Pot Debate - Alex Berenson & Dr. Michael Hart

00:03two one and we're live ladies and gentlemen or gentlemen and two ladies and gentlemen listening but you two unless you have some non-binary handle that you enjoy it's it's a new world please please introduce yourself sure so I'm dr. Mike Hart originally from st. John's Newfoundland now I'm residing in London Ontario and I'm a family doctor and I've been practicing cannabis medicine for just over five years and use her my name is Alex Berenson I used to be a New York Times reporter then I became a spy novelist and most recently I wrote the book tell your children the truth about marijuana mental illness and violence which came out last month and has not endeared me to the cannabis advocacy community I'd say have they attacked you mercilessly for this book yes and that's and that's okay I've also heard from a lot of parents you know some users but parents who've

01:01told me that the book really encapsulate s' they're their family's problems in the last couple years I suspect my my real thoughts here before we even get started as a we're gonna find that the truth is somewhere in the middle here I don't think marijuana is a hundred percent safe honestly for everybody I really don't I know too many people that have had experiences where they took too much particularly edibles and I don't I want to say I know anybody who had psychotic breaks but I know some people that freaked out for weeks you know in fact we just had a comedian here from Brazil a couple days ago Rafi Bosco's who said he took a couple of hits of a vape pen he was high for 14 days went to a psychiatrist and and he's a big guy he's like six foot five six six you know and you know they told him to keep taking it cuz you know he's like he's you're so big just keep smoking and

02:01so he doesn't smoke so he just kept hitting his vape pen he said I was high for two weeks yeah you need to do it properly right yes he held to the same standard as any other medicines to identify that there's risks and there's benefits to it yeah and and some people are definitely you know going to be more susceptible to those risks yeah and we need to kind of you know tease out those people and make sure that those people you know don't put themselves at risk yeah I think so as well and this is one of the reasons why I want to state this because I'm a well-known marijuana advocate but I I do believe I believe absolutely there are great benefits to it I think there's great benefits in terms of relieving pressure or ocular pressure for people that have glaucoma people with AIDS who are medication people with cancer that are going through chemotherapy find

02:50great benefit in terms of helping them and then there's also some people with autism I know people that they're children of autism and they give them small amounts of edible marijuana and stop seizures it's incredibly beneficial in the form of CVD for a lot of different ailments but I think with all things and this is a stance that I've kind of like really come to accept over the last few years with all things that affect the mind they affect everyone slightly differently absolutely yeah Alex you want to say I suspect you know there were people who said don't go on with Joe he's just gonna you know he's gonna try to eat you alive and and especially they'll be it'll be two on one I told them the truth first of all I I'll go on with anybody and I am glad you had me on or you're having me on because uh you know Bill Moore he won't have me on he's afraid to talk to me

03:42about this why well he said well he you know he told the or his people told the Simon & Schuster PR people we just don't want to have him on and an NPR had a national NPR show had an interview scheduled with me an hour-long segment and they cancelled it they said they said we don't believe in the conclusions of the book okay you don't believe in the conclusions in the book have me on ask me anything you know and that's why I'm so happy that you're not afraid to have me on that we can have a conversation that we can have a conversation come at me with any question you want about the science um I mean I'll say right off the top I don't think marijuana is medicine it has a few medical uses that have been you know CBD has been shown to reduce seizures and kid that's great THC has been shown to reduce the nausea associated with chemotherapy that's nice but for the

04:33most part people use THC and cannabis as recreational intoxicants they use them to get high the same when they use alcohol the same way they use other drugs and the sooner we we accept that reality the better off we'll all be that this is a drug and it has risks and benefits and the risks and benefits are different than alcohol they're different than other drugs but I don't think if you look sort of on a population level basis they're less than alcohol I don't think you can even say that I don't I really strongly disagree with that and I mean you just have to look at the death rate right you know more people die from alcohol than you know almost all drugs combined but when we're looking at cannabis there's zero deaths attributed to the use of cannabis itself sure you could say you know someone could use cannabis and jump off a cliff or something like that but we're talking

05:21about the lethal dose you cannot die from cannabis and just based upon that alone it makes it much much safer than alcohol did you say that if that is the case so ok so that's a really good question the normal number that's used for US deaths from alcohol is about ninety thousand now about thirty to forty thousand of those deaths are deaths from the physical effects of alcohol right essentially liver damage either chronic liver damage you get cirrhosis you die in some cases you can drink so much that you kill yourself in a night so that's about thirty to forty thousand deaths the other deaths are generally associated with alcohol meaning somebody drank exactly violence suicide car accidents and all those numbers are basically based on studies from the 90s and before where you know people looked at traffic accidents and there were a certain number of those accidents where

06:14people had a blood alcohol content of higher than 0.1 they said okay that's an alcohol associated death that's a fine way to count as far as I'm concerned nobody has ever done that count for cannabis and I can tell you based on on the tox screens that I've seen from Colorado where people had cannabis in their blood and committed suicide people liked cannabis in their art I should say THC in their blood and got into fatal confrontations with police officers if if if and when we do this number for cannabis which we need to do as soon as possible the numbers gonna be a lot higher than zero I suspect it will be in the 10 to 20,000 range we won't know till we actually do it okay but let's let's eliminate let's go even over the alcohol let's eliminate all things like violence and let's eliminate suicide and let's assume those people would have committed violence and committed suicide without

07:03it you're still looking at a giant number of people who drink themselves to death thousands and thousands and thousands of people every year versus zero with marijuana and you're aware I'm sure that correlation does not equal causation and that especially in a place like Colorado were you dealing with cannabis something that stays in the system for many many weeks if you're testing people and they test positive for marijuana and they wind up committing suicide or they wind up committing violence they don't even necessarily have to have been under the influence of it well as you know there's when you test the blood you can test the both the active metabolite and the inactive metabolite THC so so the tests when you do a blood test on somebody who's you know who's committed suicide it's sophisticated enough to tease that out so there's a lot of people who have

07:49the active metabolite in their blood I agree alcohol is a physically toxic substance cannabis is a neurotoxin for a lot of people but in addition to you know the death there's also just morbidity that that's associated with alcohol I mean it ruins people's lives that ruins marriages it leads to weight gain it leads to a lot of metabolic disease I think you I say that for some people with marijuana too I think you could say some people especially weight gain that some people smoke a lot of pot and they get lazy and they start eating cheetos all day and and you can also say that with some people you know the waking bakers that you know seem to be wasting their lives away and that's like the stereotypical negative con you know when you're we talking about a negative description of a marijuana user it's the wake-and-bake all right the person who's talking all the time you could

08:35absolutely say that could ruin relationships you could absolutely say that would ruin your job yeah you could but again to you know we're using the term marijuana and really we should be using THC or high THC when we're saying that okay because you know people who use I see VD every day as we know or most people listing this property BD is non-psychoactive yes not get you high super benefit you know that can be extremely beneficial for you know a variety of different disorders that people have yeah so you know we need to be careful at using cannabis versus using you know THC because the THC that can do that and to your point you know but you know you say like your th so you can cause the munchies and of course that's you know not good for someone who doesn't want to gain weight and just you know so people know the the way that it does do that is when THC attaches to the

09:23cb1 receptor you get an increase in hormone called ghrelin and ghrelin can actually induce hunger and that's why people get get the munchies but you know that it's not necessarily a bad thing if you're someone who has cancer for if you're someone you know who's wasting away from from from a terrible illness you know so sometimes you know having having the munchies is is definitely a good thing and i know you know a lot of people have said to me you know it's not available so you should probably you know not talk about as much but there is another cannabinoid called th cv so you know there's there's over 100 cannabinoids in cannabis cncd are only two of them you know those are the main ones that people know about so THC v has been shown to actually reduce appetite so if we can get that out there in the market you know like we have with with CBD then we can almost still eliminate

10:14or potentially you know substantially reduce the problem that people have with with with THC by using it with THC v doctor I have a question for you when people come into your practice did they do they want high CBD products or did they want to get intoxicated and you know Canada it's flat zero sure of course yeah so it's like if they don't need to go to him to get in time right so people so you're seeing a population that is genuinely interested in the health benefits absolutely because I mean if and I mean I'm glad that that that's legalized in Canada because it does make my job a little bit easier because being like basically everyone who's coming to me now I know that they want to use it medically because if they want to use it recreationally I mean they just go to the store right kind of a pain to you know get in to see me come in and have the discussion all that type of stuff so

11:02you know the people who see me now you know they're all using it medically and then you know to answer your question though Alyx almost all my patients as soon as they come in they say I don't want to get high I don't want to get high like that's almost what everyone says so you know I think the word is out there that you know CBD is non psychoactive and it doesn't get you high and I think that a lot of people are really interested in that compound and you know if if if the people didn't have the the success that they've had over the past few years you know it wouldn't be as popular as it is so you know I think that you know we do need to look at the scientific evidence but we do need to listen to others and the antidotal evidence is you know something that would that we should consider because it is so strong Alex let me ask you this why don't you consider it

11:48medicine when it has proven medical benefits well it obviously can be medicine for these narrow things that the FDA has approved it for but as you know I'm sure when people talk about it as medicine when the the the the the ballot initiatives that have gotten it approved as medicine have really essentially deceived voters about the process right so you go to a you you go to a pot doctor you get an authorization that authorization essentially enables you to buy as much cannabis as you want for the next year most of the time in reality these doctors are not giving you a real medical examination they're saying to you hey do you have pain do you have anxiety here's your authorization I don't think you should speak for every single doctor we don't do that at my clinic and I know that you know a lot of the clinics in Canada anyway we definitely do not do that and

12:39you know we provide a lot of education at my clinic and there's other clinics in Canada that also provide and and I and I imagine there's a spectrum but in the US this was a second and I spoke to advocates for my book I spoke to Rob Campea who you know who ran the Marijuana Policy Project for a long time for the book and he and he acknowledged you know the advocates knew that this was a backdoor route to legalization yeah I used to joke around about it yeah my doctor said whadya tea pot I said I get headaches he said when you get headaches I said whenever I think about the fact that pots of legal prescription let's be honest about I'm not really look I say in the book at the end I don't think this should be this substance should be legal I have favored decriminalization which sort of jumping ahead here but if it's gonna be legal I'd rather have it be legal for

13:25recreational use I'd rather that we don't pretend that THC high cannabis is a medicine and I'd rather separate it but yeah why he's saying don't pretend because there's many medicines that have horrific side of them the medicine THC in regards to children's autism is pretty significant and well-documented the epilepsy autism those are two huge things that happen with children that they've been shown to severely mitigate with with edible marijuana so I have to push back on you a little bit CBD has been shown to reduce seizures in children with epilepsy it's it's okay they may be anecdotal but I have a good friend who has a child who he uses it on and he showed it mean it's been a game-changer yeah I mean let's just let me in turn off for sex like I had a patient four or five years ago and she was 20 years old she couldn't drive a car because she had seizures right so

14:23you can imagine being 20 years old not being able to drive a car all your friends are driving around so she uses a little bit of CBD not even every day she's never had a seizure saying she's able to drive her car but this is we're talking about CBD he's talking about THC so and so you're talking about you're talking about a case okay and and I'm not saying that your friend's situation didn't happen I'm not saying it's not real what I'm saying is that the reason we have clinical trials is because science the way you know whether a medicine works or not whether a chemical compound works whatever that compound is the best way to know is you give it to two groups of you give you give the real medicine to one group of people and you give a placebo to the other group and you see the changes in those two groups over time and you find out whether or not your theory about whether this works

15:13on a population level basis is real or not that's how that is at the core of medical science and we've basically thrown that rule out for THC well that's not entirely correct you do know that there's were studies that were run in the Nixon administration that showed the efficacy of marijuana and the safety of it and those were all squashed and you also I'm sure you you know like when we're talking about marijuana you're talking about something that's federally illegal it's not something that's Eagle that's easy to run these FDA studies on yes and I do that and I say the in the book I think we should drop that I think anybody who's got a legitimate interest in researching either THC or canvas or any of the compounds for a for a medical condition let them run phase 1 phase 2 phase 3 trust let's see if this if this can if this plant is good for these things I think that's a great idea but

15:59still why are you saying that you don't think it is medicine when all these people find benefit in it so so do you think they're getting it from just the CBD the minimal amount of CBD in in marijuana no I think that again there there's been a lot of research done on THC and cannabis to see whether or not those whether THC is a compound and whether smoked cannabis can treat these conditions and for the most part the studies have been negative the again there's negative in what way meaning they haven't shown any actual like can you state aside these studies there I mention them in my book okay well what what were the conclusions these studies when you're saying that they're not positive that they again that they didn't work that the drug did not work on what on cancer on Alzheimer's disease on irritable bowel syndrome on also Alec's mean you know you're thrown a few

16:51different things out there and you know I appreciate the fact that we can't be going around you know saying things like you know cannabis cures cancer right but you know I you know and I've done videos and this even like recently stating that but if you look at the research I mean specifically if you look at specific cancers there are studies that have shown that GHC and CBD can help like it's safe we're talking about breast cancer and I did a video on this recently you know if you are her2 positive and you use cheat seeing CBD it can in fact reduce tumor size and it can reduce tumor growth now if you have what I'm sorry client and what does that mean a chi what is a subset of breast cancer right so there's there's different types of breast cancer and that's just one subset of breast cancer so there are other breast cancer which do not express cannabinoid

17:42receptors and you know I've seen one study at least again it's only one study that showed that when they gave TC and that animal model and actually caused a proliferation of of tumors so it worsened them so you know I do agree with you Alex in the fact that you know we have to be careful about using you know terms like that but that just doesn't mean that we can't say that cannabis is no good for cancer at all and I mean even in the National Academies of science and engineering report you know they said that cancer was was great for chemotherapy induced nausea and vomiting right so you know it's definitely a really good you know medicine for you know a lot of different things and and when we're talking about GHC you know i allure of course and we need to be careful about about THC but it definitely is still a medicine and you know to your point with regards to

18:29you know it's not being a medicine safe or something like PTSD you know I come from it from a clinicians point of view so I'm not a researcher so I need to make sure that my patients are getting better it's very frustrating for me just to say to someone oh there's nothing I can do for you there's nothing I can do for it you know so and I understand that you know doing something sometimes it's not going to be beneficial just because you're doing something you have to do something that actually works but you know we do have epidemiological studies and we have other studies or the shown that you know when when patients are given cannabis it can reduce their symptoms of PTSD there's also another study you know I don't use this drug too often call it called NAB alone so NAB alone is just pure THC nav alone was shown to reduce nightmares and people who have PTSD so

19:19you know it's just saying just so just because THC a psychoactive doesn't mean that it's not a medicine and just to keep on the topic of of PTSD in addition to that we've identified mechanisms of action I know I know there's one study I think mat Hill was on the was one of the authors of that study and he noted that in people who have PTSD there's an over 50% decrease in in levels of inanimate so an image is a naturally-occurring yeah which is which is naturally occurring tank in the canal but it correct so you can get that through through exercise which is one excellent way to do it you know and that's part of the the high that you get when after you exercise but the other way you can get is by using cannabis so when she attaches those cb1 receptors you can get a release of an and amide and it's cannabidiol can actually increase in an amide and by another mechanism of action

20:15as well so you know there's different ways where we can you know raise a level of deficiency so you know to me as a clinician you know if I have someone who is not doing very well you know they've been on a bunch of different medications I've identified that you know they have PTSD we have mechanisms of action we have studies and then again to you know don't discount my clinical experience right I've been working for over five years you know just with just with cannabis I mean I do other medicines I use prescribe other medicines as well but I've been doing Kandice medicine for over five years and you know there's a lot that that I've learned right so as much as I've learned you know through reading studies and if you're going to conferences and things like that you know for sure that the the best resource as a clinician is is to learn from your patients and and

21:05to hear what your patients tell me and you know the the things that my patients tell me is that THC is really effective for the sleep at night and a lot of my patients especially my veteran patients have done really really well with that and just just one further point too you know there was I know it was 2015 I believe it was there was a a meta-analysis done I can pull it up if we need to that indicated that you know a lot of medicines that are being used now for PTSD are just simply ineffective and the other thing too is that there's never been a medicine made specifically for PTSD so all the medicines that people are using or for anxiety or they're for depression or they're for insomnia at the frozen earth or for something else you know but when we look at like like a study that says people with PTSD have a lower level of an and imide and then if you can increase that

21:53a level of an animai you know that's a good way to treat someone it doesn't matter whether it's a vitamin whether it's a hormone if long as you are correcting a deficiency you're generally going to get excellent clinical results so let me let me sort of try to frame this a different way alcohol reduces blood pressure ok alcohol in you know generally tends to reduce cardiovascular events for people and during Prohibition you could actually get a doctor's note for alcohol as a medicine but alcohol is not a medicine okay it's a recreational intoxicant it has some positive biological qualities and some negative biological qualities and you know there was an argument I think in 10 to 20 years ago should we recommend that people drink moderately one to two drinks a day and I think for the most part the medical profession has come down on the side saying let's not do that

22:44there's too many noncardiac negative side effects with alcohol just on the north of Alex in Canada right now I know the safe alcohol drinking guidelines are 14 drinks 50 men 29 drinks a week for women so you know two a day over men one and a half for women so you're saying okay like there's we don't see huge negative consequences at that level okay that's that's fine like that's a totally reasonable way to think about alcohol but what we're not saying to people is this is a medicine and I think that's where the confusion around really around high THC cannabis lies and I and again I don't mean to say that your friend's child is not benefiting I if you say he or she's benefiting I believe you what I'm saying is that that's not good enough for science we need randomized controlled trials and when those trials have been done and a lot of them have been done Jo a lot of them

23:39have been done they've almost unequivocally shown that cannabis doesn't work as a medicine the only actual place where beyond these sort of very limited conditions like chemotherapy associated nausea which obviously is terrible for people who have it but isn't you know isn't that common fortunately um cannabis has been shown to work as a pain reliever right probably for the same reasons that alcohol works as a pain reliever deserve dulls your awareness of your pain but even in that study or in those even in those studies they're mostly done against placebo not against opioids or against NSAIDs like ibuprofen and there was a very big study for cannabis use in chronic paying over a multi-year period in Australia that came out last year that showed that people who used cannabis had a had more pain and used more opiates at the end of four years than people who

24:32didn't so that so I we're almost argue about what medicine is yeah that study though had a lot of flaws in it and the other thing is that you need to look at someone who is already using cannabis versus someone who is just using opioids so if someone is just using opioids and they want to come off cannabis you know there's multiple yeah sorry sorry come off of opiates with cannabis you know multiple studies have shown that that that can be effective and that's not was what was done in the Australian study that that you refer right it's a more naturalistic approach right and and also to you know they they didn't have access to medical marijuana during that whole during the whole time right so those were all self-reported and they were getting it from you know recreational sources they weren't getting it from that's a big that's a big distinction though Alyx like they weren't getting it

25:22from a doctor who prescribed it two of them they were there this was a self-reported study and people are getting cannabis that you know they didn't really know what they were getting it wasn't they weren't given any information from a doctor and that's why it's a medicine Alex because you can tell someone you can tell a patient to take you know a certain amount of CBD every single day and when you take a certain amount every single day it can reduce your symptoms and sometimes you need to increase that and sometimes you need to decrease that thing we should do that with all medicines we should be really clear about the distinction though between CBD and marijuana I mean we're really talking about the psychoactive version of it I mean this is where what you're saying it's negative yeah you're not you're not really arguing that and I think you know dr. Hart is talking about he's talking

26:05about using this as a medicine certainly using the CVD he's titrating his patients he's monitoring them he's not writing them an authorization and saying come back in a year when it when it's up he's he's he's being a physician and you know and I think to the extent that marijuana is medicine we want people like him so you admit it's medicine no no no I don't admit that but you just said that I don't think I just said that I said to the extent I'm trying to have I'll stop doing that but you know I think you said something else that was really interesting to me and this came up in the book - so you're a clinician you see sick people and it was funny my wife's a doctor - she's a psychiatrist that's how I sort of got him this but my wife is a forensic psychiatrist less than a clinician these days her job is to evaluate people not so much to treat people your job is to treat people you

26:58see sick people you want to help them feel better and you don't want to tell them there's nothing I can do for you there's nothing there's there's no hope for your pain there's no hope for your PTSD you want to help them and I totally get that but if you're an epidemiologist or a researcher who's who's trying to guide the you know the the the views and the medical practice of hundreds of thousands of doctors that's not good enough so you need to step back and I think I think you know this this epidemiologist and in Britain who I talked to he said to me he said you know I try not to draw conclusions because so often when I try to draw them I'm wrong yeah and we need to be you know careful about that right and and Alex you know you know one thing that was mentioned in your book you know is that you know you officers you often cited the National Academies of science and engineering

27:47right but you know ziva Cooper you know she's a member of that committee I mean she put out on 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 which came that which by the way that context were came from right but this is a someone you cited no I didn't cite her excited to Kate you say that you cited that the report and she's a member of that of that okay so she said in response to the recent Newark Times editorial on canvas as a committee member on nasan which is that committee and cannabinoids report we did not conclude that cannabis causes schizophrenia then the drug Alliance policy also said the report and did not reach that conclusion so you know those are pretty too authoritative you know sources that are saying that you know in

28:41your book you didn't cite the research properly right and then also they're saying that you left a lot out right they said that they have found an association between marijuana use and improved cognitive outcomes and individuals with psychotic disorders that's straight from the same report and you know you failed to mention that right so I think that you know when we're writing books or when we're giving out information you want to do it from a balanced approach and you don't want to just select you know the small amount of material that's just going to support your study you know we want to be truthful here you know Joe's show has always been very truthful I mean Joe said right right at the beginning he doesn't think that that the cannabis is perfect for everyone and I don't think that either and in Canada you know we have really strict guidelines to follow

29:29you know basically no one prescribes cheap seed anyone under the age of of 25 and you know all the conferences and stuff that I go to you know we don't really have too many discussions about that like the doctors don't really have many you know much of a backlash about that so why is a distinction at age of 25 or they decide that age so 25 basically is when you're your friend oh yeah it's fully developed and when you do look at the studies that do show you know an association between between cannabis and psychosis it's almost all in adolescents you know I think that Alex only has one study and is in its book that shows an extremely weak correlation between an adult using cannabis and then developing any type of mental illness later so you know 25 is a it's a good age but it's definitely a you know kind of a conservative ish ish age but you know it's it's something

30:27that that we follow and I think that you know we've done well with that in Canada so Alex why did you leave those conclusions oh I need to push back here okay so the National Academy of Medicine report was drawn up by committee of 16 researchers ziva Cooper is the one who's publicly said the report said this but I think that we should have emphasized that it also said this okay what I what I wrote in that New York Times op-ed I wrote in the book is the plain language of the report and the plain language is this cannabis use is associated with a risk of developing schizophrenia and other psychoses the higher the use the greater the risk I may have a word or two wrong and that because I'm doing it from memory but that's what it said and by the way the committee was very clear they separated depression they said there we don't see as nearly as high risk for depression as

31:23psychosis even though by the way today just today JAMA psychiatry the Journal of the American Medical Association Psychiatry put out a meta-analysis showing that cannabis is associated with depression and suicidal thinking and actually suicide attempts at a three and a half to one rate this is this literally was released today but - but to go back Ziva is one of 16 members of that committee so if you're gonna talk up if you're gonna say that I miss quoted the report which I didn't I quoted in entirely accurately you need to say well why aren't the other 15 members of that committee saying that I miss quoted 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 miss quoted it maybe she maybe we should ask why the other members of the committee are not speaking out against my book well I

32:16think that she was just one of the 16 members that that came out but you know you can't really expect all the other members to potentially you know come out with that why not well some people did something wrong if I'm excluded to them well some people will and some people won't you know some people have you know the personality some people have the platform like you know Ziva has a bunch of followers on our Twitter people know who she is you know a lot of people who do research actually are not into social media at all like I don't think you were at all before you you had your book were you yeah okay yes so so urine into social media at all so you know I don't think that most people on that committee are are into social media you know Ziva just just happens to be and you know I even spoke to Ziva on the phone about this and you know and and she said that yeah

33:01you know I I don't that she agrees with everything that was in the report but she doesn't agree with your conclusions and to go back ones are quoted from the report but you're only quoting there but you're only quoting the parts that that site or sorry that back your your opinions you're not quoting the entire part like you left like why did you leave out the part that said they have found an association between marijuana use and improved cognitive outcomes and individuals with psychotic disorders right so you're leaving out that part so why'd you leave out that part if you can find me a psychiatrist who thinks that it's a good idea for somebody with an active psyche okay it's ordered why'd you leave out that part well my book presents it makes a case right it makes a case that this is a big issue that we have not heard about at all and the reasons that we

33:53haven't heard about it have a lot to do with the advocacy community and the way they've presented this data for 25 years I wrote a book that is trying to break through a lot of noise so but still like to get a balanced approach did you decide that you would say only going to write about things that confirm your the belief that you held when you were writing this and what you were trying to push in the title of the book and then in the conclusion of the book I think that's a really great question I say in the introduction of the book this book is not balanced okay there's not a lot of evidence in there if you if you want to read about how indica and sativa strains are different and right you know you're not gonna read that in this book this it but I will also I also want to say this I didn't come at this and I say this in the introduction in the book too

34:41as an anti cannabis Crusader in fact when my wife said to me as she said to me over and over again in 20 you know 14 and 15 and 16 these are the cases that I'm seeing these are the terrible things that people are doing after cannabis use I sort of said to her at first of all why do I always have to here but this is the dinner table but but more importantly you know why why is it that maybe these people were using other drugs maybe maybe you're seeing a slice of the population that it's not representative why is it that I should believe this this sounds like reefer madness to me and you know ultimately my wife who's the one who went it you know she was actually as I was talking to dr. Hart about this she grew up in Newfoundland - she went to the Memorial University of Newfoundland medical school and she went to Harvard and Columbia for her postgraduate training

35:29you know eventually she got tired of me yapping back at her and she said why she go read the studies yourself and it was that that led me to read to write this book because when I read the studies I could not believe the strength of the evidence Jo but you still even saying that you you're still seeing positive results that you're you're excluding okay there's there's this one there's this one Centon that means not just one sense but but there are a few sentences about how it may be that cannabis helps people's positive it helps it helps cognition in people with psychosis maybe maybe not wouldn't that qualify as medicine not if it no it wouldn't be approved as medicine if it's causing they have other psychotic episodes but if these people have psychotic breaks and improves cognitive function and people with psychotic breaks so so it wouldn't that be something that you would prescribe

36:23does no one know again you need to think about how the FDA is looking at medicine oh I understand the FDA's position sure but I mean I'm looking at it as medicine I mean if we could prove this through Studies and through some sort of clinical trials if it is improving your IQ two points on a test it is I'm not I'm it's making you floridly psychotic you're not that's not medicine well it's not necessarily at the same time one of the things that I read about schizophrenia was that there's people were trying to make correlation between marijuana use and schizophrenia but the problem with that correlation and what I read and maybe you could help me on this yeah was that it's the exact same number that you find the general population is essentially 1% of the general population has schizophrenia which is one out of a hundred people and when you have marijuana users you see is essentially

37:17that same number mirrored and so they're saying a small no that's not true hold on but listen 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 but they were disputing this in this study because they were saying but because that's is mirrored in the general population again correlation does not equal causation rather I think you gotta tell them that's not true tell me truly what that means so traditionally yes when you look at the stats you'll see that you know the people who use cannabis versus the people who don't use cannabis have very similar rates but you know getting to the exact rates you know so in the u.s. they say that the range if for schizophrenia is between 0.25 to 0.6 4% globally they say it's 0.33 to 0.75 percent so you know right there it's you

38:08know apparently lower in the US and the u.s. is is has the highest percentage of cannabis consumption in the world and the u.s. also has a lot of people that are using high potency THC so you know I think that you know we really need to be be careful about throwing out you know stats like that because you know when you do look at the stats that we have it shows that even though you know the kick that there's a lot of cannabis use in the United States schizophrenia rates have remained the same so I have to push back really hard this is one of the great myths of legalization okay um no one knows what the schizophrenia or psychosis rate in the is in the US right because a lot of people aren't treated people aren't treated people are get different diagnoses at different times and we have we have bad health care in this country and we have a lot of protections around mental health in fact

38:57in 2017 the National Institutes of mental health suddenly changed its estimate for the percentage of people with schizophrenia in the u.s. from 1.1 percent to 0.3 percent they did it with no public notice and then this researcher said hey this is a miracle they just cured 2 million people with schizophrenia and the and then in response to that the director of the NIH said well we actually don't know how many people have schizophrenia in the United States nobody knows nobody knows if the rate is increasing nobody knows if it's decreasing the only countries where they can count noses on this with any accuracy are in northern Europe because they have good health care because I have slightly you know less protections around our individual privacy and mental health privacy and so they are able to count cases and in Denmark and Finland which are which are the two places where they've actually

39:47done this research in the last 20 years they've shown increasing rates of schizophrenia between about 1995 and about 2010 and that goes side-by-side with increasing rates of cannabis use in the 90s so the people who are saying that there's no evidence of population wide increases in psychosis are just wrong that's possible there's other friends oh absolutely environmental factors is a bunch of other different things let me let me sit there on this we absolutely don't have the evidence at this point to say that cannabis use in the u.s. is causing a population level increase in psychosis and schizophrenia which are by the way those are sort of different illnesses and we can we can talk about that too so we don't have the evidence to say there's a definite increase but what I'm saying is that what you have been told that there is no increase in schizophrenia or psychosis rates in the

40:36US that's we don't know if that's true or not we just let me ask you this there has been proven that there's an increase in marijuana use is that correct correct how when when did the increase begin and how what how what percentage increase so there was a there was an increase in the 90s an increase in use and in potency you sort of bottom doubt around 1991 and then there was sort of a flat bottomed out mean it has an increase in tonight you 54 cent since 92 it's a lot letting you expect a corresponding increase in schizophrenia if there was any sort of correlation so hold on let me just let me walk you through okay it bottomed out in the early 90s okay I increased again increased in the 90s flattened out between about 2000 2006 and since then has been going up again especially in let's say the last three four years and the other thing is that potency in the

41:26last 15 years has gone way up I think anybody would dispute that but okay it's a friend a gun so what I'm saying to you is we don't know there is evidence there is there is now evidence on a population level basis in those other countries that schizophrenia and psychosis has gone up and there's for the first time in 2017 there's data showing that serious mental illness which is not the same as psychosis or schizophrenia in the u.s. doubled between 2008 and 2017 in the and the in people aged 18 to 25 and those are the people who are most likely to be using so for the first time there's actually evidence of what you're talking about which is a population wide increase now again I'm not gonna say can I get you to clarify it should say serious mental health serious mental illness so this was defined there's a study called the national survey on drug use and health

42:18it's done every year covers 70,000 people federal government funds it it sort of the best data source we have on all this stuff it showed that and they're not counting cases either no but let me just be as clear as I can on this nobody's counting schizophrenia cases on a national or even state level because in the US but you say to people did you have depression so bad that you couldn't get out of bed did you you know were you hospitalized this year for psycho for for any inpatient psychiatric reason and and if you look at those numbers in 2008 three point seven percent remember it may be three point eight percent of Americans 18 to 25 reported at least one symptom so they were categorized as having serious mental illness that year in 2017 that number was seven point five percent so that's a doubling so again I am NOT going to say that proves that the

43:16increase in cannabis use has caused this this population some things but something bad has happened and if you look at kids 12 to 17 interestingly they over that time period didn't have a big increase in cannabis use in general teenagers are actually are pretty healthy now although Jul and vaping may be undoing that and those kids didn't have a population level increase in serious mental illness can I stop you for a second there because there's other factors one of the big one is you've all know a herati has a great book 21 lessons for the 21st century I really I read that it's great and one of the things they talk about is the onset of social media Jonathan Haidt talked about that as well and that the onset of social media is actually more hate and then you Vaughn Harada but the Jonathan Haidt talks about it with young people yeah that's a huge American mind yeah I

44:07think that social media and the pressures of social media have led an incredible amount of young people to serious mental distress you know serious anxiety serious depression and suicide amongst young girls has increased some 50 percent according to hate over the period of 2007 - I think 2000 and whenever his book was written and I think they're directly correlating that to the pressures of social media and to you know anonymous online bullying and all these different factors that are affecting kids yeah so I think that that could be considered a far more significant new form of distress to children and young people then even marijuana I think it does it twofold because I think that you know what makes people really depressed maybe more so than than anxious but definitely both is that when you compare yourself to someone else and you know you know people you know

45:03obviously that we've done that you know all all humans have done that you know since history began but now everything is online you can compare your life to everyone and if people are doing all the time and even worse than that and you know we should talk about this too is that the income gap is getting is getting water so it's like people's lives not only are they getting you know better than other people's lives but it's but it now it's on it's on display so everyone can see it whereas before you know maybe what you wouldn't have seen it because it wasn't on social media but now it's on social media so you have this huge income gap that just keeps getting bigger and bigger and bigger and then you have people going going on social media and they're comparing themselves and you're absolutely right especially in that in that age population mean people under

45:48under the age of 30 you know they're definitely you know they're being bullied online like I see every day in my office like literally every day people are being bullied online and that's you know something that I never had you know to deal with growing up yeah and you know a lot of kids do have to have to deal with that just one more note - on the since Colorado has has has legalized cannabis is this important for for this this is the subject miss topic they've actually seen marijuana rates decrease so it's important for people to know that you know no no no no they've decided tnehews or overall use overall has gone up tnews is flat overall uses up okay yeah I'm talking about teen you've got that'll got that's the category that were talking about under under 30 right so teen use you know what classify is part of that category so you know in Colorado we have seen a decrease do you

46:42think that's because of the lack of either because it's not illegal it's not as exciting to them part of it for sure you know and I mean part of it is like one worry I had you know I haven't looked into the statistics yet it was you know when when you're growing up and when you're in high school you know if you want to be part of the you know cool crowd so to say what you know you usually drink or you smoke pot you know that's what so people do I hope that that doesn't change because pot seeing as medicine I hope that you know people don't you don't move on to or do something you know harsher because they don't see pot as cool anymore right because it's legal yeah so I got a pushback on the whole thing please so everything you say about social media is down you know it sort of intuitively sounds correct right the problem is the data doesn't support this at all the

47:35data shows that teenagers another 12 to 17 those kids are healthier than they were ten or twenty or thirty years ago they drink less they smoke less they have sex later that fewer abortions they are healthier okay okay and their mental health doesn't seem to have changed that much based on the NSDUH data okay the data shows a big change in kids 18 to 25 they go to college something goes wrong for a lot of those kids at least in the last few years now but wait a minute even when you're talking about suicide rates suicide rates are there especially with young girls who are apparently more affected by social media they have gone up significantly since the rise of social media that is the big factor people for almost a second more so than cannabis use and then that's a fact so so you're so you're talking about a tiny tiny number the people who know no it's not a

48:28tiny number it's a fifty percent increase of people that commit suicide they're young girls the people who commit suicide in the United States are middle-aged white men wait a minute you're discounting these young girls that are committing suicide to fit your statistics or fit your conclusions no what I'm saying is that's a tiny tiny number but it's it's a 50% increase is not a tiny amount this is something we can look up well let's find out what the numbers are like because like when Jonathan hate was on the podcast and he discussed it I mean he showed this chart and it's an alarming increase directly correlating with the increase in use of social media sure but you push back against that it seems to be a factor what what I'm when 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 ones saying they're less healthy you

49:18just said they're more healthy yeah I'm saying they're more healthy we're saying that mental health has nothing to do with cardiovascular to use drugs they're less likely to have sex but it's more likely to commit suicide that is a tiny tiny number what are you talking about if it's 50 percent increase that's a huge difference we should look up the number if we're gonna if we're going to look Jonathan hates work is like very well-respected what I'm saying to you is that there's a clear increase in psychological distress in kids and young adults 18 to 25 okay there's a clear increase and those are the people who are most likely to be using cannabis research the people that are most likely on social media as well sure and that's the stressful period 17 you should live in at home like 18 to 25 then you got to go to university you got a deal or seize the moment you concede that and I've

50:09said in the beginning the program that I think the marijuana with some people is not beneficial and in fact could be negative but I don't understand why you're not willing to admit that social media has a significant and unprecedented impact on young people that we've never seen before I would totally agree with it but I don't think that you can say based on the population level data that the impact is all negative it may be listen maybe who's saying that the impact is all negative what we're saying is is a 50% increase in suicide with young girls right but that's Hugh let me give me an example when you were 15 or I was 15 maybe you got really drunk right and wound up in a bathtub like maybe kids today are less likely to do that because of social media because they know it's gonna be on Instagram forever I don't think that's true I don't think that's proven and

50:54there's anything that would point to that well what I can tell you is proven is that kids today I'm talking about teens 12 to 17 have less psychological distress by all these measures I'm talking about their actual behaviors are better or a better or worse that's a moral judgment but they're healthier than they were ten or twenty or thirty years ago they're less likely to have sex they're less when they're 14 which I think must be was a good thing they're less likely to be drinking they're less likely to be smoking those are good things well less likely to be drinking less likely to be smoking less likely to have sex does not correlate to positive mental outlook and less suicide well yes there's I agree there we look let's look at the numbers but depression and suicide are the very difficult things to measure right depression it's a hard number depression is look at this spike

51:48the bottom number is oh okay I mean this is what I'm saying the death rate first of all this is this is okay the death rate for girls aged 15 to 19 is four per 100,000 jokes of 40 it's at a 40-year high right so I mean you'd be hard-put to say that's a huge spike it was three per hundred thousand in 1975 and it's a little bit over four in 2015 that's not that's one case per 100,000 girls yeah I don't know what I don't know what the actual facts are I'm looking at this right now suicide rates for teens 15 and 19 years this is something that we'd have to study sure people have this discussion it's spiked for boys in the 1990s yeah is that about 95 what enormous if you put middle-aged men on this turret you'd have to you'd have to blow out the ceiling like people the suicide crisis is unfortunately a crisis of age okay I would agree with that I think well we

52:45actually talked about that yesterday with Andrew yang that suicide amongst men in their 50s and then they start to feel useless yeah yeah and especially if they lose their jobs but what Jonathan Haidt is pointing to is a direct correlation between social media use depression and suicide amongst young girls thank you for finding what is it this is the article it's from his from this suicide rate 14 girls the highest it's been in 40 years is social media to blame right so okay new data prevented released Thursday by the Atlanta based Centers for Disease Control and Prevention suicide rates amongst 15 to 19 year old girls doubled between 2007 and 2015 reaching a 40-year high I would say that's significant again I would and and it's obviously a terrible thing when anybody commits about it but we're talking about 2 per 100,000 I understand it's it's 5 well what for 2 to 4 okay

53:36that means for every 100,000 American girls in 2015 5 committed suicide that's not a very high number but I mean that's also someone who's pushed to the extreme taking their life how many girls are experiencing severe depression but don't commit suicide that's the real factor because this is what hate directly connects to social media again the 50% increase you're talking about a relatively small number because not as many girls commit suicide as men but still this could you're talking about you were talking about depression right and you were talking about these significant factors it would lead people to be to have poor mental health yeah this could be a huge factor in this right and I think that too it leads people to you know suicidal ideations and depression and anxiety I mean right here we're just looking at charges you know the worst endpoint possible it's

54:28very rare amongst girls period yes right or not or less it is yes men do commit suicide more than women do but you know we really have to be you know careful about that because you know again suicide is is the aim that's it's the worst thing that could possibly happen so what about you know all all the all the things leading up to it you know are there people who who don't commit suicide but you know suffer from terrible depression suffer from terrible anxiety suffer from terrible insomnia you know those people are not accounted for in that graph III agree and what I'm saying is that cannabis use has spiked in the United States in the last 15 years and teens notwithstanding we've seen a large degradation in a number of these social outcomes and now just today we have a JAMA psychiatry paper that looked at a bunch of other studies that said cannabis use in teenagers is associated

55:22with depression suicidal ideation and suicide attempts in people once they get to 18 to 30 okay maybe a factor what's his part it could possibly be a factor yes but it might it might also be that these kids are depressed because of social media and they're using cannabis or they're depressed because their friends died from opioid overdose there's a lot of potential you know we are conceding the fact that you know you just said again that study was done on adolescents you know Joe and I have both conceded multiple times that you know we do not think high GHC cannabis is good for people in that age category but you know just just to back up just a little bit again you know I don't like I said earlier that you know I don't prescribe Chi C generally to anyone under the age of 25 most other doctors in Canada don't but I think that we should be prescribing CBD to these kids like a lot

56:14of those kids you know who have suicidal ideations depression I mean you know you could never do a study on it but you know how many of those kids wouldn't have committed suicide or wouldn't be feeling this way if they were using CBD because we know SSRI selective serotonin reuptake inhibitors you know which are the most commonly prescribed medication for depression and anxiety even in adolescence we know that they they can increase suicidal ideations that's been shown I mean it's written right on right on the package so again like as a clinician you have to you know treat your patients if you're just treating people with something that's it's not effective or the that has your horrible side effects you're going to look at other alternative treatments a lot of people have have shown our sorry have had excellent results with CBD in that age category you know I've had had it done in my

57:09practice and lots of other you know physicians have had it done in in their practice so it's really important that when we're talking about teenagers and when you're talking about that study you're talking about high potency THC in adolescents that's where you know Joe and I both can see that you know THC is is not a good medicine look if GW Pharma or somebody else can do a study with CBD and depression or some other cannabinoids and non-intoxicating cannabinoid and depression and get it approved for that that'd be great we need we we need all the treatments for depression and for and boy do we need treatments for psychosis that we can get I totally agree with it and I'm really glad to hear you say you don't think that adolescents should be using high potency or any no and they and they should try it it's also you know stay away from the other medication so I want

58:02to push back on this on the alcohol versus a cannabis for teens thing and I know that this is a common feeling among you know among people in Brooklyn and among people in LA and sort of right I mean right think yeah me sir you know sort of the general center left to left you everywhere is that cannabis is better for teens than alcohol I totally disagree with that canvas alcohol would no one's saying that I'm just saying alcohol is bad too we agree but you know I mean I think you have heard this right oh I'd rather have my kids smoking pot my 16 year old I think that's crazy you you have to really be careful with anything that severely perturbs your sense of reality when you're a young kid and you're trying to form your vision of the world I think to unpack what we're saying here is that there is an increase in mental health disorders amongst young kids that corresponds to the increased

58:55use of social media and may correspond to the use of cannabis but that's not necessarily proven what we'd guarantee almost universally is these kids are on social media yeah and and also to I think much more likely that they're on social media then use cannabis I think a lot of them use cannabis I don't think all of them I think all of them were on social media absolutely yeah I think that you know almost every single kid these days these days has a cell phone and they have some type of social media account I'm worried about kids using everything I'm worried about them using valium I'm worried about these stimulants are all yes Zach I think I think psychiatrists give out a dd medicine yeah it's too frequent i oh 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

59:54trying to get into a good college I know so many people that are on that I know so many people whether they're journalists I know comedians I know a lot of people we're on adderall yes yeah and you need to develop that kind of like toughness when you're young like it shouldn't just be like you know 14 years old and then you know you run into your first you know bit of trouble in your life and then you you reach for a pill that's terrible right that's a terrible coping coping mechanism so you know 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 gonna take this pill you need it for the rest of your life and that's said to people all the time oh you have a biochemical deficiency and this is what you need we need kids to be tougher right so you

60:44need you need them to you know build up some resiliency so that you know when they do go through hard times you know they have better coping mechanisms like Joe talks about diet and exercise all the time I talked about diet and exercise all the time literally you guys delivered and that's kind of how I got my my start on social media it is through diet and exercise yeah I found the exercise is a big one for you kids I mean it was a gigantic factor for me personally when I was 15 years old I really got into martial arts and it changed my life it changed my life by alleviating so much anxiety giving me so much more relaxed my parents talked about to like there's to use there's you before martial arts is you after martial arts but you have relatively young kids yes and so do i and boy they love the devices I mean I mean we have to fight and we you know our kids the fortune

61:30under 3 & 6 at this point they don't have their own iPad or iPhone or anything but but you give it to them for five minutes it's like crack it's like yes you got a tear down to their hand oh yeah my kid just turn their shoulder what I try to get the iPad from her they're like no no no one more one more like it's crazy it's a little made it's it's very fun and exciting for them you know and look it's not entirely negative like we have this this TV setup with this dance game that they play and they're sweating and dancing and after it's over the giggling and laughing it's in a massive alleviate er of physical stress because it's like they're constantly got to follow this thing and it's it's an exercise routine yeah I mean they're really their cardio they're there for cardiovascular rate it gets up and they're they really feel good afterwards so it's not entirely negative but it's

62:18mostly negative yes yeah yeah but if you have like I don't know is that Nintendo Wii or whatever it is yeah you can do well it's an Xbox is this little thing that scans it or you actually can use your phone and if you hold a phone you like I'll give them my phone my wife will give the other one the her phone and like the phone shows how you're moving that's right right so like like you mimic this thing that the person on the screen is doing but that mean that's one thing that could could be considered positive I think for the most part the real issue is social pressure and anxiety that comes from kids talking about each other and they they push buttons they push buttons on each other because they know that they can it has but you would get free from it when you went home you're not free from it ever now these kids are waking up in the middle of the night and checking their

63:12Twitter account and finding their friends are talking about them whether it's on Facebook or whatever and this girl from school that and she commented on my youtube video this is dealing with yeah you know look at her with her fat face lol and then this little 12 year olds like oh that is that's a severe severe factor that no one had to consider before yeah and it makes you almost not want to go to school like those kids don't go to school because because of that because they don't want to have to deal with you know someone said some idea in my office all the time someone said something to them last night on social media so I didn't go to school today because they don't want to have to face that like that's something that you know my generation never ever had to face but but I do I mean I do I think we're a little bit off topic here in terms of so we're time at depression and we're

63:59talking about a factor could be considered as big if not bigger but social media now was people to get psychotic I don't know about that well I don't listen this is why I don't know about that severe anxiety lack of sleep depression absolutely are correlated with altercations on social media sure but social interactions that are severely negative they're correlated with poor mental health the good news is the brain is a relatively strong and power for some people but if you look at situation levels of psychosis okay again it's less than one percent for schizophrenia which is the most severe version you have sort of yet bipolar disorder psychosis depressive psychosis other kinds of psychosis maybe you get to about three to four percent of the population is going to be diagnosed clinically with one of these illnesses over the course of their life so so okay

64:55on the one hand that's that's a lot of people on the other hand most people are not gonna get psychotic and most of the time if they do there's either a genetic component that's obvious because psychosis and schizophrenia often do run in families or there's an environmental component that's that's pretty obvious how many people can get psychotic they can get a brain tumor can make them psychotic they can you know late in life they can get dementia that makes them psychotic there's oftentimes a pretty clear organic cause okay so when we're taught so so the brain is a relatively strong and healthy organ and it takes a lot to break it and that's why I mean that's a bold state is a bold statement but I would not I would not agree with that at all you really you think no okay I mean I'm not saying that people don't get depressed takes a lot to break people are depressed although I'm

65:44talking about the trio that the anti-psychotic medication was a number one prescribed medications crazy like people say to me you know that people used to say oh I'm on antidepressants I'm on I'm on anti-anxiety medication now people like I hear them at parties and stuff saying like oh I'm on seroquel I'm just thinking like well that person just tell a bunch people that like they're on antipsychotics great weird that people don't know that Sarah : Adam Baelfire antipsychotics right because they've been sort of marketed as outside the class when in reality they're part of the class but I got a push back on you a little bit sales numbers for those drugs those are expensive drugs they're not the most prescribed drugs in the country hold on abilify was the most prescribed drug in the United States just look that up we know we have Odetta we've talked about it on the

66:27podcast because it's insane that is insane and we do we go to this is a good time to to talk a little bit about about genetics after we don't look at this as we can tease out a few things by looking at genetics this antipsychotic abilify is the biggest selling drug right us to be a top seller drug has to be expensive and also widely use abilify is both it's the fourteenth most prescribed brand name medication so it's 46 but that's crazy all the people with actual diseases this is a fourteenth most prescribed brand name medication of retails for about thirty dollars a pill well doctor I mean doctor can probably tell you that this is getting prescribed as an add-on antidepressant Fulsom what that is - is that are struggling men like like life is hard for a lot of people like very hard very difficult okay so a lot of people need something sometimes at the

67:19end of the day or during the day to help them get through the day cannabis you know especially the CBD component and also the THC component when used properly is okay like I tell people all the time I've made I've made social media posts about it that like you know 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 like drugs and like you know prostitution gambling and all these other brutal as other people have if you doing all that then like you're doing you're doing pretty good overall right so gambling is not bad people handheld devices that that are inherently addictive where they can bet on sports every 15 seconds there's a super bad idea hundred percent agree you talk about that - yeah you know it's one things benefited me with social media is my eyesight is going older I can't even

68:20read my Twitter feed I these people I don't live it if I don't put my glasses I don't know what the there's Hank oh my god people don't get depressing it actually I'm saying psychosis is a different thing okay okay I think we are discussing overall mental health yes I mean look I'm saying this because I really think that this is something that I've made a big turn over the last few years with myself that I don't often break yes please go I don't think marijuana is as safe as I used to think it is I used to think it was benign I really used to think there was no big deal but I have a friend that I discussed the other day who was a really confident muscular a handsome man that never did anything and he took a marijuana edible to go to sleep and for two weeks this guy was fighting this is a different guy not that I was talking it's not Rafi no a different guy he took it and he

69:14experienced suicidal thoughts and and all these he had like severe consequences I think that the 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 as saying that one reason it's interesting what not reason I think that alcohol is so widely accepted despite all the problems it causes and again alcohol can certainly cause problems yeah is that alcohol affects most people pretty much the same way you know if and you sort of know if what somebody looks like when they have one drink when they have five drinks got some dresses I've got some friends that get those gerbil eyes you ever see when they start talking crazy but you sort of know that and you sort of know how long it's gonna take to clear your body and you yes cannabis is so different it's a really

70:08complicated drug and it does affect different people in different yes and also the tolerance has changed yes okay so you know people say well two and a half milligrams of THC you vape it that's like one drink for somebody who you know who doesn't use but then if you if you're a tolerant user you can use 200 milligrams in a day that's eighty drinks yeah it's a weird drug and then there's the issue of eating it yes when you eat it your body produces something called eleven hydrogen's on the tab alight it's a far more psycho act you are all along for the ride when that happened yes you are yes and it can take days for it to get out of your system I know many people have eaten marijuana edibles and then they call me up the next day like dude I'm still hot yeah yeah so so so I think I think the legalization community has sort of said for years like oh there's basically no

70:57downsides to this there's only upsides the cops will bust smokers there'll be tax revenue all these people have a way to get high that's clearly safer than alcohol and unfortunately that's just not true I think you're right and I think the the issue that people from what I've read are having with your book or people that are marijuana advocates that think that your position is unbalanced and that you've ignored the positive aspects of THC in terms of like what he was talking about cognitive benefits for people with psychotic episodes and that you were only focusing on the negative plead guilty today yeah because I think that for 20 years people have only heard the positive right eye I think that's I think that's also I'll plead guilty to that myself because I think that I've only been discussing the positives and one of the things that I've tried very

71:43hard 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 examine my own positions and try to figure out am i coming at this from a truly balanced position or am I trying to support a conclusion that I started out with and I'm trying to you know somehow or another back up my own work or back up my own just my own statements and and and sort of prop them up instead of being really honest and objective it's very difficult to do listen I wrote a book called tell your children the truth about marijuana mental illness and violence you're I don't think you can you can think that that book is gonna be a compendium of the pros and cons above if you want to tell your children the truth though you really do want to tell them the pros and

72:29cons right and you did indicate Alex you said you know we should tell people the truth yeah in the book right so you know I think that when you're telling and you're saying that that you're telling the truth and Alex I'm agreeing with you that you're killing part of the truth right but part of the truth is you know a little bit deceiving and deceptive it in some ways right you want to tell the whole truth when you tell the whole truth then you give the whole story and the people can actually make you know a good informed decision based upon that like if people are going to just read one part of the story then of course they're gonna make a decision just based upon that one part they're not going to make you know an informed decision based upon all of the products come and because of that people are going to make you know some very poor choices I completely

73:15agree with that but to me the last 20 years have been an exercise in the other side in the legalization side doing a very very good job talking up its arguments and essentially there's there's almost nobody on the other side there's this one Jeff Sessions you had the goddamn Attorney General's telling people that good people don't smoke marijuana but that's that's a terrible thing to say sure people don't smoke marijuana there's a lot of wonderful people who smoke my this is not true and and and by the way I think this is a personal choice okay especially for adults yeah okay and and you can make bad personal choices you go out look I play cards I'd love to play poker I'm said that on this trip to LA I didn't get to go to a poker room but you can go a new casino and you can see people change encouraged me but you can go to a casino and see people have lost

74:17their houses it doesn't mean that gambling should be illegal it also means that there's less and more dangerous forms that device in your hand where you can bet on what the next pitch is gonna be if it's gonna be a ball or a strike yeah that's more dangerous than my having to drive to the commerce and play there and one hundred percent or 98 percent THC that an eighteen-year-old vapes is a lot more dangerous than a five percent you know CBD 15 percent THC product that dr. Hart might suggest his patient uses once a night to go to second rate but that that's the message that you know we should be putting out there right we shouldn't just be you know focusing on one side of the story like that part you know should also be you know included in the book and like you know your book you know in some ways has made me rethink the way that I write you know because my first book was

75:03co-authored with Jeremy cost and called friendly fire you know my second book that I'm writing it's called canvas for ptg so it's how to transform post-traumatic stress into post-traumatic growth right because I feel that and you know we all know examples of people that have you encountered really difficult obstacles in their life and some people have you know succumb to that stress and they've gone down you know the wrong path kind of thing and then other people have used that stress to their advantage and they've actually become you know better because of it and you know CBD and THC can both help facilitate that process you know when you're looking at someone like like a veteran for example you know the hallmark of song with PTSD is someone who doesn't leave their home and they can't sleep at night so like when I see a vet in my office a lot of the

75:52times they'll be leaving their home like five to ten days a month right so when you give them CBD and this is really important for people understand CBD has been shown to decrease learned fear that's incredible right so if you can get people outside of their home because I'm not talking about again you know someone who's you know too nervous to like go to a you know at the bar with like the friends or some like that I'm talking to people who like you know it's difficult for them to go to the grocery store just like pick up a few things so you know those the type of people that I see in my practice of CBD is really excellent for that then when you look at you know the the nighttime component you know THC again is excellent for reducing nightmares that's been shown in studies and it was even shown with one pharmaceutical drug now blown again I don't really use now blown very much

76:39because 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 she she can reduce nightmares and you know if you have you if you have PTSD I mean if you talk to someone who has PTSD and again this is this comes from a clinicians point of view they will tell you I will try anything and that's the same way when you get with like you know the parents of kids who have seizures all day nobody wants to see that you're in like I'm like Alex you know if your kids you know ever started getting getting seizures which you know I hope I hope they don't because it's it's terrible you know what what I can do it at people but if that ever happened you know I would hope that you would consider you know CBD as a potential yeah I think he's not against that I think we have to be

77:30really clear as tension like CBD you know again CBD at all I don't know I don't think anybody is I think no one really is arguing except maybe the federal government in certain levels is arguing against CBD that's probably some pushback from the pharmaceutical industry the reality is CBD is proven to be at least as far as I've read very safe and very effective for a bunch of different disorders especially those that are about reducing and have it something to do with inflammation or seizures yeah one of my good friends his son has developed seizures and CBD knocked it out just killed it this is very recently you know you're somebody who's you know who's a cannabis user you obviously know a lot of users why do you think it is that people you know in legal states where they can really express a preference they can go into a dispensary know exactly what they're

78:15buying why is it that they want such high potency THC product because they get used to it your tolerance develops it builds up you know every year we do this thing called sober October well we don't do any no drinking no no pot and then we do some sort of crazy challenge me and three of my buddies and when we do it what it's it's very interesting how your tolerance is radically reduced I guess I'll smoke pot at the end of that month and I'm like holy like I don't even know what I'm talking about the mid-sentence and I'm just blitzkrieged whereas you know now like I smoked a little weed last night did some stand-up had a great old time there's no issues with it at all but I'm used to it and if the weed that I smoked last I assume you don't smoke I do not okay if you and me were together last night and I gave you a hit of my joint you'd be still there in the corner in

79:07the fetal position what and the is going on because the marijuana is ridiculously powerful but once you're accustomed to it once your body acclimates it's really not that big of a deal the problem is you 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 given this other comedian how many milligrams of those stars of death Oh Tilly like when we give Owen what did he give oh I think just one you ruined his life end about 200 to 250 and went out the Joey made a video but the day changed Owens life like literally the guy's head up like he went outside he vanished he's gone well I think I think there's a real argument to be made it's particularly with him well I was gonna make two points on that so you definitely can develop a tolerance yeah and I tell people all the time try and take at least one three week break

80:08but the evidence does show that if you stop for four weeks generally all your receptors return and will be like you've never used cannabis before so that's and that's even with people who are really really heavy users I can go back and get the study but I mean these people are you using I'm pretty sure it was like close like seven joints a day well really heavy users and noop dogs a good example of that you know my friend Tony Hinchcliffe his good buddies with Snoop Dogg and he said Snoop Dogg just smokes all day and he just like is always high and you know you're like well what do you do when you're not I is like what I'm never not high so everything he does he is high as really everything he does look for that guy it's not that big of a deal and for the way he lives his life like he's just a relaxed easygoing guy it's no problem you could be high all day and

80:59live his life and he's obviously wildly successful with this strategy yeah loudly second point I was gonna I was gonna make on that too though was there does not appear to be any tolerance at the cb2 receptor so Chi Chi attaches to the cb1 receptor and that's and that's where we know we can get tolerance you know some people you know they they have some pain they use some THC and sometimes they need a little bit more same sometimes asleep you know they use THC it'll work and then we'll stop working with CBD too we haven't seen that meaning like the people who you know get get seizure control generally they don't need to increase the dose like the girl I was talking about earlier you know I first subscriber I think when she was 20 and she was my 20 she's 25 now she's never increased her dose and she's just used the same amount to CBD for the last think we

81:52should really stop talking about CBD I just wanted to make a note on the on BIA tolerance of anyone I just wanted to make a note that CB to the doesn't appear to be tolerance it's all yeah it's just there's just such a significant impact when when it comes to especially edible THC it's a there's a significant impact on people's state of mind and it's not always good no that's just a fact we were talking about this when when you were out but you know that's why I so I had an interview I was that guy was doing a radio interview on the Acela from from DC to New York last month and this woman came in and was Baltimore she sat down next to me and I finished the interview and she said she said I couldn't help overhearing I thought out Jesus like she's she's a pothead or she's just annoyed that I was doing this but no she said you know I was in Seattle last month she's this

82:45woman was in her early 30s she was a lawyer married she said and a friend of mine said to me let's let's have let's do an edible she said I took it we bought a small dose we asked him for a small dose I took half of it so I think she took like five milligrams if that and she said she said I got so paranoid she said I couldn't sleep all night fortunately my friend took and didn't have any problem and sort of watched over me but she said the worst part was it took me weeks weeks for the anxiety to face and I said I said do you have do you have a history of mental health problems she said no I don't she said she said I'd used you know I'd smoked in college and but this was just a totally different experience I think there's a big problem with education a big problem with the education that edible marijuana as we talked about before I think you were in the bathroom the 11 hydroxy

83:36metabolite is it's processed by the liver it's a radically different drug radically different and its really a psychedelic and in a very in for me personally edible marijuana and flotation tanks I might as well be taking a bucket of acid because it is a crazy goddamn experience now I personally enjoy being paranoid and I know this sounds crazy but I think with me it gives me and I think I live a pretty blessed life and I like I like the feeling of paranoia because it allows me to explore maybe some area like maybe in a specific paranoia that you're it's a freak out man I think I have maybe an abundance of confidence maybe I have too much right maybe I'm too successful what I like about the paranoia that comes with edible marijuana is it allows me to check myself it allows me to put myself examine all of my behavior in the darkest recesses of my mind my thoughts

84:37and and gives me a perspective makes me a nicer person you go just a little tiny just like the other psychedelics I think it just it gives you just a little knocks down an ego just a little I mean some people use it and like at the end of the day and then you know like like Joe said I think it makes you reflect sometimes better and more objectively meaning that like you know maybe had an encounter with someone earlier in the day and then you know late at night you toke up a bet you're like ah man I should have done things a little bit different I'm it just it forces you to reflect in a different state and sometimes when you reflect in that state you come up with thoughts that that you just want to come up with before yeah like my patients say to me all the time like it just kind of breaks this like negative state that I have I'm just able to break out of a negative state and

85:32think illogically you know I'm set people say that to me all the time but but see you're to me you're talking about something different and it works for you right you your paranoia is it sounds more almost existential it's how can I be a better person what am I doing wrong in my life it's not my wife is poisoning me or you know or the cops are gonna bust the door shoot me yes okay yeah that's a different thing and that's why difficulty that's why Marin marijuana drives this extreme violence in some people or those people need to get their together well that's possible too aren't really common bro but they may need to be intervened before and to Joe's point though they have shown in studies that if you make an intervention other outside of the psychotic symptoms you can actually reduce the incidence of violence yes and also to I think it's you know a good

86:37point I was going to mention earlier to bring up genetics because we are teasing out genetics for people and we are discovering that certain people do have certain genetics that do predispose them to certain cannabis disorders right so you know I'm involved with with the company that's doing that right now we're trying to create cannabis genetic test for people right and there's three genes that we've identified so far you know one of those mapk 14 genotype and that has been shown to be associated with a deficit in brain volume when you do use cannabis and then there's two other genes that a key t1 and the CA d mm to genotype you know both of those have also been shown to be associated with cannabis but again you know how many people have them dmap k14 is roughly about 8% is what we're seeing the achy t1 is around 4% and the CA d m2 is around is around 5% so that's almost

87:3720% of the population but but but we're seeing but if we can identify I love that stuff lines main yeah yeah that's wicked so if we can identify you know the people who are at risk then we can Mabley potentially you know you use the medicine in a way where only the people who don't have these genetics are using the medicine and then you know for the people who do have these genetics you know they stick mostly to CBD I just think you know that that's a better approach then you know just just kind of prohibiting cannabis or saying that you know we shouldn't we shouldn't use it at all or saying that it's Madison I think that it should be held to the same standard as any other medicine and I think that if we had an incredible medicine that worked for some people and it didn't work for others then what we would do is we try to figure out why and you know I've been

88:31doing that my companies have been doing that it's called anent life you know full disclosure I am on the board and that life.com and you know and when we use these different these different strategies you know then we can actually reduce the overall harm and that should be another thing that we can add into the mix because for sure there's people who are definitely more predisposed to mental illness and definitely more predisposed to to psychosis I mean there do seem to be some people who just it breaks really fast and I'm not sure why I mean again it's probably genetic there's yeah I think but you know it's why you you mentioned you know your friend who's whose child has autism and and you said well you know I if that if that were my child of course I would want to do anything possible but I have to tell you in the last month since the book came out I've heard the other side

89:21of this okay 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 you know read the book or heard about the book and and who have the resources to stay involved with their kids when they have these terrible breaks who who have gone completely off the rails and the worst story that I've heard so far came from a woman in Connecticut whose son graduated from high ever further you know it's a the college in the east and you know sounds like a really good guy he wanted to yeah you know teach disadvantaged kids he had a girlfriend who was going to met or was a pre-med trying to go to med school they moved to New Mexico and for some reason the guy decided to start smoking this was 2012 and within a few months he lost everything okay the the girlfriend had left he lost his job he had his

90:10first inpatient hospitalization now this is a family with money okay this is Connecticut suburban ah and they have spent the last six years trying to save their son and they have failed she told me that they've spent more than half a million dollars he was hospitalized at Harvard you know he had the best treatment none it's made a difference to him and what is the symptoms are so so so he's he's completely schizophrenic now and he's completely paranoid and he believes and this is the this is that so he's his girlfriend is long gone but she tried CBD ah that's a good question I think he's continued to use cannabis I don't know if he's use CBD but let me let me just tell you where he is now okay so he's one of these guys who has a really bad delusion his delusion is that his girlfriend has died and been replaced by a robot so that's the kind of delusion

90:58that leads you to kill people and so and so this guy's been now hospitalized 17 times he's he's gone he's on the streets of Houston she doesn't know where he is and I'll tell you you know you read beautiful boy you see the movie and you think well the wasn't I'm not familiar beautiful boy is about um a beautiful mind isn't no no beautiful boy is it is a book that came out I think a couple years ago got turned into a movie you should have him on a Nick Chef and David Sheff father and son and the son became a meth addict and essentially almost died he they he started smoking cannabis when he was twelve and within a couple years it had all gone completely downhill for him I'm surprised it's a it's a pretty popular book but anyway have you heard of it no Jamie and I've heard of the movie yeah yeah um so so you think well okay the worst thing that can happen you as a

91:49parent the worst thing is your your child becomes an opioid addict and you wait for the call that he overdosed and died it turns out that that's the second worst thing the worst thing that can happen is your son the college graduate the want to be do-gooder becomes a schizophrenic living on the streets and then you're waiting for the call that he killed himself or he killed somebody else and so my my you know my 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 gonna be back to writing novels I'm gonna be in Austin but this will still be part of my life but this woman these parents they are gonna spend their lives trying to just destroy the cannabis industry and that is real well I think that would be a foolish thing to do but I think there is a real possibility that some people who have a tendency to

92:40schizophrenia could be triggered by cannabis I don't think there's no need in Austin about that but I think it's also possible that God would have gotten schizophrenia anyway look it's possible but he was sort of at the outer edge of the window and he had no idea the window it's usually for boys it's sort of 17 to 23 24 he's showing any issue according to her I mean this is from her so she's the mother but but well I'm sure she'd be the one who knows the most there are people though too who just kind of have a decline with or or without cannabis you do here is just a breakup it's just they just you know I I mean I know people you know that we've gone to medical and stuff 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 yet they drop out of school no one ever hears from again you know they don't

93:30read you know get get back into school that's it that that does happen you're all the time that's the agility of the human mind yeah it is and it affects a certain percentage of the population regardless of cannabis use there's a lot of people out there that up skates are friendly that I've never used cannabis ever and they've gone completely you know off the edge I don't know if you can necessarily blame cannabis for that and it would be really interesting to find out if there was some form of a treatment like you were saying with CBD that could counteract that maybe has been shown in early stage studies to have some moderate impact on psychosis I I don't think from the the numbers that I've seen suggest it really isn't that strong as an mi psychotic but I do think that if I were a researcher in schizophrenia I would be looking at the endocannabinoids yeah yeah you have to

94:25look at this again I look at it you know from a clinical perspective Lee the antipsychotics that we have out there are not good they have terrible they have terrible side effects and most of them do have some initial Bennett benefit but after two to three years there's almost no benefit one right and they have as you said really bad side effects weight gain metabolic disturbances like people want to get off of them so if you have something like CBD that doesn't have any of those side effects of as a clinician you're gonna want to try it right because you know that the other tools that you have are not really that effective yes right so you know CBD can should definitely be you know utilized for people who have who have psychosis and schizophrenia well I think you know we talked about life changes like things that happen badly and your life losing your job losing your girlfriend deaths

95:14in the family can contribute with some folks but psychedelic drugs can as well I mean it's a fact yeah but for some people psychedelic drugs have tremendous benefits for PTSD quitting alcohol quitting hard drugs there's a lot of people that have used mushrooms MDMA for PTSD is a huge thing that Maps is studying right now but you can't deny that there's other people and well-documented that have taken LSD that have taken psilocybin and taken them in large doses in gone yes and never recovered yeah you know and that's why - I forget who it was maybe it was McKenna who is on and you guys were saying that like you know we need to use psychedelic medicines but we need to use them properly right and that's the same way with with with cannabis as well and I consider cannabis too psychedelic yeah particularly when you eat it absolutely you know it is it is a mild psychedelic

96:06and you know so those rests and benefits to that and you know we need to tease out the rest and tease out the benefits and make sure that people we should make but Alex we need to make sure that people are informed and they get the entire picture right so you know does your book have some truth in it yes of course it does but does it tell the whole truth absolutely not right and that's the message that you know I think people should be hearing people shouldn't be hearing just part of the truth they should be hearing the whole truth and again you know like in your book like you compared you know that the Mexico in India right and you know I talked it to German Lopez on the phone about this and you know who talked to Isaac Hampshire's right and he said so so Isaac Campos you know he's the guy who who basically you know was told the story of how how in Mexico you know

96:52people were blaming marijuana people were blaming marijuana on causing psychosis during kind of like the early 1900's and then there was some evidence as well in India at that time so I was kind of made the connection you know 9,000 miles part you know they're both saying the same thing but you know he said that you know you did misinterpret the evidence on it right and and in German told me that on the phone and I mean all the cannabis that was used in Mexico at that time was in you know really marginalized environments and then when you look at the India study you know that they say and I know that you addressed this in your book house cuz I did read your book sounds like you did I bought your book so you know in some ways I did yeah so I read your book and like I said you know you did address in the part on India that yeah you know some of the report

97:44was wrong but I mean the fact is that all almost a lot of those cases in India were were actually attributed to alcohol or opiates or other things and then the other thing in in Mexico is that it was in those environments so you know basically what I'm kind of getting in here is like you know that the National Academy of Sciences and engineering you know they you know disagree with how you interpreted their findings and they know these people deceive how you interpreted their finds okay but Ziva is only one of the sixteen members I get that but if we asked other members I think that they would all say the same thing because Alex wouldn't you be upset if someone just quoted one part of your book and then left out all the other parts I mean I would think that would be a huge disservice to my work I would not want I would not have put one and put in a ton

98:37of effort into something and then for someone to only have you know that just to pick up the part that you know that really depends on ORS nuance honestly if I'd written the NASM report the a.m. report and came out in 2017 and nobody had patient any attention to it which nobody did and nobody did for two years and suddenly people were paying attention to it I'd be pretty happy about that but what what dr. Hart is Hawking 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 it's stupid of me I got a copy of my bag but so this is fascinating to me the the British you know they colonized India and they set up what they called lunatic asylum was really psychiatric hospital sort of very primitive psychiatric hospitals and they were really initially for soldiers in the Indian Army and they were run by British doctors and what

99:33these 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 canopy what they called ganja actually in Indians called ganja or bong which is a very weak preparation of basically or Indian hemp just sort of low-grade cannabis and so and so they started counting and they raised the twenty to thirty percent of the people who were coming to asylums or heavy cannabis users and that was way more than alcohol is more than opium and this really fascinating doctor named George Francis William EWTN's wrote a book in 1908 and he looked at the evidence and and it is amazing to hear how he describes schizophrenia how he describes cannabis how he describes the cases of violence around cannabis it's like it's like any psychiatrist today certainly any forensic psychiatrist like my wife would

100:30would like everything in the book would ring completely true and it was so fascinating to me to stumble on this and realize this is something people were talking about for more than a hundred years mmm so could we agree that there are some people where cannabis is not a good idea absolutely right we could agree that that's a all right would think we all great we're also agree that some people can't eat peanuts absolutely yeah yeah right yeah you know why peanuts kill you that's yeah it's more dangerous Oh so these second six hundred a year yeah people die from peanuts so yeah I think more people die from cameras as a result in the suicides okay well there's no correlation there's no study no somebody's got to do the work but why you saying that then because I've looked at enough data to tell me you think marijuana is causing homicides oh yeah this is what the book is about

101:25but anyhow so what does it causes paranoia and psychosis in people and paranoid psychosis are huge risks for homicide and schizophrenia studies that refute that there are no studies that refute that paranoid psychosis are huge risk for homicide schizophrenia is a 20x20 times Joe well Jamie I sent you a document yesterday I mean there's there's multiple studies that show that you know marijuana laws are not associated with with any drug yeah so the use of the drug which could possibly trigger psychosis psychosis and schizophrenia which are correlated with murder so they're not correlated their triggers that's an absolute fact yeah triggers because of the paranoia and delusions and you think that someone's out to get you and they're not absolutely I mean the out of the numbers okay so the numbers are if you're if you have a diagnosis of schizophrenia you are

102:21twenty times as likely to commit homicide as somebody who's healthy now it's actually worse than that for cannabis okay and here's why what so the National Alliance for mental illness and the mental illness Advocate advocacy groups hate talking about this why they hate talking about it obviously because it stigmatizes people with mental illness so what they say and this is true is if you have a diagnosis but you're taking your antipsychotics even though the side effects might be unpleasant you're in treatment you're you're you're not using recreational drugs your risk for violence isn't that high it's not that much higher than a healthy person okay and you know fortunately healthy people don't commit murder that often the problem is if you 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 who

103:10because they're not using because they're on antipsychotics it means that the excess risk in the people who are using and who's untrue whose psychosis is untreated it must be spectacularly high and the numbers bear that out so so there's a really good study from last year 2018 a small group of patients in in Switzerland Isis what's Ron Lind is a safe country is a low base crime rate but fifty percent of the people who are using cannabis and had psychosis over a three-year period committed violence in that group of people that's mostly 20-something man well you know there's a study here and I just sent it to Jamie and it's it's titled risk factors for violence and psychosis a systemic review and meta-analysis of 110 studies so you know that's it's quite a few studies okay so you know let me just just read part of it out to you so if violence was strongly associated with the history of

104:06polysubstance abuse strong associate with diagnostic oriented substance use disorder and recent substance misuse and moderately associate with the history of alcohol misuse a history of substance misuse recent alcohol misuse recent drug misuse and a history of drug misuse it was unclear if there was an association between violence and history of cannabis masseuse so again this is a hundred and ten studies they very carefully looked at all of the different risk factors as to what could trigger violence just let me finish Alex and what they said again it was unclear if there was an association between violence and a history of cannabis misuse right so that's a hundred and ten studies so cannabis use in there is going to get locked in with poly substance use like because a lot of people who use are gonna be using other drugs Holle substance means multiple subs so

105:02everything else was found to have significantly sophistical announced and I have not just mine a study that dr. hurt assignment I'd like to look at it without looking at it I can't push back as hard as I would like what I can tell you is that I have many studies in the book that show that cannabis use is associated with violence in people with psychosis okay 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 in in studies of young men in China and the UK there are big studies out there that show cannabis use is associated with violence Ibiza I got grilled over there for that they get manager yeah I just said it yes some dignitary or royal person how Lisp right isn't that how it all started through yeah yeah believe so noted yeah the way

106:13the people in Spain prints words was directly affected by this one person apparently but um so this these this correlation between people that have schizophrenia and using cannabis how do you is schizophrenia diagnosis it's purely based on behavior basically yes yeah it's a clinic there's no blood tests do a brain scan it's basically how you behave and and what you tell the doctor about how you write right in our eyes or it's very subjective because you're asking someone basically a series of questions I mean it's no different than you know depression really I mean you just just asking someone a series of questions and then you know based upon that which is very subjective then you're gonna make you know a clinical decision whereas when it's like a blood test like if someone you know passes you know a certain amount of hemoglobin a1c you know and depending on which chart

107:09you're looking at then you're going to call that person pre-diabetic or diabetic but you know our fortune we just don't have those objective measurements and again that's why you know Alex was saying earlier that that you know the they couldn't really figure out you know how many people in the United States had had schizophrenia and I understand that but at the same time to I mean it's okay to to adjust you know the way that you diagnose someone over the course of years and you learn things because you know you could easily say that almost everyone has some type of mental illness and I mean people should understand that you know there's seven different basic human emotions you know I've talked to sports there's there's anger there's contempt there's disgust there's fear sadness surprise and happiness that's seven so you know depending on which way surprise goes I mean six out of those

107:59seven are negative right because we're wired to basically detect threats so you know we're making you know the all these diagnosis I think we have to be careful because you some people are calling themselves depressed and some people are calling themselves anxious when really you know they're just not dealing with basic human emotions that they need to understand and need to deal with like people are getting angry about being angry or like depressed about being depressed like if you feel one of these emotions just kind of sit with it and just kind of reflect on it and I think you know that's a much much better way to kind of kind of T to tease things out button you want to come back to to my original point I think that you know more people are understanding that you know we don't just need to give out a pill for everything and that you know everyone shouldn't just be labeled as

108:46having a mental health diagnosis because if things just keep you know going the way they are you know what's by 2040 it's gonna be like 50% of people are gonna have like a mental health disorder so I people just need to understand that life is hard you got to deal with these motions sometimes it's not that big of a deal and that's why and that's awesome yeah for some folks and that's why I'm such a big fan of Jordan Peterson because yeah you know he's he's kind of tough on people and he said but let me stop there because Jordan Peterson was on SSRIs for years yeah a long long time like for a long long time as was his family and that's what's crazy about him is what got him off as a carnivore diet limitation diet where he only eats meat with salt and drinks water and the healthier that he's ever been in his life and that is a another massively controversial subject yeah let me push

109:39back a little bit because I think people you know as controversial as the book has been about about cannabis and psychosis this violence issue is even more controversial and obviously for a fair number of people it doesn't really doesn't sync with the stereo side it doesn't say with how they've experienced cannabis use right so I think I think alcohols are really interesting comparison um I'm a Canadian from Newfoundland I'm sorry youthful age understand marijuana's loose and Landis is a Newfoundland trade myself to say that way your tongue I'm wrong lane look what Jimenez pulled up marijuana use increases violent behavior fifty years study finds casual link between cannabis and subsequent violent behavior new research published online in advance of print of the journals like psychological medicine concludes that continued use of cannabis causes violent

110:42behavior as a direct result of changes in brain function that are caused by smoking weed over many years researchers have long debated a possible link between the use of marijuana and violent crime in contrast to alcohol meth and many other illegal drugs the metal wing effects of cannabis seemed unsuited to promoting violent behavior however ample ample previous research has linked marijuana used to increased violent behavior the sticky problem in such studies are that many confounding factors co-founding factors involved in interpreting this correlation so ok 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 associated or instead the two are associated through some other factors such as socioeconomic status personality traits or many other variables that are related to the

111:37propensity to use marijuana so I think that's a fairly good summary well of the issues that James had the study came from 411 boys who were born in 1953 in London 97% of which were Caucasian and all of them are raised in two-parent households so so you know so those people are relatively stable if they're to family to parents to have parents be to that's all so no it's possible so so I think the alcohol comparison is again a good one because anybody who's ever been in a bar at 9 p.m. and gone back at 2 a.m. knows that alcohol dis inhibits people right it causes fights right it it makes people loud it makes a lot of it does right it's good imagine that's good that's alcohol and sex you're a terrible idea right it certainly causes some sexual violence okay but at the same time everybody knows that you can have a drink you know you can have a beer at that backyard barbecue you can classify

112:43that's right it doesn't mean that you're gonna get in a fight and it actually might enhance your conversation social lubricant all that good stuff all that good stuff and you might even know people I mean I do know people who I would say have a problem with drinking okay but it's mostly they're sitting at home drinking scotch watching baseball until they fall asleep that night now that's obviously not a healthy way to use alcohol but it doesn't make them violent but we know on a population basis that alcohol causes violence it causes drunk driving it causes problems and it's said that in the study that that I quoted earlier but it's it's said that alcohol again they they didn't or sorry cannabis they weren't sure right so okay so this is again I would like to read the paper that you're quoting from because I have so much other research but here's here's what

113:29I'm saying about cannabis okay cannabis for a lot of people yeah they can just smoke it and as people you know many people have tweeted at me the only thing I attacked was a bowl of nachos hmm like and so and so that's true for some people but that could be sent with the alcohol well that's exactly logical variable and there's so many studies that say that that the cannabis laws have actually decreased crime so so even though for many people cannabis isn't gonna cause violence that doesn't mean it can't cause violence in some people especially or at least could be affair or at least could be a factor especially with the kind of violence that I am talking about and then I write about in the book which is again so alcohol it maybe makes a argument into a brawl it makes a brawl into something where somebody picks up a stick it makes that into something where somebody pulls out

114:24a knife it escalates right cannabis is different cannabis causes paranoia and psychosis and it certainly causes those things temporarily even if it doesn't cause them permanently so a distortion in reality that could lead to you do some things tear and it's usually to somebody you're not actually fighting with it's a family member that 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 reality and literally thinks like this my 85 year old grandmother is going to kill me so I better stab her to death first that happens it happens a lot and if you look at the amount of violence that people with psychosis commit on a population level basis it looks like people with schizophrenia commit about six to ten percent of all the murders in this country and it looks like people have

115:17sort of broader to more broadly defined psychosis again bipolar with psychosis other psychotic conditions temporary psychosis they might be responsible for as much as 20 percent of the violent crime in the United States that's a lot of violent crime and what I'm saying is that it is quite clear that drug use mediates that violent crime in other words if you're not using you can keep your impulses in check but when you do use you become dangerous so when we're talking about biological variability if we factor in schizophrenia you know essentially what you're saying is that there are people that have schizophrenia that don't commit violence but that they're much more likely to commit violence if you add some sort of psych medication whether it's marijuana whether it's something else that perturbs reality for them and particularly psychotics bring down these

116:05yes so recreational drug that's the worse the worst cases of all are cannabis and a stimulant because to these they both like cocaine or meth exactly yeah so when you get that you get paranoid from two sources mm-hmm and you get the only good thing about cannabis from this point of use that kind of knocks people down a little bit but meth brings them right back 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 yes we don't know whether or not he would have become a schizophrenic and and exhibited those symptoms without the marijuana we really don't know we do know he did with it that's that's correct and 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

116:51using we really have to be described because it brings out the worst Brian and and you know somebody said this a friend of mine of old friend mine from the New York Times said so every time there's a hurricane people some people on the right say well you can't prove that global warming caused that one hurricane that would have happened anyway and he and they're right you can't prove it and you can't prove that any one case of psychosis was caused by marijuana but when you look at the big studies at the population level data the Association is really clear and everything points the same way and the synthetic cannabinoids k2 and spice those can clearly produce psychosis in people and people with psychosis tend to slip back into it if they use at some point you got to start to say to yourself why does everything go the same way yeah I also have a personal friend

117:37and I'd really didn't think about this guy but there's another personal friend that I know that is a martial arts instructor that had a psychotic break he became schizophrenic and he's a regular marijuana user and the people around him associated that with that and in fact people that are regular cannabis users were trying to get him to stop using marijuana if you're close to being on the edge and you use a little bit of cannabis for sure let me tell you something this guy was not on the edge when I knew him when I knew him he was very rational very rational but something happened somewhere along the line was he would did he become a pretty heavy smoker over time I do not know because we don't live in the same area anymore but he got really heavily really heavily medicated and did some really crazy and wanted being hospitalized and this was not the case before I mean

118:25whatever it was that triggered him I mean it when I was around him when he was younger I would have said he's a total normal guy and I would have never saw that coming he was a heavy marijuana user heavy heavy but I don't know how he's doing now I hope he's okay but we're you know we have mutual friends yeah and he became a schizophrenic and and you know you will see you know cases like that but you know when you do look at a lot of the larger data on cannabis and violence I mean it's just it's just not there like there's lots of data that suggests that you know medical marijuana laws for example can actually have a decrease in overall they could I mean laughing there's a study that says it gives no comfort to the people who lose their children because of these psychotic breaks that's right and those studies are really bad so the place that you can criticize bad

119:15though because they're because state level data is not great the place the book has been criticized or andr there was a rand review though and in 2013 and I mean that that's again that statement that marijuana use does not induce violent crime and the links between marijuana use and property client crime are feign right there I think we all agree that marijuana use by itself with people that aren't schizophrenic probably doesn't induce violent crime but with people that are schizophrenic or people where it triggers schizophrenia it could potentially induce violent crime my friend did not get violent although he did do a violent thing it wasn't to a person yeah I think I think we have to be really careful because there's no just like with diet just like with the food and you know like allergies all these different variabilities when it comes to human beings I think we have to be really

120:05really careful about lumping all people together when it comes to how they get affected by various compounds yes so so the state levels thing if you want so the place the book has been criticized in my mind sort of the most fairly is it points out that in the four states that legalized first which is Alaska Washington Oregon Colorado if you look at 2013 and then you compare that to 2017 mm-hmm murders and AGG assaults violent crime are up substantially in those states and substantially more than in the US can I stop you there is there a possibility there's a correlation between organized crime because one of the things about selling marijuana is the people that have always been selling marijuana have been criminals when you make things legal in a state the people that were selling an illegal flock to that state and that's true so that there's there's a direct correlation

120:58between people being robbed that there was also a significant problem with credit cards and banks where everyone was having to do all the transactions with cash there was a lot of violence as was associated with marijuana in regards to that and also massive increase in population so so and that's so where the reason why Trump is actually not really against cannabis in some ways it's because he feels that if we have medical marijuana laws that especially the states that are that the better border states that the crimes gonna drop drops tremendously and it has dropped they they did a study last year and it dropped over the drop seven percent in Arizona and then again you know Benjamin Hanson who's who's in the data so far so he said that the murder rate did not demonstrate that marijuana legalization increases Vons and then it may have actually demonstrated that legalization slightly

121:56decrease ponts and he thinks that the reason that there was an increase in the murder rate particularly in Washington is because there was a large income gap they say a Washington has the tenth largest income gap in the United States and that's how did that change how they respond to the murderer good question Durham I'm so I haven't you know I didn't get to speak with Benjamin about this it sounds like confirmation bias well he I mean if that that is one thing that has been shown to you know increase mental illness like we talked about and can definitely increase violence is when you have an income gap right but how's the income gap shifted that directly correlates to the legalization of marijuana because during the scene because during the same period the income gap particularly in Washington and increased so he feels that you know a corresponding number right so he feels

122:46that that it's it's likely more to that and I mean he I mean I understand but I mean you have to respect this guy I mean I don't respect them because I know what he did with his data and so Joe this this is maddening to me okay okay okay violent crime in those four states increased more rapidly than in the u.s. period between 2013 and 2017 just conjecture aside no credible data exists it supports a significant association between the increased violent crime and marijuana legalization furthermore studies suggest that so far violent crime decreases in states with legalized medical marijuana until new research credibly suggests otherwise that claim that a demonstratable link between the two exist will remain classified as fault okay so that's just not true okay I know it's knope's okay and I know we trust Snopes how do we trust them that okay there's a

123:39lot I was gonna say that too but they're they give all of their their source right okay so again my lease do you are you on of those where are these sources and what's wrong with it here let me just go back to okay what I'm saying yeah please do 2013 Oregon Washington Colorado Alaska mm-hmm there are 450 murders in those four states there are 30,000 AGG assaults period okay 2017 Oregon Washington Colorado Alaska there are 620 murders in those four states that's an almost 40% increase there are 38,000 AGG assaults that's a 25% increase if you adjust for population you still get big increases in Denver 2018 almost 70 murders there were about 35 in 2013 Seattle 27 2018 there were 34 35 murders there were I think 19 in 2013 these increases are real okay they now now okay can we say that marijuana legalization caused those increases we cannot yet there are other

124:43possibilities and your what are those well one positive all population deed increase it's also possible that these states quote-unquote imported violent crime in other words that you got a population of transients coming in in part because marijuana was legal but those people are likely to commit violent crime and on top of that organized crime people that are selling absolutely there may have been some people who are exporting to Nebraska to Minnesota to other states there's crime associated with that but what I am saying is that unequivocally unequivocally the people who said legalization is going to decrease violent crime and people did say that and Cory Booker in 2010 17 said it he said that it actually had decreased violent crime in states that legalized and he didn't say it randomly he said it when he was introducing legislation to legalize marijuana on the federal level

125:33those people are wrong and they need to stop saying it I know and by the way that Oregon economist used he used the wrong data set for his charts okay he used I used the real numbers okay the FBI homicide numbers he used numbers that include justifiable homicide no police that's not right because the FBI reported that the murder rate went up 1% from 2015 to 2016 as compared the nationwide which went up one point nine percent and then it dropped by eleven point six percent between 2016 and twenty seconds with do not know what you're talking about okay those are FBI numbers I'm reading not know what you're talking about the numbers are clear okay I use them reading them right now 2016 release of FBI uniform crime reports from Oregon okay yes Oregon you're not reading the reports from the United States you're picking one state for Jamie Gries the entire country from that time period to

126:31so yes I picked those four states where marijuana was legalized is it sort of cherry picking you know it's not it's picking every stable country arrays that's what I'm trying to show yes if something wrong will pull back so we can see the holes so first of all that's a that's violent crime for knitters and a crime rate be in there Oh violent crime and that assaults aren't they no so so so the four categories of violent crime are murder AGG assault robbery and rape rape has sort of gone sideways the last years robberies actually have gone down it's murders and AGG assaults that are inter personal violent crime okay just to go back to this Oregon economist because this Madden's me he used a dataset that is not the standard data set to report murder what is the difference he used the data set that includes justifiable homicides meaning I'm in my house you

127:27come in I shoot you and kill you the police don't charge me with anything right and police homicides let's not let an interrupt let me finish the those two categories of crime are not likely to be impacted by cannabis use cops are not smoking when they're on patrol I hope and if you are using you're very unlikely to have your murder viewed as justifiable homicide the fair comparison is the base murder rate in the US and that's the number that used and I am Telling You I mean I know these numbers I sleep you know I wake up with these numbers cannabis the for cannabis legal states on a per capita basis crime murders rose 31 percent on a per capita basis in those four states over the 2013 2017 period maybe I'm sorry I said 31 maybe it's 29 percent so maybe I say I woke up with anyway the for the US it's 18 percent 29 percent versus 18 percent that's the gap and I

128:28am NOT saying that I know that cannabis legalization caused that gap what I'm saying is people need to stop claiming that cannabis legalization reduces violent crime it in it has increased in those I asked you in those states was it Universal the increase was it almost identical yes Alaska was the most then I think merged went up more in color in Washington and and what's also interesting job if you're if you really want to bring go into the numbers is the gap actually widened year by year so that's sort of what you would expect if this is the result of a psychomimetic effect in other words a psychosis causing effect because cannabis doesn't cause psychosis it's right away people breakdown 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

129:19okay so you know I'm gonna go back again to the Netherlands okay because they've had you know cannabis legalized forever and they have one fifth of the homicide rate that the United States does right so they also have a lower cannabis use that's true but still you know one one kickboxers on one one fifth I mean it's still it's pretty drastic overall and and again you know Alex you know you know I appreciate some of the way 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 it has a long and accepted history of use people are accustomed to it so I think things kind of even out I think one of the things that we're dealing with with the United States is people that have just they don't they don't have history of experience and it becomes legal and then they use it and maybe

130:13some 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 cotton one who had an edible and became suicidal and this up for weeks that is very confident very articulate very intelligent he's not a not a weirdo not a not transient extreme extremely successful you know I think there are there are variables that we need to take into consideration there's certain human beings that exhibit a pattern of behavior that's directly correlated to cannabis use that I don't experience so if I could say from my own personal biases that that's that's nothing it doesn't do anything I've been smoking for years doesn't do well you probably don't have one of those three genes that we were talking about and you probably also too you know don't overuse or you have some type of you know legitimacy as to why you you are

131:11you are using it and you know one I want to keep going with this but you know at the end of the show I think that we should make some type of like recommendations for people just because I hate when you know you have this big you know three-hour podcast and then at the end of it it's just like hey guys just be safe you know some type of like recommendations like I love the podcast with with with with crecer and Joel Wright but at the at the end of it was just sort of like hey guys don't eat the American diet I think most people realize that one person was going on data and the other person was you know yeah yeah I mean I'm sure I find it so fascinating that now when you think back through your you know through your life you've thought of somebody who was affected I have several people I'll bet I'll bet if you think about it you'll think of more people

132:10no I maybe but those are the big ones and like I said my friend who is a martial arts instructor was a pretty significant issue with a lot of our friends we were trying to figure out what was wrong with him beforehand he was sending me these videos that didn't make any sense and I was like what in the is this like I'll explain to you more off him Arabic so I don't have to out this guy but a lot of people that were close to him were really seriously concerned now it is it something that would have happened anyway I don't know don't how is he since 20s late 20s 20 you know that's right around the age so a little a little bit late ish because like I said a lot of the studies even when you look at the ones on adolescence like for sure it's it's below like they have done studies like below 18 is worse yes and say below 25 below 15 is worse than say 18 like the younger you go the worse and

133:06he seems to be fine now that's good that's good is he using that I don't know after I know and it's you know I'm not an expert on this subject but it's because of this of something called pruning that we go through so everyone goes through this and basically if your adolescence you're going to drop off some some weak neural connections to kind of pick up some stronger ones you know it's the best way to kind of explain it when you use cannabis you can potentially accelerate that process and then because you accelerate that process you don't get those good neural connections and then you know people unfortunately you know develop things like like psychosis and in schizophrenia so you know that's kind of where they were the issue lies so 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

133:54discuss the benefits in this podcast make sure that people understand that you know I believe that marijuana is medicine it's an excellent medicine but the other thing too is we do want to mitigate the risks because there are real risks out there so you know I do appreciate you know us talking about adolescents and making sure that they do stay away from cannabis yeah and I mean especially that's like I've read these you know these cases the case files sometimes you know the kids started using when he was 11 and you know it's like that kid never had a chance right man and obviously oftentimes these are kids coming from disadvantaged backgrounds anyway but you know they're using by 11 and it's 16 they put a you know put a gun to somebody's head and pull the trigger I mean the the pre-adolescent and early teen use we got to do everything we can to stop the problem is yeah like if you

134:46if you smoke pot and junior high like say seven eight nine like you're probably gonna smoke pot and highs yeah like that's the I mean that's what I saw but we're not when I was growing up and you know even when I was home for Christmas for a few days like yeah a couple of my friends even talked about you know some people that we knew you know smoked tunne pot in high school and like now like they're they're they're crazier they're not really doing too too much you know so but you do have to be careful with that I think there's a lot of ignorance we're dealing with a lot of ignorance and a current when it comes to biological variability right we we don't really understand how a lot of these different things affect people including like just diet and what what what causes depression like how much how much of what we constitute or what we just decide is depression is inflammation

135:35poor gut health there's a lot of variables there's a lot of them marijuana is absolutely one of those variables and again I don't have an issue with it I liked it I love the stuff but it does it doesn't with me right but I'm also honest and so I see these people were it's pretty obvious to me that something's going on and that marijuana is not a good idea for them and I just think you know like I said in the past I'd might put myself have been guilty of using this this sort of blanket description of it as being a positive influence and then it's a good thing for people I don't think it's a good thing for everybody no it's definitely not a good thing for everybody and it's definitely not a good thing for the people who have that those genetics that I discussed earlier and you know also to like you know if you you need to have some type of like self awareness like the people who you know

136:26don't do well with cannabis you know you shouldn't have to you to have your friends tell you that you came ain't like you're not going to work you should got yourself like but that's hard for people yeah that's one of the most difficult things for people to do is itself of self assess yeah you know to be objective you know and and it's a really I've obviously I've heard from a lot of people who used heavily and seen other people who've used heavily and last month and I think is very interesting why people continue to use when they're getting paranoid and and you know the most cogent argument and again I'm I'm not it you know you've smoked a handful of times in college in Afrikaans I actually don't think I'd be comfortable using high THC cannabis now knowing what I know but anyway so the people the most got some right here I'm gonna get hotbox to put on the most I thought I was so

137:25interesting this guy said well you know my friends I've talked to them I said I'm paranoid now but I'm gonna smoke through it I'm gonna smoke so much that I'm almost comfortable being paranoid and I think that's a dangerous thing to do to your mind because you're you're sort of counting on being able to step back from that and stop using yeah that's a that's a silly way of looking at it I think that some of what we call paranoia just normal paranoia is hyper sensitivity and hyper awareness and awareness to a lot of things that you're putting off in the back your head because in order to function as a normal person get through this life you can't really be aware of everything otherwise you'd be yes look you paralyzed by fear we're in space okay we are on a gigantic ball that's spinning a thousand miles an hour curling through infinities this is reality take us out thin layer of gas it's

138:18protecting us from everything that's flying around in our like the Sun is gonna end like at the I mean imagine if people do live to an infinite number we realize something son is dying you're gonna freak out about that it's all relative right so there there's only so much you really can't think about in some of what paranoia is is this hyper awareness of all these variables that you really haven't haven't considered and then also we're talking about before the things that can be beneficial the hyper awareness of how you communicated with people maybe you could have done a better job with that maybe you you came in hot maybe you were upset about something else when you ran into them you were already at a seven and they brought you to a 10 it was totally unnecessary within a normal situation you would have only been a tattoo those things are real and sometimes marijuana

139:21helps highlight all the errors in your way I think it can be a tool but my description of it is like any other tool with it like a hammer you can build a house of the hammer or you can just hit yourself in the dick if you're crazy and this this is something that I think we should consider when we're discussing almost any psychedelic medicine and I think that I really do believe that marijuana is a psychedelic and I don't even think it's a mild one especially when it's in edible form I don't think it's mild at all yeah I mean that there's some people that come in to my office for example and like just when I meet them like after one or two minutes I was just I just got to decide in my head this person's not using THC right you know like this this person is ancient what could what gives you those elders anxious yeah it's just a feeling of they're not really they're not

140:10someone who can just sit and kind of like be by themself you know they just kind of give me the impression that you know they're not going to do well with cannabis because if they have any type of change in their in their psyche they're gonna see that as bad that's bad you know right and like you got it when you're using cannabis you you have to be sown and who-who knows that okay I'm gonna get a little bit of maybe paranoia doubt or at least my psyche is gonna change a little bit I am using you know psychoactive substance and not be able to freak out right but some people you know I know that if they use a little bit of THC they probably would have a freakout they probably would have a bad experience generates people who are you know very very fearful you know the other side of that coin though is that if you use CBD and like we discussed earlier that can decrease learned fear

141:01right so so that's so you know that's something that's really helpful for those patients but you know I do agree that you know we have to be careful about using high THC in certain groups of people for sure you know I think one of the it's great to hear dr. Hart say this I one of the real disappointments for me with this book has been but really the biggest this point for me has been that the DPA the drug policy Alliance and that some of the other advocates they just want to yell at me and they want to say that I don't understand correlation and causation and then I'm cherry-picking studies let's let's acknowledge that a lot of people use this drug and that's true whether it's legal or not and let's acknowledge that probably in 2020 certainly if there's a Democrat elected most of the Democratic candidates have said they they favor legalization there

141:49will legalized cannabis will probably be the law in the United States okay and let's talk about what we're gonna tell people who are using and and and you know I had this roundtable with the executive director of the DPA and some other people this was a this is about a month ago you know sure shortly after the book came out and I proposed what I thought were really common-sense warnings and she basically wouldn't agree and she agreed to like one of the five of them I were the warnings you proposed it was stuff like you know if cannabis if you have a family history of severe mental illness you probably should not use cannabis you probably you should not use Kant or try to delay your use until you're in your 20s I think was one of them and one of them I mean I thought I couldn't believe I was getting pushed back on this was was something like if if you're having strange

142:36thoughts especially paranoid thoughts while using cannabis the drug may be increasing your risk for severe mental illness and you should not use it I mean I think that's I think if you know now look we can argue about how severe severe is right but certainly if you wind up in the ER even once yeah that's a bad sign yeah I just I just don't understand why the legalization look I can understand why people who are selling this drug don't care right we know if you know if tobacco has taught us one thing is that when you're selling a product you will sell it to people even if it kills them okay but I don't understand why these people who are supposed to be science driven and supposed to be thinking about the greater good won't agree to reasonable discussions about the what the warning should be on this I think you did yourself a slight disservice by not

143:23including some of the beneficial aspects of cannabis I standing your perspective I understand why you were doing that because you really wanted to highlight the dangers but I think that's one of the things that they can point to when they say you cherry pick data but I think that also it's really important to when you're having these kind of conversations to have a long one I mean this we've really covered the full gamut right and I think this is probably one of the reasons why Bill Maher didn't want to have you on because he's got five other people on the panel everybody's talking over everybody and you have five minutes to get your case out and I don't think it's possible yes I think this is a really this is a long complicated discussion that has to do with biological variabilities it has to do with unique situations with human human psychology the way the brain functions whether or

144:08not it can act as a trigger to schizophrenia where someone may not have ever experienced that trigger without it maybe if they just became a long-distance runner and they would have lived a healthy life with no psychotic breaks at all we don't really know and unfortunately once someone goes off the deep end we might never find out yes and sorry go on no I'm just saying I think we have to be very careful in saying we know what it does we know what anything does cuz you don't know you know what it does for you you know some some people can't eat fish you know the shellfish and their their throat seizes up we there's so many variables when it comes to the human body whether it's your genetics or you know what you've eaten in the past and how its shaped your gut biome there's so much that we don't know and don't understand about how we interact with all the various substances that we

145:00take into our body yes yeah what one thing though - you know I note it in your book Alex is that you know you said that you didn't think that cannabis can help the opioid epidemic is that true I certainly don't think it's a good idea for people who are at risk of opioid use okay so you know I have seen a lot of people in my practice come off of opioids with cannabis use and there are you know various medical studies that do show that people who use cannabis cane cane replace opioids with with that candy because a lot of folks feel though that that's a pain in you know in defensive that does just a patch and they're really the best way to get off of opiates is ibogaine and that ibogaine which is the the repeat rate of addiction of people try it again afterwards is really low i I think I you know one of the things that that is just the accessibility the affordability like

145:51I've never administered ibogaine before well it was it's illegal in the United States but you mean in it's a particularly ruthless medication that I've never tried personally but the people that I know that have tried it have had spectacular results especially people that have had problems with pills yeah in fact a friend of mine my friend ed clay he opened up a clinic in Mexico based on his own interaction with with pills he had an injury he got hooked on the pills and really had a problem so went down to Mexico and went through a navigating session and cured him just whacked it out did it change literally changes the way your brain interfaces with your addiction it's not it's not simply a perspective enhancer it changes how you your body and your brain deal with with opiates I think Tim Ferriss has actually talked about that before yes well yeah but I mean you know I've

146:43seen 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 can help the opioid crisis and then also to you you want to look at it from a clinical perspective right so we know that opioids can kill people right because it acts on the brain stem whereas whereas you know cannabis doesn't so you know you might be saying you know you're just substituting one for the other and you know sometimes that is true but if you're using a less harmful substance you know to me that's like a huge win right so if someone you know has to drink you know 12 beers a night versus smoking like one joint man that's that's awesome and I mean you look at all all these clinics like you look at like methadone clinics I mean what are they doing they're trying to get people off one substance to you know a substance that is a little bit less

147:32harmful and I think that when you when you use cannabis you know it can be effective for opioids it can also be effective for benzodiazepines and for other medicines as well so you know it would be awesome if everyone would just you know feel happy and great all the time by just exercise and nutrition and you know that's what I advocate and that's what I try to do personally and that's what I try to you know say to my patients all the time but I understand though that you know sometimes life is hard sometimes you know if things hit you you know you have you have crisis in your life you have you know personal crisis that can you know throw off your mental health and then you have you get into a car accident you know and you could be in really severe pain and and in those times you know sometimes diet exercise meditation doing all the right things just isn't quite enough and you know I

148:23think that it's great that we have cannabis for those situations because it does seem to be you know very effective and has less side effects compared to some of the other met it's compared to some of the other medicines that we have traditionally used and you know even though you know I'm talking about opiates and deaths you know we can also talk about insights right like non-steroidal anti-inflammatory drugs so you know these drugs can also you know wreak havoc under GI system I saw one study actually I tweeted out ronda patrick tweeted out said that if you use NSAIDs it was really short I got to look it up again but it was like two weeks it can decrease your jörgen a door opens which can stimulate your testosterone level by like 25 percent and on that note - we should talk about I can't believe it forgot to talk about this but opiates can drastically inhibit

149:15your your testosterone production right which is a huge thing for depression because I've had guys come in to me before that have been you know really really depressed you just give them a small amount of testosterone a man they're off their antidepressants and they're off to the races they're doing great so you know are we creating a lot of people who are who are depressed because they're using opiates and their testosterone levels are low and you know for men I mean having low testosterone horrible you know your libido goes when you're gonna have low motivation you know you're not going to feel as well you're not gonna want to do things so you know if you're giving someone a medicine that that that nails their their testosterone levels down that's gonna really you know wreak havoc on their mental health I just want to make a note too because bang Greenfield -

150:03again I really really respect I like that guy a lot you know it was talking a little bit with about testosterone and and and cannabis and how can drop it so I think there was three studies I saw done on on humans and two of them noted no statistical difference and drop in testosterone levels and one study the other study noted a small statistical difference so you know I think that you know it may drop your testosterone levels a little bit but it's not gonna you know substantially drop them so just so people people know know that because I know that comes up all the time you know yes as the as the as the dumb anti-drug advocates like to say doobies cause boobies risperdal causes that's a different issue risperdal an anti-psychotic risperidone yeah so so look I think I think the issue of whether cannabis is a gateway drug there it's a hundred percent clear that cannabis is a gateway

151:17drug the argument is we see a hostile harmful thing is that clear the argument is why okay so so it's quite clear that cannabis use oftentimes proceeds other drug use whether it's opioids cocaine other drugs now one argument and this actually pro-legalization argument is one reason it's a gateway is that if it's illegal you gotta buy it from your friendly neighborhood dealer he might have access to heroin or cocaine other drugs and so eventually maybe you decide to try one of those other drugs so actually that's really why the Dutch legalized they wanted to create an avenue for people to use cannabis that wasn't connected to other drugs okay another possibility is that using an addictive intoxicating substance you might like it and you might want to try other addictive intoxicating substances and it might prime your brain and then the third possibility really is that

152:08they're just some people risk takers out there right they use they're gonna use cannabis they're going to gamble they're gonna in cannabis a little bit easier to access than other drugs so they're probably gonna try cannabis first so it's not really that that cannabis drive the use it's just that cannabis is first they're just curious people what's your thoughts on well what I will say I mean I'm just gonna go back to the name report right and I mean I mean you quote these people yes in your book you know so this committee couldn't find sufficient data demonstrating an association between cannabis suits and nishan the opioid use they found no compelling evidence to support the gateway drug theory so so again but that's the goes the people that you quote in your book so there's been more research done since then but what does have radically changed I would say

152:53things have changed some here's here's here's what I would brother I think that probably it's a combination of these things right it's there's certainly an environmental factor where again if you're buying from somebody who's gotten access to other illegal drugs maybe you try those drugs at the same time getting high it feels good and maybe you want to try other drugs and at the same time you're just a risk taker okay what is what nobody seriously ever said until about the last five years is that cannabis could be an off-ramp for opioids okay and there's a lot of reasons to believe that's a really bad idea first of all cannabis if you actually need opioids for pain relief cannabis is not a good enough pain reliever it's like alcohol it's a mild pain reliever it's not strong enough you're dying from cancer cannabis it probably is not the pain reliever that you need

153:38you need opioids okay and the again the state level data is not as good if you want to really figure out what's happening to an individual the best way to do that is to follow that individual and there's a really good paper that came out in 2017 after the NAMM report so they didn't have it that shows that people who used cannabis in 2001 is based on a large national study in the US were three times as likely to be using opioids three years later okay and that just intuitively makes sense to me and the other thing that people on the legalization side don't ever talk about is who are the two countries that have the most cannabis use in the West the US and Canada where the two who are the two countries that have by far the worst opioid epidemic the US and Canada okay but there's a real issue with that because the United States is also the only country other than New Zealand that

154:28allows pharmaceutical context yes I mean there's a there's the amount doesn't the amount of opiates that are prescribed the United States is preposterous I agree particularly the V 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 yeah maybe you could just literally go from embassy to pharmacy yeah yeah we have a problem with the way we prescribe drugs in this country opioids ATD drugs benzos SSRIs all are connected to Canada so makes sense that it would filter over there yes but what I would say is the people who think that cannabis is not part of that overprescribing problem are deluding themselves and what do you think did that so he can't repeat the question so so so I agree with Joe with the way the access to opioids in the US I mean certainly it's come down a little

155:17bit in the last couple years but you know Purdue Pharma there's a special place in hell for those guys but not just not just opiates we prescribe too many benzos we prescribe too many a DD drugs we probably prescribe too many SSRIs we prescribe too much in this country I think we all agree I think that cannabis is another example of us looking for a drug to solve our problem but what I'm ok again just from a clinical perspective you know I can't just rely on on diet and exercise for all my patients I have to use other tools and again like everyone here in this room like we're all pretty healthy I don't have you know a bad back or you know I don't have a mental health diagnosis or anything going on so you know I have to look at patients that are coming to me right so the way I see it is that you know we just mentioned a bunch of other drugs you know

156:08antidepressant synthetic means all these types of things you know cannabis and again you know I'm gonna separate the THC and the CBD it's an incredible medicine and it doesn't kill people right so as a clinician you know that that's so comforting for me to know that every single night I go to bed I killed zero people I know that right so that's really really comforting for me to know also I feel you know we're just talking about amphetamines and we were just talking about you know SSRIs I feel that cannabis you know particularly the CBD component can actually be more effective you know that's what I've seen a lot in my practice and other people have seen that as well you know I think that we need to need to take that into consideration when we're using all these drugs and Alex you know some of the things that you're saying you know they're quite you know a

156:55durable and and in a lot of things like researchers say you know are quite a durable as well and and you know they they feel that they can you know tell clinicians you know give them really good advice but they're not the ones in the trenches they're not the ones in front of the people they're not the ones that that have to have to chat with patients you know I have an obligation to do something for my patients to make them better I really feel you know we just listed a bunch of drugs that cannabis is a really really effective tool and and it doesn't kill anybody so you know because of that you know I'm gonna I'm gonna keep keep using it but like I said I'm always looking for other drugs I'm always looking for other you know alternatives that to also help my patients but I think that you know using cannabis is a really effective tool for a lot of clinicians and it's helped a

157:47lot of patients but what do you think about his argument about it being a gateway drug other than what these people have said in the study that there's no evidence it supports it's a gateway drug what are your personal feelings about that argument so I I don't feel that that cannabis is the gateway drug I do feel that you know one of the the things that you mentioned earlier is that you know some people kind of had this personality where they're like Andres parent right and they they just they just want to want to try something so you know the fact is that alcohol and cannabis just get introduced first most of time most people you know don't do you know coke or LSD and then he say hey man let us try some some cannabis right so it's just that that's the very first one there so if we so you could say anything that was easier access if there was some new drug that you know did something

158:37similar to alcohol or similar to cannabis and that was introduced in in our society you'd be calling that the gateway drug well and I do feel and I I do laughs clearly been demonstrated as being the gateway drug to almost all hard drugs because 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 after and and I know that the name you know they don't they don't feel that the cannabis is a gateway drug either I mean again they said you know they found no compelling evidence to support the Gateway theory and again I mean these are the people that you are and in your book out right let me just go a little bit further they said in a retrospective cohort study may it from et al and the 2016 examined the transition from cannabis use to the use of other illicit

159:24drugs they found that the probability of initiating other illicit drugs after cannabis did not differ significantly from the probability of starting with other illicit drugs so it's just that cannabis is their first it's definitely not a gateway drug in any stretch of the imagination again I I just I totally disagree and there again there was 50 years of data on this I know the studies that he's quoting but there are there are many others and I think the argument is as to why and again I think the argument that that to some extent having access to this drug via you know illegally tends to open you up to other illegal stuff which are to me is already made for legalization so but I do want to throw one thing out there you know I don't know how many of your viewers have teenage kids or you know it's probably they're probably more likely to be teenage kids and to have teenage kids

160:14but you know the book has the one thing that really worries me in the if we're talking about gateway drugs is that Jewel and vaping are really a gateway to THC vaping so you can you know you can write it up because well first of all it gets people it gets kids teenagers used to inhaling you know this illicit substance and you can actually retrofit a jewel pod with THC they don't sell them but you can you know you can easily go online and look up how to do it and I think it really worries me and I've heard from a lot of parents in the last month that there is an epidemic of nicotine vaping and THC vaping going on right now and that I think and we're talking about 15 16 17 year-olds inhaling pure THC the most dangerous form of this drug and I think unfortunately it's not going to take long before the mental health consequence of that become apparent and and I really

161:13do hope that the book gives parents some tools to talk to their kids about that if nothing else last words I would actually wanted to go over a few things that maybe I thought you might be interested in okay okay so you know you're a dude you're over 50 so prostate cancer so you know it's been shown that CBD may actually be beneficial for prostate cancer and one thing within that too in the same study they actually found that people who used CBD and we're on chemotherapeutics is actually augmented the efficacy of what you think they're good for prostate cancer do you mean to prevent it do you need to treat it prevent and treat yeah yeah and then they say you know THC may actually be a little bit effective because a cane and this comes back to testosterone but it can antagonize DHT so DHT is another testosterone you know hormone as you know and that's you know more more

162:08linked to prostate cancer one thing to know we didn't get really get to talk about was CTE and and concussions you know 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 tweet and I really appreciate that you know and Jesse owns a 3-year study show that the mortality rate overall was there was nine and a half percent for people who had suffered a TBI people who test it I know you know we talked about correlation causation but you know the THC users only had a two point four percent mortality rate the non T she was just had 11.5% whatever I mean that's really really significant right like it's just THC and not CBD because CBD has been shown to be very beneficial for people with traumatic brain injuries yeah yeah it's actually pdn THC or both beneficial yes so that was you know again a correlation you can causation

162:57but I mean that that the stats are so over overwhelming like if it was you know non cheatsy was like three point five percent I woulda bring it up but it's eleven point five eleven point five percent compared to two point four percent and again CBD yes and there's even yo mechanisms of action have even been identified with that it decreases you know in inflammation in your brain post concussion you know one last thing to again there's only one study so and it was done on rats but you know I'm I'm Aikido guy too but the study on rats interestingly it showed that if you have if you do have a high-fat diet that you can actually decrease sensitivity at the cb1 receptor and they think that that's just because there's an increase in your endogenous cannabinoids to AG and in an amide when you when you do have a high-fat diet and then you kind you don't go okay sure

163:55and then Alzheimer's you know again I know your plus plus 50 so you know cheats II know 30 watts to keep doing this podcast young forever be excused to stop so THC has been shown to inhibit the formation of beta amyloid plaque so that's the you know the hallmark of Alzheimer's disease and then CBT CBD has also been shown to be effective for for all-stars disease as well you know it was a rat study that was gonna get into but it's it's fairly fairly it's fairly detailed so you know might be best just to say that Akane you know help with rescue memory and patients if you do you CBD meaning that it may actually reverse and that's been shown before too they've done that in mice I got interrupted okay and I think you would agree this data is some of it's some of it's sort of epidemiological some of its preclinical it's very very early none of it really proves my dad but but let me say I'm a

165:00clinician okay if someone comes to me and they have a concussion it's very fresh strangest to say to them hey physical cognitive should rest go home okay it's really frustrating to say that's somewhat also to you know that the high-fat diet thing you know Joe and I both follow you know very very similar diet so that's something I want to share with regards to you know the the Alzheimer's disease we have really really poor medications for that and we have an aging population so again like Alex like you want to look at everything which is what I'm doing like I'm looking at everything and I'm trying to make a clinical decision am I using some things like without you know randomized control trials of course a.m. but again on the condition so I'm using you know mechanisms of action I'm using what I've see and in clinic and I'm using epidemiological studies and I'm also taken into account

165:48what other medicines do I have you know based upon all the data this seems to be ineffective treatment and I am absolutely not saying that you as a clinician shouldn't do that especially your in Canada cannabis is legal you should you should use your best judgment what I'm saying is that when we're talking about policy decisions around cannabis and THC and to a much lesser sense 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 and you know a guy I know in Peter Bock who very smart these a pulmonologist he's at Memorial sloan-kettering in New York and he wrote a piece in The Wall Street Journal a few a couple weeks ago talking about cannabis as limits as medicine and he said something that I thought was so well put which is the reason why people want cannabis to work for Alzheimer's

166:40and cancer and a bunch of things where does where there's really no evidence that it works is that we don't have good treatments we want cures we want help we if we're clinicians I mean I'm not a clinician you're a clinician want to be able to give people who come into our office is something but that hope is not a substitute for science it doesn't mean then it works and even you want you want your patients to have hope okay but that advocates the people who are using this to push especially to push THC and to capitalize on the public confusion around THC and CBD I think that is a real it's a real disservice to people okay listen I think we covered everything it's a complicated subject it really is and I think it's really important to discuss how complicated it is I don't I don't think there's I've never heard such a detailed analysis of all this stuff and in a way where you

167:37can get two opposing people that are you know very civil about it but agree on certain aspects of it I think I think we really highlighted all those things Joe thank you so much Evan thank you thank you guys thank you so much really appreciate it doctor our thanks give out yours social media please sure so I'm at dr. Mike Hart on Twitter I'm at dr. Mike art on Instagram and I'm at dr. Mike art on on Facebook so it's dr mi ke har T and Alex your book is tell your children that's available now it's available everywhere it's available now and if I had a copy I'd give you a contest okay I'll give you the copy i okay alright well thank you guys thank you very much pigs