The Joe Rogan Experience - February 13, 2019


Joe Rogan Experience #1246 - Pot Debate - Alex Berenson & Dr. Michael Hart

Topics
marijuana benefits cannabis and cancer studies suicide rates social media depression cannabis Cannabis for PTSD treatments cannabis genetics test schizophrenia and cannabis treatments cannabis violence psychosis studies marijuana psychosis income gap and marijuana legalization pruning and cannabis risks cannabis opioid crisis CTE and concussions THC and CBD for Alzheimer's
Hosted by
Joe Rogan
Guests
Dr. Michael Hart
Mentioned
Mike Howard Jonathan Haidt Jamie Marijuana Ibiza Ziva Cooper Snoop Dogg Owen Yuval Noah Harati Jordan Peterson Benjamin Hansen Beautiful Boy Isaac Campos Bill Maher Joey Diaz Seroquel Juul Tony Hitchcliffe Rhonda Patrick Ben Greenfield and 34 more
Joe Rogan Experience #1245 - Andrew Yang Joe Rogan Experience #1247 - Andy Stumpf

Episode Stats


Length

2 hours and 48 minutes

Words per minute

182.15

Word count

30,649

Sentence count

2,494

Harmful content

Misogyny

24

sentences flagged

Toxicity

114

sentences flagged

Hate speech

19

sentences flagged


Summary

Summaries generated with gmurro/bart-large-finetuned-filtered-spotify-podcast-summ .

In this episode, Dr. Mike Hart and Alex Berenson discuss the pros and cons of medical marijuana, the dangers and benefits of edibles and edibles, and whether or not they should be legalized. Dr. Hart is a family physician in London, Ontario, Canada and has been practicing cannabis medicine for over 5 years. He is also the author of the new book, Tell Your Children: The Truth About Marijuana, Mental Illness and Violence, which was released last month and has not endeared him to the cannabis advocacy community. Alex is a spy novelist and has written for the New York Times and the New Yorker, and is a best-selling author. He is a regular contributor to NPR and has appeared on the Tonight Show with Jay Shetty and Bill Maher, and he is a frequent guest on The Late Show with Stephen Colbert. He's also a regular guest on HBO's Hard Knocks and The Late Night with Seth Meyers, and hosts the podcast, and is the host of the show's new show, . and he's also the host and creator of on the podcast , which you can catch on Comedy Central, HBO, and CBS Radio. and other network shows. Dr. Michael Hart sits down with him to talk about his new book. . He's a family doctor, author, spy novelist, and author, and former spy novelist. , and he also writes about cannabis and mental illness. The Truth about Mental illness and violence, which he wrote. And he's a book called about marijuana and mental health. which is out now, which you should be listening to right now. to find out what he thinks of it. If you don't know who he's talking about, then you're in for a good ol' time! or if you want to get your own copy of the book, listen to it here. I'll tell you what he's up to, and you'll get a discount code for a discount on the book at the end of the episode. Thank you for listening to this episode! Thanks for listening and tweet me what you think of it? if you think it's a good one! if it's good, I'll send me a review! and I'll have me on the next one. Tweet me :) to let me know what you thought of it!

Transcript

Transcripts from "The Joe Rogan Experience" are sourced from the Knowledge Fight Interactive Search Tool. Explore them interactively here.
Misogyny classifications generated with MilaNLProc/bert-base-uncased-ear-misogyny .
Toxicity classifications generated with s-nlp/roberta_toxicity_classifier .
Hate speech classifications generated with facebook/roberta-hate-speech-dynabench-r4-target .
Topics generated with Qwen2.5-3B-Instruct.
Hosts, guests, and mentioned names generated with spaCy (en_core_web_sm), reconciled against Wikidata.
00:00:04.000 Three, two, one, and we're live, ladies and gentlemen, or gentlemen, you two.
00:00:11.000 Ladies and gentlemen listening, but you two, unless you have some non-binary handle that you enjoy. 0.76
00:00:16.000 It's a new world.
00:00:18.000 Please, please introduce yourself.
00:00:21.000 Sure, so I'm Dr. Mike Hart, originally from St. John's, Newfoundland.
00:00:26.000 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.
00:00:32.000 And use her. 0.97
00:00:33.000 My name is Alex Berenson.
00:00:35.000 I used to be a New York Times reporter.
00:00:37.000 Then I became a spy novelist.
00:00:38.000 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.
00:00:50.000 Have they attacked you mercilessly for this book?
00:00:54.000 Yes, they have.
00:00:55.000 And that's okay.
00:00:58.000 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.
00:01:09.000 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.
00:01:17.000 I don't think marijuana is 100% safe.
00:01:21.000 Honestly, for everybody.
00:01:23.000 I really don't.
00:01:24.000 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,
00:01:39.000 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.
00:01:48.000 He was high for 14 days.
00:01:50.000 Went to a psychiatrist, and he's a big guy.
00:01:53.000 He's like 6'5", 6'6".
00:01:55.000 And they told him to keep taking it, because he's like, you're so big, just keep smoking.
00:02:01.000 And so he doesn't smoke, so he just kept hitting his vape pen. 0.98
00:02:03.000 He said, I was high for fucking two weeks. 0.99
00:02:05.000 Yeah. 0.99
00:02:06.000 Yeah, so you need to do it properly, right?
00:02:08.000 It needs to be held to the same standard as any other medicine.
00:02:11.000 So we need to identify that there's risks and there's benefits to it.
00:02:15.000 And some people are definitely going to be more susceptible to those risks.
00:02:20.000 And we need to kind of tease out those people and make sure that those people don't put themselves at risk.
00:02:27.000 Yeah, I think so as well.
00:02:29.000 And this is one of the reasons why I want to state this because I'm a well-known marijuana advocate.
00:02:33.000 But I believe absolutely there are great benefits to it.
00:02:38.000 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.
00:02:48.000 They're going through chemotherapy, find great benefit in terms of helping them.
00:02:52.000 And then there's also some people with autism.
00:02:55.000 I know people that they're children of autism and they give them small amounts of edible marijuana and stop seizures.
00:03:01.000 It's incredibly beneficial in the form of CBD for a lot of different ailments.
00:03:05.000 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.
00:03:17.000 Absolutely.
00:03:18.000 Yeah.
00:03:18.000 Alex, you want to say something?
00:03:19.000 No, no.
00:03:20.000 Well, first of all, I suspect, you know, there are people who said, don't go on with Joe.
00:03:23.000 He's just going to, you know, he's going to try to eat you alive.
00:03:26.000 And especially, it'll be two on one.
00:03:29.000 I told them the truth.
00:03:30.000 First of all, I'll go on with anybody.
00:03:33.000 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.
00:03:40.000 He's afraid to talk to me about this.
00:03:42.000 Why?
00:03:44.000 Well, his people told the Simon& Schuster PR people, we just don't want to have him on.
00:03:50.000 And NPR had a national NPR show had an interview scheduled with me, an hour-long segment, and they canceled it.
00:03:57.000 They said, we don't believe in the conclusions of the book.
00:04:00.000 Okay, you don't believe in the conclusions of the book?
00:04:02.000 Have me on.
00:04:03.000 Ask me anything.
00:04:04.000 And that's why I'm so happy to...
00:04:07.000 That you're not afraid to have me on.
00:04:08.000 That we can have a conversation.
00:04:10.000 That we can have a conversation.
00:04:11.000 Come at me with any question you want about the science.
00:04:15.000 I'll say right off the top, I don't think marijuana is medicine.
00:04:18.000 It has a few medical uses.
00:04:22.000 CBD has been shown to reduce seizures in kids.
00:04:24.000 That's great.
00:04:26.000 THC has been shown to reduce the nausea associated with chemotherapy.
00:04:31.000 That's nice.
00:04:32.000 But for the most part, people use THC and cannabis as recreational intoxicants.
00:04:38.000 They use them to get high the same way they use alcohol, the same way they use other drugs.
00:04:41.000 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.
00:04:48.000 And the risks and benefits are different than alcohol.
00:04:51.000 They're different than other drugs.
00:04:52.000 But I don't think if you look sort of on a population level basis, they're less than alcohol.
00:04:56.000 I don't think you can even say that.
00:04:58.000 I really strongly disagree with that.
00:05:01.000 I mean, you just have to look at the death rate, right?
00:05:04.000 More people die from alcohol than almost all drugs combined.
00:05:09.000 But when we're looking at cannabis, there's zero deaths attributed to the use of cannabis itself.
00:05:15.000 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.
00:05:22.000 You cannot die from cannabis.
00:05:24.000 And just based upon that alone, it makes it much, much safer than alcohol.
00:05:30.000 Yeah, how could you say that if that is the case?
00:05:33.000 So, okay, so that's a really good question.
00:05:35.000 The normal number that's used for U.S. deaths from alcohol is about 90,000.
00:05:39.000 Now, about 30,000 to 40,000 of those deaths are deaths from the physical effects of alcohol, right?
00:05:45.000 Essentially liver damage, either chronic liver damage, you get cirrhosis, you die.
00:05:49.000 In some cases, you can drink so much that you kill yourself in a night.
00:05:53.000 So that's about 30,000 to 40,000 deaths.
00:05:55.000 The other deaths are generally associated with alcohol, meaning...
00:06:00.000 Violence.
00:06:01.000 Exactly.
00:06:02.000 Violence, suicide, car accidents.
00:06:04.000 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%.
00:06:17.000 They said, okay, that's an alcohol-associated death.
00:06:20.000 That's a fine way to count as far as I'm concerned.
00:06:23.000 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.
00:06:41.000 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.
00:06:48.000 I suspect it will be in the 10,000 to 20,000 range.
00:06:51.000 We won't know until we actually do it.
00:06:52.000 Okay, but let's eliminate, let's go even over the alcohol. 1.00
00:06:56.000 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.
00:07:04.000 You're still looking at a giant number of people who drink themselves to death.
00:07:08.000 Thousands and thousands and thousands of people every year versus zero with marijuana.
00:07:12.000 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,
00:07:31.000 they don't even necessarily have to have been under the influence of it.
00:07:34.000 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.
00:07:48.000 So there's a lot of people who have the active metabolite in their blood.
00:07:52.000 I agree.
00:07:53.000 Alcohol is a physically toxic substance.
00:07:55.000 Cannabis is a neurotoxin for a lot of people.
00:07:57.000 But in addition to the deaths, there's also just the morbidity that's associated with alcohol.
00:08:03.000 I mean, it ruins people's lives.
00:08:05.000 It ruins marriages.
00:08:06.000 It leads to weight gain.
00:08:08.000 It leads to a lot of metabolic disturbances.
00:08:10.000 I think you could say that for some people with marijuana, too.
00:08:12.000 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.
00:08:19.000 And you could also say that...
00:08:21.000 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?
00:08:34.000 The person who's high all the time.
00:08:35.000 You could absolutely say that that could ruin relationships.
00:08:37.000 You could absolutely say that it would ruin your job.
00:08:41.000 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.
00:08:48.000 Because people who use high CBD every day, as we know, or most people listening to this, CBD is non-psychoactive.
00:08:56.000 It does not get you high.
00:08:57.000 Super beneficial.
00:08:58.000 That can be extremely beneficial for a variety of different disorders that people have.
00:09:02.000 So we need to be careful about using cannabis versus using THC because it's really the THC that can do that.
00:09:09.000 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. 0.82
00:09:18.000 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.
00:09:32.000 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.
00:09:41.000 So sometimes having the munchies is definitely a good thing. 1.00
00:09:47.000 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.
00:10:00.000 THC and CBD are only two of them.
00:10:02.000 Those are the main ones that people know about.
00:10:04.000 So THCV has been shown to actually reduce appetite.
00:10:08.000 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,
00:10:23.000 I have a question for you.
00:10:24.000 When people come into your practice, do they Do they want high CBD products, or do they want to get intoxicated?
00:10:31.000 No, absolutely.
00:10:32.000 Well, in Canada, it's fully legal.
00:10:33.000 Sure, of course.
00:10:33.000 Yeah, so it's like, they don't need to go to him to get intoxicated.
00:10:36.000 Right, so you're seeing a population that is genuinely interested in the health benefits.
00:10:41.000 Absolutely, because I mean, I'm glad that that's legalized in Canada, because it does make my job a little bit easier.
00:10:49.000 Basically, everyone who's coming to me now, I know that they want to use it medically.
00:10:53.000 Because if they want to use it recreationally, they just go to the store, right?
00:10:57.000 Because it's kind of a pain to get in to see me, come in and have the discussion, all that type of stuff.
00:11:02.000 So the people who see me now, they're all using it medically.
00:11:06.000 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.
00:11:13.000 I don't want to get high.
00:11:14.000 That's almost what everyone says.
00:11:16.000 So I think the word is out there that CBD is non-psychoactive and it doesn't get you high.
00:11:23.000 And I think that a lot of people are really interested in that compound.
00:11:27.000 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.
00:11:34.000 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.
00:11:40.000 And the anecdotal evidence is, you know, something that we should consider because it is so strong.
00:11:45.000 Alex, let me ask you this.
00:11:47.000 Why don't you consider it medicine when it has proven medical benefits?
00:11:51.000 Well, it obviously can be medicine for these narrow things that the FDA has approved it for.
00:11:55.000 But as you know, I'm sure, when people talk about it as medicine, when the...
00:12:01.000 The ballot initiatives that have gotten it approved as medicine have really essentially deceived voters about the process, right?
00:12:09.000 So you go to a pot doctor, you get an authorization.
00:12:14.000 That authorization essentially enables you to buy as much cannabis as you want for the next year.
00:12:19.000 Most of the time, in reality, these doctors are not giving you a real medical examination.
00:12:24.000 They're saying to you, hey, do you have pain?
00:12:25.000 Do you have anxiety?
00:12:26.000 Here's your authorization.
00:12:27.000 I don't think you should speak for every single doctor.
00:12:30.000 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.
00:12:39.000 We provide a lot of education at my clinic, and there's other clinics in Canada that also provide a lot of education.
00:12:45.000 And I imagine there's a spectrum.
00:12:47.000 But in the U.S., this was a – and I spoke to advocates for my book.
00:12:51.000 I spoke to Rob Campia, who ran the Marijuana Policy Project for a long time, for the book.
00:12:56.000 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.
00:13:04.000 My doctor said, why do you need pot? 0.99
00:13:06.000 I said, I get headaches.
00:13:07.000 He said, when you get headaches?
00:13:08.000 I said, whenever I think about the fact that pot's illegal.
00:13:11.000 Yeah.
00:13:12.000 I mean, let's be honest about it.
00:13:14.000 I'm not – look, I say in the book at the end, I don't think this should be – this substance should be legal.
00:13:19.000 I favor decriminalization.
00:13:20.000 We're sort of jumping ahead here.
00:13:22.000 But if it's going to be legal, I'd rather have it be legal for recreational use.
00:13:26.000 I'd rather that we don't pretend that THC-high cannabis is a medicine.
00:13:30.000 And I'd rather separate out doctors like Dr. Holmes.
00:13:33.000 But THC is a medicine, though.
00:13:34.000 Yeah, but why are you saying don't pretend?
00:13:36.000 Because there's many medicines that have horrific side effects.
00:13:40.000 The medicine THC in regards to children's autism is pretty significant and well-documented.
00:13:48.000 Epilepsy, autism, those are two huge things that happen with children that they've been shown to severely mitigate with edible marijuana.
00:13:57.000 So I have to push back on you a little bit.
00:13:58.000 CBD has been shown to reduce seizures in children with epilepsy.
00:14:02.000 It's FDA-approved for that.
00:14:04.000 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.
00:14:13.000 Yeah, I mean, Just let me interrupt for a sec.
00:14:15.000 I had a patient four or five years ago, and she was 20 years old.
00:14:20.000 She couldn't drive a car because she had seizures, right?
00:14:23.000 So you can imagine being 20 years old, not being able to drive a car.
00:14:27.000 All your friends are driving around.
00:14:28.000 So she uses a little bit of CBD, not even every day.
00:14:32.000 She's never had a seizure since.
00:14:35.000 And now she's able to drive her car.
00:14:36.000 But this is, we're talking about CBD. He's talking about THC. So you're talking about a case.
00:14:44.000 And I'm not saying that your friend's situation didn't happen.
00:14:47.000 I'm not saying it's not real.
00:14:48.000 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.
00:15:07.000 And you see the changes in those two groups over time.
00:15:09.000 And you find out whether or not your theory about whether this works on a population level basis is real or not.
00:15:16.000 That is at the core of medical science.
00:15:19.000 And we've basically thrown that rule out for THC. Well, that's not entirely correct.
00:15:24.000 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.
00:15:31.000 And you also, I'm sure you know, like when we're talking about marijuana, you're talking about something that's federally illegal.
00:15:37.000 It's not something that's easy to run these FDA studies on.
00:15:41.000 Yes, and I say at the end of the book, I think we should drop that.
00:15:44.000 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.
00:15:54.000 Let's see if this plant is good for these things.
00:15:58.000 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?
00:16:06.000 Do you think they're getting it from just the CBD, the minimal amount of CBD in marijuana?
00:16:11.000 No, I think that, again, there's been a lot of research done on THC and cannabis to see whether or not those...
00:16:19.000 Whether THC is a compound and whether smoke cannabis can treat these conditions.
00:16:23.000 And for the most part, the studies have been negative.
00:16:26.000 Negative in what way?
00:16:27.000 Meaning they haven't shown any actual...
00:16:30.000 Can you cite these studies?
00:16:32.000 I mention them in my book.
00:16:34.000 Okay.
00:16:35.000 Well, what were the conclusions of these studies when you're saying that they're not positive?
00:16:39.000 That they...
00:16:39.000 Again, that they...
00:16:41.000 Didn't work, that the drug didn't work.
00:16:43.000 Didn't work on what?
00:16:44.000 On cancer, on Alzheimer's disease, on irritable bowel syndrome, on all kinds of things.
00:16:49.000 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?
00:16:59.000 Right.
00:17:00.000 And I've done videos on this even recently stating that.
00:17:05.000 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.
00:17:14.000 Say if we're talking about breast cancer, and I did a video on this recently.
00:17:18.000 If you are HER2 positive, And you see CBD, it can in fact reduce tumor size and it can reduce tumor growth.
00:17:27.000 Now, if you have...
00:17:28.000 I'm sorry, can I interrupt you?
00:17:30.000 What does that mean?
00:17:31.000 It's a subset of breast cancer. 0.81
00:17:33.000 Right, so there's different types of breast cancer and that's just one subset of breast cancer. 0.93
00:17:39.000 So there are other breast cancers which do not express cannabinoid receptors.
00:17:43.000 And I've seen one study, at least.
00:17:46.000 Again, it's only one study that showed that when they gave CHC in that animal model, it actually caused a proliferation of tumors.
00:17:52.000 So it worsened them.
00:17:53.000 So I do agree with you, Alex, in the fact that we have to be careful about using terms like that.
00:18:00.000 But that just doesn't mean that we can't say that cannabis is no good for cancer at all.
00:18:03.000 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?
00:18:12.000 So it's definitely a really good medicine for a lot of different things.
00:18:18.000 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.
00:18:27.000 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.
00:18:36.000 So I'm not a researcher.
00:18:38.000 So I need to make sure that my patients are getting better.
00:18:41.000 It's very frustrating for me just to say to someone, oh, there's nothing I can do for you.
00:18:45.000 There's nothing I can do for you.
00:18:47.000 And I understand that doing something sometimes is not going to be beneficial just because you're doing something.
00:18:54.000 You have to do something that actually works.
00:18:56.000 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,
00:19:11.000 called Nabilone.
00:19:12.000 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.
00:19:25.000 And just to keep on the topic of PTSD, in addition to that, we've identified mechanisms of action.
00:19:32.000 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.
00:19:47.000 Which is the naturally occurring cannabinoid in your brain.
00:19:50.000 Yes, which is the naturally occurring endocannabinoid, correct.
00:19:52.000 So you can get that through exercise, which is one excellent way to do it.
00:19:57.000 And that's part of the high that you get after you exercise.
00:20:01.000 But the other way that you can get it is by using cannabis.
00:20:04.000 So when THC attaches to those CB1 receptors, you can get a release of anandamide.
00:20:09.000 And cannabidiol can actually increase anandamide by another mechanism of action as well.
00:20:16.000 So, you know, there's different ways where we can, you know, raise a level of deficiency.
00:20:21.000 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,
00:20:38.000 right?
00:20:39.000 I've been working for over five years just with cannabis.
00:20:44.000 I mean, I do other medicines.
00:20:45.000 I prescribe other medicines as well, but I've been doing cannabis medicine for over five years.
00:20:50.000 And there's a lot that I've learned, right?
00:20:52.000 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.
00:21:07.000 And the things that my patients tell me is that THC is really effective for their sleep at night.
00:21:13.000 And a lot of my patients, especially my veteran patients, have done really, really well with that.
00:21:18.000 And just one further point, too.
00:21:21.000 I know it was in 2015, I believe it was.
00:21:23.000 There was a meta-analysis done.
00:21:25.000 I can pull it up if we need to.
00:21:27.000 That indicated that a lot of the medicines that are being used now for PTSD are just simply ineffective.
00:21:33.000 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.
00:21:45.000 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.
00:21:57.000 It doesn't matter whether it's a vitamin, whether it's a hormone.
00:21:59.000 As long as you are correcting a deficiency, you're generally going to get excellent clinical results.
00:22:05.000 Right.
00:22:05.000 So let me sort of try to frame this a different way.
00:22:09.000 Alcohol reduces blood pressure.
00:22:12.000 Alcohol generally tends to reduce cardiovascular events for people.
00:22:18.000 And during prohibition, you could actually get a doctor's note for alcohol as a medicine.
00:22:23.000 But alcohol is not a medicine.
00:22:25.000 It's a recreational intoxicant.
00:22:26.000 It has some positive biological qualities and some negative biological qualities.
00:22:31.000 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?
00:22:39.000 And I think for the most part, the medical profession has come down on the side of saying, let's not do that.
00:22:44.000 There's too many non-cardiac negative side effects with alcohol.
00:22:49.000 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.
00:22:58.000 So, you know, basically two a day for men, one and a half for women.
00:23:01.000 So you're saying, okay, like, we don't see huge negative consequences at that level.
00:23:07.000 Okay.
00:23:09.000 That's fine.
00:23:10.000 That's a totally reasonable way to think about alcohol.
00:23:13.000 But what we're not saying to people is, this is a medicine.
00:23:16.000 And I think that's where the confusion really around high THC cannabis lies.
00:23:21.000 And again, I don't mean to say that your friend's child is not benefiting.
00:23:26.000 If you say he or she's benefiting, I believe you.
00:23:30.000 What I'm saying is that that's not good enough for science.
00:23:33.000 We need randomized controlled trials.
00:23:35.000 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.
00:23:44.000 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.
00:23:57.000 Probably for the same reasons that alcohol works as a pain reliever.
00:24:00.000 It dulls your awareness of your pain.
00:24:03.000 But even in that study, or even in those studies, they're mostly done against placebo, not against opioids or against NSAIDs like ibuprofen.
00:24:14.000 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.
00:24:33.000 So we're almost arguing about what medicine is.
00:24:36.000 Yeah, that study, though, had a lot of flaws in it.
00:24:40.000 And the other thing is that you need to look at someone who is already using cannabis versus someone who is just using opioids.
00:24:47.000 So if someone is just using opioids and they want to come off cannabis, you know, there's multiple...
00:24:53.000 Come off opiates?
00:24:54.000 Sorry, come off of opiates with cannabis.
00:24:56.000 You know, multiple studies have shown that that can be effective.
00:25:00.000 And that's not what was done in the Australian study that you're referring to.
00:25:03.000 Right, it's a more naturalistic approach.
00:25:06.000 And also, too, they didn't have access to medical marijuana during that whole time.
00:25:13.000 Those are all self-reported, and they were getting it from recreational sources.
00:25:19.000 That's a big distinction, though, Alex.
00:25:21.000 They weren't getting it from a doctor who prescribed it to them.
00:25:25.000 This was a self-reported study, and people were getting cannabis that they didn't really know what they were getting.
00:25:31.000 It wasn't They weren't given any information from a doctor.
00:25:34.000 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.
00:25:43.000 And when you take a certain amount every single day, it can reduce your symptoms.
00:25:46.000 And sometimes you need to increase that, and sometimes you need to decrease that.
00:25:50.000 We do that with all medicines.
00:25:51.000 We should be really clear about the distinction, though, between CBD and marijuana.
00:25:55.000 I mean, we're really talking about the psychoactive version of it, and this is where you're saying it's negative.
00:26:00.000 You're not really arguing that CBD is negative.
00:26:03.000 And I think, you know, Dr. Hart is talking about...
00:26:05.000 He's talking about using this as a medicine, certainly using the CBD. He's titrating his patients.
00:26:10.000 He's monitoring them.
00:26:11.000 He's not writing them an authorization and saying, come back in a year when it's up.
00:26:16.000 He's being a physician.
00:26:18.000 And, you know, and I think...
00:26:20.000 To the extent that marijuana is medicine, we want people like him...
00:26:23.000 So you admit it's medicine?
00:26:25.000 No, no, no.
00:26:25.000 I don't admit that.
00:26:26.000 But you just said that.
00:26:28.000 I don't think I just said that.
00:26:32.000 I think I said to the extent, I'm trying to meet you halfway, but I'll stop doing that.
00:26:37.000 But, you know, I think you said something else that was really interesting to me, and this came up in the book, too.
00:26:42.000 So you're a clinician.
00:26:43.000 You see sick people.
00:26:45.000 And, you know, it's funny, my wife's a doctor, too.
00:26:47.000 She's a psychiatrist. 0.63
00:26:48.000 That's how I sort of got in this.
00:26:49.000 But my wife is a forensic psychiatrist less than a clinician these days. 0.94
00:26:53.000 Her job is to evaluate people, not so much to treat people.
00:26:56.000 Your job is to treat people.
00:26:58.000 You see sick people.
00:26:59.000 You want to help them feel better.
00:27:02.000 And you don't want to tell them, there's nothing I can do for you.
00:27:05.000 There's no hope for your pain.
00:27:06.000 There's no hope for your PTSD. You want to help them.
00:27:09.000 And I totally get that.
00:27:11.000 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.
00:27:22.000 So you need to step back.
00:27:23.000 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.
00:27:35.000 Yeah, and we need to be, you know, careful about that, right?
00:27:38.000 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?
00:27:48.000 But, you know, Ziva Cooper, you know, she's a member of that committee.
00:27:51.000 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.
00:28:06.000 Hold on, let me finish.
00:28:06.000 No, no, I'm just trying to give people context of where it came from.
00:28:08.000 Right, but this is someone you cited, right?
00:28:11.000 No, I didn't cite her, I cited the report.
00:28:12.000 Okay, you cited the report, and she's a member of that, okay?
00:28:17.000 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.
00:28:29.000 Then, the Drug Alliance policy also said the report did not reach that conclusion.
00:28:35.000 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?
00:28:45.000 And then also, they're saying that you left a lot out, right?
00:28:48.000 They said that They have found an association between marijuana use and improved cognitive outcomes in individuals with psychotic disorders.
00:28:56.000 That's straight from the same report.
00:28:58.000 And you failed to mention that.
00:29:01.000 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...
00:29:09.000 Select the small amount of material that's just going to support your study.
00:29:14.000 We want to be truthful here.
00:29:17.000 Joe's show has always been very truthful.
00:29:19.000 I mean, Joe said right at the beginning, he doesn't think that cannabis is perfect for everyone.
00:29:24.000 And I don't think that either.
00:29:26.000 And in Canada, we have really strict guidelines to follow.
00:29:30.000 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.
00:29:41.000 Like, the doctors don't really have much of a backlash about that.
00:29:46.000 Why is the distinction the age of 25?
00:29:48.000 Why do they decide that age?
00:29:49.000 So, 25 basically is when your brain is fully developed.
00:29:55.000 And when you do look at the studies that do show an association between cannabis and psychosis, it's almost all in adolescence.
00:30:04.000 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.
00:30:17.000 So, you know, 25 is a good age, but it's definitely a, you know, kind of a conservative-ish age.
00:30:26.000 But, you know, it's something that we follow, and I think that, you know, we've done well with that in Canada.
00:30:30.000 So, Alex, why did you leave those conclusions?
00:30:32.000 So, I need to push back here.
00:30:34.000 So the National Academy of Medicine report was drawn up by a committee of 16 researchers.
00:30:42.000 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.
00:30:53.000 What I wrote in that New York Times op-ed, what I wrote in the book, is the plain language of the report.
00:31:00.000 And the plain language is this.
00:31:02.000 Cannabis use is associated with a risk of developing schizophrenia and other psychoses.
00:31:08.000 The higher the use, the greater the risk.
00:31:10.000 I may have a word or two wrong in that because I'm doing it from memory, but that's what it said.
00:31:14.000 And by the way, the committee was very clear.
00:31:17.000 They separated depression.
00:31:19.000 They said we don't see nearly as high risk for depression as psychosis.
00:31:24.000 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.
00:31:43.000 This literally was released today.
00:31:45.000 But to go back, Ziva is one of 16 members of that committee.
00:31:49.000 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?
00:31:59.000 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?
00:32:09.000 Maybe we should ask why the other members of the committee are not speaking out against my book.
00:32:15.000 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.
00:32:24.000 Why not?
00:32:25.000 Why not?
00:32:25.000 If I did something wrong, if I misquoted them.
00:32:28.000 Well, some people will and some people won't.
00:32:30.000 Some people have the personality.
00:32:32.000 Some people have the platform.
00:32:34.000 Ziva has a bunch of followers on her Twitter.
00:32:36.000 People know who she is.
00:32:37.000 A lot of people who do research actually are not into social media at all.
00:32:41.000 I don't think you were at all before you had your book, were you?
00:32:45.000 Yeah.
00:32:45.000 I mean, I was a novelist, so I was promoted.
00:32:47.000 Yeah, so you weren't into social media at all.
00:32:49.000 So, you know, I don't think that most people on that committee are into social media.
00:32:54.000 You know, Ziva just happens to be.
00:32:56.000 And, you know, I even spoke to Ziva on the phone about this.
00:32:59.000 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.
00:33:09.000 My conclusions are – Quoted from the report.
00:33:11.000 But you're only quoting the parts that back your opinions.
00:33:20.000 You're not quoting the entire part.
00:33:23.000 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?
00:33:31.000 So you're leaving out that part.
00:33:33.000 So why did you leave that part out?
00:33:35.000 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?
00:33:43.000 Well, my book presents, it makes a case, right?
00:33:46.000 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.
00:33:58.000 I wrote a book that is trying to break through a lot of noise.
00:34:03.000 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?
00:34:22.000 I think that's a really great question.
00:34:24.000 I say in the introduction of the book, this book is not balanced.
00:34:27.000 There's not a lot of evidence in there.
00:34:28.000 If you want to read about how indica and sativa strains are different, you're not going to read that in this book.
00:34:36.000 But I also want to say this.
00:34:38.000 I didn't come at this, and I say this in the introduction of the book, too, as an anti-cannabis crusader. 0.99
00:34:43.000 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.
00:34:50.000 These are the terrible things that people are doing after cannabis use.
00:34:54.000 I sort of said to her, first of all, why do I always have to hear about this at the dinner table?
00:34:59.000 But more importantly, you know, why...
00:35:03.000 Why is it that maybe these people are using other drugs?
00:35:07.000 Maybe you're seeing a slice of the population that's not representative.
00:35:12.000 Why is it that I should believe this?
00:35:13.000 This sounds like reefer madness to me.
00:35:15.000 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.
00:35:23.000 She went to the Memorial University of Newfoundland Medical School.
00:35:26.000 And she went to Harvard and Columbia for her postgraduate training.
00:35:30.000 You know, eventually she got tired of me yapping back at her and she said, why don't you go read the studies yourself?
00:35:35.000 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.
00:35:42.000 Right.
00:35:42.000 But you're still, even in saying that, you're still seeing positive results that you're excluding from your book.
00:35:51.000 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.
00:36:06.000 Maybe, maybe not.
00:36:07.000 Wouldn't that qualify as medicine?
00:36:10.000 No, it wouldn't be approved as medicine if it's causing them to have other psychotic episodes.
00:36:14.000 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?
00:36:24.000 No.
00:36:24.000 No, again, you need to think about how the FDA is looking at medicine.
00:36:27.000 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.
00:36:35.000 If it is improving your IQ to points on a test, I'm not saying it is.
00:36:39.000 Is that all it is?
00:36:40.000 I think we'd have to look it up.
00:36:42.000 I'd have to look at that.
00:36:43.000 I'm not sure what the exact outcomes are.
00:36:45.000 But at the same time, it's making you florally...
00:36:48.000 No, no, it's true. 0.62
00:36:49.000 But at the same time, it's making you floridly psychotic.
00:36:52.000 That's not medicine.
00:36:53.000 Well, it's not necessarily at the same time.
00:36:54.000 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...
00:37:04.000 Was that it's the exact same number that you find the general population.
00:37:08.000 Essentially 1% of the general population has schizophrenia, which is 1 out of 100 people.
00:37:13.000 And when you have marijuana users, you see essentially that same number mirrored, and so they're saying a small number of people...
00:37:20.000 That's not true, Joe.
00:37:21.000 Hold on, but let me get...
00:37:23.000 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.
00:37:32.000 They were disputing this in this study because the same number is mirrored in the general population.
00:37:38.000 Again, correlation does not equal causation, right?
00:37:40.000 Dr. Hart, I think you've got to tell them that's not true.
00:37:43.000 Tell me.
00:37:43.000 Tell me what that means.
00:37:44.000 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.
00:37:52.000 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%.
00:38:02.000 Globally, they say it's 0.33% to 0.75%.
00:38:06.000 So, right there, it's apparently lower in the US. And the US has the highest percentage of cannabis consumption in the world.
00:38:15.000 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,
00:38:35.000 schizophrenia rates have remained the same.
00:38:37.000 So I have to push back really hard on this.
00:38:38.000 This is one of the great myths of legalization.
00:38:42.000 No one knows what the schizophrenia or psychosis rate is in the US. Suddenly,
00:39:02.000 changed its estimate for the percentage of people with schizophrenia in the US from 1.1% to 0.3%.
00:39:08.000 They did it with no public notice, and then this researcher said, hey, this is a miracle.
00:39:13.000 They just cured 2 million people with schizophrenia.
00:39:15.000 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.
00:39:22.000 Nobody knows.
00:39:23.000 Nobody knows if the rate is increasing.
00:39:25.000 Nobody knows if it's decreasing.
00:39:26.000 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.
00:39:42.000 And in Denmark and Finland, Which are the two places where they've actually done this research in the last 20 years.
00:39:49.000 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.
00:39:59.000 So the people who are saying that there's no evidence of population-wide increases in psychosis are just wrong.
00:40:05.000 But isn't it possible that there's other factors?
00:40:07.000 Absolutely.
00:40:08.000 I mean, environmental factors, there's a bunch of other different things that you can consider.
00:40:11.000 Let me be clear on this.
00:40:12.000 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.
00:40:26.000 So we don't have the evidence to say there's a definite increase.
00:40:29.000 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.
00:40:39.000 We just don't know.
00:40:40.000 Let me ask you this.
00:40:40.000 There has been proven that there's an increase in marijuana use.
00:40:44.000 Is that correct?
00:40:44.000 Yes.
00:40:44.000 Absolutely.
00:40:45.000 When did the increase begin and what percentage is that increase?
00:40:50.000 So there was a...
00:40:52.000 Increase in the 90s, an increase in use and in potency.
00:40:55.000 Use sort of bottomed out around 1991. And then there was sort of a flat...
00:41:00.000 Bottomed out?
00:41:01.000 Meaning it hasn't increased since 91 to 2019?
00:41:02.000 No, no, no.
00:41:03.000 It's gone up to 50% since 92, roughly.
00:41:05.000 That's a lot.
00:41:06.000 That's a lot.
00:41:07.000 Wouldn't you expect a corresponding increase in schizophrenia if there was any sort of correlation?
00:41:12.000 Hold on.
00:41:12.000 Let me walk you through.
00:41:13.000 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.
00:41:24.000 And the other thing is that potency in the last 15 years has gone way up.
00:41:28.000 I don't think anybody would dispute that.
00:41:30.000 But has schizophrenia gone up?
00:41:31.000 So what I'm saying to you is we don't know.
00:41:34.000 There is evidence.
00:41:35.000 There is now evidence on a population level basis in those other countries that schizophrenia and psychosis has gone up.
00:41:43.000 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.
00:42:01.000 So for the first time, there's actually evidence of what you're talking about, which is a population-wide increase.
00:42:08.000 Can I get you to clarify?
00:42:11.000 Can you say serious mental health?
00:42:13.000 So serious mental illness, so this was defined, there's a study called the National Survey on Drug Use and Health.
00:42:19.000 It's done every year, covers 70,000 people, federal government funds it.
00:42:22.000 It's sort of the best data source we have on all this stuff.
00:42:26.000 It showed that, and they're not counting cases either.
00:42:30.000 Let me just be as clear as I can on this.
00:42:32.000 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?
00:42:43.000 Were you hospitalized this year for any inpatient psychiatric reason?
00:42:49.000 And if you look at those numbers, in 2008, 3.8% of Americans, 18 to 25, reported at least one symptom.
00:43:02.000 So they were categorized as having serious mental illness that year.
00:43:07.000 In 2017, that number was 7.5%.
00:43:11.000 So that's a doubling.
00:43:13.000 So again, I am not going to say that proves that the increase in cannabis use has caused this population level increase.
00:43:21.000 But something bad has happened.
00:43:23.000 And if you look at kids 12 to 17, interestingly, they, over that time period, didn't have a big increase in cannabis use.
00:43:31.000 In general, teenagers are actually...
00:43:33.000 Are pretty healthy now, although Juul and vaping may be undoing that.
00:43:37.000 And those kids didn't have a population level increase in serious mental illness.
00:43:41.000 Can I stop you for a second there?
00:43:43.000 Because there's other factors.
00:43:44.000 Oh, sure.
00:43:44.000 One of the big ones is Yuval Noah Harati has a great book, 21 Lessons for the 21st Century.
00:43:49.000 I read that.
00:43:50.000 It's great.
00:43:50.000 And one of the things they talk about is the onset of social media.
00:43:54.000 Jonathan Haidt talked about that as well.
00:43:55.000 And the onset of social media is actually more hate than Yuval Harati.
00:44:02.000 But Jonathan Haidt talks about it with young people.
00:44:05.000 I think it's the coddling of the American mind.
00:44:07.000 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,
00:44:27.000 I think, 2000, whenever his book was written.
00:44:30.000 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.
00:44:39.000 So I think that could be considered a far more significant new form of distress to children and young people than even marijuana.
00:44:51.000 I think it does it twofold.
00:44:53.000 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.
00:45:02.000 And people, obviously we've done that, all humans have done that since history began.
00:45:09.000 But now, everything is online.
00:45:12.000 You can compare your life to everyone.
00:45:14.000 And people are doing it all the time.
00:45:15.000 And even worse than that, and we should talk about this too, is that the income gap is getting wider.
00:45:21.000 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.
00:45:30.000 Whereas before, maybe you wouldn't have seen it because it wasn't on social media.
00:45:34.000 But now it's on social media.
00:45:36.000 So you have this huge income gap that just keeps getting bigger and bigger and bigger.
00:45:40.000 And then you have people going on social media and they're comparing themselves.
00:45:43.000 And you're absolutely right, especially in that age population.
00:45:47.000 I mean, people under the age of 30, you know, they're definitely, you know, they're being bullied online.
00:45:53.000 Like I see it every day in my office.
00:45:55.000 Like literally every day people are being bullied online.
00:45:58.000 And that's, you know, something that I never had, you know, to deal with growing up.
00:46:02.000 Yeah.
00:46:02.000 And a lot of kids do have to deal with that.
00:46:06.000 Just one more note, too.
00:46:09.000 Since Colorado has legalized cannabis, this is important for this subject and this topic, they've actually seen marijuana rates decrease.
00:46:19.000 So it's important for people to know that...
00:46:22.000 No, no, no.
00:46:23.000 Are you talking about teen use or overall use?
00:46:26.000 Overall use has gone up.
00:46:27.000 Teen use is flat.
00:46:29.000 Overall use is up.
00:46:30.000 Okay, yeah, I'm talking about teen use.
00:46:32.000 That's the category that we're talking about, under 30. So teen use would classify as part of that category.
00:46:38.000 So in Colorado, we have seen a decrease.
00:46:41.000 Do you think that's because of the lack of, because it's not illegal, it's not as exciting to them?
00:46:47.000 Part of it, for sure.
00:46:49.000 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.
00:47:06.000 That's what people do.
00:47:08.000 I hope that that doesn't change because pot's seen as medicine.
00:47:14.000 I hope that people don't move on to or do something harsher because they don't see pot as cool anymore.
00:47:22.000 Right.
00:47:22.000 There's no stigma attached to it because it's legal?
00:47:24.000 Yeah.
00:47:25.000 So I've got to push back on a couple of things.
00:47:26.000 Okay, please.
00:47:28.000 So everything you say about social media, it sort of intuitively sounds correct, right?
00:47:32.000 The problem is the data doesn't support this at all.
00:47:35.000 The data shows that teenagers, 12 to 17, those kids are healthier than they were 10 or 20 or 30 years ago.
00:47:44.000 They drink less, they smoke less, they have sex later, they have fewer abortions, they are healthier.
00:47:49.000 Okay.
00:47:50.000 And their mental health doesn't seem to have changed that much based on the NSDUH data, okay?
00:47:56.000 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.
00:48:07.000 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.
00:48:19.000 That is the big factor.
00:48:21.000 Hold on a second.
00:48:22.000 More so than cannabis use, and that's a fact.
00:48:24.000 So you're talking about a tiny, tiny number.
00:48:27.000 No, no, it's not a tiny number.
00:48:29.000 It's a 50% increase of people that commit suicide that are young girls.
00:48:33.000 The people who commit suicide in the United States are middle-aged white men.
00:48:36.000 Okay, but you're discounting these young girls that are committing suicide to fit your statistics or to fit your conclusions.
00:48:43.000 No, what I'm saying is that's a tiny, tiny number.
00:48:45.000 But a 50% increase is not a tiny amount.
00:48:48.000 This is something we can look up.
00:48:50.000 Well, let's find out what the numbers are.
00:48:52.000 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.
00:49:02.000 Sure.
00:49:04.000 Why would you push back against that?
00:49:06.000 That seems to be a factor.
00:49:07.000 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.
00:49:16.000 No one's saying they're less healthy.
00:49:17.000 You just said they're more healthy.
00:49:19.000 Yeah, I'm saying they're more healthy.
00:49:20.000 We're saying mental health has nothing to do with cardiovascular fitness.
00:49:25.000 No, no, no.
00:49:25.000 I mean mentally healthy.
00:49:26.000 I mean, they're less likely to use drugs, they're less likely to have sex.
00:49:28.000 But they're more likely to commit suicide.
00:49:30.000 That is a tiny, tiny number.
00:49:33.000 What are you talking about?
00:49:34.000 If it's a 50% increase, that's a huge difference.
00:49:36.000 We should look up the number.
00:49:39.000 Look, Jonathan Haidt's work is very well respected.
00:49:43.000 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.
00:49:52.000 And those are the people who are most likely to be using cannabis right now.
00:49:56.000 Those are the people that are most likely on social media as well.
00:49:58.000 Sure.
00:49:58.000 And that's a stressful period of your life.
00:50:00.000 But I don't understand.
00:50:01.000 Like, 12 to 17, you're usually living at home.
00:50:03.000 Like, 18 to 25, then you've got to go to university.
00:50:06.000 You've got to deal with all these courses and stuff.
00:50:08.000 I'm willing to concede.
00:50:08.000 I'm willing to concede.
00:50:08.000 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.
00:50:14.000 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.
00:50:25.000 I would totally agree with that.
00:50:26.000 But I don't think that you can say, based on the population-level data, that the impact is all negative.
00:50:31.000 It may be...
00:50:33.000 Who's saying that the impact is all negative?
00:50:34.000 What we're saying is a 50% increase in suicide with young girls.
00:50:38.000 That's huge.
00:50:38.000 Let me give you an example.
00:50:40.000 When you were 15, or I was 15, maybe you got really drunk and wound up in a bathtub.
00:50:46.000 Maybe kids today are less likely to do that because of social media because they know it's going to be on Instagram forever.
00:50:52.000 I don't think that's true.
00:50:53.000 I don't think that's proven.
00:50:54.000 I don't think there's anything that would point to that.
00:50:57.000 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.
00:51:07.000 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.
00:51:16.000 They're less likely to have sex when they're 14, which I think most people say is a good thing.
00:51:20.000 They're less likely to be drinking.
00:51:22.000 They're less likely to be smoking.
00:51:23.000 Those are good things.
00:51:25.000 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.
00:51:33.000 Well, yes, I agree.
00:51:35.000 Let's look at the numbers.
00:51:37.000 But depression and suicide are very difficult things to measure, right?
00:51:41.000 Well, suicide is actually pretty easy to measure.
00:51:44.000 It's a hard number.
00:51:45.000 Depression is more complicated.
00:51:49.000 The bottom number is in females.
00:51:51.000 So, okay, I mean, this is what I'm saying.
00:51:53.000 The death rate, first of all, this is, okay, the death rate for girls age 15 to 19 is 4 per 100,000, Joe.
00:52:01.000 It's at a 40-year high.
00:52:03.000 Right.
00:52:04.000 So, I mean, you'd be hard put to say that's a huge spike.
00:52:07.000 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. 0.97
00:52:17.000 Right.
00:52:19.000 Yeah, I don't know what the actual facts are.
00:52:21.000 I'm looking at this right now.
00:52:22.000 Suicide rates for teens, 15 to 19 years old.
00:52:25.000 This is something that we'd have to study to have this discussion.
00:52:28.000 We've got a giant spike for boys in the 1990s. 0.98
00:52:31.000 What the fuck is that about? 0.96
00:52:32.000 95. An enormous spike. 0.99
00:52:34.000 What I'm telling you is if you put middle-aged men on this chart, you'd have to blow out the ceiling. 0.98
00:52:39.000 The suicide crisis is unfortunately a crisis of age.
00:52:43.000 Okay, I would agree with that.
00:52:45.000 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.
00:52:52.000 Yeah.
00:52:52.000 Yeah, and especially if they lose their jobs.
00:52:54.000 But what Jonathan Haidt is pointing to is a direct correlation between social media use, depression, and suicide amongst young girls.
00:53:02.000 Thank you for finding it.
00:53:03.000 What is it?
00:53:04.000 This is the article it's from.
00:53:07.000 Suicide rate for teen girls, the highest it's been in 40 years is social media to blame.
00:53:10.000 Right.
00:53:12.000 Okay.
00:53:14.000 New data released Thursday by the Atlanta-based Centers for Disease Control and Prevention.
00:53:19.000 Suicide rates amongst 15 to 19-year-old girls doubled between 2007 and 2015, reaching a 40-year high.
00:53:26.000 I would say that's significant.
00:53:27.000 Again, and it's obviously a terrible thing when anybody commits suicide, but we're talking about two per 100,000.
00:53:33.000 I understand.
00:53:33.000 Actually, it's five.
00:53:35.000 Well, it went from two to four.
00:53:36.000 Okay, that means for every 100,000 American girls in 2015, five committed suicide.
00:53:41.000 That's not a very high number, but I mean, that's also someone who's pushed to the extreme of taking their life.
00:53:47.000 How many girls are experiencing severe depression but don't commit suicide? 0.88
00:53:52.000 That's the real factor, because this is what hate directly connects to social media.
00:53:58.000 Again, the 50% increase, you're talking about a relatively small number because not as many girls commit suicide as men.
00:54:04.000 But still, you were talking about depression, and you were talking about these significant factors that would lead people to have poor mental health.
00:54:14.000 This could be a huge factor in this, right?
00:54:17.000 And I think that, too, it leads people to suicidal ideations and depression and anxiety.
00:54:22.000 I mean, right here we're just looking at suicide, which is the worst endpoint possible.
00:54:27.000 Which is very rare amongst girls, period.
00:54:30.000 Yes, absolutely.
00:54:30.000 Or less common, I should say.
00:54:32.000 It is, yes.
00:54:33.000 Men do commit suicide more than women do. 1.00
00:54:36.000 But we really have to be careful about that because, again, suicide is the end.
00:54:42.000 It's the worst thing that could possibly happen.
00:54:44.000 So what about all the things leading up to it?
00:54:48.000 Are there people who don't commit suicide but suffer from terrible depression, suffer from terrible anxiety, suffer from terrible insomnia?
00:54:56.000 Those people are not accounted for in that graph.
00:55:00.000 I agree.
00:55:01.000 And what I'm saying is that cannabis use has spiked in the United States in the last 15 years.
00:55:07.000 And teens notwithstanding, we've seen a large degradation in a number of these social outcomes.
00:55:13.000 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.
00:55:31.000 What's that?
00:55:32.000 It could possibly be a factor.
00:55:33.000 Sure.
00:55:33.000 Yes, but it might also be that these kids are depressed because of social media and they're using cannabis.
00:55:39.000 Or they're depressed because their friends died from opioid overdose.
00:55:42.000 There's a lot of potential.
00:55:43.000 There's a lot of factors.
00:55:44.000 You know, we are conceding the fact that, you know, you just said again that study was done on adolescence.
00:55:50.000 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.
00:56:00.000 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.
00:56:10.000 But I think that we should be prescribing CBD to these kids.
00:56:14.000 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,
00:56:30.000 selective serotonin reuptake inhibitors, You know, which are the most commonly prescribed medication for depression and anxiety, even in adolescence.
00:56:37.000 We know that they can increase suicidal ideation.
00:56:42.000 That's been shown.
00:56:42.000 I mean, it's written right on the package.
00:56:45.000 So again, as a clinician, you have to treat your patients.
00:56:50.000 If you're just...
00:56:52.000 Treating people with something that's not effective or that has horrible side effects, you're going to look at other alternative treatments.
00:57:00.000 A lot of people have had excellent results with CBD in that age category.
00:57:07.000 I've had it done in my practice and lots of other physicians have had it done in their practice.
00:57:13.000 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...
00:57:20.000 THC in adolescence.
00:57:23.000 That's where Joe and I both can see that THC is not a good medicine.
00:57:30.000 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.
00:57:41.000 We need all the treatments for depression and boy do we need treatments for psychosis that we can get.
00:57:48.000 I totally agree with that.
00:57:49.000 And I'm really glad to hear you say you don't think that adolescents should be using high potency or any hard drugs.
00:57:56.000 Especially alcohol.
00:57:57.000 No, and they should try to also stay away from the other medications.
00:58:02.000 So I want to push back on this, on the alcohol versus cannabis for teens thing.
00:58:06.000 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.
00:58:21.000 I totally disagree with that.
00:58:23.000 Cannabis, alcohol...
00:58:24.000 But no one's saying that.
00:58:25.000 I'm just saying alcohol is bad too.
00:58:27.000 We agree.
00:58:28.000 But you have heard this, right?
00:58:30.000 Oh, I'd rather have my kid smoking pot. 0.99
00:58:32.000 My 16-year-old, I think that's crazy.
00:58:34.000 I think you have to really be careful with anything that severely perturbs your sense of reality.
00:58:41.000 When you're a young kid and you're trying to form your vision of the world.
00:58:46.000 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.
00:59:02.000 What we guarantee, almost universally, is these kids are on social media.
00:59:09.000 I think much more likely that they're on social media than use cannabis.
00:59:14.000 I think a lot of them use cannabis.
00:59:15.000 I don't think all of them do.
00:59:17.000 I think all of them are on social media.
00:59:19.000 Absolutely.
00:59:20.000 I think that almost every single kid these days has a cell phone and they have some type of social media account.
00:59:28.000 I'm worried about kids using everything.
00:59:30.000 I'm worried about them using Valium.
00:59:33.000 I'm worried about them using Xanax.
00:59:35.000 They get prescribed benzos.
00:59:36.000 Yes.
00:59:36.000 I'm worried about them using Adderall.
00:59:39.000 Yes.
00:59:40.000 Prozac.
00:59:40.000 I think psychiatrists give out ADD medicine more.
00:59:44.000 Yes.
00:59:44.000 Much too frequently.
00:59:45.000 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. 1.00
00:59:56.000 I know so many people that are on that shit. 0.99
00:59:59.000 I know so many people, whether they're journalists, I know comedians, I know a lot of fucking people who are on Adderall. 1.00
01:00:07.000 And you need to develop that toughness when you're young. 0.99
01:00:10.000 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.
01:00:19.000 That's terrible, right?
01:00:20.000 That's a terrible coping mechanism.
01:00:23.000 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.
01:00:36.000 And that's said to people all the time.
01:00:38.000 They say, oh, you have a biochemical deficiency and this is what you need.
01:00:42.000 We need kids to be tougher, right?
01:00:44.000 So you need them to build up some resiliency so that when they do go through hard times, they have better coping mechanisms.
01:00:52.000 Like Joe talks about diet and exercise all the time.
01:00:54.000 I talk about diet and exercise all the time.
01:00:57.000 Well, clearly you guys live it.
01:00:58.000 And that's kind of how I got my start on social media, is through diet and exercise.
01:01:02.000 Yeah, I think exercise is a big one for young kids.
01:01:05.000 I mean, it was a gigantic factor for me, personally.
01:01:08.000 When I was 15 years old, I really got into martial arts, and it changed my life.
01:01:11.000 It changed my life by alleviating so much anxiety, giving me so much more relaxation.
01:01:15.000 My parents talk about it.
01:01:16.000 They're like, there's two yous. 0.56
01:01:18.000 There's you before martial arts, and there's you after martial arts.
01:01:21.000 But you have relatively young kids, I know.
01:01:23.000 And so do I. And boy, they love the devices.
01:01:26.000 I mean, we have to fight.
01:01:28.000 And our kids, fortunately, they're three and six at this point.
01:01:31.000 They don't have their own iPad or iPhone or any of that stuff.
01:01:33.000 But you give it to them for five minutes.
01:01:37.000 It's like crack.
01:01:38.000 It's like you've got to tear it out of their hands.
01:01:39.000 Oh, yeah, my kid will just turn their shoulder when I try to get the iPad from her. 1.00
01:01:43.000 They're like, no, no, no, one more, one more.
01:01:45.000 It's crazy.
01:01:47.000 It's very fun and exciting for them.
01:01:49.000 And look, it's not entirely negative.
01:01:52.000 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.
01:02:00.000 It's a massive alleviator of physical stress because they're constantly got to follow this thing, and it's an exercise routine.
01:02:09.000 I mean, their cardiovascular rate gets up, and they really feel good afterwards.
01:02:15.000 So it's not entirely negative, but it's mostly negative.
01:02:19.000 Yeah, but if you have, I don't know, is it Nintendo Wii or whatever it is?
01:02:24.000 Yeah, you can do some exercises.
01:02:25.000 It's an Xbox with this little thing that scans it, or you actually can use your phone.
01:02:29.000 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.
01:02:39.000 It's very weird.
01:02:40.000 So, like, you mimic this thing that the person on the screen is doing.
01:02:45.000 But, I mean, that's one thing that could be considered positive. 0.96
01:02:50.000 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. 0.98
01:02:59.000 They push buttons on each other because they know that they can. 0.92
01:03:02.000 But do you think that's always been part of high school?
01:03:04.000 Don't you?
01:03:05.000 It has, but you would get free from it when you went home.
01:03:08.000 You're not free from it ever now. 0.99
01:03:10.000 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. 0.99
01:03:21.000 This is what they're dealing with. 1.00
01:03:23.000 You know, look at her with her fat face, LOL. And then this little 12-year-old is like, oh! 0.99
01:03:28.000 That's a severe, severe factor that no one had to consider before.
01:03:34.000 And it makes you almost not want to go to school.
01:03:36.000 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.
01:03:41.000 I see it in my office all the time.
01:03:43.000 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.
01:03:49.000 Like, that's something that, you know, my generation never, ever had to face.
01:03:53.000 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.
01:03:59.000 Right, but we're talking about a factor that could be considered as big, if not bigger, than marijuana.
01:04:03.000 But social media does not cause people to get psychotic.
01:04:06.000 Okay.
01:04:06.000 I don't know about that.
01:04:08.000 Well, I don't listen, this is why I don't know about that.
01:04:10.000 Severe anxiety, lack of sleep, depression, absolutely are correlated with altercations on social media.
01:04:19.000 Sure.
01:04:19.000 Sure, but...
01:04:20.000 Social interactions that are severely negative.
01:04:23.000 They're correlated with poor mental health.
01:04:25.000 The good news is the brain is a relatively strong and powerful organ.
01:04:29.000 For some people.
01:04:29.000 And if you look at sort of worldwide...
01:04:31.000 It's not for everybody.
01:04:33.000 Some people are in a really bad situation, right?
01:04:35.000 If you look at worldwide levels of psychosis, okay?
01:04:37.000 Again, it's less than 1% for schizophrenia, which is the most severe version.
01:04:41.000 You add bipolar disorder with psychosis, depressive psychosis, other kinds of psychosis.
01:04:45.000 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.
01:04:54.000 So, okay, on the one hand, that's a lot of people.
01:04:56.000 On the other hand, most people are not going to get psychotic.
01:04:59.000 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.
01:05:10.000 I mean, people can get psychotic.
01:05:12.000 They can get a brain tumor that can make them psychotic.
01:05:14.000 They can, you know, late in life, they can get dementia that makes them psychotic.
01:05:17.000 There's oftentimes a pretty clear organic cause, okay?
01:05:21.000 So, when we're talking...
01:05:23.000 The brain is a relatively strong and healthy organ, and it takes a lot to break it.
01:05:29.000 And that's why...
01:05:30.000 Boy, that's a bold statement.
01:05:32.000 It is a bold statement, but again...
01:05:33.000 I would not agree with that at all.
01:05:35.000 Really, you think?
01:05:36.000 No.
01:05:37.000 Okay.
01:05:38.000 I'm not saying that people don't get depressed or anxious.
01:05:41.000 It takes a lot to break.
01:05:41.000 People are depressed all over the place.
01:05:43.000 Depressed, yes.
01:05:43.000 I'm talking about the kind of...
01:05:45.000 Do you know that fucking antipsychotic medication was the number one prescribed medication in the country? 0.99
01:05:50.000 It's crazy. 0.99
01:05:50.000 People used to say, oh, I'm on antidepressants, I'm on anti-anxiety medication. 0.99
01:05:56.000 Now people, I hear them at parties and stuff saying, oh, I'm on Seroquel.
01:06:00.000 I'm just thinking, did that person just tell a bunch of people that they're on antipsychotic?
01:06:05.000 It's weird that people don't know that Seroquel and Atombilify are antipsychotics, right?
01:06:08.000 Because they've been sort of marketed as outside the class when in reality they're part of the class.
01:06:12.000 But I got to push back on you a little bit.
01:06:15.000 Sales numbers for those drugs, those are expensive drugs.
01:06:18.000 They're not the most prescribed drugs in the country.
01:06:20.000 Hold on.
01:06:21.000 Abilify was the most prescribed drug in the United States.
01:06:24.000 We should look that up.
01:06:25.000 No, we have looked that up.
01:06:26.000 We've talked about it on the podcast because it's insane.
01:06:28.000 That is insane.
01:06:29.000 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.
01:06:36.000 Because we can tease out a few things by looking at genetics.
01:06:40.000 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.
01:06:47.000 It's the 14th most prescribed brand name medication.
01:06:51.000 So it's 14th. 1.00
01:06:52.000 But fucking, that's crazy. 1.00
01:06:53.000 Right, I agree. 0.99
01:06:54.000 Out of all the people with actual diseases, this is the 14th most prescribed brand name medication that retails for about $30 a pill.
01:07:01.000 Well, Dr. Hart can probably tell you, this is getting prescribed as an add-on antidepressant for some people.
01:07:05.000 What that means, though, too, is that people are struggling, man.
01:07:09.000 Like, life is hard for a lot of people.
01:07:12.000 Like, very hard, Alex.
01:07:14.000 Very difficult, okay?
01:07:16.000 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.
01:07:24.000 Cannabis, especially the CBD component, and also the THC component, when used properly, is okay.
01:07:32.000 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.
01:07:49.000 Let's back off on prostitution, bro. 1.00
01:07:52.000 If you're doing all that, then you're doing pretty good overall, right?
01:07:56.000 Some gambling's not bad, bro.
01:07:58.000 A little bit of gambling.
01:07:59.000 You want to bet on some fights, you know what's good.
01:08:02.000 Absolutely.
01:08:03.000 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.
01:08:12.000 I 100% agree.
01:08:14.000 Look, man, you know what's one thing that's benefited me with social media is my eyesight is going.
01:08:18.000 As I've gotten older, I can't even read my Twitter feed. 1.00
01:08:21.000 Ah, fuck these people. 1.00
01:08:22.000 I don't read it. 1.00
01:08:23.000 If I don't put my glasses on, I don't know what the fuck they're saying. 1.00
01:08:25.000 Oh, my God. 0.99
01:08:26.000 So good.
01:08:28.000 But I'm not saying people don't get depressed and get anxious.
01:08:32.000 I'm saying psychosis is a different thing.
01:08:34.000 Yes.
01:08:35.000 I think we are, though, discussing overall mental health.
01:08:39.000 Yes.
01:08:40.000 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.
01:08:48.000 I'll take a quick bathroom break.
01:08:50.000 Yeah, please go.
01:08:50.000 I don't think marijuana is as safe as I used to think it is.
01:08:53.000 I used to think it was benign.
01:08:54.000 I really used to think there was no big deal. 0.96
01:08:56.000 But I have a friend that I discussed the other day who is a really confident, fucking muscular, handsome man that never did anything. 0.98
01:09:04.000 And he took a marijuana edible to go to sleep. 0.96
01:09:07.000 And for two weeks, this guy was – this is a different guy, not the guy I was talking about.
01:09:11.000 Oh, it's not the guy?
01:09:11.000 Not Rafi.
01:09:12.000 No, a different guy.
01:09:13.000 He took it and he experienced suicidal thoughts and all these, he had like severe consequences.
01:09:19.000 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.
01:09:32.000 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.
01:09:41.000 Is that alcohol affects most people pretty much the same way?
01:09:45.000 And you sort of know what somebody looks like when they have one drink, when they have five drinks, if they have ten drinks.
01:09:52.000 I've got some friends that get those gerbilized.
01:09:54.000 You ever see when people get shark eyes?
01:09:56.000 They're just gone.
01:09:57.000 Yeah.
01:09:57.000 And then they start talking crazy and like, whoa!
01:10:01.000 But you sort of know that.
01:10:02.000 And you sort of know how long it's going to take to clear your body.
01:10:05.000 Cannabis is so different.
01:10:07.000 It's a really complicated drug.
01:10:09.000 And it does affect different people in different ways.
01:10:11.000 And also the tolerance has changed radically.
01:10:14.000 Yeah.
01:10:14.000 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.
01:10:21.000 But then, if you're a tolerant user, you can use 200 milligrams in a day.
01:10:26.000 That's 80 drinks.
01:10:28.000 It's a weird drug.
01:10:30.000 And then there's the issue of eating it.
01:10:31.000 Yes.
01:10:32.000 When you eat it, your body produces something called 11-hydroxymetabolite.
01:10:36.000 It's far more psychoactive.
01:10:38.000 Yeah, you are all long for the ride when that happens.
01:10:40.000 Yes, you are.
01:10:41.000 Yes, and it can take days for it to get out of your system.
01:10:44.000 I know many people have eaten marijuana edibles, and then they call me up the next day like, dude, I'm still hot.
01:10:48.000 Yeah.
01:10:49.000 Yeah.
01:10:50.000 So I think the legalization community has sort of said for years, like, oh, there's basically no downsides to this.
01:10:58.000 There's only upsides.
01:10:59.000 The cops will bust smokers. 1.00
01:11:01.000 There'll be tax revenue.
01:11:02.000 All these people have a way to get high that's clearly safer than alcohol.
01:11:06.000 And unfortunately, that's just not true.
01:11:08.000 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,
01:11:24.000 cognitive benefits for people with psychotic episodes, and that you're only focusing on the negative.
01:11:29.000 I guess I will plead guilty to that.
01:11:31.000 Because I think that for 20 years people have only heard the positives.
01:11:34.000 Right.
01:11:35.000 I think that's also, I'll plead guilty to that myself because I think that I've only been discussing the positives.
01:11:41.000 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,
01:12:02.000 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.
01:12:11.000 It's very difficult to do.
01:12:13.000 Listen, I wrote a book called Tell Your Children the Truth About Marijuana Mental Illness and Violence. 0.82
01:12:17.000 I don't think you can think that that book is going to be a compendium of the pros and cons of marijuana.
01:12:25.000 Well, if you want to tell your children the truth, though, you really do want to tell them the pros and cons.
01:12:30.000 And you did indicate, Alex, you said we should tell people the truth in the book, right?
01:12:35.000 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...
01:12:46.000 It's a little bit deceiving and deceptive in some ways, right?
01:12:49.000 You want to tell the whole truth.
01:12:51.000 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.
01:12:58.000 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.
01:13:06.000 They're not going to make an informed decision based upon all of the parts.
01:13:10.000 And because of that, people are going to make some very poor choices.
01:13:14.000 I completely agree with that.
01:13:16.000 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.
01:13:26.000 And essentially, there's almost nobody on the other side.
01:13:28.000 There's this one guy, Kevin Sabet, who's gotten killed.
01:13:31.000 What about Jeff Sessions? 1.00
01:13:31.000 I mean, you had the fucking goddamn attorney general who's telling people that good people don't smoke marijuana. 1.00
01:13:36.000 And that's literally a quote that he says. 1.00
01:13:39.000 Thank God that little moron's not in office anymore. 1.00
01:13:42.000 But that's a terrible thing to say. 1.00
01:13:44.000 Good people don't smoke marijuana.
01:13:46.000 There's a lot of wonderful people who smoke marijuana.
01:13:48.000 That's just not true.
01:13:49.000 And by the way, I think this is a personal choice, especially for adults.
01:13:53.000 And you can make bad personal choices.
01:13:56.000 Look, I play cards.
01:13:57.000 I love to play poker.
01:13:59.000 I'm sad that on this trip to LA I didn't get to go to a poker room.
01:14:02.000 But you can go into a casino and you can see people who've lost.
01:14:04.000 You can change your flight.
01:14:09.000 Don't encourage me.
01:14:15.000 But you can go to a casino and see people who've lost their houses.
01:14:18.000 It doesn't mean that gambling should be illegal.
01:14:20.000 It also means that there's less and more dangerous forms.
01:14:23.000 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.
01:14:31.000 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.
01:14:45.000 Agreed.
01:14:45.000 But that's the message that we should be putting out there, right?
01:14:49.000 We shouldn't just be focusing on one side of the story.
01:14:52.000 That part should also be included in the book.
01:14:56.000 And your book, in some ways, has made me rethink the way that I write.
01:15:01.000 Because my first book was co-authored with Jeremy Koston called Friendly Fire.
01:15:06.000 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.
01:15:13.000 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.
01:15:32.000 And, you know, CBD and THC can both help facilitate that process.
01:15:39.000 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.
01:15:48.000 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.
01:15:55.000 When you give them CBD, and this is really important for people to understand, CBD has been shown to decrease learned fear.
01:16:02.000 That's incredible.
01:16:04.000 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.
01:16:15.000 I'm talking to people who it's difficult for them to go to the grocery store, just pick up a few things.
01:16:21.000 Those are the type of people that I see in my practice.
01:16:23.000 CBD is really excellent for that.
01:16:25.000 Then when you look at the nighttime component, THC, again, is excellent for reducing nightmares.
01:16:32.000 That's been shown in studies.
01:16:34.000 And it was even shown with one pharmaceutical drug, Nablon.
01:16:37.000 Again, I don't really...
01:16:38.000 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,
01:16:54.000 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.
01:17:02.000 And that's the same way when you get with the parents of kids who have seizures all day.
01:17:09.000 Nobody wants to see that.
01:17:11.000 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.
01:17:21.000 But, you know, if that ever happened, you know, I would hope that you would consider, you know, CBD as a potential treatment option.
01:17:28.000 Yeah, I think he's not against that.
01:17:30.000 I think we have to be really clear on this distinction.
01:17:32.000 Like, CBD, you're not against CBD at all.
01:17:34.000 And I don't think anybody is.
01:17:35.000 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.
01:17:43.000 The reality is CBD has proven to be...
01:17:46.000 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.
01:17:56.000 Or seizures.
01:17:56.000 Yeah, one of my good friends, his son, has developed seizures and CBD knocked it out.
01:18:01.000 Just killed it entirely.
01:18:03.000 This is very recently.
01:18:04.000 You're somebody who's a cannabis user.
01:18:07.000 You obviously know a lot of users.
01:18:08.000 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?
01:18:20.000 Because they get used to it.
01:18:22.000 Your tolerance develops.
01:18:24.000 It builds up.
01:18:26.000 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.
01:18:37.000 When we do it, it's very interesting how your tolerance is radically reduced. 0.99
01:18:42.000 Like, I'll smoke pot at the end of that month, and I'm like, holy shit! 0.96
01:18:46.000 Like, I don't even know what I'm talking about in the mid-sentence, and I'm just blitzkrieged. 0.98
01:18:50.000 Whereas, you know, now, like, I smoked a little weed last night, did some stand-up, had a great old time.
01:18:55.000 There was no issues with it at all, but I'm used to it.
01:18:57.000 And if the weed that I smoked last night, I assume you don't smoke marijuana.
01:19:01.000 I do not. 0.99
01:19:02.000 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? 0.97
01:19:10.000 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. 0.97
01:19:16.000 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?
01:19:30.000 Oh, Tilly? 0.99
01:19:32.000 When we give Owen, what did he give Owen?
01:19:34.000 Oh, I think just one.
01:19:35.000 He ruined his life.
01:19:36.000 It would have been about $200 to $250 million.
01:19:38.000 Yeah, I've heard that podcast.
01:19:39.000 You're saying like $250 million.
01:19:40.000 The guy opened the door and went out.
01:19:41.000 Joey made a video, but the day changed Owen's life. 0.99
01:19:45.000 Like, literally, he fucked the guy's head up. 0.98
01:19:47.000 Like, he went outside and he vanished. 1.00
01:19:49.000 He's gone.
01:19:52.000 That's cannabis psychosis.
01:19:54.000 Well, I think there's a real argument to be made, particularly with him.
01:19:58.000 Well, I was going to make two points on that.
01:20:01.000 So you definitely can develop a tolerance.
01:20:04.000 And I tell people all the time, try and take at least one three-week break.
01:20:08.000 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.
01:20:17.000 Yeah, that's my experience.
01:20:19.000 And that's even with people who are really, really heavy users.
01:20:23.000 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.
01:20:29.000 So really heavy users.
01:20:31.000 Snoop Dogg's a good example of that.
01:20:33.000 My friend Tony Hitchcliffe is good buddies with Snoop Dogg, and he said Snoop Dogg just smokes all day.
01:20:39.000 And he's just like, he's always high.
01:20:41.000 And you're like, well, what do you do when you're not high?
01:20:44.000 He's like, what?
01:20:44.000 Yeah.
01:20:45.000 He's like, I'm never not high. 1.00
01:20:47.000 So everything he does, he is high as fuck. 1.00
01:20:50.000 Literally everything he does. 1.00
01:20:51.000 For that guy, it's not that big of a deal.
01:20:52.000 And for the way he lives his life, he's just a relaxed, easy-going guy.
01:20:57.000 It's no problem.
01:20:58.000 You can be high all day and live his life.
01:21:00.000 And he's obviously wildly successful with this strategy.
01:21:03.000 Yeah, wildly successful.
01:21:04.000 And the second point I was going to make on that, too, though, was...
01:21:09.000 There does not appear to be any tolerance at the CB2 receptor.
01:21:13.000 So THC attaches to the CB1 receptor, and that's where we know we can get tolerance.
01:21:18.000 Some people, they have some pain, they use some THC, and sometimes they need a little bit more, sometimes asleep.
01:21:25.000 You know, they use THC, it'll work, and then it'll stop working.
01:21:27.000 With CBD, too, we haven't seen that.
01:21:30.000 Meaning, like, the people who, you know, get seizure control, generally, they don't need to increase their dose.
01:21:36.000 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.
01:21:43.000 She's never increased her dose.
01:21:45.000 She's just used the same amount of CBD for the last five years.
01:21:48.000 That's a medicine, right?
01:21:49.000 Like, it works for you.
01:21:51.000 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.
01:22:04.000 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.
01:22:15.000 And it's not always good.
01:22:16.000 That's just a fact.
01:22:17.000 I mean, we were talking about this when you were out, but, you know, so I had an interview.
01:22:23.000 I was that guy.
01:22:24.000 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.
01:22:32.000 She sat down next to me, and I finished the interview, and she said, I couldn't help overhearing.
01:22:37.000 I thought, oh, Jesus, like, she's a pothead, or she's just annoyed that I was doing this. 1.00
01:22:42.000 But no, she said, you know, I was in Seattle last month, This woman was in her early 30s.
01:22:47.000 She was a lawyer, married.
01:22:49.000 She said, and a friend of mine said to me, let's do an edible.
01:22:54.000 She said, we bought a small dose.
01:22:57.000 We asked them for a small dose.
01:22:58.000 I took half of it.
01:22:59.000 So I think she took like five milligrams, if that. 0.85
01:23:02.000 And she said, I got so paranoid.
01:23:05.000 She said, I couldn't sleep all night.
01:23:07.000 Fortunately, my friend took and didn't have any problem and sort of watched over me.
01:23:11.000 But she said, the worst part was it took me weeks, weeks for the anxiety to fade.
01:23:17.000 And I said, do you have a history of mental health problems?
01:23:20.000 And she said, no, I don't.
01:23:21.000 She said, and I'd used, you know, I'd smoked in college.
01:23:26.000 But this was just a totally different experience for her.
01:23:28.000 I think there's a big problem with education.
01:23:30.000 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.
01:23:40.000 Radically different.
01:23:40.000 And it's really a psychedelic.
01:23:43.000 For me, personally, edible marijuana and flotation tanks, I might as well be taking a fucking bucket of acid. 1.00
01:23:51.000 Because it is a crazy goddamn experience. 0.99
01:23:54.000 Now, I personally enjoy being paranoid. 0.99
01:23:57.000 And I know this sounds crazy, but I think with me, it gives me...
01:24:01.000 I think I live a pretty blessed life.
01:24:06.000 And I like the feeling of paranoia because it allows me to explore maybe some areas...
01:24:12.000 Is it a specific paranoia that you have?
01:24:14.000 It's a freak out, man.
01:24:16.000 I think...
01:24:17.000 I have maybe an abundance of confidence.
01:24:20.000 Maybe I have too much.
01:24:22.000 Maybe I'm too successful.
01:24:23.000 What I like about the paranoia that comes with edible marijuana is it allows me to check myself.
01:24:30.000 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.
01:24:41.000 It might knock down the ego just a little tiny bit.
01:24:44.000 Just like the other psychedelics.
01:24:46.000 I think it just, it gives you just a little, it knocks down the ego just a little.
01:24:50.000 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.
01:25:00.000 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.
01:25:09.000 You know, like, that happens to people all the time.
01:25:12.000 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.
01:25:23.000 My patients say to me all the time, it just kind of breaks this negative state that I have.
01:25:29.000 I'm just able to break out of a negative state and think logically.
01:25:34.000 People say that to me all the time.
01:25:36.000 But see, to me, you're talking about something different, and it works for you, right?
01:25:41.000 Your paranoia, it sounds more almost existential.
01:25:45.000 It's, how can I be a better person?
01:25:46.000 What am I doing wrong in my life?
01:25:48.000 It's not, my wife is poisoning me. 0.53
01:25:51.000 No, no, no joke!
01:25:53.000 No joke!
01:25:55.000 Like, this is funny.
01:25:56.000 When you're schizophrenic and you use...
01:25:57.000 Yeah, no, I understand. 1.00
01:25:59.000 Or, you know, or the cops are going to bust through the fucking door and shoot me. 1.00
01:26:03.000 Yes, no, you're right. 1.00
01:26:04.000 Okay, that's a different thing, and that's why...
01:26:06.000 That's a different kind of paranoia.
01:26:07.000 That's why marijuana drives this extreme violence in some people. 1.00
01:26:12.000 Or, those people need to get their fucking shit together. 1.00
01:26:14.000 That's possible, too. 1.00
01:26:15.000 Well, I mean...
01:26:18.000 The aliens aren't really coming, bro.
01:26:20.000 But they may need to be intervened before.
01:26:23.000 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.
01:26:35.000 Yeah.
01:26:36.000 And also, too, I think it's a good point.
01:26:38.000 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?
01:26:51.000 So, you know, I'm involved with a company that's doing that right now.
01:26:55.000 We're trying to create...
01:26:57.000 Cannabis genetic test for people, right?
01:26:59.000 And there's three genes that we've identified so far.
01:27:03.000 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.
01:27:14.000 And then there's two other genes, the AKT1 and the CADM2 genotype.
01:27:19.000 Both of those have also been shown to be associated with cannabis.
01:27:23.000 But again, how many people have them?
01:27:26.000 The MAPK14 is roughly about 8% is what we're seeing.
01:27:30.000 The AKT1 is around 4%.
01:27:32.000 And the CADM2 is around 5%.
01:27:36.000 But you add that up, that's almost 20% of the population.
01:27:39.000 But if we can identify...
01:27:42.000 I love that stuff, Lion's Mane.
01:27:45.000 Yeah, it's great.
01:27:45.000 Yeah, it's wicked.
01:27:47.000 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.
01:28:00.000 And then for the people who do have these genetics, they stick mostly to...
01:28:05.000 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.
01:28:17.000 I think that it should be held to the same standard as any other medicine.
01:28:21.000 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.
01:28:29.000 And, you know, I've been doing that.
01:28:31.000 My company's been doing that.
01:28:33.000 It's called Enant Life.
01:28:34.000 You know, full disclosure, I am on the board, enantlife.com.
01:28:38.000 And, you know, when we use these different strategies, you know, then we can actually reduce the overall harm.
01:28:46.000 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.
01:28:56.000 I mean, there do seem to be some people who just – it breaks really fast, and I'm not sure why.
01:29:02.000 I mean, again, it's probably genetic.
01:29:04.000 Yeah, I think most likely it is.
01:29:06.000 But it's funny.
01:29:06.000 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.
01:29:17.000 But I have to tell you, in the last month since the book came out, I've heard the other side of this.
01:29:22.000 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.
01:29:40.000 And the worst story that I've heard so far came from a woman in Connecticut whose son graduated from Haverford.
01:29:47.000 It's a college in the East.
01:29:49.000 And sounds like a really good guy.
01:29:52.000 He wanted to teach disadvantaged kids.
01:29:55.000 He had a girlfriend who was going to med or was a pre-med trying to go to med school.
01:29:59.000 They moved to New Mexico.
01:30:00.000 And for some reason, the guy decided to start smoking.
01:30:03.000 This was 2012, and within a few months, he'd lost everything, okay?
01:30:07.000 The girlfriend had left.
01:30:09.000 He'd lost his job.
01:30:10.000 He had his first inpatient hospitalization.
01:30:12.000 Now, this is a family with money, okay?
01:30:13.000 This is Connecticut, suburban, and they have spent the last six years trying to save their son, and they have failed.
01:30:22.000 She told me that they've spent more than half a million dollars.
01:30:25.000 He was hospitalized at Harvard.
01:30:27.000 You know, he had the best treatment.
01:30:29.000 None of it's made a difference to him.
01:30:31.000 And what are the symptoms like?
01:30:32.000 So he's completely schizophrenic now, and he's completely paranoid, and he believes, and this is the, so his girlfriend is long gone.
01:30:40.000 Has he tried CBD? That's a good question.
01:30:43.000 I think he's continued to use cannabis.
01:30:45.000 I don't know if he's used CBD. But let me just tell you where he is now, okay?
01:30:50.000 So he's one of these guys who has a really bad delusion.
01:30:53.000 His delusion is that his girlfriend has died and been replaced by a robot. 0.96
01:30:57.000 So that's the kind of delusion that leads you to kill people.
01:30:59.000 And so this guy's been now hospitalized 17 times.
01:31:04.000 He's gone.
01:31:05.000 He's on the streets of Houston.
01:31:07.000 She doesn't know where he is.
01:31:09.000 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.
01:31:13.000 Oh, Beautiful Boy is about— A Beautiful Mind, isn't it?
01:31:16.000 No, no.
01:31:16.000 Beautiful Boy is a book that came out, I think, a couple years ago and got turned into a movie.
01:31:21.000 You should have them on.
01:31:22.000 Nick Sheff and David Sheff, father and son.
01:31:24.000 And the son became a meth addict and essentially almost died.
01:31:32.000 He started smoking cannabis when he was 12, and within a couple of years it had all gone completely downhill for him.
01:31:38.000 I'm surprised.
01:31:39.000 It's a pretty popular book.
01:31:41.000 But anyway...
01:31:41.000 Have you heard of it?
01:31:42.000 No.
01:31:43.000 Jamie?
01:31:44.000 And I've heard the movie, yeah.
01:31:46.000 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.
01:31:57.000 It turns out that that's the second worst thing.
01:31:59.000 The worst thing that can happen is...
01:32:01.000 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.
01:32:12.000 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.
01:32:23.000 This will still be part of my life.
01:32:25.000 But this woman, these parents, They are going to spend their lives trying to destroy the cannabis industry, and that is real. 0.84
01:32:32.000 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.
01:32:43.000 There's no question about that.
01:32:45.000 But I think it's also possible that guy would have gotten schizophrenia anyway.
01:32:48.000 Look, it's possible, but he was sort of at the outer edge of the window, and he had no...
01:32:52.000 Out of the other edge of the window?
01:32:53.000 Meaning it's usually, for boys, it's sort of 17 to 23, 24. Was he showing any issues before at all?
01:32:59.000 No, according to her.
01:33:00.000 I mean, this is from her.
01:33:01.000 So she's the mother, but...
01:33:02.000 Well, I'm sure she'd be the one who knows the most, right?
01:33:05.000 There are people, though, too, who just kind of have a decline with or without cannabis.
01:33:09.000 You do hear of people with schizophrenia.
01:33:11.000 It's just a breakup.
01:33:13.000 They just can't handle life. 1.00
01:33:15.000 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. 0.99
01:33:26.000 They drop out of school. 0.97
01:33:28.000 No one ever hears from them again.
01:33:30.000 They don't get back into school.
01:33:32.000 That's it.
01:33:33.000 That does happen all the time.
01:33:35.000 That speaks to the fragility of the human mind.
01:33:39.000 This is a terrible disease.
01:33:41.000 It's a terrible disease to have.
01:33:42.000 It is.
01:33:43.000 And it affects a certain percentage of the population regardless of cannabis use.
01:33:47.000 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.
01:33:55.000 I don't know if you can necessarily blame cannabis for that.
01:33:59.000 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.
01:34:07.000 So CBD has been shown in early stage studies to have some moderate impact on psychosis.
01:34:13.000 I don't think from the numbers that I've seen suggest it really isn't that strong as an antipsychotic.
01:34:18.000 But I do think that if I were a researcher in schizophrenia, I would be looking at the endocannabinoid system.
01:34:24.000 Yeah, you have to look at this from a clinical perspective.
01:34:29.000 The antipsychotics that we have out there are not good.
01:34:32.000 They have terrible side effects.
01:34:33.000 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.
01:34:42.000 And they have, as you said, really bad side effects.
01:34:45.000 Weight gain, metabolic disturbances.
01:34:47.000 People want to get off of them.
01:34:49.000 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.
01:34:56.000 Because you know that the other tools that you have are not really that effective.
01:35:00.000 So, CBD should definitely be utilized for people who have psychosis and schizophrenia.
01:35:07.000 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.
01:35:19.000 I mean, it's a fact.
01:35:20.000 For some people, psychedelic drugs have tremendous benefits for PTSD, quitting alcohol, quitting hard drugs.
01:35:28.000 There's a lot of people that have used mushrooms, MDMA for PTSD is a huge thing that MAPS is studying right now.
01:35:34.000 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.
01:35:43.000 And never recovered.
01:35:45.000 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?
01:35:57.000 And that's the same way with cannabis, as well.
01:36:00.000 I consider cannabis a psychedelic, particularly when you eat it.
01:36:03.000 Absolutely.
01:36:04.000 It is a mild psychedelic.
01:36:06.000 And so there's risks and benefits to that.
01:36:08.000 And we need to tease out the risks and tease out the benefits and make sure that people are...
01:36:13.000 But Alex, we need to make sure that people are informed and they get the entire picture.
01:36:17.000 Right?
01:36:17.000 So, you know...
01:36:19.000 Does your book have some truth in it?
01:36:21.000 Yes, of course it does.
01:36:22.000 But does it tell the whole truth?
01:36:24.000 Absolutely not, right?
01:36:25.000 And that's the message that I think people should be hearing.
01:36:28.000 People shouldn't be hearing just part of the truth.
01:36:30.000 They should be hearing the whole truth.
01:36:32.000 And again, in your book, you compared Mexico and India, right?
01:36:37.000 And, you know, I talked to German Lopez on the phone about this, you know, who talked to Isaac Campos, right?
01:36:43.000 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.
01:37:02.000 And then there was some evidence as well in India at that time.
01:37:05.000 So Alex kind of made the connection, 9,000 miles apart.
01:37:09.000 They're both saying the same thing.
01:37:11.000 But he said that you did misinterpret the evidence on it, right?
01:37:15.000 And German told me that on the phone.
01:37:18.000 And I mean, all the cannabis that was used in Mexico at that time was in really marginalized environments.
01:37:24.000 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.
01:37:30.000 Sounds like you did.
01:37:31.000 I bought your book, so in some ways I did support you.
01:37:36.000 So I read your book, and like I said, you did address in the part on India that...
01:37:42.000 Yeah, you know, some of the report was wrong.
01:37:46.000 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.
01:37:54.000 And then the other thing in Mexico is that it was in those environments.
01:37:58.000 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...
01:38:06.000 You know, disagree with how you interpreted their findings and then these people disagree with how you interpreted their findings.
01:38:14.000 Okay, but Ziva is only one of the 16 members.
01:38:18.000 I get that.
01:38:18.000 But if we asked other members, I think that they would all say the same thing because Alex, wouldn't you be upset?
01:38:25.000 If someone just quoted one part of your book and then left out all the other parts.
01:38:31.000 I mean, I would think that would be a huge disservice to my work.
01:38:34.000 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...
01:38:43.000 Well, that really depends on what it ignores nuance.
01:38:45.000 Honestly, if I had written the NASEM report, the NAM report...
01:38:49.000 And it came out in 2017 and nobody had paid any attention to it, which nobody did, and nobody did for two years.
01:38:55.000 And suddenly people were paying attention to it.
01:38:57.000 I'd be pretty happy about that.
01:38:58.000 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. 0.99
01:39:06.000 Stupid of me. 0.98
01:39:08.000 I got a copy in my bag. 1.00
01:39:11.000 So this is fascinating to me.
01:39:19.000 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.
01:39:28.000 And they were really initially for soldiers in the Indian army and they were run by British doctors.
01:39:33.000 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.
01:39:44.000 In India it's called ganja.
01:39:45.000 Or bong, which is a very weak preparation of basically Indian hemp, just sort of low-grade cannabis.
01:39:56.000 And so they started counting, and they realized that 20 to 30 percent of the people who were coming to asylums...
01:40:03.000 We're heavy cannabis users.
01:40:25.000 It's like any psychiatrist today, certainly any forensic psychiatrist like my wife, would – like everything in the book would ring completely true.
01:40:34.000 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.
01:40:41.000 So – Could we agree that there are some people where cannabis is not a good idea?
01:40:49.000 Absolutely.
01:40:49.000 Oh, yeah.
01:40:50.000 Right.
01:40:50.000 We could agree that.
01:40:51.000 I think we all agree.
01:40:53.000 We also agree that some people can't eat peanuts.
01:40:56.000 Absolutely.
01:40:57.000 Yeah.
01:40:57.000 Yeah.
01:40:57.000 Right?
01:40:58.000 Yeah, it's not the same thing, though.
01:41:00.000 Yeah.
01:41:00.000 You know why?
01:41:01.000 Peanuts kill you.
01:41:02.000 That's true.
01:41:02.000 Yeah, it's more dangerous.
01:41:04.000 At least like 7,600 a year people die from peanuts.
01:41:07.000 Again, I think more people die from cannabis as a result of the homicide and the suicide.
01:41:11.000 Okay, well there's no correlation that you can prove on paper that...
01:41:15.000 I know!
01:41:15.000 Somebody's got to do the work!
01:41:17.000 Wait a minute, but why are you saying that then?
01:41:19.000 Because I've looked at enough data to tell me...
01:41:21.000 You think marijuana's causing homicides?
01:41:23.000 Oh yeah!
01:41:24.000 This is what the book is about!
01:41:25.000 But how so?
01:41:26.000 Because it causes paranoia and psychosis in people.
01:41:29.000 And paranoia and psychosis are huge risks for homicide.
01:41:32.000 And schizophrenia is a huge risk for homicide.
01:41:33.000 But there's multiple studies that refute that.
01:41:35.000 There are no studies that refute that paranoia and psychosis are huge risks for homicide.
01:41:40.000 Schizophrenia is a 20x.
01:41:42.000 20 times, Joe.
01:41:43.000 Jamie, I sent you a document yesterday.
01:41:47.000 I mean, there's multiple studies that show that marijuana laws are not associated with any type of violence.
01:41:54.000 Okay, but let's forget about marijuana laws. 1.00
01:41:56.000 Let's just talk about marijuana use.
01:41:57.000 The use of the drug, yes.
01:41:58.000 So the use of the drug, which could possibly trigger psychosis and schizophrenia, which are correlated with murder, is that what you're saying?
01:42:06.000 They're not correlated, they're triggers.
01:42:07.000 That's an absolute fact.
01:42:08.000 Triggers. 1.00
01:42:09.000 Because of the paranoia and delusions and you think that someone's out to get you and they're not.
01:42:13.000 Absolutely.
01:42:15.000 What are the numbers?
01:42:16.000 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.
01:42:24.000 Now, it's actually worse than that for cannabis, okay?
01:42:27.000 And here's why.
01:42:28.000 So the National Alliance for Mental Illness and the Mental Illness Advocacy Groups hate talking about this.
01:42:34.000 Why do they hate talking about it?
01:42:35.000 Obviously because it stigmatizes people with mental illness.
01:42:38.000 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...
01:42:47.000 You're not using recreational drugs.
01:42:50.000 Your risk for violence isn't that high.
01:42:52.000 It's not that much higher than a healthy person.
01:42:55.000 Fortunately, healthy people don't commit murder that often.
01:43:00.000 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,
01:43:19.000 it must be spectacularly high.
01:43:22.000 And the numbers bear that out.
01:43:24.000 So there's a really good study from last year, 2018, a small group of patients in Switzerland.
01:43:32.000 Now, Switzerland is a safe country.
01:43:33.000 It's a low base crime rate.
01:43:34.000 But 50% of the people who were using cannabis and had psychosis over a three-year period committed violence in that group of people.
01:43:43.000 That's mostly 20-something men.
01:43:44.000 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.
01:43:57.000 So, you know, it's quite a few studies, okay?
01:44:00.000 So, you know, let me just read part of it out to you.
01:44:04.000 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,
01:44:20.000 recent drug misuse, and a history of drug misuse.
01:44:23.000 It was unclear if there was an association between violence and a history of cannabis misuse.
01:44:30.000 So again, this is 110 studies.
01:44:33.000 They very carefully looked at all of the different risk factors as to what could trigger violence.
01:44:39.000 Just let me finish, Alex.
01:44:40.000 And what they said, again, it was unclear if there was an association between violence and a history of cannabis misuse.
01:44:48.000 So that's 110 studies.
01:44:51.000 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.
01:44:58.000 Polysubstance means multiple substances, alcohol, cannabis.
01:45:01.000 Exactly.
01:45:02.000 But everything else was found to have significant statistical significance.
01:45:07.000 And I have not, I do not know the study that Dr. Hart is talking about.
01:45:10.000 I'd like to look at it.
01:45:12.000 Without looking at it, I can't push back as hard as I would like.
01:45:16.000 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.
01:45:26.000 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.
01:45:50.000 Ibiza.
01:45:51.000 Ibiza?
01:45:52.000 I've been to Ibiza twice.
01:45:53.000 I know, wouldn't you like to be the guy doing it?
01:45:55.000 Are you supposed to say Ibiza?
01:45:56.000 You aren't supposed to say Ibiza.
01:45:59.000 I got grilled over there for that.
01:46:00.000 They get mad at you.
01:46:02.000 I can't believe I just said it.
01:46:04.000 Yeah, some dignitary or royal person had a lisp, right?
01:46:08.000 Isn't that how it all started?
01:46:09.000 Is that true?
01:46:10.000 Yeah, I believe so.
01:46:12.000 Noted.
01:46:12.000 Yeah, the way the people in Spain pronounce words was directly affected by this one person, apparently.
01:46:21.000 So this correlation between people that have schizophrenia and using cannabis, is schizophrenia a diagnosis that's purely based on behavior?
01:46:35.000 Basically, yes.
01:46:37.000 There's no blood test.
01:46:38.000 You can't do a brain scan.
01:46:39.000 It's basically how you behave.
01:46:40.000 And what you tell the doctor about how you're feeling.
01:46:43.000 And what about fMRIs?
01:46:45.000 It's very subjective.
01:46:47.000 Because you're asking someone basically a series of questions.
01:46:50.000 I mean, it's no different than depression, really.
01:46:54.000 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.
01:47:02.000 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.
01:47:13.000 But unfortunately, we just don't have those objective measurements.
01:47:16.000 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.
01:47:25.000 And I understand that.
01:47:27.000 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.
01:47:41.000 People should understand that there's seven different basic human emotions.
01:47:46.000 I've talked about this before.
01:47:47.000 There's anger, there's contempt, there's disgust, there's fear, sadness, surprise, and happiness.
01:47:54.000 That's seven.
01:47:55.000 You know, depending on which way surprise goes, I mean, six out of those seven are negative, right?
01:48:01.000 Because we're wired to basically detect threats.
01:48:04.000 So, you know, when we're making all these diagnoses, I think we have to be careful because...
01:48:10.000 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.
01:48:21.000 People are getting angry about being angry or depressed about being depressed.
01:48:25.000 If you feel one of these emotions, just kind of sit with it and just kind of reflect on it.
01:48:30.000 And I think that's a much, much better way to tease things out.
01:48:35.000 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,
01:48:51.000 By 2040, it's going to be like 50% of people are going to have a mental health disorder.
01:48:55.000 People just need to understand that life is hard.
01:48:58.000 You've got to deal with these emotions sometimes.
01:49:00.000 It's not that big of a deal.
01:49:01.000 For some folks.
01:49:03.000 For some folks.
01:49:03.000 Yeah, for some folks.
01:49:04.000 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.
01:49:10.000 Okay, but let me stop you there because Jordan Peterson was on...
01:49:15.000 That's interesting.
01:49:16.000 Yeah, he was.
01:49:17.000 For a long, long time.
01:49:18.000 I mean, like, for a long, long time.
01:49:20.000 As was his family.
01:49:21.000 And what's crazy about him is what got him off is a carnivore diet.
01:49:25.000 I know.
01:49:25.000 I know.
01:49:26.000 Which is an elimination diet where he only eats meat with salt and drinks water.
01:49:30.000 And he's healthier than he's ever been in his life.
01:49:32.000 And that is another massively controversial subject.
01:49:37.000 So, let me...
01:49:39.000 I want to push back a little bit.
01:49:40.000 Because I think people, you know, as controversial as the book has been about cannabis and psychosis, this violence issue is even more controversial.
01:49:49.000 And obviously for a fair number of people, it doesn't really...
01:49:52.000 It doesn't sync with the stereotype.
01:49:54.000 And it doesn't sync with how they've experienced cannabis use, right?
01:49:57.000 So I think alcohol is a really interesting comparison.
01:50:02.000 Of course.
01:50:04.000 Blame the Canadian. 0.99
01:50:08.000 Why do you have to go national on them?
01:50:10.000 We were talking about...
01:50:11.000 My wife's actually from Newfoundland. 1.00
01:50:14.000 Newfoundland.
01:50:15.000 Newfoundland, as in understand!
01:50:17.000 Marijuana increases...
01:50:17.000 No, Newfoundland is how you say it.
01:50:19.000 You can't say Newfoundland.
01:50:20.000 I've trained myself to say it that way.
01:50:21.000 You're telling me I'm wrong?
01:50:23.000 Look what Jamie just pulled up.
01:50:25.000 Marijuana use increases violent behavior.
01:50:27.000 A 50-year study finds casual link between cannabis and subsequent violent behavior.
01:50:33.000 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.
01:50:48.000 Researchers have long debated a possible link between the use of marijuana and violent crime.
01:50:52.000 In contrast to alcohol, meth, and many other illegal drugs, the mellowing effects of cannabis seemed unsuited to promoting violent behavior.
01:50:59.000 However, ample previous research has linked marijuana use to increased violent behavior.
01:51:05.000 The sticky problem in such studies are that many co-founding factors involved in interpreting this correlation.
01:51:16.000 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,
01:51:35.000 personality traits, or many other variables that are related to the propensity to use marijuana.
01:51:40.000 So I think that's a fairly good summary of the issues.
01:51:44.000 What's up, James?
01:51:45.000 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.
01:51:57.000 So those people are relatively stable if they're two-parent households. 0.99
01:52:02.000 Most parents beat the shit up. 0.99
01:52:04.000 No, it's possible. 0.99
01:52:06.000 So I think the alcohol comparison is, again, a good one.
01:52:10.000 Because anybody who's ever been in a bar at 9 p.m.
01:52:13.000 and gone back at 2 a.m.
01:52:15.000 knows that alcohol disinhibits people.
01:52:17.000 It causes fights.
01:52:18.000 It makes people loud. 0.99
01:52:20.000 It causes a lot of fucking, too. 0.99
01:52:22.000 It does, does, does. 0.99
01:52:23.000 No, it really does, right?
01:52:24.000 It's good and bad.
01:52:26.000 I don't know if that's good.
01:52:27.000 I mean...
01:52:28.000 Sometimes it makes people's life better.
01:52:30.000 Some people think alcohol and sex are a terrible idea.
01:52:33.000 Right?
01:52:33.000 I mean, it certainly causes some sexual violence, too.
01:52:36.000 Sure, yeah, yeah.
01:52:36.000 So, okay.
01:52:37.000 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...
01:52:43.000 A glass of wine with dinner.
01:52:44.000 That's right.
01:52:44.000 And it doesn't mean that you're going to get in a fight.
01:52:47.000 And it actually might enhance your conversation, social lubricant, all that good stuff.
01:52:51.000 All that good stuff.
01:52:52.000 And you might even know people – I mean I do know people who I would say have a problem with drinking.
01:52:56.000 But it's mostly they're sitting at home drinking scotch, watching baseball until they fall asleep that night.
01:53:02.000 Now that's obviously not a healthy way to use alcohol, but it doesn't make them violent.
01:53:06.000 But we know on a population basis that alcohol causes violence.
01:53:11.000 It causes drunk driving.
01:53:12.000 It causes problems.
01:53:14.000 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.
01:53:22.000 Right.
01:53:22.000 So, okay.
01:53:23.000 So this is, again, I would like to read the paper that you're quoting from because I have so much other research.
01:53:28.000 But here's what I'm saying about cannabis, okay?
01:53:32.000 Cannabis for a lot of people, yeah, they can just smoke it.
01:53:34.000 And as people, you know, as many people have tweeted at me, the only thing I attacked was a bowl of nachos, right?
01:53:39.000 And so that's true for some people.
01:53:42.000 But that could be said with alcohol as well.
01:53:44.000 That's exactly.
01:53:44.000 Biological variability.
01:53:45.000 And there's so many studies that say that the cannabis laws have actually decreased crime.
01:53:50.000 No, no, no.
01:53:51.000 No, no.
01:53:51.000 You got to let me finish.
01:53:52.000 You got to let me finish.
01:53:53.000 You got to let me finish.
01:53:54.000 Let's let him finish.
01:53:54.000 Okay.
01:53:55.000 Go ahead, Alex.
01:53:56.000 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.
01:54:08.000 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.
01:54:19.000 It makes a brawl into something where somebody picks up a stick.
01:54:21.000 It makes that into something where somebody pulls out a knife.
01:54:24.000 It escalates.
01:54:25.000 Cannabis is different.
01:54:27.000 Cannabis causes paranoia and psychosis.
01:54:30.000 And it certainly causes those things temporarily, even if it doesn't cause them permanently.
01:54:34.000 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.
01:54:41.000 It's a family member.
01:54:43.000 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, 0.98
01:54:58.000 so I better stab her to death first. 1.00
01:55:01.000 That happens. 1.00
01:55:02.000 It happens a lot.
01:55:04.000 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.
01:55:15.000 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.
01:55:28.000 That's a lot of violent crime.
01:55:30.000 And what I'm saying is that it is quite clear that drug use mediates that violent crime.
01:55:36.000 In other words, if you're not using, you can keep your impulses in check.
01:55:40.000 But when you do use, you become dangerous.
01:55:43.000 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.
01:55:51.000 We're good to go.
01:55:55.000 We're good to go.
01:56:13.000 Like cocaine or meth, exactly.
01:56:15.000 So when you get that, you get paranoia from two sources.
01:56:18.000 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.
01:56:24.000 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.
01:56:40.000 We really don't know, but we do know he did with it.
01:56:42.000 That's correct.
01:56:43.000 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.
01:56:52.000 They really have to be discouraged because it brings out the worst.
01:56:55.000 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.
01:57:06.000 That would have happened anyway.
01:57:07.000 And they're right.
01:57:09.000 You can't prove it.
01:57:09.000 And you can't prove that any one case of psychosis was caused by marijuana.
01:57:14.000 But when you look at the big studies, at the population level data, the association is really clear.
01:57:20.000 And everything points the same way.
01:57:22.000 And the synthetic cannabinoids, K2 and Spice, those can clearly produce psychosis in people.
01:57:27.000 And people with psychosis tend to slip back into it if they use.
01:57:31.000 At some point, you've got to start to say to yourself, why does everything go the same way?
01:57:35.000 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.
01:57:43.000 He became schizophrenic and he's a regular marijuana user and the people around him associated that with that.
01:57:50.000 In fact, people that are regular cannabis users were trying to get him to stop using marijuana.
01:57:55.000 If you're close to being on the edge and you use a little bit of cannabis, for sure it can induce that.
01:58:01.000 This guy was not on the edge when I knew him.
01:58:04.000 Yeah.
01:58:04.000 When I knew him, he was very rational.
01:58:06.000 Very rational.
01:58:07.000 But something happened somewhere along the line.
01:58:09.000 Did he become a pretty heavy smoker over time?
01:58:12.000 I do not know because we don't live in the same area anymore. 0.96
01:58:15.000 But he got really heavily medicated and did some really crazy shit and wound up being hospitalized. 0.79
01:58:23.000 Yeah. 0.67
01:58:23.000 And this was not the case before. 0.67
01:58:25.000 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.
01:58:34.000 He was a heavy marijuana user.
01:58:36.000 Heavy.
01:58:37.000 Heavy.
01:58:37.000 I don't know how he's doing now.
01:58:38.000 I hope he's okay, but we have mutual friends, and he became a schizophrenic.
01:58:45.000 And, you know, you will see, you know, cases like that.
01:58:49.000 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.
01:58:56.000 Like, there's lots of data that suggests that, you know, medical marijuana laws, for example, can actually have a decrease in overall.
01:59:03.000 Well, they could.
01:59:04.000 I mean, there's a study that says that.
01:59:06.000 That gives no comfort to the people who lose their children because of these psychotic breaks.
01:59:11.000 That's right.
01:59:11.000 And those studies are really bad.
01:59:13.000 So the place that you can criticize— Why are they bad, though?
01:59:15.000 Because state-level data is not great.
01:59:17.000 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.
01:59:32.000 Can we stop right there?
01:59:33.000 I think we all agree that marijuana use by itself with people that aren't schizophrenic probably doesn't induce violent crime.
01:59:39.000 But with people that are schizophrenic or people where it triggers schizophrenia, it could potentially induce violent crime.
01:59:45.000 My friend did not get violent, although he did do a violent thing.
01:59:49.000 It wasn't to a person.
01:59:50.000 I think we have to be really careful because...
01:59:54.000 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.
02:00:13.000 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,
02:00:28.000 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?
02:00:40.000 Is there a possibility there's a correlation between organized crime?
02:00:43.000 Because one of the things about selling marijuana is the people that have always been selling marijuana have been criminals.
02:00:48.000 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.
02:00:57.000 There's a direct correlation between people being robbed.
02:01:01.000 There was also a significant problem with credit cards and banks, where everyone was having to do all their transactions with cash.
02:01:08.000 There was a lot of violence that was associated with marijuana in regards to that.
02:01:12.000 And also, massive increase in population.
02:01:15.000 And that's part of the reason why Trump is actually not really against cannabis in some ways.
02:01:21.000 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.
02:01:31.000 And it has dropped.
02:01:32.000 They did a study last year and it dropped over 15% in Colorado.
02:01:36.000 And it dropped 7% in Arizona.
02:01:38.000 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.
02:01:57.000 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.
02:02:04.000 They say that Washington has the 10th largest income gap in In the United States.
02:02:09.000 But how did that change, though, the correspondence to the murder rate?
02:02:12.000 Good question, Jerome.
02:02:14.000 So I didn't get to speak with Benjamin about this.
02:02:18.000 That sounds like confirmation bias.
02:02:20.000 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.
02:02:31.000 But how has the income gap shifted that directly correlates to the legalization of marijuana?
02:02:36.000 Because during the same period, the income gap, particularly in Washington, increased.
02:02:42.000 So he feels that...
02:02:44.000 In a corresponding number?
02:02:45.000 Right.
02:02:46.000 So he feels that it's likely more to that.
02:02:49.000 I mean, I understand, but you have to respect this guy.
02:02:53.000 I don't have to respect him because I know what he did with his data.
02:02:56.000 Tell me what he did with his data.
02:02:57.000 So, Joe, this is maddening to me.
02:03:00.000 Okay.
02:03:01.000 Violent crime in those four states increased more rapidly than in the U.S. Period.
02:03:07.000 Between 2013 and 2017. Here, Jamie just posted this up here.
02:03:11.000 Conjecture aside, no credible data exists.
02:03:13.000 It supports a significant association between the increased violent crime and marijuana legalization.
02:03:17.000 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.
02:03:32.000 Okay, so that's just not true.
02:03:34.000 I know it's Snopes, and I know we trust Snopes.
02:03:37.000 I don't trust them that much.
02:03:39.000 I was going to say that too, but they give all of their links right here if you'd like to.
02:03:44.000 So again, where are these sources?
02:03:48.000 Yeah, I've read this stuff.
02:03:49.000 And what's wrong with them?
02:03:50.000 Let me just go back to what I'm saying.
02:03:52.000 Yeah, please do.
02:03:53.000 2013. Oregon, Washington, Colorado, Alaska.
02:03:58.000 There are 450 murders in those four states.
02:04:01.000 There are 30,000 ag assaults.
02:04:03.000 Period.
02:04:04.000 Okay.
02:04:05.000 2017, Oregon, Washington, Colorado, Alaska.
02:04:09.000 There are 620 murders in those four states.
02:04:11.000 That's an almost 40% increase.
02:04:13.000 There are 38,000 ag assaults.
02:04:15.000 That's a 25% increase.
02:04:16.000 If you adjust for population, you still get big increases.
02:04:20.000 In Denver, 2018, almost 70 murders.
02:04:23.000 There were about 35 in 2013. Seattle, 2018, There were 34, 35 murders.
02:04:30.000 There were, I think, 19 in 2013. These increases are real.
02:04:35.000 Now, can we say that marijuana legalization caused those increases?
02:04:41.000 We cannot yet.
02:04:43.000 There are other possibilities.
02:04:45.000 What are those?
02:04:47.000 Well, first of all, population did increase.
02:04:50.000 It's also possible that these states, quote-unquote, imported violent crime.
02:04:53.000 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. 0.94
02:05:00.000 And on top of that, organized crime people that are selling.
02:05:03.000 Absolutely.
02:05:04.000 There may have been some people who are exporting to Nebraska, to Minnesota, to other states.
02:05:09.000 There's crime associated with that.
02:05:11.000 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.
02:05:27.000 And he didn't say it randomly.
02:05:28.000 He said it when he was introducing legislation to legalize marijuana on the federal level.
02:05:33.000 Those people are wrong, and they need to stop saying it.
02:05:36.000 I know, and by the way, that Oregon economist used...
02:05:40.000 He used the wrong data set for his charts.
02:05:43.000 I used the real numbers, the FBI homicide numbers.
02:05:48.000 He used numbers that include justifiable homicides and police homicides.
02:05:51.000 No, that's not right.
02:05:51.000 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.
02:06:06.000 You do not know what you're talking about, okay?
02:06:08.000 Those are FBI numbers.
02:06:09.000 I'm reading it.
02:06:09.000 You do not know what you're talking about.
02:06:11.000 The numbers are clear.
02:06:15.000 I'm reading them right now.
02:06:16.000 2016 release of FBI uniform crime reports from Oregon.
02:06:20.000 Okay.
02:06:21.000 Yes, Oregon.
02:06:22.000 You're not reading the reports from the United States.
02:06:24.000 You're picking one state for one year.
02:06:27.000 That state that has legalized medical candidates.
02:06:30.000 Over the entire country from that time period, too.
02:06:32.000 So to pick those four states where marijuana was legalized is sort of cherry-picking.
02:06:36.000 No, it's not.
02:06:36.000 It's picking every state where they were legalized and comparing it to the whole country.
02:06:40.000 It's the whole country erased.
02:06:41.000 But did the whole country see a similar increase?
02:06:44.000 No, that's what I'm trying to show.
02:06:46.000 If I'm trying to show something wrong, then...
02:06:48.000 We'll pull back so we can see the whole thing.
02:06:50.000 So first of all, that's violent crime, not murders and ag assaults.
02:06:55.000 Well, violent crime and ag assaults, aren't they... 0.93
02:06:58.000 No, so the four categories of violent crime are murder, ag assault, robbery, and rape.
02:07:05.000 Rape has sort of gone sideways the last few years. 0.94
02:07:07.000 Robberies actually have gone down.
02:07:08.000 It's murders and ag assaults that are interpersonal violent crime.
02:07:13.000 Okay, just to go back to this Oregon economist because this maddens me.
02:07:16.000 He used a data set that is not the standard data set to report murder rates.
02:07:21.000 What is the difference?
02:07:22.000 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.
02:07:32.000 But the data sets you use in your book aren't even published.
02:07:35.000 Let's not interrupt.
02:07:36.000 Let me finish.
02:07:37.000 Those two categories of crime are not likely to be impacted by cannabis use.
02:07:42.000 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.
02:07:50.000 The fair comparison is Is the base murder rate in the U.S. And that's the number that I used.
02:07:57.000 And I am telling you, I mean, I know these numbers.
02:08:00.000 I sleep, you know, I wake up with these numbers.
02:08:03.000 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.
02:08:16.000 I'm sorry, I said 31%, maybe it's 29%, so maybe I woke up.
02:08:21.000 Anyway, for the U.S., it's 18%.
02:08:24.000 29% versus 18%.
02:08:26.000 That's the gap.
02:08:28.000 And I am not saying that I know that cannabis legalization caused that gap.
02:08:33.000 What I'm saying is people need to stop claiming that cannabis legalization reduces violent crime.
02:08:39.000 It has increased in those states.
02:08:41.000 Can I ask you, in those states, was it universal, the increase?
02:08:43.000 Was it almost identical?
02:08:45.000 Yes.
02:08:45.000 Alaska was the most.
02:08:47.000 Then I think MERS went up more in Washington.
02:08:51.000 And what's also interesting, Joe, if you really want to go into the numbers, is the gap actually widened year by year.
02:08:58.000 So that's sort of what you would expect if this is the result of a psychomimetic effect.
02:09:02.000 In other words, a psychosis-causing effect.
02:09:04.000 Because cannabis doesn't cause psychosis right away.
02:09:07.000 People break down.
02:09:08.000 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.
02:09:20.000 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.
02:09:31.000 Right, but they also have a lower cannabis use.
02:09:34.000 That's true.
02:09:35.000 They also have very few guns.
02:09:37.000 But still, you know, one-fifth...
02:09:39.000 They do a lot of kickboxers, though.
02:09:41.000 They do a lot of kickboxers.
02:09:43.000 But one-fifth, I mean, it's still...
02:09:46.000 It's pretty drastic overall.
02:09:47.000 And again, you know, Alex, you know, I appreciate some of the...
02:09:50.000 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.
02:10:03.000 So I think things kind of even out.
02:10:04.000 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...
02:10:22.000 The one who had an edible and became suicidal and was fucked up for weeks. 0.65
02:10:28.000 Guy's very confident, very articulate, very intelligent. 0.95
02:10:31.000 He's not a weirdo, not a transient, extremely successful.
02:10:37.000 You know, I think there are variables that we need to take into consideration.
02:10:41.000 There's certain human beings that exhibit a pattern of behavior that's directly correlated to cannabis use that I don't experience. 0.99
02:10:49.000 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. 0.97
02:10:56.000 Well, you probably don't have one of those three genes that we were talking about earlier. 0.99
02:11:00.000 Yeah, you're clearly pretty psychiatrically healthy.
02:11:02.000 And you probably also, too, don't overuse or you have some type of legitimacy as to why you are using it.
02:11:12.000 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...
02:11:22.000 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.
02:11:29.000 You know what I mean?
02:11:30.000 It's like...
02:11:31.000 Seriously.
02:11:33.000 It's so true. 0.84
02:11:33.000 It's like... 0.84
02:11:34.000 It's so true. 0.84
02:11:37.000 I'm at it. 1.00
02:11:38.000 Good luck, you fucks. 1.00
02:11:39.000 It's like... 1.00
02:11:40.000 Some type of recommendations.
02:11:43.000 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.
02:11:52.000 I think most people realize that one person was going on data and the other person was...
02:11:58.000 Joe, I find it so fascinating that now when you think back through your life, you've thought of somebody who was affected.
02:12:06.000 I have several people.
02:12:07.000 I'll bet as you think about it, you'll think of more people.
02:12:11.000 Maybe, but those are the big ones.
02:12:13.000 And like I said, my friend who is a martial arts instructor, it was a pretty significant issue with a lot of our friends.
02:12:17.000 We were trying to figure out what was wrong with them beforehand.
02:12:20.000 He was sending me these videos that didn't make any sense. 0.98
02:12:23.000 And I was like, what in the fuck is this? 0.98
02:12:26.000 I'll explain to you more off-air so I don't have to out this guy. 0.98
02:12:30.000 But a lot of people that were close to him were really seriously concerned.
02:12:35.000 Now, is it something that would have happened anyway?
02:12:38.000 I don't know.
02:12:39.000 How old was he?
02:12:40.000 He's in his 20s.
02:12:41.000 Late 20s?
02:12:42.000 How old exactly?
02:12:43.000 Late 20s, 20...
02:12:44.000 That's right around the age.
02:12:46.000 It is a little bit late-ish.
02:12:50.000 Because like I said, a lot of the studies, even when you look at the ones on adolescence, for sure it's below...
02:12:57.000 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.
02:13:06.000 He seems to be fine now.
02:13:07.000 That's good.
02:13:08.000 Is he using now?
02:13:09.000 I don't know.
02:13:09.000 I have to find out.
02:13:11.000 I'm not an expert on this subject but it's because of something called pruning that we go through.
02:13:17.000 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.
02:13:26.000 It's the best way to kind of explain it.
02:13:29.000 When you use cannabis, you can potentially accelerate that process.
02:13:33.000 And then because you accelerate that process, you don't get those good neural connections.
02:13:39.000 And then people, unfortunately, develop things like psychosis and schizophrenia.
02:13:45.000 So that's kind of where the issue lies.
02:13:48.000 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.
02:14:01.000 It's an excellent medicine.
02:14:03.000 But the other thing, though, too, is we do want to mitigate the risks because there are real risks out there.
02:14:10.000 So, you know, I do appreciate, you know, us talking about adolescents and making sure that they do stay away from cannabis.
02:14:17.000 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?
02:14:28.000 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.
02:14:38.000 I mean, the pre-adolescent and early teen use, we got to do everything we can to stop it.
02:14:45.000 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.
02:14:52.000 That's what I saw when I was growing up.
02:14:56.000 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.
02:15:12.000 You do have to be careful with that.
02:15:14.000 I think...
02:15:15.000 We're dealing with a lot of ignorance.
02:15:16.000 We're dealing with a lot of ignorance when it comes to biological variability, right?
02:15:22.000 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.
02:15:37.000 There's a lot of variables.
02:15:38.000 There's a lot of them.
02:15:39.000 Marijuana is absolutely one of those variables.
02:15:42.000 And again, I don't have an issue with it.
02:15:44.000 I like it.
02:15:45.000 I love the stuff. 0.72
02:15:46.000 But it doesn't fuck with me.
02:15:48.000 But I'm also honest. 0.77
02:15:49.000 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.
02:15:56.000 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.
02:16:10.000 I don't think it's a good thing for everybody.
02:16:11.000 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.
02:16:19.000 Also, too, you need to have some type of self-awareness.
02:16:25.000 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.
02:16:34.000 You should be able to figure out yourself.
02:16:36.000 But that's hard for people.
02:16:37.000 I mean, it's one of the most difficult things for people to do is to self-assess, you know, to be objective.
02:16:42.000 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.
02:16:48.000 And I think it's very interesting why people continue to use when they're getting paranoid.
02:16:53.000 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.
02:17:01.000 I actually don't think I'd be comfortable using high THC cannabis now knowing what I know.
02:17:05.000 But anyway, so the people – I got some right here.
02:17:13.000 I'm going to get hotboxed. 0.99
02:17:16.000 I'll give you the shit to put Elon on the moon. 0.99
02:17:21.000 But the most cogent argument, I thought it was so interesting. 0.99
02:17:25.000 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.
02:17:30.000 I'm going to smoke so much that I'm almost comfortable being paranoid.
02:17:34.000 And I think that's a dangerous thing to do to your mind.
02:17:38.000 Because you're sort of counting on being able to step back from that and stop using.
02:17:43.000 Yeah, that's a silly way of looking at it.
02:17:46.000 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,
02:18:02.000 you can't really be aware of everything.
02:18:05.000 Paralyzed by fear.
02:18:06.000 We're in space.
02:18:08.000 Okay, we are on a gigantic ball that's spinning a thousand miles an hour, hurling through infinity.
02:18:14.000 This is reality.
02:18:15.000 It's a thin layer of gas that's protecting us from everything that's flying around in our solar system. 0.99
02:18:22.000 And by the way, at best you get 85 years and then it's all shit anyway. 1.00
02:18:25.000 Right, and even if you make it to 100, the last 15 is dog shit. 0.99
02:18:29.000 You can't really, you can't think too much about this stuff. 0.99
02:18:31.000 Maybe the stem cells and stuff will be too, too bad.
02:18:34.000 Yeah, maybe.
02:18:34.000 Yeah, maybe you're going to live to be 300. What do you do?
02:18:36.000 The universe is infinite.
02:18:38.000 You know, like, you're going to die.
02:18:39.000 Like, the sun is going to end. 0.98
02:18:41.000 Like, at the end, I mean, imagine if people do live to an infinite number where we realize our fucking sun is dying. 0.96
02:18:46.000 You're going to freak out about that.
02:18:48.000 It's all relative, right?
02:18:50.000 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.
02:18:59.000 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.
02:19:09.000 Maybe you were upset about something else when you ran into them.
02:19:11.000 You were already at a seven, and they brought you to a ten, and it was totally unnecessary.
02:19:15.000 With a normal situation, you would have only been at a two.
02:19:18.000 Those things are real, and sometimes marijuana helps highlight all the errors in your way.
02:19:24.000 I think it can be a tool, but my description of it is like any other tool, like a hammer. 1.00
02:19:29.000 You can build a house with a hammer, or you can just hit yourself in the dick if you're fucking crazy. 0.99
02:19:33.000 And this is something that I think we should consider when we're discussing almost any psychedelic medicine. 1.00
02:19:40.000 And I think that I really do believe that marijuana is a psychedelic.
02:19:43.000 And I don't even think it's a mild one, especially when it's in edible form.
02:19:47.000 I don't think it's mild at all.
02:19:48.000 Yeah, I mean, there's some people that come in to my office, for example, and like...
02:19:54.000 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.
02:20:03.000 What gives you that?
02:20:04.000 Is that what it is?
02:20:05.000 Anxious?
02:20:05.000 Yeah, it's just a feeling of they're not someone who can just sit and be by themselves.
02:20:13.000 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.
02:20:26.000 That's bad.
02:20:28.000 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.
02:20:39.000 I am using psychoactive substance.
02:20:41.000 And not be able to freak out.
02:20:43.000 But some people, I know that if they use a little bit of THC, they probably would have a freak out.
02:20:50.000 They probably would have a bad experience.
02:20:52.000 Generally, it's people who are very, very fearful.
02:20:55.000 Now, the other side of that coin, though, is that if you use CBD, and like we discussed earlier, that can decrease learned fear.
02:21:01.000 So that's something that's really helpful for those patients.
02:21:06.000 I do agree that we have to be careful about using high THC in certain groups of people, for sure.
02:21:15.000 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.
02:21:31.000 And they want to say that I don't understand correlation and causation and that I'm cherry-picking studies.
02:21:36.000 Let's acknowledge that a lot of people use this drug.
02:21:39.000 And that's true whether it's legal or not.
02:21:42.000 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.
02:21:49.000 There will – legalized cannabis will probably be the law in the United States, okay?
02:21:53.000 And let's talk about what we're going to tell people who are using.
02:21:57.000 And I had this roundtable with the executive director of the DPA and some other people.
02:22:03.000 This was about a month ago, shortly after the book came out.
02:22:07.000 And I proposed what I thought were really common sense warnings.
02:22:10.000 And she basically wouldn't agree.
02:22:12.000 I mean, she agreed to like one of the five of them.
02:22:14.000 What were the warnings you proposed?
02:22:16.000 It was stuff like, you know, if cannabis, if you have a family history of severe mental illness, you probably should not use cannabis.
02:22:22.000 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.
02:22:28.000 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.
02:22:45.000 I mean, I think that's – I think if – now look, we can argue about how severe is, right?
02:22:50.000 But certainly if you wind up in the ER even once – That's a bad sign.
02:22:55.000 I just don't understand why the legalization...
02:22:58.000 Look, I can understand why people who are selling this drug don't care.
02:23:02.000 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.
02:23:09.000 But I don't understand why these people who are supposed to be...
02:23:13.000 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.
02:23:21.000 I think you did yourself a slight disservice by not including some of the beneficial aspects of cannabis.
02:23:26.000 I understand your perspective.
02:23:27.000 I understand why you were doing that because you really wanted to highlight the dangers.
02:23:31.000 But I think that's one of the things that they can point to when they say you cherry-pick data.
02:23:35.000 But I think that also it's really important when you're having these kind of conversations to have a long one.
02:23:41.000 I mean, we've really covered the full gamut, right?
02:23:45.000 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.
02:23:50.000 Everybody's talking over everybody and you have five minutes to get your case out.
02:23:53.000 And I don't think it's possible.
02:23:55.000 I think this is a really...
02:23:56.000 This is a long...
02:23:58.000 Complicated discussion that has to do with biological variabilities.
02:24:01.000 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.
02:24:14.000 Maybe if they just became a long-distance runner and they would have lived a healthy life with no psychotic breaks at all.
02:24:20.000 We don't really know.
02:24:21.000 And unfortunately, once someone goes off the deep end, we might never find out.
02:24:24.000 Yes.
02:24:25.000 Sorry, go on.
02:24:26.000 No, I'm just saying, I think we have to be very careful in saying we know what it does.
02:24:32.000 We know what anything does.
02:24:34.000 Because you don't know.
02:24:35.000 You know what it does for you.
02:24:36.000 You know, some people can't eat fish, you know? 1.00
02:24:39.000 They eat fucking shellfish and their throat seizes up. 0.99
02:24:43.000 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. 0.99
02:24:54.000 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.
02:25:02.000 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.
02:25:09.000 Is that true?
02:25:10.000 I certainly don't think it's a good idea for people who are at risk of opioid use.
02:25:15.000 Okay.
02:25:15.000 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.
02:25:31.000 A lot of folks feel, though, that that's just a patch.
02:25:35.000 And really the best way to get off of opiates is Ibogaine.
02:25:39.000 And that Ibogaine, the repeat rate of addiction or people try it again afterwards is really low.
02:25:46.000 I think one of the things with that is just the accessibility, the affordability.
02:25:51.000 I've never administered Ibogaine before.
02:25:55.000 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.
02:26:01.000 But the people that I know that have tried it have had spectacular results, especially people that have had problems with pills.
02:26:07.000 Yeah.
02:26:07.000 In fact, a friend of mine, my friend Ed Clay, he opened up a clinic in Mexico based on his own interaction with pills.
02:26:14.000 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. 0.86
02:26:22.000 Just whacked it out. 0.98
02:26:23.000 It literally changes the way your brain interfaces with your addiction.
02:26:28.000 It's not simply a perspective enhancer.
02:26:31.000 It changes how your body and your brain deal with opiates.
02:26:36.000 I think Tim Ferriss has actually talked about that before as well.
02:26:41.000 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.
02:26:52.000 And then also, too, you want to look at it from a clinical perspective, right?
02:26:56.000 So we know that opioids can kill people, right?
02:26:59.000 Because it acts on the brainstem, whereas, you know, cannabis doesn't.
02:27:02.000 So, you know, you might be saying, you know, you're just substituting one for the other.
02:27:07.000 And, you know, sometimes that is true.
02:27:09.000 But if you're using a less harmful substance, you know, to me, that's like a huge win, right?
02:27:14.000 So if someone, you know, has to drink, you know, 12 beers a night versus smoking like one joint, man, that's awesome.
02:27:23.000 And I mean, you look at all these clinics, like you look at like I mean, what are they doing?
02:27:27.000 They're trying to get people off one substance to a substance that is a little bit less harmful.
02:27:33.000 And I think that when you use cannabis, it can be effective for opioids.
02:27:38.000 It can also be effective for benzodiazepines and for other medicines as well.
02:27:44.000 It'd be awesome if everyone would just feel happy and great all the time by just exercise and nutrition.
02:27:51.000 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.
02:27:58.000 But I understand though that sometimes life is hard.
02:28:02.000 Sometimes things hit you.
02:28:04.000 You have crisis in your life.
02:28:06.000 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.
02:28:14.000 And in those times, you know, sometimes diet, exercise, meditation, doing all the right things just isn't quite enough.
02:28:23.000 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.
02:28:38.000 And even though I'm talking about opiates and deaths, We can also talk about NSAIDs, right?
02:28:45.000 Like non-steroidal anti-inflammatory drugs.
02:28:47.000 So, these drugs can also wreak havoc on your GI system.
02:28:52.000 I saw one study, actually, I tweeted out, Rhonda Patrick tweeted out, said that if you use NSAIDs, it was really short.
02:28:59.000 I got to look it up again, but it was like...
02:29:20.000 I've had guys come in to me before.
02:29:23.000 That have been, you know, really, really depressed.
02:29:26.000 You just give them a small amount of testosterone and, man, they're off their antidepressants and they're off to the races.
02:29:30.000 They're doing great.
02:29:31.000 So, you know, are we creating a lot of people who are depressed because they're using opiates and their testosterone levels are low?
02:29:40.000 And, you know, for men, I mean, having low testosterone is horrible.
02:29:44.000 You know, you're going to have low motivation.
02:29:47.000 You're not going to feel as well.
02:29:48.000 You're not going to want to do things.
02:29:49.000 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.
02:30:00.000 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.
02:30:13.000 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.
02:30:29.000 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.
02:30:37.000 So just so people know that, because I know that comes up all the time, you know. 0.97
02:30:43.000 Yes, as the dumb anti-drug advocates like to say, doobies cause boobies. 1.00
02:30:49.000 Oh yeah, that is not right. 0.99
02:30:58.000 I'm joking.
02:31:00.000 Risperdal causes boobies.
02:31:02.000 That's a different issue.
02:31:04.000 Risperdal is an antipsychotic.
02:31:05.000 Risperdal, yeah.
02:31:07.000 So, look, I think the issue of whether cannabis is a gateway drug, it's 100% clear that cannabis is a gateway drug.
02:31:18.000 The argument is why...
02:31:18.000 Did you say it was 100% clear?
02:31:20.000 100% clear.
02:31:20.000 The argument is why, okay?
02:31:22.000 So, it's quite clear that cannabis use oftentimes precedes other drug use, whether it's opioids, cocaine, other drugs.
02:31:31.000 Now...
02:31:31.000 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.
02:31:40.000 He might have access to heroin or cocaine, other drugs.
02:31:44.000 And so eventually, maybe you decide to try one of those other drugs.
02:31:47.000 So actually, that's really why the Dutch legalized.
02:31:49.000 They wanted to create an avenue for people to use cannabis that wasn't connected to other drugs.
02:31:55.000 Okay.
02:31:56.000 Another possibility is that using an addictive intoxicating substance...
02:32:00.000 You might like it, and you might want to try other intoxicating substances, and it might prime your brain.
02:32:05.000 And then the third possibility, really, is that there are just some people who are risk-takers out there, right?
02:32:11.000 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.
02:32:19.000 So it's not really that cannabis drives the use, it's just that cannabis is first.
02:32:24.000 They're just curious people.
02:32:25.000 What's your thoughts on...
02:32:27.000 What I will say, I mean, I'm just going to go back to the NAM report, right?
02:32:30.000 I mean, you quoted these people in your book.
02:32:34.000 So, this committee couldn't find sufficient data demonstrating an association between cannabis use and initiating opioid use.
02:32:41.000 They found no compelling evidence to support the gateway drug theory.
02:32:45.000 But those are the people that you quoted in your book.
02:32:48.000 So, there's been more research done since then.
02:32:51.000 But things have radically changed?
02:32:53.000 I would say things have changed some.
02:32:55.000 Here's what I would probably say.
02:32:56.000 I think that probably it's a combination of these things, right?
02:32:59.000 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.
02:33:06.000 At the same time...
02:33:08.000 Getting high feels good, and maybe you want to try other drugs, and at the same time, you're just a risk taker.
02:33:13.000 Okay.
02:33:15.000 What nobody seriously ever said until about the last five years is that cannabis could be an off-ramp for opioids, okay?
02:33:22.000 And there's a lot of reasons to believe that's a really bad idea.
02:33:25.000 First of all, cannabis, if you actually need opioids for pain relief, cannabis is not a good enough pain reliever.
02:33:31.000 It's like alcohol.
02:33:31.000 It's a mild pain reliever.
02:33:33.000 It's not strong enough.
02:33:34.000 If you're dying from cancer, cannabis...
02:33:36.000 It probably is not the pain reliever that you need.
02:33:38.000 You need opioids, okay?
02:33:40.000 And, again, the state-level data is not as good.
02:33:43.000 If you want to really figure out what's happening to an individual, the best way to do that is to follow that individual.
02:33:49.000 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.
02:34:06.000 And that just intuitively makes sense to me.
02:34:09.000 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?
02:34:17.000 The US and Canada.
02:34:18.000 Who are the two countries that have by far the worst opioid epidemic?
02:34:22.000 The US and Canada.
02:34:24.000 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.
02:34:31.000 Yes, but Canada doesn't. 0.98
02:34:34.000 The amount of opiates that are prescribed in the United States is fucking preposterous. 0.99
02:34:38.000 I agree. 0.91
02:34:38.000 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. 0.91
02:34:45.000 Yep.
02:34:45.000 And you could just literally go from pharmacy to pharmacy.
02:34:49.000 No, we have a problem with the way we prescribe drugs in this country.
02:34:52.000 Opioids, ADD drugs, benzos, SSRIs, all of them.
02:34:56.000 And we're connected to cannabis, so it makes sense that it would filter over there.
02:34:59.000 Yes, but what I would say is that people who think that cannabis is not part of that over-prescribing problem are diluting themselves.
02:35:06.000 And what do you think to that?
02:35:08.000 Sorry, can you repeat the question again?
02:35:10.000 So I agree with Joe.
02:35:13.000 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.
02:35:22.000 But it's not just opioids.
02:35:23.000 We prescribe too many benzos.
02:35:24.000 We prescribe too many ADD drugs.
02:35:26.000 We probably prescribe too many SSRIs.
02:35:29.000 We prescribe too much in this country.
02:35:31.000 I think we all agree.
02:35:32.000 I agree with that.
02:35:33.000 And I think...
02:35:34.000 That cannabis is another example of us looking for a drug to solve our problems.
02:35:40.000 Okay, again, just from a clinical perspective, I can't just rely on diet and exercise for all my patients.
02:35:49.000 I have to use other tools.
02:35:50.000 And again, everyone here in this room, we're all pretty healthy.
02:35:54.000 I don't have a bad back or I don't have a mental health diagnosis or anything going on.
02:36:00.000 You know, I have to look at patients that are coming to me, right?
02:36:03.000 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.
02:36:10.000 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?
02:36:19.000 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.
02:36:28.000 I know that, right?
02:36:29.000 So that's really, really comforting for me to know.
02:36:32.000 Also, I feel, you know, we were just talking about amphetamines and we were just talking about, you know, SSRIs.
02:36:37.000 I feel that cannabis, you know, particularly the CBD component is Can actually be more effective.
02:36:42.000 That's what I've seen a lot in my practice and other people have seen that as well.
02:36:46.000 So I think that we need to take that into consideration when we're using all these drugs.
02:36:51.000 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.
02:37:09.000 They're not the ones in front of the people.
02:37:10.000 They're not the ones that have to chat with patients.
02:37:14.000 I have an obligation to do something for my patients to make them better.
02:37:18.000 I really feel, we just listed a bunch of drugs, that cannabis is a really, really effective tool and it doesn't kill anybody.
02:37:27.000 So because of that, I'm going to keep using it.
02:37:32.000 But like I said, I'm always looking for other drugs.
02:37:34.000 I'm always looking for other alternatives to also help my patients.
02:37:39.000 But I think that using cannabis is a really effective tool for a lot of clinicians and it's helped a lot of patients.
02:37:48.000 But what do you think about his argument about it being a gateway drug?
02:37:51.000 Other than what these people said in the study that there's no evidence that supports it, it's a gateway drug.
02:37:55.000 What are your personal feelings about that argument?
02:37:58.000 So I don't feel that cannabis is the gateway drug.
02:38:02.000 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.
02:38:10.000 And they just want to try something.
02:38:13.000 So, you know, the fact is that alcohol and cannabis just get introduced first most of the time.
02:38:18.000 Most people, you know, don't do, you know, Coke or LSD and then say, hey man, let's try some cannabis, right?
02:38:27.000 So it's just that that's the very first one there.
02:38:30.000 So if we...
02:38:31.000 You could say anything that was easier access.
02:38:34.000 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.
02:38:45.000 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.
02:38:58.000 And I know that the name, they don't feel that cannabis is a gateway drug either.
02:39:04.000 I mean, again, they said they found no compelling evidence to support the gateway theory.
02:39:09.000 And again, I mean, these are the people that you are quoting in your book, Alex, right?
02:39:13.000 Let me just go a little bit further.
02:39:15.000 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.
02:39:25.000 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.
02:39:34.000 So it's just that cannabis is there first.
02:39:37.000 It's definitely not a gateway drug in any stretch of the imagination.
02:39:41.000 Again, I totally disagree.
02:39:43.000 And again, there's 50 years of data on this.
02:39:45.000 I know the studies that he's quoting, but there are many others.
02:39:49.000 And I think the argument is as to why.
02:39:52.000 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.
02:40:04.000 But I do want to throw one thing out there.
02:40:07.000 I don't know how many of your viewers have teenage kids.
02:40:11.000 They're probably more likely to be teenage kids than to have teenage kids.
02:40:14.000 But the book has...
02:40:19.000 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.
02:40:31.000 Why do you say that?
02:40:32.000 Because, well, first of all, it gets kids, teenagers, used to...
02:40:46.000 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.
02:40:57.000 And we're talking about 15-, 16-, 17-year-olds inhaling pure THC, the most dangerous form of this drug.
02:41:05.000 And I think, unfortunately, it's not going to take long before the mental health consequences of that become apparent.
02:41:11.000 And I really do hope that the book gives parents some tools to talk to their kids about that, if nothing else.
02:41:19.000 Last words?
02:41:21.000 I actually wanted to go over a few things that maybe I thought you might be interested in.
02:41:26.000 Okay.
02:41:26.000 Okay, so, you know, you're a dude, you're over 50, so prostate cancer.
02:41:31.000 So, you know, it's been shown that CBD may actually be beneficial for prostate cancer.
02:41:36.000 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.
02:41:47.000 Good for prostate cancer, do you mean to prevent it?
02:41:49.000 Yes.
02:41:50.000 Do you mean to treat it?
02:41:51.000 Prevent and treat, yeah.
02:41:53.000 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.
02:42:10.000 One thing, too, we didn't really get to talk about was CTE and concussions.
02:42:16.000 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.
02:42:21.000 I really appreciate that.
02:42:23.000 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.
02:42:39.000 The non-THC users had 11.5% mortality rate.
02:42:42.000 I mean, that's really, really significant, right?
02:42:44.000 And this is just THC and not CBD? Because CBD has been shown to be very beneficial for people with traumatic brain injuries.
02:42:51.000 So CBD and THC are both beneficial?
02:42:54.000 Yes.
02:42:54.000 So that was, you know, again, a correlation equal causation, but I mean that the stats are so overwhelming.
02:43:00.000 Like if it was, you know, non-cheat C was like 3.5%, I would have bring it up.
02:43:03.000 But it's 11.5% compared to 2.4%.
02:43:08.000 And again, CBD, yes.
02:43:10.000 And there's even, you know, mechanisms of action have even been identified with that.
02:43:14.000 It decreases, you know, inflammation in your brain post-concussion.
02:43:19.000 Yeah.
02:43:20.000 You know, one last thing, too.
02:43:22.000 Again, there's only one study on it, and it was done on rats, but, you know, I'm a keto guy, too.
02:43:28.000 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.
02:43:40.000 And they think that that's just because there's an increase in your endogenous cannabinoids, 2-AG and anandamide.
02:43:47.000 When you do have a high-fat diet.
02:43:52.000 And then, can I maybe keep going?
02:43:54.000 Sure.
02:43:54.000 Okay, sure.
02:43:55.000 And then Alzheimer's, you know.
02:43:58.000 Again, I know you're plus 50, so, you know, THC. Say Joe has Alzheimer's?
02:44:04.000 No, I'm not saying.
02:44:06.000 It's probably on twice.
02:44:06.000 I know that he wants to keep doing this podcast forever, I think.
02:44:10.000 Maybe that would be an excuse to stop.
02:44:12.000 So THC has been shown to inhibit the formation of beta amyloid plaques.
02:44:16.000 That's the hallmark of Alzheimer's disease.
02:44:20.000 And then CBD has also been shown to be effective for Alzheimer's disease as well.
02:44:26.000 There's a rat study that was going to...
02:44:28.000 I don't want to get into, but it's fairly detailed.
02:44:32.000 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.
02:44:41.000 And that's been shown before, too.
02:44:43.000 They've done that in mice.
02:44:44.000 I've got to interrupt you for one second, okay?
02:44:46.000 And I think you would agree.
02:44:49.000 Some of it's sort of epidemiological, some of it's preclinical.
02:44:53.000 It's very, very early.
02:44:55.000 None of it really proves much.
02:44:58.000 Alex, just let me say, I'm a clinician, okay?
02:45:01.000 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?
02:45:08.000 It's really frustrating to say that to someone.
02:45:10.000 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.
02:45:19.000 With regards to the Alzheimer's disease, we have really, really poor medications for that.
02:45:25.000 And we have an aging population.
02:45:27.000 So again, Alex, you want to look at everything, which is what I'm doing.
02:45:30.000 I'm looking at everything and I'm trying to make a clinical decision.
02:45:34.000 Am I using some things without randomized controlled trials?
02:45:38.000 Of course I am.
02:45:39.000 But again, I'm a clinician, so I'm using mechanisms of action.
02:45:43.000 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.
02:45:53.000 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.
02:46:02.000 What I'm saying is that when we're talking about...
02:46:04.000 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.
02:46:20.000 You know, a guy I know named Peter Bach, who is very smart.
02:46:23.000 He's a pulmonologist.
02:46:24.000 He's at Memorial Sloan Kettering in New York.
02:46:26.000 And he wrote a piece in the Wall Street Journal a couple weeks ago talking about cannabis's limits as medicine.
02:46:33.000 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.
02:46:41.000 And a bunch of things where there's really no evidence that it works is that we don't have good treatments.
02:46:46.000 We want cures.
02:46:48.000 We want help.
02:46:49.000 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.
02:46:55.000 But that hope is not a substitute for science.
02:46:58.000 It doesn't mean that it works.
02:47:00.000 And even...
02:47:01.000 You want your patients to have hope, okay?
02:47:04.000 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.
02:47:20.000 Okay.
02:47:20.000 Listen, I think we covered everything.
02:47:22.000 It's a complicated subject.
02:47:24.000 It really is.
02:47:26.000 And I think it's really important to discuss how complicated it is.
02:47:29.000 I don't think there's...
02:47:31.000 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.
02:47:43.000 I think we really highlighted all those things.
02:47:45.000 Joe, thank you so much for having us.
02:47:46.000 Thank you.
02:47:47.000 Thank you guys.
02:47:47.000 Thank you so much.
02:47:48.000 Really appreciate it.
02:47:49.000 Dr. Hart, thanks.
02:47:49.000 Give out your social media please.
02:47:51.000 Sure.
02:47:52.000 So I'm at Dr. Mike Hart on Twitter.
02:47:54.000 I'm at Dr. Mike Hart on Instagram.
02:47:56.000 And I'm at Dr. Mike Hart on Facebook.
02:47:59.000 So it's D-R-M-I-K-E-H-A-R-T. And Alex, your book is Tell Your Children. 0.73
02:48:04.000 It's available now.
02:48:05.000 It's available everywhere.
02:48:06.000 It's available now.
02:48:08.000 And if I had a copy, I'd give you a copy.
02:48:10.000 That's okay.
02:48:12.000 I'll give you the copy I have.
02:48:13.000 Okay.
02:48:13.000 All right.
02:48:14.000 Well, thank you guys.
02:48:15.000 Both of you.
02:48:15.000 Thank you very much.
02:48:16.000 Thanks.