HealthyGamerGG - The Problem With Weed

Episode Date: January 3, 2022

Dr. K talks weed addiction Support this podcast at — https://redcircle.com/healthygamergg/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy Learn more about your ad choices. Visit megaphone.fm/adchoices

All right, so here's the problem with weed. You know, so as a psychiatrist, I recognize that there are medical uses for marijuana. I think the most convincing medical reason I've seen for using marijuana is to help people with opioid addiction. That's kind of counterintuitive. But it does seem to work well because there are a lot of physiologic problems that happen with heavy opiate use that sort of get better. And I think on balance it's a good thing to do. You know, has to be prescribed and stuff like that. The basic issue with marijuana, you have to understand how marijuana works in the brain.

So the first thing is that marijuana works on these things called anundamide receptors. So the anundamide receptor was coined by an Indian guy. I assume, I think he was Indian because he named it after the Sanskrit word for bliss. So he was like, there are these bliss receptors in our brain. And that's what like marijuana acts on. So a lot of people think that marijuana acts like makes people stupider. Right? So people say like, oh, I've been smoking pot in my entire.

life like my IQ's fine. So marijuana doesn't work like that. What marijuana does, I think, is far more insidious. So if you look at the cannabinoid system in the brain, it involves habit formation and motivation. So like once a, how can I say this? Early on in the brain, when you are reinforcing a behavior, it is the dopamine system that reinforces a behavior. Once you have a habit formed, the primary neurotransmitter is no longer dopamine. It's, it's, you know, Abinoids. So, for example, like, the first time I brush my teeth, I may really enjoy it. Or let's talk about video game addiction, for example. So the first time I play a video game, it's a lot of fun. It's dopamine. I enjoy it. Then I want to play again, and I want to play again. And each time I get less dopamine, less dopamine, less dopamine. And if you guys have been addicted to video games, you understand at some point you cross this critical threshold where you keep playing the game, but you stop having fun. And it's like, what the hell is going on at that point? Why are you even doing it if it's no longer even rewarding. So the interesting thing is if you understand neuroscience, there's like actually a good reason for that. And that's that like the shift of

the behavior moves from a reward circuit to a habituated circuit. So habits in the brain are governed by a different circuit than like the dopamine system. So the nucleus accumbens mesolimbic system, those are both dopaminergic systems that involve pleasure followed by behavioral reinforcement. At some point, you move into the autopilot circuits, which are different circuits of the brain. And once you enter an autopilot, it's not like there's any reward, right? So if you think about brushing your teeth, there's like no reward there anymore, right? Even if you think about dogs, for example, when you're training a dog at the very beginning in order to get them to fetch, you have to give them a reward because there's no inherent dopaminergic reward for fetching a ball or a stick. So you

throw the ball when the dog brings it, you give them a treat, boom, they get a hit of dopamine. You do it again, boom, they get a hit of dopamine. Boom, they get a hit of dopamine. You do that 10 times, 20 times, 30 times. Their brain becomes habituated to it and you no longer need to provide a dopaminergic reward to engage in the behavior. Y'all get that? Gaming is the same. Once you move over to the cannabinoid system, then it becomes a habit. Then it becomes hard to break, despite the fact that it's not even fun. So why is marijuana a problem? I don't know exactly how, but marijuana screws up that circuit. Marijuana makes it hard.

My observation, clinical observation, okay? So now, like, we know that basic neuroscience, but we don't know that that neuroscience actually translates to human behavior. I haven't seen those studies yet. I don't think our stuff is sophisticated enough. But clinically, what I've seen is when people use pot, they fall into this weird, habitual non-enjoyment way easier. They, like, fall into bad habits, and it's really, really hard to get them out of

of those habits. And what I've discovered is that if I can get them sober from marijuana, their ability to change their habits becomes way easier. Okay, so someone's saying, okay, so sorry for me throwing out a lot of words and you're confused. Do you all get that or not? So here's a quick summary. Our brain has two circuits. One is a reward circuit that we release dopamine, which allows us to feel pleasure and reinforces a behavior. So, for example, I'm drinking this iced coffee right now, and it tastes good. So when I drink it, I get a hit of dopamine, and it's like, ooh, I want more. Over time, if you look at people who develop addictive behaviors, they still engage in the behavior, but they don't actually feel any pleasure from it. The reason for

that is because we have a separate circuit of the brain that starts to take over, which is the habit circuit. So once something becomes a habit, it no longer gives us a reward. But we're still driven to do it even though we don't enjoy it anymore. So when we get addicted to a video game and we just start playing video games and like we don't even enjoy them anymore, that's a problem of our habit circuit getting messed up. And the habit circuit's primary neurotransmitter is an endocannabinoid or a cannabinoid. It's a endo means, it's basically internal THC, right? It's a cannabis compound like neurotransmitter that is built within us. So when people use marijuana,

the biggest problem that I see is it becomes hard for them to break habits. I'm not quite sure how it works, but I suspect that it has something to do with the fact that the cannabinoid receptors in the brain, the marijuana receptors in the brain, have something to do with habit formation and habit execution.

And when people smoke pot, it's just hard for them to make changes in their life. Is that better? Yeah, so people are asking, do you have any advice for medical cannabis users? That's where, like, I think you should talk to your doctor because the risks and benefits are like individualized, right? So like when I think about using medical cannabis, I look at an individual person, I think about, okay, what are the risks, what are the benefits, what do we gain, what do we lose? And for each individual person or

situation, it's going to be slightly different. I quit week three weeks ago and I still get cold sweats and very vivid dreams. Is that normal? I'm not sure, to be honest. So that too is something that you should talk to your doctor about because cold sweats and vivid dreams. How can I say this? So you guys understand that like a substance causes particular changes, but the substance acts within an individual body. Which means that like, you know, so the reason, how, does that make sense? Like there's an individual. So if you talk about the effects of marijuana, there is no such thing technically is the effects of marijuana.

there is no such thing technically is the effects of marijuana because the marijuana has to act within a human being. So the effects of marijuana are going to be filtered through an individual human being. So when we talk about the effects of marijuana, basically what we're doing is averaging the effects within a thousand individuals and sort of saying this is the effect of the drug, which is scientifically valid. But in terms of any individual case, there's going to be a slightly different presentation

because your receptors, your metabolism, your brain is going to be different, which means I can take one compound and put it in a thousand people and it'll act slightly differently. That's why if you look at like protocols for medication, it's not like there's one antidepressant that works equally for all people. We have 30 antidepressants that each have different efficacy within different people. And so that's what's tricky about medicine. It's also what makes it fun because it's not like there's a one-size-fits-all solution. So in terms of your particular relationship to a substance, there's going to be a lot of individuation there.