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Welcome to the Thriving with Addiction Podcast, where we explore how recovery is not just about surviving, but about truly living.
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Each week we'll dive into the science, stories, and strategies that help people and families heal from addiction and build healthier, more resilient lives.
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I'm your host, Dr.
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John Avery.
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Let's get started.
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Her multidisciplinary research investigates the neurobiology underlying substance use disorders and related psychiatric illnesses.
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A major focus of the research focuses on opiate abuse and the developmental effects of cannabis, which we'll talk about today.
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The group also conducts human clinical trials towards developing novel therapies for opiate use disorder.
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Dr.
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Hurd has been inducted into both the National Academy of Sciences and the National Academy of Medicine.
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Yes, been welcome.
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Thank you, John, for having me.
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No, of course.
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It's great to meet you.
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And you're you're the expert in cannabis, and so we needed you to come on since there seems to be so many different opinions about it these days or from the beginning of time, really.
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Um how'd you get interested though in the brain and cannabis?
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What brought you here?
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It's actually a long journey and a strange journey when I think about it.
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Um I've always been interested in the brain from I was a kid.
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I always tell people as a weird kid, just, you know, why do people act the way they do?
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And and I knew it was from the brain.
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And so I started off being interested in actually neurodegenerative disorders when I was training to be a neuroscientist.
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And in studying those uh, like for example, Parkinson's disease is a disorder where the dopamine cells are damaged.
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And dopamine is a transmitter that's not only for, you know, many people think about it for reward, um, but it's about motor function and attention.
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And we use drugs that target the dopaminergic system in teasing out the neurobiology of Parkinson's related disorders.
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And I was just fascinated by how these drugs, which turned out were like amphetamine and cocaine, completely changed behavior.
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Um, and that's when I started looking into drugs, the neuroscience of drugs of abuse.
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And in studying adults with, you know, substance use disorders, I wanted to know how did they get there?
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And looking at different risk factors as genetics and early life events.
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And one of them is early use of cannabis.
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And so that's how I started down the cannabis path years ago now.
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When I was becoming an addiction psychiatrist, a lot of people encouraged me not to, which is why I decided to become an addiction psychiatrist and study the stigma of addiction.
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What about on the research side?
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Were were people encouraging of that transition from sort of the, you know, the bread and butter of the brain Parkinson's to trying to tackle and understand addiction?
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I will tell you that I had previous people early that who I thought were going to be great mentors in my life, who indeed said, do not go into studying addiction.
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And I didn't understand it, I think, completely in terms of the degree of stigma.
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But I think that there is actually a greater stigma today, still on the clinical side for you know clinicians like yourself compared to the to the basic science.
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So the basic science of addiction, uh, people get a lot of high, you know, high impact publications because using off the psychiatric disorders, you can model addiction more in an animal model than you can model, for example, schizophrenia.
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So you have now a lot of basic science and addiction is very well established, very well respected, but the stigma that comes with clinical substance use disorders, I think is still there, sadly.
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Right.
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Now that's that's a a good point.
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Um sometimes you guys have, you guys are saying to us or to patients or to families, this is really uh a brain disorder, and we can really see everything that's going on.
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And and sometimes we haven't quite communicated that well to people and family who are struggling, but the the evidence is there.
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Absolutely.
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The evidence is there.
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The the problem still is that many people think of substance use disorders as disorders of, you know, of lack of morals, lack of will, lack of that.
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And I don't think that they understand the nature of substance use disorders.
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Yes, you cannot develop a substance use disorder if you never consume the substance.
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So it's unlike, you know, Huntington's disease.
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If you have the the risk, if you for Huntington's the genetic risk, you will develop Huntington's.
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But if you never take an opioid, you will never develop an opioid use disorder, even if you have a genetic risk.
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So I think, you know, that is one of the reasons why I think our society, you know, look at people's substance use discord that they brought it on themselves.
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But many people go through the same thing of experimenting, especially during adolescence, with substances and other things.
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But a small handful get stuck in this and for no fault of their own, while others go on to lead, you know, very productive lives.
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And I think that that's you know the issue of substance use disorders and psychiatric disorders in general.
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And then among um substances that one study as a neuroscientist, I think sometimes the opiates and the cocaines and amphetamines, they're sort of more accepted almost than cannabis, right?
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I I think you talked early on that in some of your early work, people argued against cannabis being accepted or understanding that's addictive and acts on the same reward pathways in the brain.
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Yes.
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I remembered when we started our first studies with cannabis, and in our animal models, we studied THC, you know, the main psychoactive cannabinoid.
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And um and getting the first paper even published because reviewers will come back like, why are you studying this?
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My grants, uh, cannabis is not addictive.
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And these are themselves neuroscientists, other, you know, investigators.
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But they were like, you should just be focusing on cocaine and heroin.
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Those are the problems.
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And I was also looking at cannabis from a developmental lens, from a developmental perspective, because for me it was, you know, is this really leading to risk for later challenges in life?
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And again, people were like, you should be studying if you're gonna study, study it in the adult brain.
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Why are you looking at it, you know, in during development?
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And this whole issue of cannabis is so benign that it can have an elastic impact on the brain.
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And of course, many, as I said earlier, many people will experiment, you know, in college, people experiment with cannabis and alcohol and cigars.
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And so they think, oh, it's fine.
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I went on to become a neuroscientist, or I went on to become a lawyer and so on.
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So, you know, it's not a problem.
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And we now know that's not the case.
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That's right.
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So let's jump into why that's not the case.
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Let's jump into cannabis.
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First, first, definitionally, cannabis, marijuana, weed, THC, CBD.
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Can you sort of unpack a little bit what we're talking about today?
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You know, I mean, marijuana is a term definitely more colloquial used on the streets.
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You know, I call it cannabis because for me, how our society has changed it from being a quote unquote recreational drug to voting for it to be medicine.
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And if that's the case, it's not marijuana that's medicine, quote unquote.
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It's cannabis.
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But even that, I think many people don't understand that cannabis is a complex plant with, you know, over 140 cannabinoids and hundreds of other chemicals that we still have very little knowledge about.
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And yes, we know a lot about THC, and we know we're now learning more about the other, the second highest cannabinoid in the plant before cannabidial CBD.
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But cannabis is complex.
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And even if it's been around like many things for thousands of years, many people think that we know a lot, but we really don't.
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And we really don't because even one of the things that we started earlier to talk about, many people weren't studying cannabis because they thought it was not a problem.
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They never thought it really had any lasting impact on the brain.
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So why study it?
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And that's and and that's the issue.
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But I do want us to talk about cannabis, and I want us to be specific and teach the public about cannabinoids because it is THC that is the issue that we see for really psychiatric and challenges and the growing psychiatric challenges with these high THC potency products that have been made as compared to CBD.
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So people put CBD in the context of of being cannabis.
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And for example, a lot of the the the voting to legalize cannabis was really a vote to legalize CBD, because when they saw that CBD was beneficial to treat, for example, these rare childhood forms of epilepsy, who wouldn't want to help the kids?
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And so a lot of the lobbyists used CBD, Charlotte Swab, as a way to say cannabis is completely, you know, fine.
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Look at this, it helps these kids with epilepsy.
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But people weren't voting for CBD.
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The laws went voting for cannabis as quote-unquote medicine.
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And so it's really important that people understand the difference between CBD, a cannabinoid, and cannabis, the complex plant.
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Right.
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And we'll talk mainly about THC today, but maybe talk a little bit just about CBD.
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I know you've done some research on it.
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I mean, as much as THC is everywhere, CBD is sort of everywhere.
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You're people are rubbing it all over their body and putting it in everything they drink, and you can go broke on CBD products.
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But but it might have some benefit.
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Tell me what what we understand about it.
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I have to say I am extremely shocked with how CBD became this huge market.
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And I would have been a multimillionaire, actually billionaire, if people had believed me and I patented, uh allowed to patent CBD, because in studying THC in our animal models, where we would see that adolescents, for example, rats that we gave THC to and study them in adulthood, they would self-administer more heroin.
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So we knew that THC was changing our endogenous opioid system, making them more sensitive to opioids.
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But I wanted to, you know, was it really THC?
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Because in our human studies, we studied cannabis and in our animal models, we were studying THC.
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And so I wanted to look at another cannabinoid.
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And I said, let's look at CBD.
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And then no one knew what CBD was.
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It was actually very difficult to even get it ligand for our human studies.
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And we saw something different.
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We saw that CBD actually reduced heroin seeking in our animal models, and then we moved it over to human clinical trials.
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So cannabinoids do differ.
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CBD is not cannabis, CBD is not THC.
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And I think that that, again, like I said, is very important.
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Now, people, you know, CBD now is in your coffee, your water, everywhere.
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I don't like that's shocking because we still don't know that much about CBD, even though I think that clearly it does not induce the psychiatric, you know, uh problems that we see with THC.
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But there's still a lot that we don't know.
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And to the point that you're setting it's very expensive, you know.
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Um a lot of these um boutique shops that had originally popped up at CBD with these creams and everything, you pay a lot for that CBD.
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But the the one issue on the negative side for CBD for me was that we did not realize that the cannabis industry would grow so fast and then use CBD to convert it to an intoxicating THC product.
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Because CBD is not intoxicating.
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We see that it reduces anxiety, but reducing anxiety does not, is not an intoxication.
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And that to me has been really um disturbing because we took a non-intoxicating product and made it intoxicating.
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By adding the THC.
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And then to clarify on the CBD, while it may help some things, it's not totally clear.
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It's it's helping for all the reasons people are marketing it, especially at the doses they're marking it and the ways people are using it, correct?
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Correct.
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I mean, I will be honest, in our clinical studies, we use doses of like 400, 800 milligrams of CBD.
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In the boutique shops, what they're buying, it's like 10 milligrams C BD.
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Right.
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So, you know, I when it so people should also know that um in the US, obviously cannabis is still illegal federally, even if it's you know, um been voted to be legal in in most states in the US.
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But there was an exclusion, hemp-derived products.
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So hemp has uh the plant has less than 0.3% THC.
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So they said, okay, for those states, especially that were used to making tobacco, now they could, like, you know, still the agriculture, the farm bill allowed them to make hemp and hemp-derived products, and hemp is CBD, basically, these CBD-rich cannabis plants.
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But they used chemistry to convert CBD to THC.
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And that is the problem.
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Um, and also it's not just that they made THC from CBD, but the chemistry that's used, also, there are toxins in there, those chemicals.
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And that's one of the things also that's a problem, that when you're using and buying these product C BD products, you don't know what's in them.
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That's a great point.
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There could be other stuff.
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There could be THC, even though they say there's there's not THC.
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And and so let's and so let's jump into THC.
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Tell me tell me about, and that's sort of what we the psychoactive component that we've associated with cannabis, with marijuana for a long time.
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Tell us about that and and tell us how the concentrations and potency of it have changed over time.
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Yeah, you know, uh, again, I think for me, and I think for a lot of people, I don't think anyone expected the explosion of these cannabis products in the manner in which they have grown.
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So, for example, you know, the plant, when people think about cannabis and like, you know, the hippie generation and woodstock and so on, the TFC concentrations were like 2%.
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They kind of rose in a little later in the 80s, 1980s to like 4%.
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And they've continued to escalate so that today you have cannabis, and you have THC products that have, um in a flower at least, like 24% THC.
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That was not the original plant at all.
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But what's worse is that they have created strains of cannabis strains that's even has 60% THC.
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And now they have products that are the concentrates, you know, the dabs and so on, but and they're vaped that can give 90% TFC.
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Think about it.
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The original plant and what you know a lot of um previous generations consumed when they experimented with cannabis was like a 4%, 2% THC um product.
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And they would smoke, and a lot of these kids in college and high school that would giggle and share one joint.
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But now they're consuming by themselves vape products.
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Vaping is also another thing, the the way, the means by which cannabis can get into your body, that they're putting THC in these huge hits, in these concentrates of 90% TFC.
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That is not the same drug.
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And I think that's another thing I wish our you know the public and and politicians and policymakers would probably start calling it a different name.
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It is not the same cannabis, it is not the same drug, and so it's like think about, you know, when cocaine itself was very addictive, and then came crack cocaine, they changed how you know uh how cocaine was consumed, and uh that even increased the addiction more.
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We know that as the concentration of any addictive substance increases, so does the addiction.
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And that's what's happened with cannabis.
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The THC, as they increase THC levels purposefully, because they wanted to get more people addicted, we've actually this had more people addicted and more psychiatric and health issues out of it.
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So the purposeful creation of a product that's 90% THC that has nothing to do with the original plant, I really do think we should be calling them a different name so people know what they're actually consuming.
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Right.
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It's sort of marijuana on drugs, basically.
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It's it's a whole new thing.
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Exactly.
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It is the turbo marijuana, turbo marijuana.
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All right, we'll figure out the name by the end of this podcast.
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I hope so.
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Yes, please, John.
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But whatever we call it, it's it's dangerous.
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And and so what you're seeing because of the availability, the access, the ease to use, you can use it in a stealth way with the vapes and the edibles, is that we're seeing well, what are we seeing?
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What's what's the evidence show in terms of who's getting addicted and and the mental health and other consequences of it?
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For me, one of the the worst things that a society could do is to not uh raise healthy children because they're the next generation and they reflect what's happening in our society.
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And today we see that these high THC products, more so than ever, have increased psychosis in young people.
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Um, I think a new study even came out from Canada, and Canada, I think, is important because they have a national healthcare system and they legalize cannabis before the US.
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And I think people don't realize it takes time to collect data to see what are the impacts of anything in our society, any change.
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And the Canadian data showed now clearly that the more recent earth cohorts they show um an earlier onset of first episode psychosis and greater number of first episode psychosis than previous generations.
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That cannot happen because of genetics.
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It cannot happen, you know, and it they real and it was related to cannabis use.
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And so for me, it's I don't think that people realized that cannabis is this drug that they thought, oh, you know, you giggled and that, you know, you may eat, you know, order pizza in the night or something, that that was would become this drug where we see a very close um association with psychosis and schizophrenia, especially the younger someone starts using cannabis, um, in in terms of teenager and the frequency.
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And now we have kids that they call it wake and bake.
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They wake up, the first thing that they have to do is to consume cannabis.
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That is not moral.
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And we see now also even more of uh in the emergency departments, more young people coming in with cannabis hypermesis syndrome, meaning, you know, this chronic vomiting and nausea.
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That never happened before with cannabis use.
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It really was like aspirus um case that could occur.
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You see now data showing greater even cardiac issues in young people with associated with cannabis use that again never occurred.
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And even children obviously showing up in terms of the toxicity to emergency departments because they'll eat a gummy that their parent made up out, left out.
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You never had those things before.
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It's a different drug that's associated with more health impact.
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And another thing that Canada, again, like I said, when you have a national healthcare and a national uh system that tracks a lot of things than we do in the US, they even see that young people are using the healthcare system because of cannabis more.
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So cannabis use is has a much greater economic impact on the healthcare system than ever before.
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Those things are actual numbers.
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They're not well somebody making up, oh, that cannabis is so bad.
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This is not the same drug.
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And so we're seeing much greater health impact across all spectrum in the healthcare system, not only in psychiatry, but in our colleagues in terms.
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Of cardiology, we see it absolutely obviously in emergency department.
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And not just Canada, I should say that also the number of epidemiological studies in the US also replicate that there's an increase in psychosis and other mental and health issues with teens and young adults using cannabis.
00:22:20.000 --> 00:22:32.720
And are these harms, which I think even include lesser things like worsening of depression and anxiety and sleep disturbance and certainly the risk of addiction and functional impairment, are these harms seen even with occasional use?
00:22:32.880 --> 00:22:40.960
Is occasional use of this sort of turbo marijuana, I mean, it's obviously different than the occasional use back in the day, but does that even come with risks?
00:22:41.039 --> 00:22:44.640
Or what should we tell parents and kids as they try to navigate this?
00:22:45.440 --> 00:22:53.839
I mean, the data shows that obviously the more frequent you use these high um potency products, the greater the risk.
00:22:54.160 --> 00:23:03.839
But there are individuals, still there are risk um in terms of even the infrequent use, and it's again because of the high potency of the THC.
00:23:04.160 --> 00:23:20.240
So, you know, a teen in a party, there somebody gives them uh this, you know, 90% THC, they've ended up in the in the hospital, even though they're not frequent users of cannabis.
00:23:20.799 --> 00:23:34.880
The question that we have, and then you, you know, you've raised in the sense of a lot of teens today, especially even adults, in terms of such an highly anxious world, teens are suffering from a lot of, you know, social media, this, the that.
00:23:34.960 --> 00:23:36.480
Their world is very stressful.
00:23:36.559 --> 00:23:42.799
And many of them, um, like adults say they use cannabis to alleviate their anxiety.
00:23:43.039 --> 00:23:50.720
But all the data shows that it exacerbates and worsens it to a point where they end up in the hospital.
00:23:50.880 --> 00:23:53.759
They need medical treatment for their anxiety.
00:23:54.079 --> 00:24:09.759
And yes, it's a it's a it's it's a it's a perplexing thing for people who say, oh, you know, our endogenous cannabinoid system is indeed important for regulating our stress response.
00:24:09.920 --> 00:24:10.480
It does.
00:24:10.799 --> 00:24:16.640
Our endogenous cannabinoid system is like a break on our stress response.
00:24:16.960 --> 00:24:20.240
But with chronic cannabis use, it takes away that break.
00:24:20.400 --> 00:24:25.359
So now it becomes it's like a uh a fast car on the highway.
00:24:25.440 --> 00:24:30.799
It just becomes it's an excessive anxiety that they they feel.
00:24:30.880 --> 00:24:37.039
And then they're like, oh, I need more cannabis, but they don't realize that the more cannabis they use, it's this ugly cycle.
00:24:37.119 --> 00:24:42.559
It just exacerbates the anxiety and the other mental health uh challenges.
00:24:42.799 --> 00:24:48.880
And and that's the thing, is you know, with mental health issues, people can't step back and see that.
00:24:49.119 --> 00:24:50.400
And that's the problem.
00:24:50.799 --> 00:24:51.039
Right.
00:24:51.200 --> 00:24:57.920
It's it's both hijacked the reward pathway, but then this withdrawal state that you enter really propels you forward because it's it's just so unpleasant.
00:24:58.000 --> 00:24:59.519
And and maybe speak to that a little more.
00:24:59.599 --> 00:25:03.440
What is it doing under the brain for your for your research and what you know?
00:25:04.400 --> 00:25:25.599
You know, the research shows that you know, chronic cannabis use or high high potency products does even change the structure of your brain cells, the structure that stays with when we studied the adolescent exposure and look in adulthood.
00:25:26.000 --> 00:25:28.480
So it's not a make-believe thing.
00:25:28.799 --> 00:25:31.440
It changes the structure of your cells.
00:25:31.920 --> 00:25:39.279
It also changes the re how quickly your stress system reacts in a negative way.
00:25:39.519 --> 00:25:57.359
So all these stress-related um your your stress hormones, the genes that regulate a lot of the stress response, they are very high, especially when exposed to high potency THC products.
00:25:57.599 --> 00:26:06.400
And yes, you know, withdrawal for cannabis, as you know, is actually one of the worst of many of the substance use disorders.
00:26:06.799 --> 00:26:15.839
You know, the depression, the sleep, sleep is a huge aspect of many mental health disorders.
00:26:16.000 --> 00:26:19.359
I should many disorders, and I think that that's one of the things as well.
00:26:19.599 --> 00:26:24.079
That you know, the withdrawal from cannabis impacts sleep tremendously.
00:26:24.400 --> 00:26:42.799
So again, many people think that cannabis is benign, but nothing is benign if it causes such huge impact on brain cells, on other cells in the body as well, but on the behavior and the long-term effects that we see.
00:26:43.039 --> 00:26:48.400
And from a research perspective, you know, my question was what maintains this?
00:26:48.559 --> 00:26:49.359
Why is it there?
00:26:49.519 --> 00:27:04.000
And we could see that these epigenetic changes and epigenetics, as you know, you know, we inherit the DNA sequence from our parents to, you know, what to determine, you know, everything in our in our bodies and and brain.
00:27:04.319 --> 00:27:11.119
But the environment can put tags on those DNA so that genes that should be turned off are now turned on and vice versa.
00:27:11.359 --> 00:27:21.839
And we see that developmental exposure to to THC changes the epigenetic platform or the signature in our brain.
00:27:22.079 --> 00:27:41.359
And that signature, interestingly, looks like what we see in aspects of schizophrenia when we look in the brains of people who were diagnosed with schizophrenia, and it changes those epigenetic changes linked to how the cells communicate at the synapse.
00:27:42.000 --> 00:27:51.279
So these are things that are not um, you know, fiction, these are actual scientific facts.
00:27:52.160 --> 00:28:00.880
High potency THC impacts the brain, it impacts fundamental biological processes, that does have a long arc.
00:28:01.200 --> 00:28:06.400
Does it mean that you can't go back to normal?
00:28:06.720 --> 00:28:07.039
No.
00:28:07.599 --> 00:28:16.480
The one thing that I will say that when we saw that these changes were mediated by these epigenetic mechanisms, I actually was very hopeful.
00:28:16.799 --> 00:28:25.920
Because unlike genetics, you can't change your the the things you inherit, but epigenetic mechanisms are reversible.
00:28:26.160 --> 00:28:28.480
And so that to me gives hope.
00:28:28.720 --> 00:28:39.359
And that's why the earlier someone stops using cannabis, make it try to make it through that really tough withdrawal period, there is hope.
00:28:39.599 --> 00:28:47.039
And, you know, obviously on a research level, we're trying to see how we can target these epigenetic mechanisms.
00:28:47.119 --> 00:28:58.400
We can target them in an animal model and reverse the the you know bad behavioral outcomes of developmental cannabis use, but trying to find ways that we can do that in humans in a healthy way.
00:28:58.799 --> 00:28:59.039
Right.
00:28:59.119 --> 00:29:01.119
And what about the person that says, all right, Dr.
00:29:01.279 --> 00:29:01.759
Heard, Dr.
00:29:01.839 --> 00:29:02.720
Avery, I get it.
00:29:02.960 --> 00:29:06.319
Kids shouldn't use weed, their brain's developing, it is all these changes.
00:29:06.480 --> 00:29:12.559
But as an adult, I hear all the worry about alcohol and weeds everywhere these days.
00:29:12.720 --> 00:29:16.160
Isn't it safer if I just smoke a little bit of weed instead of drinking?
00:29:16.319 --> 00:29:23.920
I mean, holiday parties this year in New York, I heard there were so many that actually were serving not no alcohol or less alcohol, but they were serving marijuana products to adults.
00:29:24.079 --> 00:29:24.240
Yeah.
00:29:24.480 --> 00:29:28.400
Um, and there's just sort of this perceived safety more, maybe even on the adult side.
00:29:28.559 --> 00:29:32.720
What would you say for the adult casual or interested user too?
00:29:33.440 --> 00:29:42.240
Yeah, I mean, the adolescent brain, absolutely, and young adult brain are much more vulnerable to cannabis than the fully mature brain.
00:29:42.480 --> 00:29:44.559
Every data shows that, really.
00:29:45.039 --> 00:29:53.440
However, even adults, because of this high potency THC products, are having mental health issues.
00:29:53.599 --> 00:29:59.599
Then so I don't want to make people to think it's only the teens and only young adults, the mature brain as well.
00:29:59.839 --> 00:30:08.640
And alcohol is one of the worst drugs, you know, substances, I should say, in our society, it creates a lot of health issues.
00:30:09.839 --> 00:30:14.720
I think everyone has to think about what they're consuming and putting in their bodies.
00:30:15.359 --> 00:30:23.599
Um if you are at a party, often many people at a party are not drinking grain alcohol.
00:30:24.480 --> 00:30:29.359
You know, many people are the same thing with cannabis.
00:30:29.599 --> 00:30:34.720
What kind of cannabis product are you putting in your your your body as an adult?
00:30:34.960 --> 00:30:37.359
You should do the same thing in looking at these products.
00:30:37.519 --> 00:30:39.599
What is the concentration of THC?
00:30:39.759 --> 00:30:41.119
To me, it's knowledge.
00:30:42.079 --> 00:30:52.720
People have to understand that our society has become guinea pigs for these companies that create these high THC products.
00:30:53.039 --> 00:30:54.640
We are their guinea pigs.
00:30:55.359 --> 00:31:01.440
We have not done that with you know nicotine, the tobacco, they never made the nicotine higher.
00:31:01.759 --> 00:31:08.240
Yes, Joule made these, you know, fruit products which got genes and so into it.
00:31:08.480 --> 00:31:10.880
But that's what the the cannabis industry has done.
00:31:11.039 --> 00:31:16.960
They have increased the TFC concentrations that even at the adult range is also vulnerable.
00:31:17.279 --> 00:31:28.319
So, you know, alcohol or cannabis, for me, it's like it's I always say, is it, you know, do you want to jump off the fifth floor or do you want to jump off the third floor?
00:31:28.400 --> 00:31:38.640
You know, it's you know, nothing is say without harm, but we do know that the THC products today are not the same.
00:31:39.039 --> 00:31:50.720
They are manufactured to create addiction, not because otherwise there was no reason for them to change the amount of THC.
00:31:51.039 --> 00:32:03.359
And not only do they increase addiction risk, they also have increased the risk for other mental health illnesses and other physical illnesses.
00:32:03.599 --> 00:32:09.599
And yes, I'm sure perhaps the the industry that was not their thought, but that is what has happened.
00:32:10.319 --> 00:32:10.480
Right.
00:32:10.559 --> 00:32:13.599
But it's encouraging if someone's listening to this and and trying to stop that.
00:32:13.680 --> 00:32:18.240
A lot of the brain changes seem potentially reversible, at least the epigenetic ones.
00:32:18.480 --> 00:32:20.000
And then what do we know about treatment?
00:32:20.079 --> 00:32:25.200
If someone's in trouble, what what are some of the options available to get to the other side of it?
00:32:26.160 --> 00:32:30.640
Um, today there are no pharmacological treatments as yet.
00:32:30.720 --> 00:32:41.839
There are a lot of you know studies in the in the pipeline for trying to develop new treatments for substance for cannabis use disorder, but there are a lot of behavioral treatments that are out there.
00:32:42.160 --> 00:32:51.119
For me, there are more and more uh clinicians that recognize um cannabis use disorder, motivational behavioral therapy.
00:32:51.359 --> 00:32:55.599
There are a lot of behavioral therapists that who can help.
00:32:55.920 --> 00:32:57.519
So there is hope.
00:32:57.680 --> 00:33:01.759
And those behavioral therapies have worked.
00:33:02.000 --> 00:33:10.480
It's just to stick it out, especially during the withdrawal period that I know a lot of people feel that they can't make it through, but you you can.
00:33:10.880 --> 00:33:12.319
You absolutely can.
00:33:13.519 --> 00:33:13.839
Right.
00:33:13.920 --> 00:33:17.680
I think there's good psychological treatments, there's 12-step treatments.
00:33:17.839 --> 00:33:25.200
Unfortunately, no medications quite yet, like we have for alcohol and nicotine and opiates, but hopefully with time, some some pharmacological sport.
00:33:25.440 --> 00:33:31.119
And sometimes it's just treating the underlying psychiatric conditions that have developed or or contributed as well, I imagine.
00:33:31.519 --> 00:33:32.079
Exactly.
00:33:32.240 --> 00:33:32.720
Exactly.
00:33:32.880 --> 00:33:46.880
Coming back to anxiety, there are treatments that are well um known for many years that, you know, psychiatrists can prescribe for you if you have and if the underlying issue is anxiety, the same thing for depression.
00:33:47.119 --> 00:33:58.559
There are, you know, we have pregnant women taking cannabis to to, you know, treat their nausea and even their anxiety is also during pregnancy.
00:33:58.799 --> 00:34:08.880
There are medications that have been well studied for the impact on their fetal and their children outcome that show that they're safe.
00:34:09.039 --> 00:34:12.239
There are many safe medications that already exist.
00:34:12.719 --> 00:34:26.559
So kind of think about what your underlying reason was to even start, and even what might have developed you due to the cannabis use, but there are medications out there that are well known to alleviate those symptoms.
00:34:26.960 --> 00:34:27.280
Right.
00:34:27.519 --> 00:34:33.920
And I guess the other thing we have to think about in terms of changing all these behaviors is how do we address this at a societal level?
00:34:34.079 --> 00:34:38.239
How we talk about marijuana and media and culture and the regulations.
00:34:38.559 --> 00:34:41.280
We need you basically talking to everyone all all the time.
00:34:41.360 --> 00:34:44.000
Uh, but what would you recommend in in those spheres?
00:34:45.679 --> 00:34:52.079
You know, sadly the force that left the barn with these high potency products.
00:34:52.239 --> 00:34:58.000
The question is, how do we as a society um bring back safety?
00:34:58.239 --> 00:35:00.719
We wear seatbells, there are laws about seatbells.
00:35:00.800 --> 00:35:06.480
Why are there not laws about the types of products that we now know cause harm?
00:35:06.800 --> 00:35:22.320
I understand we will, you know, we're never going to make cannabis illegal, but make safe products that are well studied, that they must fit a certain level, that everybody can just make these high potency THC products that we know cause harm.
00:35:22.480 --> 00:35:28.320
Those are the things that policymakers and the public need to understand and demand of their politicians.
00:35:28.559 --> 00:35:29.679
The same thing.
00:35:29.840 --> 00:35:49.760
Um, there's now, you know, bills on um the capital being discussed about closing the hemp um loopholes where people made, where industry made these intoxicating Delta 8, 9 TFC products, delta 8 that's a time TFC products from CBD.
00:35:49.920 --> 00:35:51.440
We can close those loopholes.
00:35:51.599 --> 00:36:00.960
But as a society, they for the first time in our history, they were our public was asked to vote that cannabis or anything was medicine.
00:36:01.199 --> 00:36:08.159
Before, we used to have to go through FDA products, every pathway to say this is medicine.
00:36:08.400 --> 00:36:20.480
Cannabis is not medicine, it has medicinal properties for some conditions, like and then you know, certain products, like obviously epidiolites for epilepsy, but it's specific for those.
00:36:20.639 --> 00:36:22.480
And that's the thing that we need more research.
00:36:22.559 --> 00:36:32.639
So to me, the public, we should be pushing our policymakers and politicians to create and demand some industry safer products.
00:36:33.519 --> 00:36:36.960
Our society and our kids and everything that deserve that.
00:36:37.360 --> 00:36:49.199
You sort of alluded it to it, and I don't think it's talked about too much, but there's sort of like a big marijuana lobby, and and like there is big tobacco, and I don't think that's quite been named as regularly as sort of the big tobacco.
00:36:49.679 --> 00:36:50.159
They're the same.
00:36:50.320 --> 00:36:50.880
And they're the same.
00:36:51.119 --> 00:36:51.519
Exactly.
00:36:51.679 --> 00:36:52.400
They are the same.
00:36:52.559 --> 00:36:54.000
And this is the issue.
00:36:54.239 --> 00:36:58.079
It's about um money over lives.
00:36:58.239 --> 00:37:07.199
And especially for cannabis, it's not that you know, people always say, oh, but cannabis is not like opioids that, you know, overdose that, you know, I can overdose this.
00:37:07.519 --> 00:37:13.679
But you're getting lifelong mental health outcomes from cannabis.
00:37:13.920 --> 00:37:20.159
And that to me is equally killing off, quote unquote, a large part of our society.
00:37:20.320 --> 00:37:21.599
That too is wrong.
00:37:22.480 --> 00:37:31.679
Well, yes, I really appreciate you taking the time to share all this with us today and uh keep doing the good work, helping us understand cannabis and all these different topics in addiction.
00:37:32.000 --> 00:37:33.119
Thanks, John, for having me.
00:37:33.360 --> 00:37:33.599
Thanks.
00:37:33.840 --> 00:37:36.400
Thanks for listening to the Thriving with Addiction Podcast.
00:37:36.559 --> 00:37:43.440
If you found today's episode helpful, please follow and subscribe wherever you listen to your podcast and share it with someone who might benefit.
00:37:43.679 --> 00:37:49.840
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00:37:50.079 --> 00:37:53.599
Stay tuned for next week's episode, and remember, thriving is hot.
00:00:00.160 --> 00:00:07.040
Welcome to the Thriving with Addiction Podcast, where we explore how recovery is not just about surviving, but about truly living.
00:00:07.200 --> 00:00:15.679
Each week we'll dive into the science, stories, and strategies that help people and families heal from addiction and build healthier, more resilient lives.
00:00:15.919 --> 00:00:16.800
I'm your host, Dr.
00:00:16.879 --> 00:00:17.760
John Avery.
00:00:18.000 --> 00:00:19.280
Let's get started.
00:00:38.240 --> 00:00:45.600
Her multidisciplinary research investigates the neurobiology underlying substance use disorders and related psychiatric illnesses.
00:00:45.840 --> 00:00:52.719
A major focus of the research focuses on opiate abuse and the developmental effects of cannabis, which we'll talk about today.
00:00:53.039 --> 00:00:58.799
The group also conducts human clinical trials towards developing novel therapies for opiate use disorder.
00:00:59.119 --> 00:00:59.359
Dr.
00:00:59.439 --> 00:01:04.719
Hurd has been inducted into both the National Academy of Sciences and the National Academy of Medicine.
00:01:04.959 --> 00:01:05.920
Yes, been welcome.
00:01:06.239 --> 00:01:07.439
Thank you, John, for having me.
00:01:07.680 --> 00:01:08.239
No, of course.
00:01:08.560 --> 00:01:09.439
It's great to meet you.
00:01:09.519 --> 00:01:19.519
And you're you're the expert in cannabis, and so we needed you to come on since there seems to be so many different opinions about it these days or from the beginning of time, really.
00:01:19.599 --> 00:01:23.200
Um how'd you get interested though in the brain and cannabis?
00:01:23.280 --> 00:01:24.159
What brought you here?
00:01:24.480 --> 00:01:28.879
It's actually a long journey and a strange journey when I think about it.
00:01:29.040 --> 00:01:32.480
Um I've always been interested in the brain from I was a kid.
00:01:32.560 --> 00:01:37.359
I always tell people as a weird kid, just, you know, why do people act the way they do?
00:01:37.599 --> 00:01:40.560
And and I knew it was from the brain.
00:01:40.719 --> 00:01:51.359
And so I started off being interested in actually neurodegenerative disorders when I was training to be a neuroscientist.
00:01:51.680 --> 00:02:00.400
And in studying those uh, like for example, Parkinson's disease is a disorder where the dopamine cells are damaged.
00:02:00.560 --> 00:02:08.800
And dopamine is a transmitter that's not only for, you know, many people think about it for reward, um, but it's about motor function and attention.
00:02:08.960 --> 00:02:18.960
And we use drugs that target the dopaminergic system in teasing out the neurobiology of Parkinson's related disorders.
00:02:19.199 --> 00:02:27.280
And I was just fascinated by how these drugs, which turned out were like amphetamine and cocaine, completely changed behavior.
00:02:27.520 --> 00:02:33.360
Um, and that's when I started looking into drugs, the neuroscience of drugs of abuse.
00:02:33.599 --> 00:02:42.000
And in studying adults with, you know, substance use disorders, I wanted to know how did they get there?
00:02:42.240 --> 00:02:46.319
And looking at different risk factors as genetics and early life events.
00:02:46.400 --> 00:02:49.360
And one of them is early use of cannabis.
00:02:49.439 --> 00:02:53.680
And so that's how I started down the cannabis path years ago now.
00:02:54.240 --> 00:03:03.280
When I was becoming an addiction psychiatrist, a lot of people encouraged me not to, which is why I decided to become an addiction psychiatrist and study the stigma of addiction.
00:03:03.360 --> 00:03:04.400
What about on the research side?
00:03:04.560 --> 00:03:14.879
Were were people encouraging of that transition from sort of the, you know, the bread and butter of the brain Parkinson's to trying to tackle and understand addiction?
00:03:15.439 --> 00:03:27.840
I will tell you that I had previous people early that who I thought were going to be great mentors in my life, who indeed said, do not go into studying addiction.
00:03:28.000 --> 00:03:33.759
And I didn't understand it, I think, completely in terms of the degree of stigma.
00:03:34.000 --> 00:03:45.280
But I think that there is actually a greater stigma today, still on the clinical side for you know clinicians like yourself compared to the to the basic science.
00:03:45.439 --> 00:04:04.960
So the basic science of addiction, uh, people get a lot of high, you know, high impact publications because using off the psychiatric disorders, you can model addiction more in an animal model than you can model, for example, schizophrenia.
00:04:05.599 --> 00:04:20.639
So you have now a lot of basic science and addiction is very well established, very well respected, but the stigma that comes with clinical substance use disorders, I think is still there, sadly.
00:04:20.959 --> 00:04:21.120
Right.
00:04:21.279 --> 00:04:23.040
Now that's that's a a good point.
00:04:23.279 --> 00:04:32.639
Um sometimes you guys have, you guys are saying to us or to patients or to families, this is really uh a brain disorder, and we can really see everything that's going on.
00:04:32.720 --> 00:04:40.399
And and sometimes we haven't quite communicated that well to people and family who are struggling, but the the evidence is there.
00:04:41.040 --> 00:04:41.600
Absolutely.
00:04:41.759 --> 00:04:43.040
The evidence is there.
00:04:43.360 --> 00:04:55.920
The the problem still is that many people think of substance use disorders as disorders of, you know, of lack of morals, lack of will, lack of that.
00:04:56.079 --> 00:05:00.560
And I don't think that they understand the nature of substance use disorders.
00:05:00.720 --> 00:05:05.920
Yes, you cannot develop a substance use disorder if you never consume the substance.
00:05:06.079 --> 00:05:08.800
So it's unlike, you know, Huntington's disease.
00:05:10.319 --> 00:05:16.079
If you have the the risk, if you for Huntington's the genetic risk, you will develop Huntington's.
00:05:16.319 --> 00:05:21.839
But if you never take an opioid, you will never develop an opioid use disorder, even if you have a genetic risk.
00:05:22.079 --> 00:05:30.000
So I think, you know, that is one of the reasons why I think our society, you know, look at people's substance use discord that they brought it on themselves.
00:05:30.160 --> 00:05:38.800
But many people go through the same thing of experimenting, especially during adolescence, with substances and other things.
00:05:39.040 --> 00:05:50.480
But a small handful get stuck in this and for no fault of their own, while others go on to lead, you know, very productive lives.
00:05:50.720 --> 00:05:56.240
And I think that that's you know the issue of substance use disorders and psychiatric disorders in general.
00:05:56.560 --> 00:06:08.959
And then among um substances that one study as a neuroscientist, I think sometimes the opiates and the cocaines and amphetamines, they're sort of more accepted almost than cannabis, right?
00:06:09.040 --> 00:06:19.439
I I think you talked early on that in some of your early work, people argued against cannabis being accepted or understanding that's addictive and acts on the same reward pathways in the brain.
00:06:19.839 --> 00:06:20.399
Yes.
00:06:20.879 --> 00:06:30.720
I remembered when we started our first studies with cannabis, and in our animal models, we studied THC, you know, the main psychoactive cannabinoid.
00:06:31.040 --> 00:06:37.759
And um and getting the first paper even published because reviewers will come back like, why are you studying this?
00:06:38.240 --> 00:06:40.800
My grants, uh, cannabis is not addictive.
00:06:40.959 --> 00:06:45.920
And these are themselves neuroscientists, other, you know, investigators.
00:06:46.079 --> 00:06:49.439
But they were like, you should just be focusing on cocaine and heroin.
00:06:49.759 --> 00:06:51.199
Those are the problems.
00:06:51.439 --> 00:07:03.759
And I was also looking at cannabis from a developmental lens, from a developmental perspective, because for me it was, you know, is this really leading to risk for later challenges in life?
00:07:03.920 --> 00:07:08.399
And again, people were like, you should be studying if you're gonna study, study it in the adult brain.
00:07:08.480 --> 00:07:12.399
Why are you looking at it, you know, in during development?
00:07:12.720 --> 00:07:21.439
And this whole issue of cannabis is so benign that it can have an elastic impact on the brain.
00:07:21.600 --> 00:07:30.480
And of course, many, as I said earlier, many people will experiment, you know, in college, people experiment with cannabis and alcohol and cigars.
00:07:30.800 --> 00:07:32.319
And so they think, oh, it's fine.
00:07:32.399 --> 00:07:36.879
I went on to become a neuroscientist, or I went on to become a lawyer and so on.
00:07:37.040 --> 00:07:39.279
So, you know, it's not a problem.
00:07:39.519 --> 00:07:41.600
And we now know that's not the case.
00:07:41.920 --> 00:07:42.399
That's right.
00:07:42.560 --> 00:07:44.639
So let's jump into why that's not the case.
00:07:44.800 --> 00:07:45.759
Let's jump into cannabis.
00:07:45.839 --> 00:07:52.800
First, first, definitionally, cannabis, marijuana, weed, THC, CBD.
00:07:52.959 --> 00:07:56.160
Can you sort of unpack a little bit what we're talking about today?
00:07:56.879 --> 00:08:00.959
You know, I mean, marijuana is a term definitely more colloquial used on the streets.
00:08:01.120 --> 00:08:12.079
You know, I call it cannabis because for me, how our society has changed it from being a quote unquote recreational drug to voting for it to be medicine.
00:08:12.240 --> 00:08:15.600
And if that's the case, it's not marijuana that's medicine, quote unquote.
00:08:15.680 --> 00:08:16.560
It's cannabis.
00:08:16.879 --> 00:08:32.559
But even that, I think many people don't understand that cannabis is a complex plant with, you know, over 140 cannabinoids and hundreds of other chemicals that we still have very little knowledge about.
00:08:32.799 --> 00:08:44.080
And yes, we know a lot about THC, and we know we're now learning more about the other, the second highest cannabinoid in the plant before cannabidial CBD.
00:08:45.360 --> 00:08:48.159
But cannabis is complex.
00:08:48.240 --> 00:08:55.840
And even if it's been around like many things for thousands of years, many people think that we know a lot, but we really don't.
00:08:56.000 --> 00:09:03.919
And we really don't because even one of the things that we started earlier to talk about, many people weren't studying cannabis because they thought it was not a problem.
00:09:04.240 --> 00:09:07.679
They never thought it really had any lasting impact on the brain.
00:09:07.840 --> 00:09:09.039
So why study it?
00:09:09.200 --> 00:09:11.519
And that's and and that's the issue.
00:09:11.840 --> 00:09:37.120
But I do want us to talk about cannabis, and I want us to be specific and teach the public about cannabinoids because it is THC that is the issue that we see for really psychiatric and challenges and the growing psychiatric challenges with these high THC potency products that have been made as compared to CBD.
00:09:37.600 --> 00:09:43.440
So people put CBD in the context of of being cannabis.
00:09:44.240 --> 00:10:02.960
And for example, a lot of the the the voting to legalize cannabis was really a vote to legalize CBD, because when they saw that CBD was beneficial to treat, for example, these rare childhood forms of epilepsy, who wouldn't want to help the kids?
00:10:03.200 --> 00:10:12.720
And so a lot of the lobbyists used CBD, Charlotte Swab, as a way to say cannabis is completely, you know, fine.
00:10:12.879 --> 00:10:16.559
Look at this, it helps these kids with epilepsy.
00:10:16.879 --> 00:10:19.279
But people weren't voting for CBD.
00:10:19.440 --> 00:10:23.360
The laws went voting for cannabis as quote-unquote medicine.
00:10:23.600 --> 00:10:31.519
And so it's really important that people understand the difference between CBD, a cannabinoid, and cannabis, the complex plant.
00:10:31.919 --> 00:10:32.080
Right.
00:10:32.240 --> 00:10:36.320
And we'll talk mainly about THC today, but maybe talk a little bit just about CBD.
00:10:36.399 --> 00:10:38.159
I know you've done some research on it.
00:10:38.320 --> 00:10:42.000
I mean, as much as THC is everywhere, CBD is sort of everywhere.
00:10:42.159 --> 00:10:48.720
You're people are rubbing it all over their body and putting it in everything they drink, and you can go broke on CBD products.
00:10:48.879 --> 00:10:50.320
But but it might have some benefit.
00:10:51.120 --> 00:10:53.039
Tell me what what we understand about it.
00:10:53.679 --> 00:11:02.080
I have to say I am extremely shocked with how CBD became this huge market.
00:11:02.240 --> 00:11:22.080
And I would have been a multimillionaire, actually billionaire, if people had believed me and I patented, uh allowed to patent CBD, because in studying THC in our animal models, where we would see that adolescents, for example, rats that we gave THC to and study them in adulthood, they would self-administer more heroin.
00:11:22.320 --> 00:11:29.120
So we knew that THC was changing our endogenous opioid system, making them more sensitive to opioids.
00:11:29.600 --> 00:11:31.919
But I wanted to, you know, was it really THC?
00:11:32.000 --> 00:11:36.559
Because in our human studies, we studied cannabis and in our animal models, we were studying THC.
00:11:36.720 --> 00:11:39.519
And so I wanted to look at another cannabinoid.
00:11:39.600 --> 00:11:42.080
And I said, let's look at CBD.
00:11:42.240 --> 00:11:44.399
And then no one knew what CBD was.
00:11:44.480 --> 00:11:48.559
It was actually very difficult to even get it ligand for our human studies.
00:11:48.879 --> 00:11:50.639
And we saw something different.
00:11:50.720 --> 00:11:57.360
We saw that CBD actually reduced heroin seeking in our animal models, and then we moved it over to human clinical trials.
00:11:57.600 --> 00:11:59.919
So cannabinoids do differ.
00:12:00.080 --> 00:12:03.919
CBD is not cannabis, CBD is not THC.
00:12:04.080 --> 00:12:06.559
And I think that that, again, like I said, is very important.
00:12:06.720 --> 00:12:12.159
Now, people, you know, CBD now is in your coffee, your water, everywhere.
00:12:12.320 --> 00:12:25.200
I don't like that's shocking because we still don't know that much about CBD, even though I think that clearly it does not induce the psychiatric, you know, uh problems that we see with THC.
00:12:25.759 --> 00:12:27.759
But there's still a lot that we don't know.
00:12:27.919 --> 00:12:30.799
And to the point that you're setting it's very expensive, you know.
00:12:30.960 --> 00:12:39.840
Um a lot of these um boutique shops that had originally popped up at CBD with these creams and everything, you pay a lot for that CBD.
00:12:40.480 --> 00:12:57.759
But the the one issue on the negative side for CBD for me was that we did not realize that the cannabis industry would grow so fast and then use CBD to convert it to an intoxicating THC product.
00:12:58.000 --> 00:13:00.240
Because CBD is not intoxicating.
00:13:00.559 --> 00:13:06.879
We see that it reduces anxiety, but reducing anxiety does not, is not an intoxication.
00:13:07.440 --> 00:13:17.519
And that to me has been really um disturbing because we took a non-intoxicating product and made it intoxicating.
00:13:18.080 --> 00:13:19.360
By adding the THC.
00:13:19.519 --> 00:13:23.759
And then to clarify on the CBD, while it may help some things, it's not totally clear.
00:13:23.840 --> 00:13:29.759
It's it's helping for all the reasons people are marketing it, especially at the doses they're marking it and the ways people are using it, correct?
00:13:30.240 --> 00:13:30.639
Correct.
00:13:30.799 --> 00:13:38.320
I mean, I will be honest, in our clinical studies, we use doses of like 400, 800 milligrams of CBD.
00:13:38.480 --> 00:13:41.840
In the boutique shops, what they're buying, it's like 10 milligrams C BD.
00:13:41.919 --> 00:13:42.240
Right.
00:13:42.480 --> 00:13:58.639
So, you know, I when it so people should also know that um in the US, obviously cannabis is still illegal federally, even if it's you know, um been voted to be legal in in most states in the US.
00:13:58.960 --> 00:14:02.960
But there was an exclusion, hemp-derived products.
00:14:03.039 --> 00:14:07.919
So hemp has uh the plant has less than 0.3% THC.
00:14:08.080 --> 00:14:23.919
So they said, okay, for those states, especially that were used to making tobacco, now they could, like, you know, still the agriculture, the farm bill allowed them to make hemp and hemp-derived products, and hemp is CBD, basically, these CBD-rich cannabis plants.
00:14:24.080 --> 00:14:27.679
But they used chemistry to convert CBD to THC.
00:14:28.159 --> 00:14:29.759
And that is the problem.
00:14:30.240 --> 00:14:40.000
Um, and also it's not just that they made THC from CBD, but the chemistry that's used, also, there are toxins in there, those chemicals.
00:14:40.080 --> 00:14:46.960
And that's one of the things also that's a problem, that when you're using and buying these product C BD products, you don't know what's in them.
00:14:47.279 --> 00:14:48.000
That's a great point.
00:14:48.080 --> 00:14:48.879
There could be other stuff.
00:14:48.960 --> 00:14:51.919
There could be THC, even though they say there's there's not THC.
00:14:52.000 --> 00:14:54.879
And and so let's and so let's jump into THC.
00:14:54.960 --> 00:15:02.799
Tell me tell me about, and that's sort of what we the psychoactive component that we've associated with cannabis, with marijuana for a long time.
00:15:03.039 --> 00:15:08.080
Tell us about that and and tell us how the concentrations and potency of it have changed over time.
00:15:08.480 --> 00:15:19.519
Yeah, you know, uh, again, I think for me, and I think for a lot of people, I don't think anyone expected the explosion of these cannabis products in the manner in which they have grown.
00:15:19.840 --> 00:15:32.399
So, for example, you know, the plant, when people think about cannabis and like, you know, the hippie generation and woodstock and so on, the TFC concentrations were like 2%.
00:15:32.799 --> 00:15:37.200
They kind of rose in a little later in the 80s, 1980s to like 4%.
00:15:37.679 --> 00:15:47.519
And they've continued to escalate so that today you have cannabis, and you have THC products that have, um in a flower at least, like 24% THC.
00:15:47.600 --> 00:15:49.600
That was not the original plant at all.
00:15:49.759 --> 00:15:59.360
But what's worse is that they have created strains of cannabis strains that's even has 60% THC.
00:15:59.759 --> 00:16:07.919
And now they have products that are the concentrates, you know, the dabs and so on, but and they're vaped that can give 90% TFC.
00:16:08.240 --> 00:16:09.120
Think about it.
00:16:09.440 --> 00:16:20.639
The original plant and what you know a lot of um previous generations consumed when they experimented with cannabis was like a 4%, 2% THC um product.
00:16:20.960 --> 00:16:27.759
And they would smoke, and a lot of these kids in college and high school that would giggle and share one joint.
00:16:28.159 --> 00:16:34.320
But now they're consuming by themselves vape products.
00:16:34.559 --> 00:16:48.960
Vaping is also another thing, the the way, the means by which cannabis can get into your body, that they're putting THC in these huge hits, in these concentrates of 90% TFC.
00:16:49.440 --> 00:16:51.200
That is not the same drug.
00:16:51.360 --> 00:17:01.200
And I think that's another thing I wish our you know the public and and politicians and policymakers would probably start calling it a different name.
00:17:01.840 --> 00:17:22.079
It is not the same cannabis, it is not the same drug, and so it's like think about, you know, when cocaine itself was very addictive, and then came crack cocaine, they changed how you know uh how cocaine was consumed, and uh that even increased the addiction more.
00:17:22.640 --> 00:17:28.319
We know that as the concentration of any addictive substance increases, so does the addiction.
00:17:28.480 --> 00:17:30.319
And that's what's happened with cannabis.
00:17:30.640 --> 00:17:45.279
The THC, as they increase THC levels purposefully, because they wanted to get more people addicted, we've actually this had more people addicted and more psychiatric and health issues out of it.
00:17:45.519 --> 00:17:58.960
So the purposeful creation of a product that's 90% THC that has nothing to do with the original plant, I really do think we should be calling them a different name so people know what they're actually consuming.
00:17:59.279 --> 00:17:59.519
Right.
00:17:59.599 --> 00:18:02.319
It's sort of marijuana on drugs, basically.
00:18:02.400 --> 00:18:03.920
It's it's a whole new thing.
00:18:04.319 --> 00:18:04.960
Exactly.
00:18:05.200 --> 00:18:09.200
It is the turbo marijuana, turbo marijuana.
00:18:09.519 --> 00:18:12.079
All right, we'll figure out the name by the end of this podcast.
00:18:12.559 --> 00:18:13.039
I hope so.
00:18:13.119 --> 00:18:13.839
Yes, please, John.
00:18:14.400 --> 00:18:16.799
But whatever we call it, it's it's dangerous.
00:18:16.960 --> 00:18:26.799
And and so what you're seeing because of the availability, the access, the ease to use, you can use it in a stealth way with the vapes and the edibles, is that we're seeing well, what are we seeing?
00:18:27.039 --> 00:18:32.559
What's what's the evidence show in terms of who's getting addicted and and the mental health and other consequences of it?
00:18:32.960 --> 00:18:49.759
For me, one of the the worst things that a society could do is to not uh raise healthy children because they're the next generation and they reflect what's happening in our society.
00:18:50.000 --> 00:18:58.400
And today we see that these high THC products, more so than ever, have increased psychosis in young people.
00:18:58.720 --> 00:19:08.880
Um, I think a new study even came out from Canada, and Canada, I think, is important because they have a national healthcare system and they legalize cannabis before the US.
00:19:09.039 --> 00:19:16.559
And I think people don't realize it takes time to collect data to see what are the impacts of anything in our society, any change.
00:19:16.799 --> 00:19:36.720
And the Canadian data showed now clearly that the more recent earth cohorts they show um an earlier onset of first episode psychosis and greater number of first episode psychosis than previous generations.
00:19:37.440 --> 00:19:41.519
That cannot happen because of genetics.
00:19:41.680 --> 00:19:46.480
It cannot happen, you know, and it they real and it was related to cannabis use.
00:19:47.119 --> 00:20:18.240
And so for me, it's I don't think that people realized that cannabis is this drug that they thought, oh, you know, you giggled and that, you know, you may eat, you know, order pizza in the night or something, that that was would become this drug where we see a very close um association with psychosis and schizophrenia, especially the younger someone starts using cannabis, um, in in terms of teenager and the frequency.
00:20:18.400 --> 00:20:21.759
And now we have kids that they call it wake and bake.
00:20:22.000 --> 00:20:26.160
They wake up, the first thing that they have to do is to consume cannabis.
00:20:27.119 --> 00:20:29.200
That is not moral.
00:20:29.440 --> 00:20:41.759
And we see now also even more of uh in the emergency departments, more young people coming in with cannabis hypermesis syndrome, meaning, you know, this chronic vomiting and nausea.
00:20:42.559 --> 00:20:45.519
That never happened before with cannabis use.
00:20:45.920 --> 00:20:50.559
It really was like aspirus um case that could occur.
00:20:50.880 --> 00:20:59.599
You see now data showing greater even cardiac issues in young people with associated with cannabis use that again never occurred.
00:20:59.680 --> 00:21:09.519
And even children obviously showing up in terms of the toxicity to emergency departments because they'll eat a gummy that their parent made up out, left out.
00:21:10.079 --> 00:21:11.680
You never had those things before.
00:21:11.839 --> 00:21:16.000
It's a different drug that's associated with more health impact.
00:21:16.400 --> 00:21:32.000
And another thing that Canada, again, like I said, when you have a national healthcare and a national uh system that tracks a lot of things than we do in the US, they even see that young people are using the healthcare system because of cannabis more.
00:21:32.240 --> 00:21:40.319
So cannabis use is has a much greater economic impact on the healthcare system than ever before.
00:21:40.799 --> 00:21:43.359
Those things are actual numbers.
00:21:43.519 --> 00:21:47.440
They're not well somebody making up, oh, that cannabis is so bad.
00:21:47.599 --> 00:21:49.119
This is not the same drug.
00:21:49.279 --> 00:21:59.680
And so we're seeing much greater health impact across all spectrum in the healthcare system, not only in psychiatry, but in our colleagues in terms.
00:22:00.160 --> 00:22:05.279
Of cardiology, we see it absolutely obviously in emergency department.
00:22:05.519 --> 00:22:19.680
And not just Canada, I should say that also the number of epidemiological studies in the US also replicate that there's an increase in psychosis and other mental and health issues with teens and young adults using cannabis.
00:22:20.000 --> 00:22:32.720
And are these harms, which I think even include lesser things like worsening of depression and anxiety and sleep disturbance and certainly the risk of addiction and functional impairment, are these harms seen even with occasional use?
00:22:32.880 --> 00:22:40.960
Is occasional use of this sort of turbo marijuana, I mean, it's obviously different than the occasional use back in the day, but does that even come with risks?
00:22:41.039 --> 00:22:44.640
Or what should we tell parents and kids as they try to navigate this?
00:22:45.440 --> 00:22:53.839
I mean, the data shows that obviously the more frequent you use these high um potency products, the greater the risk.
00:22:54.160 --> 00:23:03.839
But there are individuals, still there are risk um in terms of even the infrequent use, and it's again because of the high potency of the THC.
00:23:04.160 --> 00:23:20.240
So, you know, a teen in a party, there somebody gives them uh this, you know, 90% THC, they've ended up in the in the hospital, even though they're not frequent users of cannabis.
00:23:20.799 --> 00:23:34.880
The question that we have, and then you, you know, you've raised in the sense of a lot of teens today, especially even adults, in terms of such an highly anxious world, teens are suffering from a lot of, you know, social media, this, the that.
00:23:34.960 --> 00:23:36.480
Their world is very stressful.
00:23:36.559 --> 00:23:42.799
And many of them, um, like adults say they use cannabis to alleviate their anxiety.
00:23:43.039 --> 00:23:50.720
But all the data shows that it exacerbates and worsens it to a point where they end up in the hospital.
00:23:50.880 --> 00:23:53.759
They need medical treatment for their anxiety.
00:23:54.079 --> 00:24:09.759
And yes, it's a it's a it's it's a it's a perplexing thing for people who say, oh, you know, our endogenous cannabinoid system is indeed important for regulating our stress response.
00:24:09.920 --> 00:24:10.480
It does.
00:24:10.799 --> 00:24:16.640
Our endogenous cannabinoid system is like a break on our stress response.
00:24:16.960 --> 00:24:20.240
But with chronic cannabis use, it takes away that break.
00:24:20.400 --> 00:24:25.359
So now it becomes it's like a uh a fast car on the highway.
00:24:25.440 --> 00:24:30.799
It just becomes it's an excessive anxiety that they they feel.
00:24:30.880 --> 00:24:37.039
And then they're like, oh, I need more cannabis, but they don't realize that the more cannabis they use, it's this ugly cycle.
00:24:37.119 --> 00:24:42.559
It just exacerbates the anxiety and the other mental health uh challenges.
00:24:42.799 --> 00:24:48.880
And and that's the thing, is you know, with mental health issues, people can't step back and see that.
00:24:49.119 --> 00:24:50.400
And that's the problem.
00:24:50.799 --> 00:24:51.039
Right.
00:24:51.200 --> 00:24:57.920
It's it's both hijacked the reward pathway, but then this withdrawal state that you enter really propels you forward because it's it's just so unpleasant.
00:24:58.000 --> 00:24:59.519
And and maybe speak to that a little more.
00:24:59.599 --> 00:25:03.440
What is it doing under the brain for your for your research and what you know?
00:25:04.400 --> 00:25:25.599
You know, the research shows that you know, chronic cannabis use or high high potency products does even change the structure of your brain cells, the structure that stays with when we studied the adolescent exposure and look in adulthood.
00:25:26.000 --> 00:25:28.480
So it's not a make-believe thing.
00:25:28.799 --> 00:25:31.440
It changes the structure of your cells.
00:25:31.920 --> 00:25:39.279
It also changes the re how quickly your stress system reacts in a negative way.
00:25:39.519 --> 00:25:57.359
So all these stress-related um your your stress hormones, the genes that regulate a lot of the stress response, they are very high, especially when exposed to high potency THC products.
00:25:57.599 --> 00:26:06.400
And yes, you know, withdrawal for cannabis, as you know, is actually one of the worst of many of the substance use disorders.
00:26:06.799 --> 00:26:15.839
You know, the depression, the sleep, sleep is a huge aspect of many mental health disorders.
00:26:16.000 --> 00:26:19.359
I should many disorders, and I think that that's one of the things as well.
00:26:19.599 --> 00:26:24.079
That you know, the withdrawal from cannabis impacts sleep tremendously.
00:26:24.400 --> 00:26:42.799
So again, many people think that cannabis is benign, but nothing is benign if it causes such huge impact on brain cells, on other cells in the body as well, but on the behavior and the long-term effects that we see.
00:26:43.039 --> 00:26:48.400
And from a research perspective, you know, my question was what maintains this?
00:26:48.559 --> 00:26:49.359
Why is it there?
00:26:49.519 --> 00:27:04.000
And we could see that these epigenetic changes and epigenetics, as you know, you know, we inherit the DNA sequence from our parents to, you know, what to determine, you know, everything in our in our bodies and and brain.
00:27:04.319 --> 00:27:11.119
But the environment can put tags on those DNA so that genes that should be turned off are now turned on and vice versa.
00:27:11.359 --> 00:27:21.839
And we see that developmental exposure to to THC changes the epigenetic platform or the signature in our brain.
00:27:22.079 --> 00:27:41.359
And that signature, interestingly, looks like what we see in aspects of schizophrenia when we look in the brains of people who were diagnosed with schizophrenia, and it changes those epigenetic changes linked to how the cells communicate at the synapse.
00:27:42.000 --> 00:27:51.279
So these are things that are not um, you know, fiction, these are actual scientific facts.
00:27:52.160 --> 00:28:00.880
High potency THC impacts the brain, it impacts fundamental biological processes, that does have a long arc.
00:28:01.200 --> 00:28:06.400
Does it mean that you can't go back to normal?
00:28:06.720 --> 00:28:07.039
No.
00:28:07.599 --> 00:28:16.480
The one thing that I will say that when we saw that these changes were mediated by these epigenetic mechanisms, I actually was very hopeful.
00:28:16.799 --> 00:28:25.920
Because unlike genetics, you can't change your the the things you inherit, but epigenetic mechanisms are reversible.
00:28:26.160 --> 00:28:28.480
And so that to me gives hope.
00:28:28.720 --> 00:28:39.359
And that's why the earlier someone stops using cannabis, make it try to make it through that really tough withdrawal period, there is hope.
00:28:39.599 --> 00:28:47.039
And, you know, obviously on a research level, we're trying to see how we can target these epigenetic mechanisms.
00:28:47.119 --> 00:28:58.400
We can target them in an animal model and reverse the the you know bad behavioral outcomes of developmental cannabis use, but trying to find ways that we can do that in humans in a healthy way.
00:28:58.799 --> 00:28:59.039
Right.
00:28:59.119 --> 00:29:01.119
And what about the person that says, all right, Dr.
00:29:01.279 --> 00:29:01.759
Heard, Dr.
00:29:01.839 --> 00:29:02.720
Avery, I get it.
00:29:02.960 --> 00:29:06.319
Kids shouldn't use weed, their brain's developing, it is all these changes.
00:29:06.480 --> 00:29:12.559
But as an adult, I hear all the worry about alcohol and weeds everywhere these days.
00:29:12.720 --> 00:29:16.160
Isn't it safer if I just smoke a little bit of weed instead of drinking?
00:29:16.319 --> 00:29:23.920
I mean, holiday parties this year in New York, I heard there were so many that actually were serving not no alcohol or less alcohol, but they were serving marijuana products to adults.
00:29:24.079 --> 00:29:24.240
Yeah.
00:29:24.480 --> 00:29:28.400
Um, and there's just sort of this perceived safety more, maybe even on the adult side.
00:29:28.559 --> 00:29:32.720
What would you say for the adult casual or interested user too?
00:29:33.440 --> 00:29:42.240
Yeah, I mean, the adolescent brain, absolutely, and young adult brain are much more vulnerable to cannabis than the fully mature brain.
00:29:42.480 --> 00:29:44.559
Every data shows that, really.
00:29:45.039 --> 00:29:53.440
However, even adults, because of this high potency THC products, are having mental health issues.
00:29:53.599 --> 00:29:59.599
Then so I don't want to make people to think it's only the teens and only young adults, the mature brain as well.
00:29:59.839 --> 00:30:08.640
And alcohol is one of the worst drugs, you know, substances, I should say, in our society, it creates a lot of health issues.
00:30:09.839 --> 00:30:14.720
I think everyone has to think about what they're consuming and putting in their bodies.
00:30:15.359 --> 00:30:23.599
Um if you are at a party, often many people at a party are not drinking grain alcohol.
00:30:24.480 --> 00:30:29.359
You know, many people are the same thing with cannabis.
00:30:29.599 --> 00:30:34.720
What kind of cannabis product are you putting in your your your body as an adult?
00:30:34.960 --> 00:30:37.359
You should do the same thing in looking at these products.
00:30:37.519 --> 00:30:39.599
What is the concentration of THC?
00:30:39.759 --> 00:30:41.119
To me, it's knowledge.
00:30:42.079 --> 00:30:52.720
People have to understand that our society has become guinea pigs for these companies that create these high THC products.
00:30:53.039 --> 00:30:54.640
We are their guinea pigs.
00:30:55.359 --> 00:31:01.440
We have not done that with you know nicotine, the tobacco, they never made the nicotine higher.
00:31:01.759 --> 00:31:08.240
Yes, Joule made these, you know, fruit products which got genes and so into it.
00:31:08.480 --> 00:31:10.880
But that's what the the cannabis industry has done.
00:31:11.039 --> 00:31:16.960
They have increased the TFC concentrations that even at the adult range is also vulnerable.
00:31:17.279 --> 00:31:28.319
So, you know, alcohol or cannabis, for me, it's like it's I always say, is it, you know, do you want to jump off the fifth floor or do you want to jump off the third floor?
00:31:28.400 --> 00:31:38.640
You know, it's you know, nothing is say without harm, but we do know that the THC products today are not the same.
00:31:39.039 --> 00:31:50.720
They are manufactured to create addiction, not because otherwise there was no reason for them to change the amount of THC.
00:31:51.039 --> 00:32:03.359
And not only do they increase addiction risk, they also have increased the risk for other mental health illnesses and other physical illnesses.
00:32:03.599 --> 00:32:09.599
And yes, I'm sure perhaps the the industry that was not their thought, but that is what has happened.
00:32:10.319 --> 00:32:10.480
Right.
00:32:10.559 --> 00:32:13.599
But it's encouraging if someone's listening to this and and trying to stop that.
00:32:13.680 --> 00:32:18.240
A lot of the brain changes seem potentially reversible, at least the epigenetic ones.
00:32:18.480 --> 00:32:20.000
And then what do we know about treatment?
00:32:20.079 --> 00:32:25.200
If someone's in trouble, what what are some of the options available to get to the other side of it?
00:32:26.160 --> 00:32:30.640
Um, today there are no pharmacological treatments as yet.
00:32:30.720 --> 00:32:41.839
There are a lot of you know studies in the in the pipeline for trying to develop new treatments for substance for cannabis use disorder, but there are a lot of behavioral treatments that are out there.
00:32:42.160 --> 00:32:51.119
For me, there are more and more uh clinicians that recognize um cannabis use disorder, motivational behavioral therapy.
00:32:51.359 --> 00:32:55.599
There are a lot of behavioral therapists that who can help.
00:32:55.920 --> 00:32:57.519
So there is hope.
00:32:57.680 --> 00:33:01.759
And those behavioral therapies have worked.
00:33:02.000 --> 00:33:10.480
It's just to stick it out, especially during the withdrawal period that I know a lot of people feel that they can't make it through, but you you can.
00:33:10.880 --> 00:33:12.319
You absolutely can.
00:33:13.519 --> 00:33:13.839
Right.
00:33:13.920 --> 00:33:17.680
I think there's good psychological treatments, there's 12-step treatments.
00:33:17.839 --> 00:33:25.200
Unfortunately, no medications quite yet, like we have for alcohol and nicotine and opiates, but hopefully with time, some some pharmacological sport.
00:33:25.440 --> 00:33:31.119
And sometimes it's just treating the underlying psychiatric conditions that have developed or or contributed as well, I imagine.
00:33:31.519 --> 00:33:32.079
Exactly.
00:33:32.240 --> 00:33:32.720
Exactly.
00:33:32.880 --> 00:33:46.880
Coming back to anxiety, there are treatments that are well um known for many years that, you know, psychiatrists can prescribe for you if you have and if the underlying issue is anxiety, the same thing for depression.
00:33:47.119 --> 00:33:58.559
There are, you know, we have pregnant women taking cannabis to to, you know, treat their nausea and even their anxiety is also during pregnancy.
00:33:58.799 --> 00:34:08.880
There are medications that have been well studied for the impact on their fetal and their children outcome that show that they're safe.
00:34:09.039 --> 00:34:12.239
There are many safe medications that already exist.
00:34:12.719 --> 00:34:26.559
So kind of think about what your underlying reason was to even start, and even what might have developed you due to the cannabis use, but there are medications out there that are well known to alleviate those symptoms.
00:34:26.960 --> 00:34:27.280
Right.
00:34:27.519 --> 00:34:33.920
And I guess the other thing we have to think about in terms of changing all these behaviors is how do we address this at a societal level?
00:34:34.079 --> 00:34:38.239
How we talk about marijuana and media and culture and the regulations.
00:34:38.559 --> 00:34:41.280
We need you basically talking to everyone all all the time.
00:34:41.360 --> 00:34:44.000
Uh, but what would you recommend in in those spheres?
00:34:45.679 --> 00:34:52.079
You know, sadly the force that left the barn with these high potency products.
00:34:52.239 --> 00:34:58.000
The question is, how do we as a society um bring back safety?
00:34:58.239 --> 00:35:00.719
We wear seatbells, there are laws about seatbells.
00:35:00.800 --> 00:35:06.480
Why are there not laws about the types of products that we now know cause harm?
00:35:06.800 --> 00:35:22.320
I understand we will, you know, we're never going to make cannabis illegal, but make safe products that are well studied, that they must fit a certain level, that everybody can just make these high potency THC products that we know cause harm.
00:35:22.480 --> 00:35:28.320
Those are the things that policymakers and the public need to understand and demand of their politicians.
00:35:28.559 --> 00:35:29.679
The same thing.
00:35:29.840 --> 00:35:49.760
Um, there's now, you know, bills on um the capital being discussed about closing the hemp um loopholes where people made, where industry made these intoxicating Delta 8, 9 TFC products, delta 8 that's a time TFC products from CBD.
00:35:49.920 --> 00:35:51.440
We can close those loopholes.
00:35:51.599 --> 00:36:00.960
But as a society, they for the first time in our history, they were our public was asked to vote that cannabis or anything was medicine.
00:36:01.199 --> 00:36:08.159
Before, we used to have to go through FDA products, every pathway to say this is medicine.
00:36:08.400 --> 00:36:20.480
Cannabis is not medicine, it has medicinal properties for some conditions, like and then you know, certain products, like obviously epidiolites for epilepsy, but it's specific for those.
00:36:20.639 --> 00:36:22.480
And that's the thing that we need more research.
00:36:22.559 --> 00:36:32.639
So to me, the public, we should be pushing our policymakers and politicians to create and demand some industry safer products.
00:36:33.519 --> 00:36:36.960
Our society and our kids and everything that deserve that.
00:36:37.360 --> 00:36:49.199
You sort of alluded it to it, and I don't think it's talked about too much, but there's sort of like a big marijuana lobby, and and like there is big tobacco, and I don't think that's quite been named as regularly as sort of the big tobacco.
00:36:49.679 --> 00:36:50.159
They're the same.
00:36:50.320 --> 00:36:50.880
And they're the same.
00:36:51.119 --> 00:36:51.519
Exactly.
00:36:51.679 --> 00:36:52.400
They are the same.
00:36:52.559 --> 00:36:54.000
And this is the issue.
00:36:54.239 --> 00:36:58.079
It's about um money over lives.
00:36:58.239 --> 00:37:07.199
And especially for cannabis, it's not that you know, people always say, oh, but cannabis is not like opioids that, you know, overdose that, you know, I can overdose this.
00:37:07.519 --> 00:37:13.679
But you're getting lifelong mental health outcomes from cannabis.
00:37:13.920 --> 00:37:20.159
And that to me is equally killing off, quote unquote, a large part of our society.
00:37:20.320 --> 00:37:21.599
That too is wrong.
00:37:22.480 --> 00:37:31.679
Well, yes, I really appreciate you taking the time to share all this with us today and uh keep doing the good work, helping us understand cannabis and all these different topics in addiction.
00:37:32.000 --> 00:37:33.119
Thanks, John, for having me.
00:37:33.360 --> 00:37:33.599
Thanks.
00:37:33.840 --> 00:37:36.400
Thanks for listening to the Thriving with Addiction Podcast.
00:37:36.559 --> 00:37:43.440
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00:37:43.679 --> 00:37:49.840
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