about cannabis and psychosis, this violence issue is even more controversial. | ||
| And obviously for a fair number of people, it doesn't really... | ||
| It doesn't sync with the stereotype. | ||
| And it doesn't sync with how they've experienced cannabis use, right? | ||
| So I think alcohol is a really interesting comparison. | ||
| Of course. | ||
| Blame the Canadian. | ||
| Why do you have to go national on them? | ||
| We were talking about... | ||
| My wife's actually from Newfoundland. | ||
| Newfoundland. | ||
| Newfoundland, as in understand! | ||
| Marijuana increases... | ||
| No, Newfoundland is how you say it. | ||
| You can't say Newfoundland. | ||
| I've trained myself to say it that way. | ||
| You're telling me I'm wrong? | ||
| Look what Jamie just pulled up. | ||
| Marijuana use increases violent behavior. | ||
| A 50-year study finds casual link between cannabis and subsequent violent behavior. | ||
| New research published online in advance of print of the journal Psychological Medicine concludes that continued use of cannabis causes violent behavior as a direct result of changes in brain function that are caused by smoking weed over many years. | ||
| Researchers have long debated a possible link between the use of marijuana and violent crime. | ||
| In contrast to alcohol, meth, and many other illegal drugs, the mellowing effects of cannabis seemed unsuited to promoting violent behavior. | ||
| However, ample previous research has linked marijuana use to increased violent behavior. | ||
| The sticky problem in such studies are that many co-founding factors involved in interpreting this correlation. | ||
| It is very difficult to determine whether or not any statistical correlation between marijuana use and violent behavior are causally linked or instead the two are associated through some other factors such as socioeconomic status, personality traits, or many other variables that are related to the propensity to use marijuana. | ||
| So I think that's a fairly good summary of the issues. | ||
| What's up, James? | ||
| To add, the study came from 411 boys who were born in 1953 in London, 97% of which were Caucasian, and all of them are raised in two-parent households. | ||
| So those people are relatively stable if they're two-parent households. | ||
| Most parents beat the shit up. | ||
| No, it's possible. | ||
| So I think the alcohol comparison is, again, a good one. | ||
| Because anybody who's ever been in a bar at 9 p.m. | ||
| and gone back at 2 a.m. | ||
| knows that alcohol disinhibits people. | ||
| It causes fights. | ||
| It makes people loud. | ||
| It causes a lot of fucking, too. | ||
| It does, does, does. | ||
| No, it really does, right? | ||
| It's good and bad. | ||
| I don't know if that's good. | ||
|
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I mean... | |
| Sometimes it makes people's life better. | ||
| Some people think alcohol and sex are a terrible idea. | ||
| Right? | ||
| I mean, it certainly causes some sexual violence, too. | ||
| Sure, yeah, yeah. | ||
| So, okay. | ||
| But at the same time, everybody knows that you can have a drink, you know, you can have a beer at the back of your barbecue, you can have... | ||
| A glass of wine with dinner. | ||
| That's right. | ||
| And it doesn't mean that you're going to get in a fight. | ||
| And it actually might enhance your conversation, social lubricant, all that good stuff. | ||
| All that good stuff. | ||
| And you might even know people – I mean I do know people who I would say have a problem with drinking. | ||
| But it's mostly they're sitting at home drinking scotch, watching baseball until they fall asleep that night. | ||
| Now that's obviously not a healthy way to use alcohol, but it doesn't make them violent. | ||
| But we know on a population basis that alcohol causes violence. | ||
| It causes drunk driving. | ||
| It causes problems. | ||
| And it said that in the study that I quoted earlier, but it said that alcohol, again, they didn't, or sorry, cannabis, they weren't sure. | ||
| Right. | ||
| So, okay. | ||
| So this is, again, I would like to read the paper that you're quoting from because I have so much other research. | ||
| But here's what I'm saying about cannabis, okay? | ||
| Cannabis for a lot of people, yeah, they can just smoke it. | ||
| And as people, you know, as many people have tweeted at me, the only thing I attacked was a bowl of nachos, right? | ||
| And so that's true for some people. | ||
| But that could be said with alcohol as well. | ||
| That's exactly. | ||
| Biological variability. | ||
| And there's so many studies that say that the cannabis laws have actually decreased crime. | ||
| No, no, no. | ||
|
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No, no. | |
| You got to let me finish. | ||
| Let's let him finish. | ||
|
unidentified
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Okay. | |
| Go ahead, Alex. | ||
| So even though for many people cannabis isn't going to cause violence, that doesn't mean it can't cause violence in some people, especially- Or at least could be a factor. | ||
| At least could be a factor, especially with the kind of violence that I am talking about and that I write about in the book, which is, again, so alcohol- It maybe makes an argument into a brawl. | ||
| It makes a brawl into something where somebody picks up a stick. | ||
| It makes that into something where somebody pulls out a knife. | ||
| It escalates. | ||
| Cannabis is different. | ||
| Cannabis causes paranoia and psychosis. | ||
| And it certainly causes those things temporarily, even if it doesn't cause them permanently. | ||
| So a distortion in reality that could lead to you doing something- Something terrible, and it's usually to somebody you're not actually fighting with. | ||
| It's a family member. | ||
| The worst cases that I've, and I've really seen a lot of these cases, are basically innocent family members who are just in the way when somebody loses touch with the reality and literally thinks, like, my 85-year-old grandmother is going to kill me, so I better stab her to death first. | ||
| That happens. | ||
| It happens a lot. | ||
| And if you look at the amount of violence that people with psychosis commit on a population level basis, it looks like people with schizophrenia commit about 6 to 10% of all the murders in this country. | ||
| And it looks like people with sort of broader, more broadly defined psychosis, again, bipolar with psychosis, other psychotic conditions, temporary psychosis, they might be responsible for as much as 20% of the violent crime in the United States. | ||
| That's a lot of violent crime. | ||
| And what I'm saying is that it is quite clear that drug use mediates that violent crime. | ||
| In other words, if you're not using, you can keep your impulses in check. | ||
| But when you do use, you become dangerous. | ||
| So when we're talking about biological variability, if we factor in schizophrenia, essentially what you're saying is that there are people that have schizophrenia that don't commit violence, but that they're much more likely to commit violence if you add some sort of psych medication, whether it's marijuana, whether it's something else that perturbs reality for them, and particularly whether it's something else that perturbs reality for them, and particularly Well, antipsychotics bring down the use. | ||
| But antipsychotics. | ||
| Yeah, so recreational drugs. | ||
| The worst cases of all are cannabis and a stimulant. | ||
|
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Because to the extent they both... - Like cocaine or math. - Or math, exactly. | |
| So when you get that, you get paranoia from two sources. | ||
| And the only good thing about cannabis from this point of view is it kind of knocks people down a little bit, but meth brings them right back up. | ||
| So is it fair to say that what we don't know is that we don't know whether or not these people, like this young man with this terrible story from Connecticut, We don't know whether or not he would have become schizophrenic and exhibited those symptoms without the marijuana. | ||
| We really don't know, but we do know he did with it. | ||
| That's correct. | ||
| And what I would also say is that for somebody like that, and this is quite clear on a population-level basis with people with schizophrenia, is you've got to discourage them from using. | ||
| They really have to be discouraged because it brings out the worst. | ||
| And somebody said this, a friend of mine, an old friend of mine from the New York Times said, so every time there's a hurricane, some people on the right say, well, you can't prove that global warming caused that one hurricane. | ||
| That would have happened anyway. | ||
| And they're right. | ||
| You can't prove it. | ||
| And you can't prove that any one case of psychosis was caused by marijuana. | ||
| But when you look at the big studies, at the population level data, the association is really clear. | ||
| And everything points the same way. | ||
| And the synthetic cannabinoids, K2 and Spice, those can clearly produce psychosis in people. | ||
| And people with psychosis tend to slip back into it if they use. | ||
| At some point, you've got to start to say to yourself, why does everything go the same way? | ||
| Yeah, I also have a personal friend, and I really didn't think about this guy, but there's another personal friend that I know that is a martial arts instructor that had a psychotic break. | ||
| He became schizophrenic and he's a regular marijuana user and the people around him associated that with that. | ||
| In fact, people that are regular cannabis users were trying to get him to stop using marijuana. | ||
| If you're close to being on the edge and you use a little bit of cannabis, for sure it can induce that. | ||
| This guy was not on the edge when I knew him. | ||
| Yeah. | ||
| When I knew him, he was very rational. | ||
| Very rational. | ||
| But something happened somewhere along the line. | ||
| Did he become a pretty heavy smoker over time? | ||
| I do not know because we don't live in the same area anymore. | ||
| But he got really heavily medicated and did some really crazy shit and wound up being hospitalized. | ||
|
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Yeah. | |
| And this was not the case before. | ||
| I mean, whatever it was that triggered him, I mean, when I was around him when he was younger, I would have said he's a total normal guy, and I would have never saw that coming. | ||
| He was a heavy marijuana user. | ||
| Heavy. | ||
|
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Heavy. | |
| I don't know how he's doing now. | ||
| I hope he's okay, but we have mutual friends, and he became a schizophrenic. | ||
| And, you know, you will see, you know, cases like that. | ||
| But, you know, when you do look at a lot of the larger data on cannabis and violence, I mean, it's just not there. | ||
| Like, there's lots of data that suggests that, you know, medical marijuana laws, for example, can actually have a decrease in overall. | ||
| Well, they could. | ||
| I mean, there's a study that says that. | ||
| That gives no comfort to the people who lose their children because of these psychotic breaks. | ||
| That's right. | ||
| And those studies are really bad. | ||
| So the place that you can criticize— Why are they bad, though? | ||
| Because state-level data is not great. | ||
| The place the book has been criticized— There was a Rand review, though, in 2013, and I mean, again, that stated that marijuana use does not induce violent crime, and the links between marijuana use and property crime are thin. | ||
| Can we stop right there? | ||
| I think we all agree that marijuana use by itself with people that aren't schizophrenic probably doesn't induce violent crime. | ||
| But with people that are schizophrenic or people where it triggers schizophrenia, it could potentially induce violent crime. | ||
| My friend did not get violent, although he did do a violent thing. | ||
| It wasn't to a person. | ||
| I think we have to be really careful because... | ||
| Just like with diet, just like with food, allergies, all these different variabilities when it comes to human beings, I think we have to be really careful about lumping all people together when it comes to how they get affected by various compounds. | ||
| So the state level thing, if you want, I'll, so the place the book has been criticized, in my mind, sort of the most fairly is, it points out that in the four states that legalized first, which is Alaska, Washington, Oregon, Colorado, if you look at 2013, and then you compare that to 2017, murders and ag assaults, violent crime, are up substantially in those states, and substantially more Can I stop you there? | ||
| Is there a possibility there's a correlation between organized crime? | ||
| Because one of the things about selling marijuana is the people that have always been selling marijuana have been criminals. | ||
| When you make things legal in a state, the people that were selling it illegal flock to that state, and that's been It's been proven to be true. | ||
| There's a direct correlation between people being robbed. | ||
| There was also a significant problem with credit cards and banks, where everyone was having to do all their transactions with cash. | ||
| There was a lot of violence that was associated with marijuana in regards to that. | ||
| And also, massive increase in population. | ||
| And that's part of the reason why Trump is actually not really against cannabis in some ways. | ||
| It's because he feels that if we have medical marijuana laws, especially the states that are border states, that the crime is going to drop tremendously. | ||
| And it has dropped. | ||
| They did a study last year and it dropped over 15% in Colorado. | ||
| And it dropped 7% in Arizona. | ||
| And then again, you know, Benjamin Hansen, who's an economist, he said that the murder rate did not demonstrate that marijuana legalization increases violence, and then it may have actually demonstrated that legalization slightly decreased violence. | ||
| And he thinks that the reason that there was an increase in the murder rate, particularly in Washington, is because there is a large income gap. | ||
| They say that Washington has the 10th largest income gap in In the United States. | ||
| But how did that change, though, the correspondence to the murder rate? | ||
| Good question, Jerome. | ||
| So I didn't get to speak with Benjamin about this. | ||
| That sounds like confirmation bias. | ||
| Well, I mean, that is one thing that has been shown to increase mental illness like we talked about and can definitely increase violence is when you have an income gap. | ||
| But how has the income gap shifted that directly correlates to the legalization of marijuana? | ||
| Because during the same period, the income gap, particularly in Washington, increased. | ||
| So he feels that... | ||
| In a corresponding number? | ||
|
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Right. | |
| So he feels that it's likely more to that. | ||
| I mean, I understand, but you have to respect this guy. | ||
| I don't have to respect him because I know what he did with his data. | ||
| Tell me what he did with his data. | ||
| So, Joe, this is maddening to me. | ||
| Okay. | ||
| Violent crime in those four states increased more rapidly than in the U.S. Period. | ||
| Between 2013 and 2017. Here, Jamie just posted this up here. | ||
| Conjecture aside, no credible data exists. | ||
| It supports a significant association between the increased violent crime and marijuana legalization. | ||
| Furthermore, studies suggest that, so far, violent crime decreases in states with legalized medical marijuana until new research credibly suggests otherwise that claim that a demonstratable link between the two exists will remain classified. | ||
| Okay, so that's just not true. | ||
| I know it's Snopes, and I know we trust Snopes. | ||
| I don't trust them that much. | ||
|
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I was going to say that too, but they give all of their links right here if you'd like to. | |
| So again, where are these sources? | ||
| Yeah, I've read this stuff. | ||
| And what's wrong with them? | ||
| Let me just go back to what I'm saying. | ||
| Yeah, please do. | ||
| 2013. Oregon, Washington, Colorado, Alaska. | ||
| There are 450 murders in those four states. | ||
| There are 30,000 ag assaults. | ||
| Period. | ||
| Okay. | ||
| 2017, Oregon, Washington, Colorado, Alaska. | ||
| There are 620 murders in those four states. | ||
| That's an almost 40% increase. | ||
| There are 38,000 ag assaults. | ||
| That's a 25% increase. | ||
| If you adjust for population, you still get big increases. | ||
| In Denver, 2018, almost 70 murders. | ||
| There were about 35 in 2013. Seattle, 2018, There were 34, 35 murders. | ||
| There were, I think, 19 in 2013. These increases are real. | ||
| Now, can we say that marijuana legalization caused those increases? | ||
| We cannot yet. | ||
| There are other possibilities. | ||
| What are those? | ||
| Well, first of all, population did increase. | ||
| It's also possible that these states, quote-unquote, imported violent crime. | ||
| In other words, that you've got a population of transients coming in, in part, because marijuana was legal, and those people are likely to commit violent crime. | ||
| And on top of that, organized crime people that are selling. | ||
| Absolutely. | ||
| There may have been some people who are exporting to Nebraska, to Minnesota, to other states. | ||
| There's crime associated with that. | ||
| But what I am saying is that unequivocally, unequivocally, the people who said legalization is going to decrease violent crime, and people did say that, and Cory Booker in 2017 said it, he said that it actually had decreased violent crime in states that legalize. | ||
| And he didn't say it randomly. | ||
| He said it when he was introducing legislation to legalize marijuana on the federal level. | ||
| Those people are wrong, and they need to stop saying it. | ||
| I know, and by the way, that Oregon economist used... | ||
| He used the wrong data set for his charts. | ||
| I used the real numbers, the FBI homicide numbers. | ||
| He used numbers that include justifiable homicides and police homicides. | ||
| No, that's not right. | ||
| Because the FBI reported that the murder rate went up 1% from 2015 to 2016 as compared to the nationwide, which went up 7.9%, and then it dropped by 11.6% between 2016 and 2017. Those are FBI numbers. | ||
| You do not know what you're talking about, okay? | ||
| Those are FBI numbers. | ||
| I'm reading it. | ||
| You do not know what you're talking about. | ||
| The numbers are clear. | ||
| I'm reading them right now. | ||
| 2016 release of FBI uniform crime reports from Oregon. | ||
| Okay. | ||
| Yes, Oregon. | ||
| You're not reading the reports from the United States. | ||
| You're picking one state for one year. | ||
|
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That state that has legalized medical candidates. | |
| Over the entire country from that time period, too. | ||
| So to pick those four states where marijuana was legalized is sort of cherry-picking. | ||
| No, it's not. | ||
| It's picking every state where they were legalized and comparing it to the whole country. | ||
| It's the whole country erased. | ||
| But did the whole country see a similar increase? | ||
|
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No, that's what I'm trying to show. | |
| If I'm trying to show something wrong, then... | ||
| We'll pull back so we can see the whole thing. | ||
| So first of all, that's violent crime, not murders and ag assaults. | ||
| Well, violent crime and ag assaults, aren't they... | ||
| No, so the four categories of violent crime are murder, ag assault, robbery, and rape. | ||
| Rape has sort of gone sideways the last few years. | ||
| Robberies actually have gone down. | ||
| It's murders and ag assaults that are interpersonal violent crime. | ||
| Okay, just to go back to this Oregon economist because this maddens me. | ||
| He used a data set that is not the standard data set to report murder rates. | ||
| What is the difference? | ||
| He used a data set that includes justifiable homicides, meaning I'm in my house, you come in, I shoot you and kill you, the police don't charge me with anything, and police homicides. | ||
| But the data sets you use in your book aren't even published. | ||
| Let's not interrupt. | ||
| Let me finish. | ||
| Those two categories of crime are not likely to be impacted by cannabis use. | ||
| Cops are not smoking when they're on patrol, I hope, and if you are using, you're very unlikely to have your murder viewed as justifiable homicide. | ||
| The fair comparison is Is the base murder rate in the U.S. And that's the number that I used. | ||
| And I am telling you, I mean, I know these numbers. | ||
| I sleep, you know, I wake up with these numbers. | ||
| Cannabis, the four cannabis legal states on a per capita basis, crime murders rose 31% on a per capita basis in those four states over the 2013-2017 period. | ||
| I'm sorry, I said 31%, maybe it's 29%, so maybe I woke up. | ||
| Anyway, for the U.S., it's 18%. | ||
| 29% versus 18%. | ||
| That's the gap. | ||
| And I am not saying that I know that cannabis legalization caused that gap. | ||
| What I'm saying is people need to stop claiming that cannabis legalization reduces violent crime. | ||
| It has increased in those states. | ||
| Can I ask you, in those states, was it universal, the increase? | ||
| Was it almost identical? | ||
| Yes. | ||
| Alaska was the most. | ||
| Then I think MERS went up more in Washington. | ||
| And what's also interesting, Joe, if you really want to go into the numbers, is the gap actually widened year by year. | ||
| So that's sort of what you would expect if this is the result of a psychomimetic effect. | ||
| In other words, a psychosis-causing effect. | ||
| Because cannabis doesn't cause psychosis right away. | ||
| People break down. | ||
| But if it's causing heavy use and some of those people are sliding into, you know, paranoia and psychosis, you'd sort of expect the gap to increase over time and that's what's happened. | ||
| Okay, so, you know, I'm going to go back again to the Netherlands, okay, because they've had, you know, cannabis legalized forever and they have one-fifth of the homicide rate that the United States does. | ||
| Right, but they also have a lower cannabis use. | ||
| That's true. | ||
| They also have very few guns. | ||
| But still, you know, one-fifth... | ||
| They do a lot of kickboxers, though. | ||
| They do a lot of kickboxers. | ||
| But one-fifth, I mean, it's still... | ||
| It's pretty drastic overall. | ||
| And again, you know, Alex, you know, I appreciate some of the... | ||
| When we're talking about the correlation between cannabis use, one of the things that we have to accept in America is that When you're in a place like the Netherlands that has a long and accepted history of use, people are accustomed to it. | ||
| So I think things kind of even out. | ||
| I think one of the things that we're dealing with with the United States is people that have just, they don't have a long history of experience and it becomes legal and then they use it and maybe some of them, like we're talking about, don't have a tolerance for it, have too much, and Like I was talking about with my friend who's like this really... | ||
| The one who had an edible and became suicidal and was fucked up for weeks. | ||
| Guy's very confident, very articulate, very intelligent. | ||
| He's not a weirdo, not a transient, extremely successful. | ||
| You know, I think there are variables that we need to take into consideration. | ||
| There's certain human beings that exhibit a pattern of behavior that's directly correlated to cannabis use that I don't experience. | ||
| So if I could say from my own personal biases that that's bullshit, that's nothing, it doesn't do anything, I've been smoking for years, doesn't do shit. | ||
| Well, you probably don't have one of those three genes that we were talking about earlier. | ||
| Yeah, you're clearly pretty psychiatrically healthy. | ||
| And you probably also, too, don't overuse or you have some type of legitimacy as to why you are using it. | ||
| And I want to keep going with this, but at the end of the show, I think that we should make some type of recommendations for people just because... | ||
| I hate when, you know, you have this big, you know, three-hour podcast and then at the end of it, it's just like, hey guys, just be safe. | ||
|
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You know what I mean? | |
| It's like... | ||
| Seriously. | ||
| It's so true. | ||
| It's like... | ||
| It's so true. | ||
| I'm at it. | ||
|
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Good luck, you fucks. | |
| It's like... | ||
| Some type of recommendations. | ||
| I love the podcast with Kresser and Joel, but at the end it was just sort of like, hey guys, don't eat the American diet. | ||
| I think most people realize that one person was going on data and the other person was... | ||
| Joe, I find it so fascinating that now when you think back through your life, you've thought of somebody who was affected. | ||
| I have several people. | ||
| I'll bet as you think about it, you'll think of more people. | ||
| Maybe, but those are the big ones. | ||
| And like I said, my friend who is a martial arts instructor, it was a pretty significant issue with a lot of our friends. | ||
| We were trying to figure out what was wrong with them beforehand. | ||
| He was sending me these videos that didn't make any sense. | ||
| And I was like, what in the fuck is this? | ||
| I'll explain to you more off-air so I don't have to out this guy. | ||
| But a lot of people that were close to him were really seriously concerned. | ||
| Now, is it something that would have happened anyway? | ||
| I don't know. | ||
| How old was he? | ||
| He's in his 20s. | ||
|
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Late 20s? | |
| How old exactly? | ||
| Late 20s, 20... | ||
| That's right around the age. | ||
| It is a little bit late-ish. | ||
| Because like I said, a lot of the studies, even when you look at the ones on adolescence, for sure it's below... | ||
| They have done studies like below 18 is worse than say below 25. Below 15 is worse than say 18. The younger you go, the worse. | ||
| He seems to be fine now. | ||
| That's good. | ||
| Is he using now? | ||
| I don't know. | ||
| I have to find out. | ||
| I'm not an expert on this subject but it's because of something called pruning that we go through. | ||
| So everyone goes through this and basically if you're adolescents you're going to drop off some weak neural connections to kind of pick up some stronger ones. | ||
| It's the best way to kind of explain it. | ||
| When you use cannabis, you can potentially accelerate that process. | ||
| And then because you accelerate that process, you don't get those good neural connections. | ||
| And then people, unfortunately, develop things like psychosis and schizophrenia. | ||
| So that's kind of where the issue lies. | ||
| You know, one thing that I am, you know, very happy that we're talking about, and I know Alex will be too, is that, you know, we want to discuss the benefits in this podcast, make sure that people understand that, you know, I believe that marijuana is medicine. | ||
| It's an excellent medicine. | ||
| But the other thing, though, too, is we do want to mitigate the risks because there are real risks out there. | ||
| So, you know, I do appreciate, you know, us talking about adolescents and making sure that they do stay away from cannabis. | ||
| Yeah, and I mean, especially that's like, I read these, you know, these cases, case files sometimes, you know, the kid started using when he was 11, and, you know, it's like that kid never had a chance, right? | ||
| And obviously, oftentimes, these are kids coming from disadvantaged backgrounds anyway, but, you know, they're using by 11, and at 16, they put a, you know, put a gun to somebody's head and pull the trigger. | ||
| I mean, the pre-adolescent and early teen use, we got to do everything we can to stop it. | ||
| The problem is, yeah, if you smoke pot in junior high, say 7, 8, 9, you're probably going to smoke pot in high school. | ||
| That's what I saw when I was growing up. | ||
| Even when I was home for Christmas for a few days, a couple of my friends even talked about some people that we knew smoked a ton of pot in high school and now they're crazy or they're not really doing too much. | ||
| You do have to be careful with that. | ||
| I think... | ||
| We're dealing with a lot of ignorance. | ||
| We're dealing with a lot of ignorance when it comes to biological variability, right? | ||
| We don't really understand how a lot of these different things affect people, including like just diet and what causes depression, like how much of what we constitute or what we decide is depression is inflammation, poor gut health. | ||
| There's a lot of variables. | ||
| There's a lot of them. | ||
| Marijuana is absolutely one of those variables. | ||
| And again, I don't have an issue with it. | ||
| I like it. | ||
| I love the stuff. | ||
| But it doesn't fuck with me. | ||
| But I'm also honest. | ||
| And so I see these people where it's pretty obvious to me that something's going on and that marijuana is not a good idea for them. | ||
| And I just think, you know, like I said, in the past, I myself have been guilty of using this sort of blanket description of it as being a positive influence and that it's a good thing for people. | ||
| I don't think it's a good thing for everybody. | ||
| No, it's definitely not a good thing for everybody, and it's definitely not a good thing for the people who have those genetics that I discussed earlier. | ||
| Also, too, you need to have some type of self-awareness. | ||
| The people who don't do well with cannabis, you shouldn't have to have your friends tell you that, okay, man, you're not doing too well with this. | ||
| You should be able to figure out yourself. | ||
| But that's hard for people. | ||
| I mean, it's one of the most difficult things for people to do is to self-assess, you know, to be objective. | ||
| You know, and I've obviously heard from a lot of people who used heavily and have seen other people who've used heavily in the last month. | ||
| And I think it's very interesting why people continue to use when they're getting paranoid. | ||
| And And, you know, the most cogent argument – and again, I'm not – you know, I've smoked a handful of times in college and after college. | ||
| I actually don't think I'd be comfortable using high THC cannabis now knowing what I know. | ||
| But anyway, so the people – I got some right here. | ||
| I'm going to get hotboxed. | ||
| I'll give you the shit to put Elon on the moon. | ||
| But the most cogent argument, I thought it was so interesting. | ||
| This guy said, well, you know, my friends, I would talk to them and say, I'm paranoid now, but I'm going to smoke through it. | ||
| I'm going to smoke so much that I'm almost comfortable being paranoid. | ||
| And I think that's a dangerous thing to do to your mind. | ||
| Because you're sort of counting on being able to step back from that and stop using. | ||
|
unidentified
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Yeah, that's a silly way of looking at it. | |
| I think that some of what we call paranoia, just normal paranoia, is hypersensitivity and hyper-awareness and awareness to a lot of things that you're putting off in the back of your head because in order to function as a normal person and get through this life, you can't really be aware of everything. | ||
| Paralyzed by fear. | ||
| We're in space. | ||
| Okay, we are on a gigantic ball that's spinning a thousand miles an hour, hurling through infinity. | ||
| This is reality. | ||
| It's a thin layer of gas that's protecting us from everything that's flying around in our solar system. | ||
| And by the way, at best you get 85 years and then it's all shit anyway. | ||
| Right, and even if you make it to 100, the last 15 is dog shit. | ||
| You can't really, you can't think too much about this stuff. | ||
| Maybe the stem cells and stuff will be too, too bad. | ||
|
unidentified
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Yeah, maybe. | |
| Yeah, maybe you're going to live to be 300. What do you do? | ||
| The universe is infinite. | ||
| You know, like, you're going to die. | ||
| Like, the sun is going to end. | ||
| Like, at the end, I mean, imagine if people do live to an infinite number where we realize our fucking sun is dying. | ||
| You're going to freak out about that. | ||
| It's all relative, right? | ||
| So there's only so much you really can think about, and some of what paranoia is, is this hyper-awareness of all these variables that you really haven't considered. | ||
| And then also, we were talking about before, things that can be beneficial, the hyper-awareness of how you communicated with people, and maybe you could have done a better job with that, maybe you You came in hot. | ||
| Maybe you were upset about something else when you ran into them. | ||
| You were already at a seven, and they brought you to a ten, and it was totally unnecessary. | ||
| With a normal situation, you would have only been at a two. | ||
| Those things are real, and sometimes marijuana helps highlight all the errors in your way. | ||
| I think it can be a tool, but my description of it is like any other tool, like a hammer. | ||
| You can build a house with a hammer, or you can just hit yourself in the dick if you're fucking crazy. | ||
| And this is something that I think we should consider when we're discussing almost any psychedelic medicine. | ||
| And I think that I really do believe that marijuana is a psychedelic. | ||
| And I don't even think it's a mild one, especially when it's in edible form. | ||
| I don't think it's mild at all. | ||
| Yeah, I mean, there's some people that come in to my office, for example, and like... | ||
| Just when I meet them, after one or two minutes, I just got to decide in my head, this person's not using THC. This person is anxious. | ||
| What gives you that? | ||
| Is that what it is? | ||
| Anxious? | ||
| Yeah, it's just a feeling of they're not someone who can just sit and be by themselves. | ||
| They just give me the impression that they're not going to do well with cannabis because If they have any type of change in their psyche, they're going to see that as bad. | ||
| That's bad. | ||
| When you're using cannabis, you have to be someone who knows that, okay, I'm going to get a little bit of maybe paranoia now, or at least my psyche is going to change a little bit. | ||
| I am using psychoactive substance. | ||
| And not be able to freak out. | ||
| But some people, I know that if they use a little bit of THC, they probably would have a freak out. | ||
| They probably would have a bad experience. | ||
| Generally, it's people who are very, very fearful. | ||
| Now, the other side of that coin, though, is that if you use CBD, and like we discussed earlier, that can decrease learned fear. | ||
| So that's something that's really helpful for those patients. | ||
| I do agree that we have to be careful about using high THC in certain groups of people, for sure. | ||
| You know, I think one of the, and it's great to hear Dr. Hart say this, one of the real disappointments for me with this book has been, really the biggest disappointment for me, has been that the DPA, the Drug Policy Alliance, and that some of the other advocates, they just want to yell at me. | ||
| And they want to say that I don't understand correlation and causation and that I'm cherry-picking studies. | ||
| Let's acknowledge that a lot of people use this drug. | ||
| And that's true whether it's legal or not. | ||
| And let's acknowledge that probably in 2020, certainly if there's a Democrat elected, most of the Democratic candidates have said they favor legalization. | ||
| There will – legalized cannabis will probably be the law in the United States, okay? | ||
| And let's talk about what we're going to tell people who are using. | ||
| And I had this roundtable with the executive director of the DPA and some other people. | ||
| This was about a month ago, shortly after the book came out. | ||
| And I proposed what I thought were really common sense warnings. | ||
| And she basically wouldn't agree. | ||
| I mean, she agreed to like one of the five of them. | ||
| What were the warnings you proposed? | ||
| It was stuff like, you know, if cannabis, if you have a family history of severe mental illness, you probably should not use cannabis. | ||
| You probably, you should not use cannabis or try to delay your use until you're in your 20s, I think was one of them. | ||
| And one of them, I mean, I thought, I couldn't believe I was getting pushback on this, was something like, So if you're having strange thoughts, especially paranoid thoughts while using cannabis, the drug may be increasing your risk for severe mental illness and you should not use it. | ||
| I mean, I think that's – I think if – now look, we can argue about how severe is, right? | ||
| But certainly if you wind up in the ER even once – That's a bad sign. | ||
| I just don't understand why the legalization... | ||
| Look, I can understand why people who are selling this drug don't care. | ||
| We know if tobacco has taught us one thing, it's that when you're selling a product, you will sell it to people even if it kills them. | ||
| But I don't understand why these people who are supposed to be... | ||
| Science-driven and supposed to be thinking about the greater good won't agree to reasonable discussions about what the warning should be on this. | ||
| I think you did yourself a slight disservice by not including some of the beneficial aspects of cannabis. | ||
| I understand your perspective. | ||
| I understand why you were doing that because you really wanted to highlight the dangers. | ||
| But I think that's one of the things that they can point to when they say you cherry-pick data. | ||
| But I think that also it's really important when you're having these kind of conversations to have a long one. | ||
| I mean, we've really covered the full gamut, right? | ||
| And I think that's probably one of the reasons why Bill Maher didn't want to have you on because he's got five other people on the panel. | ||
| Everybody's talking over everybody and you have five minutes to get your case out. | ||
| And I don't think it's possible. | ||
| I think this is a really... | ||
| This is a long... | ||
| Complicated discussion that has to do with biological variabilities. | ||
| It has to do with unique situations with human psychology, the way the brain functions, whether or not it can act as a trigger to schizophrenia where someone may not have ever experienced that trigger without it. | ||
| Maybe if they just became a long-distance runner and they would have lived a healthy life with no psychotic breaks at all. | ||
| We don't really know. | ||
| And unfortunately, once someone goes off the deep end, we might never find out. | ||
| Yes. | ||
| Sorry, go on. | ||
| No, I'm just saying, I think we have to be very careful in saying we know what it does. | ||
| We know what anything does. | ||
| Because you don't know. | ||
| You know what it does for you. | ||
| You know, some people can't eat fish, you know? | ||
| They eat fucking shellfish and their throat seizes up. | ||
| There's so many variables when it comes to the human body, whether it's your genetics or what you've eaten in the past and how it's shaped your gut biome. | ||
| There's so much that we don't know and don't understand about how we interact with all the various substances that we take into our body. | ||
| One thing, though, too, I noted in your book, Alex, is that you said that you didn't think that cannabis can help the opioid epidemic. | ||
| Is that true? | ||
| I certainly don't think it's a good idea for people who are at risk of opioid use. | ||
| Okay. | ||
| So, you know, I have seen a lot of people in my practice come off of opioids with cannabis use, and there are various medical studies that do show that people who use cannabis can replace opioids with cannabis use. | ||
| A lot of folks feel, though, that that's just a patch. | ||
| And really the best way to get off of opiates is Ibogaine. | ||
| And that Ibogaine, the repeat rate of addiction or people try it again afterwards is really low. | ||
| I think one of the things with that is just the accessibility, the affordability. | ||
| I've never administered Ibogaine before. | ||
| Well, it's just because it's illegal in the United States, and it's a particularly ruthless medication that I've never tried personally. | ||
| But the people that I know that have tried it have had spectacular results, especially people that have had problems with pills. | ||
|
unidentified
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Yeah. | |
| In fact, a friend of mine, my friend Ed Clay, he opened up a clinic in Mexico based on his own interaction with pills. | ||
| He had an injury, he got hooked on the pills, and really had a fucking problem, so went down to Mexico and went through an Ibogaine session and cured him. | ||
| Just whacked it out. | ||
| It literally changes the way your brain interfaces with your addiction. | ||
| It's not simply a perspective enhancer. | ||
| It changes how your body and your brain deal with opiates. | ||
| I think Tim Ferriss has actually talked about that before as well. | ||
| But, I mean, you know, I've seen it in my practice and there are medical studies, so I don't think that we should throw out the fact that, you know, cannabis can help the opioid crisis. | ||
| And then also, too, you want to look at it from a clinical perspective, right? | ||
| So we know that opioids can kill people, right? | ||
| Because it acts on the brainstem, whereas, you know, cannabis doesn't. | ||
| So, you know, you might be saying, you know, you're just substituting one for the other. | ||
| And, you know, sometimes that is true. | ||
| But if you're using a less harmful substance, you know, to me, that's like a huge win, right? | ||
| So if someone, you know, has to drink, you know, 12 beers a night versus smoking like one joint, man, that's awesome. | ||
| And I mean, you look at all these clinics, like you look at like I mean, what are they doing? | ||
| They're trying to get people off one substance to a substance that is a little bit less harmful. | ||
| And I think that when you use cannabis, it can be effective for opioids. | ||
| It can also be effective for benzodiazepines and for other medicines as well. | ||
| It'd be awesome if everyone would just feel happy and great all the time by just exercise and nutrition. | ||
| And that's what I advocate and that's what I try to do personally and that's what I try to say to my patients all the time. | ||
| But I understand though that sometimes life is hard. | ||
| Sometimes things hit you. | ||
| You have crisis in your life. | ||
| You have personal crisis that can throw off your mental health and then you have You get into a car accident, you know, and you could be in really severe pain. | ||
| And in those times, you know, sometimes diet, exercise, meditation, doing all the right things just isn't quite enough. | ||
| And, you know, I think that it's great that we have cannabis for those situations because It does seem to be very effective and has less side effects compared to some of the other medicines that we have traditionally used. | ||
| And even though I'm talking about opiates and deaths, We can also talk about NSAIDs, right? | ||
| Like non-steroidal anti-inflammatory drugs. | ||
| So, these drugs can also wreak havoc on your GI system. | ||
| I saw one study, actually, I tweeted out, Rhonda Patrick tweeted out, said that if you use NSAIDs, it was really short. | ||
| I got to look it up again, but it was like two weeks. | ||
| It can decrease your your gonadotropins, which can stimulate your testosterone level by like 25%. | ||
| And on that note too, we should talk about, I can't believe I forgot to talk about this, but opiates can drastically inhibit your testosterone production, right? | ||
| Which is a huge thing for depression because I've had guys come in to me before. | ||
| That have been, you know, really, really depressed. | ||
| You just give them a small amount of testosterone and, man, they're off their antidepressants and they're off to the races. | ||
| They're doing great. | ||
| So, you know, are we creating a lot of people who are depressed because they're using opiates and their testosterone levels are low? | ||
| And, you know, for men, I mean, having low testosterone is horrible. | ||
| You know, you're going to have low motivation. | ||
| You're not going to feel as well. | ||
| You're not going to want to do things. | ||
| So, you know, if you're giving someone a medicine that nails their testosterone levels down, that's going to really, you know, wreak havoc on their mental health. | ||
| I just want to make a note, too, because Ben Greenfield, who, again, I really, really respect, I like that guy a lot, was talking a little bit with you about testosterone and cannabis and how it can drop it. | ||
| So I think there was three studies I saw done on humans, and two of them noted no statistical difference in dropping testosterone levels, and one study, the other study, noted a small statistical difference. | ||
| So, you know, I think that it may drop your testosterone levels a little bit, but it's not going to, you know, substantially drop them. | ||
| So just so people know that, because I know that comes up all the time, you know. | ||
| Yes, as the dumb anti-drug advocates like to say, doobies cause boobies. | ||
|
unidentified
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Oh yeah, that is not right. | |
| I'm joking. | ||
| Risperdal causes boobies. | ||
| That's a different issue. | ||
| Risperdal is an antipsychotic. | ||
| Risperdal, yeah. | ||
| So, look, I think the issue of whether cannabis is a gateway drug, it's 100% clear that cannabis is a gateway drug. | ||
| The argument is why... | ||
| Did you say it was 100% clear? | ||
| 100% clear. | ||
| The argument is why, okay? | ||
| So, it's quite clear that cannabis use oftentimes precedes other drug use, whether it's opioids, cocaine, other drugs. | ||
| Now... | ||
| One argument, and this is actually a pro-legalization argument, is one reason it's a gateway is that if it's illegal, you've got to buy it from your friendly neighborhood dealer. | ||
| He might have access to heroin or cocaine, other drugs. | ||
| And so eventually, maybe you decide to try one of those other drugs. | ||
| So actually, that's really why the Dutch legalized. | ||
| They wanted to create an avenue for people to use cannabis that wasn't connected to other drugs. | ||
| Okay. | ||
| Another possibility is that using an addictive intoxicating substance... | ||
| You might like it, and you might want to try other intoxicating substances, and it might prime your brain. | ||
| And then the third possibility, really, is that there are just some people who are risk-takers out there, right? | ||
| They're going to use cannabis, they're going to gamble, and cannabis is a little bit easier to access than other drugs, so they're probably going to try cannabis first. | ||
| So it's not really that cannabis drives the use, it's just that cannabis is first. | ||
| They're just curious people. | ||
| What's your thoughts on... | ||
| What I will say, I mean, I'm just going to go back to the NAM report, right? | ||
| I mean, you quoted these people in your book. | ||
| So, this committee couldn't find sufficient data demonstrating an association between cannabis use and initiating opioid use. | ||
| They found no compelling evidence to support the gateway drug theory. | ||
| But those are the people that you quoted in your book. | ||
| So, there's been more research done since then. | ||
| But things have radically changed? | ||
| I would say things have changed some. | ||
| Here's what I would probably say. | ||
| I think that probably it's a combination of these things, right? | ||
| There's certainly an environmental factor where, again, if you're buying from somebody who's got access to other illegal drugs, maybe you try those drugs. | ||
| At the same time... | ||
| Getting high feels good, and maybe you want to try other drugs, and at the same time, you're just a risk taker. | ||
| Okay. | ||
| What nobody seriously ever said until about the last five years is that cannabis could be an off-ramp for opioids, okay? | ||
| And there's a lot of reasons to believe that's a really bad idea. | ||
| First of all, cannabis, if you actually need opioids for pain relief, cannabis is not a good enough pain reliever. | ||
| It's like alcohol. | ||
| It's a mild pain reliever. | ||
| It's not strong enough. | ||
| If you're dying from cancer, cannabis... | ||
| It probably is not the pain reliever that you need. | ||
| You need opioids, okay? | ||
| And, again, the state-level data is not as good. | ||
| If you want to really figure out what's happening to an individual, the best way to do that is to follow that individual. | ||
| And there's a really good paper that came out in 2017 after the NAM report, so they didn't have it, that shows that people who used cannabis in 2001, this is based on a large national study in the U.S., were three times as likely to be using opioids three years later. | ||
| And that just intuitively makes sense to me. | ||
| And the other thing that people on the legalization side don't ever talk about is, who are the two countries that have the most cannabis use in the West? | ||
| The US and Canada. | ||
| Who are the two countries that have by far the worst opioid epidemic? | ||
| The US and Canada. | ||
| Okay, but there's a real issue with that because the United States is also the only country other than New Zealand that allows pharmaceutical companies to advertise. | ||
| Yes, but Canada doesn't. | ||
| The amount of opiates that are prescribed in the United States is fucking preposterous. | ||
| I agree. | ||
| Particularly, I don't know if you ever saw the documentary, the OxyContin Express, but the way Florida used to be structured where they didn't have a database. | ||
| Yep. | ||
| And you could just literally go from pharmacy to pharmacy. | ||
| No, we have a problem with the way we prescribe drugs in this country. | ||
| Opioids, ADD drugs, benzos, SSRIs, all of them. | ||
| And we're connected to cannabis, so it makes sense that it would filter over there. | ||
| Yes, but what I would say is that people who think that cannabis is not part of that over-prescribing problem are diluting themselves. | ||
| And what do you think to that? | ||
| Sorry, can you repeat the question again? | ||
| So I agree with Joe. | ||
| The way the access to opioids in the U.S., I mean, certainly it's come down a little bit in the last couple of years, but, you know, Purdue Pharma, there's a special place in health for those guys. | ||
| But it's not just opioids. | ||
| We prescribe too many benzos. | ||
| We prescribe too many ADD drugs. | ||
| We probably prescribe too many SSRIs. | ||
| We prescribe too much in this country. | ||
| I think we all agree. | ||
| I agree with that. | ||
| And I think... | ||
| That cannabis is another example of us looking for a drug to solve our problems. | ||
| Okay, again, just from a clinical perspective, I can't just rely on diet and exercise for all my patients. | ||
| I have to use other tools. | ||
| And again, everyone here in this room, we're all pretty healthy. | ||
| I don't have a bad back or I don't have a mental health diagnosis or anything going on. | ||
| You know, I have to look at patients that are coming to me, right? | ||
| So, the way I see it is that, you know, we just mentioned a bunch of other drugs, you know, antidepressants, amphetamines, all these types of things. | ||
| You know, cannabis, and again, you know, I'm going to separate the THC and the CBD. It's an incredible medicine and it doesn't kill people, right? | ||
| So as a clinician, you know, that's so comforting for me to know that every single night I go to bed, I killed zero people. | ||
| I know that, right? | ||
| So that's really, really comforting for me to know. | ||
| Also, I feel, you know, we were just talking about amphetamines and we were just talking about, you know, SSRIs. | ||
| I feel that cannabis, you know, particularly the CBD component is Can actually be more effective. | ||
| That's what I've seen a lot in my practice and other people have seen that as well. | ||
| So I think that we need to take that into consideration when we're using all these drugs. | ||
| And Alex, some of the things that you're saying, they're quite admirable and a lot of things like researchers say, are quite admirable as well and they feel that they can tell clinicians, give them really good advice, but they're not the ones in the trenches. | ||
| They're not the ones in front of the people. | ||
| They're not the ones that have to chat with patients. | ||
| I have an obligation to do something for my patients to make them better. | ||
| I really feel, we just listed a bunch of drugs, that cannabis is a really, really effective tool and it doesn't kill anybody. | ||
| So because of that, I'm going to keep using it. | ||
| But like I said, I'm always looking for other drugs. | ||
| I'm always looking for other alternatives to also help my patients. | ||
| But I think that using cannabis is a really effective tool for a lot of clinicians and it's helped a lot of patients. | ||
| But what do you think about his argument about it being a gateway drug? | ||
| Other than what these people said in the study that there's no evidence that supports it, it's a gateway drug. | ||
| What are your personal feelings about that argument? | ||
| So I don't feel that cannabis is the gateway drug. | ||
| I do feel that one of the things that you mentioned earlier is that some people kind of have this personality where they're like an experiment. | ||
| And they just want to try something. | ||
| So, you know, the fact is that alcohol and cannabis just get introduced first most of the time. | ||
| Most people, you know, don't do, you know, Coke or LSD and then say, hey man, let's try some cannabis, right? | ||
| So it's just that that's the very first one there. | ||
| So if we... | ||
| You could say anything that was easier access. | ||
| If there was some new drug that did something similar to alcohol or similar to cannabis that was introduced in our society, you'd be calling that the gateway drug. | ||
| Well, alcohol has clearly been demonstrated as being the gateway drug to almost all hard drugs because of the loosening of inhibitions, whereas the opposite could be said about cannabis, that it makes you paranoid, you might actually be less likely to try cocaine afterwards. | ||
| And I know that the name, they don't feel that cannabis is a gateway drug either. | ||
| I mean, again, they said they found no compelling evidence to support the gateway theory. | ||
| And again, I mean, these are the people that you are quoting in your book, Alex, right? | ||
| Let me just go a little bit further. | ||
| They said, in a retrospective cohort study, Mayette from ETAL in 2016 examined the transition from cannabis use to the use of other illicit drugs. | ||
| They found that the probability of initiating other illicit drugs after cannabis did not differ significantly from the probability of starting with other illicit drugs. | ||
| So it's just that cannabis is there first. | ||
| It's definitely not a gateway drug in any stretch of the imagination. | ||
| Again, I totally disagree. | ||
| And again, there's 50 years of data on this. | ||
| I know the studies that he's quoting, but there are many others. | ||
| And I think the argument is as to why. | ||
| And again, I think the argument that to some extent having access to this drug illegally tends to open you up to other illegal stuff, which to me is an argument for legalization. | ||
| But I do want to throw one thing out there. | ||
| I don't know how many of your viewers have teenage kids. | ||
| They're probably more likely to be teenage kids than to have teenage kids. | ||
| But the book has... | ||
| The one thing that really worries me, if we're talking about gateway drugs, is that Juul and vaping are really a gateway to THC vaping. | ||
| Why do you say that? | ||
| Because, well, first of all, it gets kids, teenagers, used to inhaling this illicit substance. | ||
| And you can actually retrofit a Juul pod with THC. | ||
| They don't sell them, but you can easily go online and look at how to do it. | ||
| And I think it really worries me, and I've heard from a lot of parents in the last month, that there is an epidemic of nicotine vaping and THC vaping going on right now. | ||
| And we're talking about 15-, 16-, 17-year-olds inhaling pure THC, the most dangerous form of this drug. | ||
| And I think, unfortunately, it's not going to take long before the mental health consequences of that become apparent. | ||
| And I really do hope that the book gives parents some tools to talk to their kids about that, if nothing else. | ||
| Last words? | ||
| I actually wanted to go over a few things that maybe I thought you might be interested in. | ||
| Okay. | ||
| Okay, so, you know, you're a dude, you're over 50, so prostate cancer. | ||
| So, you know, it's been shown that CBD may actually be beneficial for prostate cancer. | ||
| And one thing within that, too, in the same study, they actually found that people who used CBD and were on chemotherapeutics has actually augmented the efficacy of the chemotherapeutics. | ||
| Good for prostate cancer, do you mean to prevent it? | ||
|
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Yes. | |
| Do you mean to treat it? | ||
| Prevent and treat, yeah. | ||
| And then they say THC may actually be a little bit effective because it can, and this comes back to testosterone a little bit, it can antagonize DHT. So DHT is another testosterone hormone, as you know, and that's more linked to prostate cancer. | ||
| One thing, too, we didn't really get to talk about was CTE and concussions. | ||
| I know a lot of your viewers are in MMA and all about that, and I tweeted out a study the other day that you were tweeting. | ||
| I really appreciate that. | ||
| It was a three-year study that showed that the mortality rate overall was 9.5% for people who had suffered a TBI. People who tested, I know we talked about correlation causation, but the THC users only had a 2.4% mortality rate. | ||
| The non-THC users had 11.5% mortality rate. | ||
| I mean, that's really, really significant, right? | ||
| And this is just THC and not CBD? Because CBD has been shown to be very beneficial for people with traumatic brain injuries. | ||
| So CBD and THC are both beneficial? | ||
| Yes. | ||
| So that was, you know, again, a correlation equal causation, but I mean that the stats are so overwhelming. | ||
| Like if it was, you know, non-cheat C was like 3.5%, I would have bring it up. | ||
| But it's 11.5% compared to 2.4%. | ||
| And again, CBD, yes. | ||
| And there's even, you know, mechanisms of action have even been identified with that. | ||
| It decreases, you know, inflammation in your brain post-concussion. | ||
| Yeah. | ||
| You know, one last thing, too. | ||
| Again, there's only one study on it, and it was done on rats, but, you know, I'm a keto guy, too. | ||
| But the study on rats, interestingly, showed that if you do have a high-fat diet, that you can actually decrease sensitivity at the CB1 receptor. | ||
| And they think that that's just because there's an increase in your endogenous cannabinoids, 2-AG and anandamide. | ||
| When you do have a high-fat diet. | ||
| And then, can I maybe keep going? | ||
|
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Sure. | |
| Okay, sure. | ||
| And then Alzheimer's, you know. | ||
| Again, I know you're plus 50, so, you know, THC. Say Joe has Alzheimer's? | ||
| No, I'm not saying. | ||
| It's probably on twice. | ||
|
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I know that he wants to keep doing this podcast forever, I think. | |
| Maybe that would be an excuse to stop. | ||
| So THC has been shown to inhibit the formation of beta amyloid plaques. | ||
| That's the hallmark of Alzheimer's disease. | ||
| And then CBD has also been shown to be effective for Alzheimer's disease as well. | ||
| There's a rat study that was going to... | ||
| I don't want to get into, but it's fairly detailed. | ||
| So it might be best just to say that it can help with rescue memory in patients if you do use CBD, meaning that it may actually reverse. | ||
| And that's been shown before, too. | ||
| They've done that in mice. | ||
| I've got to interrupt you for one second, okay? | ||
| And I think you would agree. | ||
| Some of it's sort of epidemiological, some of it's preclinical. | ||
| It's very, very early. | ||
| None of it really proves much. | ||
| Alex, just let me say, I'm a clinician, okay? | ||
| If someone comes to me and they have a concussion, it's very frustrating just to say to them, hey, physical cognitive rest, go home, okay? | ||
| It's really frustrating to say that to someone. | ||
| Also, too, the high-fat diet thing, Joe and I both follow a very, very similar diet, so that's something I want to share. | ||
| With regards to the Alzheimer's disease, we have really, really poor medications for that. | ||
| And we have an aging population. | ||
| So again, Alex, you want to look at everything, which is what I'm doing. | ||
| I'm looking at everything and I'm trying to make a clinical decision. | ||
| Am I using some things without randomized controlled trials? | ||
| Of course I am. | ||
| But again, I'm a clinician, so I'm using mechanisms of action. | ||
| I'm using what I see in In clinic, and I'm using epidemiological studies, and I'm also taking into account what other medicines do I have, you know, based upon all the data, this seems to be an effective treatment. | ||
| And I am absolutely not saying that you as a clinician shouldn't do that, especially you're in Canada, cannabis is legal, you should use your best judgment. | ||
| What I'm saying is that when we're talking about... | ||
| Policy decisions around cannabis and THC, and to a much lesser extent CBD, the advocacy groups have seized on this very, very preliminary data to say a lot of things about cannabis and THC that have not been proven. | ||
| You know, a guy I know named Peter Bach, who is very smart. | ||
| He's a pulmonologist. | ||
| He's at Memorial Sloan Kettering in New York. | ||
| And he wrote a piece in the Wall Street Journal a couple weeks ago talking about cannabis's limits as medicine. | ||
| And he said something that I thought was so well put, which is the reason why people want cannabis to work for Alzheimer's and cancer. | ||
| And a bunch of things where there's really no evidence that it works is that we don't have good treatments. | ||
| We want cures. | ||
| We want help. | ||
| We, if we're clinicians, I mean, I'm not a clinician, you're a clinician, want to be able to give people who come into our offices something. | ||
| But that hope is not a substitute for science. | ||
| It doesn't mean that it works. | ||
| And even... | ||
| You want your patients to have hope, okay? | ||
| But the advocates, the people who are using this to push, especially to push THC and to capitalize on the public confusion around THC and CBD, I think that is a real, it's a real disservice to people. | ||
| Okay. | ||
| Listen, I think we covered everything. | ||
| It's a complicated subject. | ||
| It really is. | ||
| And I think it's really important to discuss how complicated it is. | ||
| I don't think there's... | ||
| I've never heard such a detailed analysis of all this stuff in a way where you can get two opposing people that are, you know, very civil about it, but agree on certain aspects of it. | ||
| I think we really highlighted all those things. | ||
| Joe, thank you so much for having us. | ||
| Thank you. | ||
| Thank you guys. | ||
| Thank you so much. | ||
| Really appreciate it. | ||
| Dr. Hart, thanks. | ||
| Give out your social media please. | ||
| Sure. | ||
| So I'm at Dr. Mike Hart on Twitter. | ||
| I'm at Dr. Mike Hart on Instagram. | ||
| And I'm at Dr. Mike Hart on Facebook. | ||
| So it's D-R-M-I-K-E-H-A-R-T. And Alex, your book is Tell Your Children. | ||
| It's available now. | ||
| It's available everywhere. | ||
| It's available now. | ||
| And if I had a copy, I'd give you a copy. | ||
| That's okay. | ||
| I'll give you the copy I have. | ||
|
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Okay. | |
| All right. | ||
| Well, thank you guys. | ||
| Both of you. | ||
| Thank you very much. |
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