Ologies with Alie Ward - Cannabinology (MARIJUANA) Part 2 with Ziva Cooper and Caroline Melly
Episode Date: April 15, 2026Neurodivergence and weed. Munchie remedies. Long term toking. The Entourage Effect. Drag a bean bag into the circle and kick back for Part 2 of Cannabinology with UCLA’s Center for Cannabis and Cann...abinoids director Dr. Ziva Cooper and Smith College cannabis anthropologist Dr. Caroline Melly. We’ll probe the great mystery and misfortune of hyperemesis, the effect of THC on memory and neuroplasticity, why edibles sometimes send you to a distant galaxy, CBD and inflammation, the risks of psychosis, older vs. younger brains and cannabis, a guy named Rick Simpson, how much weed is the right amount of weed, and if any studies warrant further research. Heads up: they do. Follow Dr. Cooper on Google Scholar Visit the UCLA Center for Cannabis and Cannabinoids website Follow Dr. Melly on Google Scholar A donation went to Last Prisoner Project More episode sources and links Other episodes you may enjoy:Psychedeliology (HALLUCINOGENS), Dolorology (PAIN), Mnemonology (MEMORY), Attention-Deficit Neuropsychology (ADHD), Molecular Neurobiology (BRAIN CHEMICALS), Addictionology (ADDICTION), Neuropathology (CONCUSSIONS), Neuropathoimmunology (MULTIPLE SCLEROSIS), Salugenology (WHY HUMANS REQUIRE HOBBIES), Obsessive-Compulsive Neurobiology (OCD), Quasithanatology (NEAR-DEATH EXPERIENCES), Oneirology (DREAMS) 400+ Ologies episodes sorted by topic Smologies (short, classroom-safe) episodes Sponsors of Ologies Transcripts and bleeped episodes Become a patron of Ologies for as little as a buck a month OlogiesMerch.com has hats, shirts, hoodies, totes! Follow Ologies onInstagram andBluesky Follow Alie Ward onInstagram andTikTok Editing by Mercedes Maitland ofMaitland Audio Productions andJake Chaffee Managing Director: Susan Hale Scheduling Producer: Noel Dilworth Transcripts by Aveline Malek Website byKelly R. Dwyer Theme song by Nick Thorburn Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
Transcript
Discussion (0)
Oh, hey, it's still the lady weeping into hash browns at the diner.
Allie Ward, this is part two of cannabinology, part two, weed.
If you're starting here for all of the supple, juicy answers to ADHD and THC and Alzheimer's
and smoking and vaping, don't start here.
Start at episode one.
We made you a whole part one.
I promise you will love it and it's fun, all the basics.
And then come back for this wall-to-wall, questions from listeners.
via patreon.com who submit them before we record. You too can join that for a mere dollar a month.
Thank you also to all the folks out there in the world wearing Ologiesmerch from Ologiesmerch.com.
And thank you to sponsors of the show who make it possible for us to donate to Akazi tweak.
And as always, thanks to those of you leaving reviews for the show, which help us get discovered
by others. Also, I read them all. I promise that I do. And thank you, Jules, who wrote that
is truly inspirational in lighting a fire of hope and immense joy in us all.
Speaking of lighting a fire, Jules, you're right on time with that one because we are blazing
toward 420. And for the few of you who listened to this last week and told me that I should
have waited to release this on 420, we've planned this for like a year. I'm one step ahead
because now you're going to know your weed better if you do celebrate. And also, you can
send this pair of episodes around to educate the masses on 420 on matters such as dab versus
shatter, indica versus sativa, the legal semantics of hemp versus marijuana, pre-rolls, gummies,
the endocannabinoid system, the bliss molecule, and a bunch more. You can also let people know
that 420 was never a police code for public reef or smoking. Rather, it was just an inside joke
that got out of hand between a group of Marin County High School stoners in the 1970s who would meet up
after school at 420 to go treasure hunting for this rumored forgotten weed patch.
They just drove around smoking weed looking for a big field of weed. They never found it.
But one of them ended up working for a grateful dead member. And now the rest is history because at
40 minutes to 5, it's always 420 somewhere. So drag up a beanbag into the circle,
kickback for neurodivergence and cannabis, the great mystery and misfortune of hyper-emesis,
munchy remedies, the entourage effect, THC and memory and neuroplasticity. Why edibles sometimes send
you to a distant galaxy, CBD and inflammation, the risks for psychosis, older versus younger
brains and cannabis, and if any studies warrant further research. With UCLA Center for Cannabis,
Dr. Ziva Cooper and Smith College Cannabis Anthropologist Dr. Caroline Melly, both cannabinologists.
So if you recall, last week we left off with a question from a patron, which was shared by
Sidney Van Fleet, Gordo, HR Puff and Stuff, Chelly Bean, Cool Next Door, Annie, and Rachel.
Hi, this is Rachel calling from the Lepine, Oregon. And I wanted to know if there's any truth
to the idea that there are long-term side effects from Canada.
misuse, especially smokers. I've read some articles that suggest that it can affect your brain
in bad ways over time. And then I've read some articles that say that that's total bunk. And I've
read some articles that say that it's only for people whose brains aren't fully developed. So I'm
curious if there has been any new research on that and if there are any new conclusions. Thank you.
And I've interviewed a vascular surgeon who's like, yes, you're smoking, you're vaping, you're putting
things into your veins. But I also have heard people say, no,
It's really not that bad to smoke it, but maybe that was just a lack of data.
So, yeah, when it comes to the method of administration, what do we know about danger?
So we have method of administration with respect to, you know, cardiovascular outcomes that you specified here, but also effects from long-term use in general.
Okay.
So there's questions about, you know, if you start using when you're younger, is it going to impact your IQ?
or are you going to be at greater risk for developing psychosis or mood disorders and cannabis use
disorder, for example, which is essentially addiction to cannabis, right? We know that that is one
effect from long-term frequent use that occurs and it does impact a segment of the population
and it's hard to treat because we don't have any therapeutics right now to be able to treat people.
So we do know for sure that that is a causal effect.
in certain populations who are using for long periods of time
at very frequent intervals.
With respect to cardiovascular outcomes
and how mode of use is going to impact those.
So this is actually an area of study that I am about to embark on
with an awesome collaborator, Holly Meadowoff,
who's an amazing cardiologist here at UCLA.
And it hasn't necessarily been, it hasn't been answered.
You know, if you smoke, if you're inhaling cannabis with some percent of THC versus if you're having it orally, does that impact cardiovascular outcomes in a way that will steer you to some type of risk down the road?
Okay.
So that hasn't been researched yet.
And it's really important given the past year where there's been alarm bells being sounded from large studies.
that have looked at people who have used cannabis once in their life or once per year
versus those who haven't. And those people who have used cannabis show increased risk for
stroke and myocardial infarction. So heart attack, right? So there have been those larger studies.
There's a lot of questions related to those studies, like other variables that might have
also increased risk for those factors. And so let's take a trip back to our excellent
24 surgical angiology episode about veins and arteries with NYU vascular surgeon and general medical hero,
Dr. Sheila Blumberg.
You mentioned smoking too.
And I have been in New York for just this past week and I'm from California and I have
walked through absolute fogs of weed.
And I feel like more people smoke not just cigarettes but just in general.
People who don't smoke cigarettes or maybe smoking more weed and vaping.
Do those have any impact on your venous health?
You ready for this?
Yeah, I think the data on vaping is that it's pretty much as bad as tobacco.
And also the particulates in vaping may actually be worse, at least for lungs in general.
But that's a different ballgame altogether.
The marijuana smoke and the legalization of marijuana has actually opened up a huge can of worms, I think, for people regarding public health.
Because you'll have conversations where people think it's natural.
me and Mother Nature.
And therefore it's not going to harm them,
but we don't have enough data on long-term use of marijuana
and how that affects the arterial system.
I can say our suspicions from the early reports now
are that it's quite damaging to your circulatory system.
And unfortunately, with the widespread use,
I think we're going to start seeing that in younger people
who are consuming it at these high rates,
and that's a big concern to me
because I think this concept of it's a plant,
and if I'd smoke it, it's not tobacco,
so it's not going to hurt me is a problem.
There's other things that are natural,
that occur in a plant, well, it's just heroin,
comes from a flower.
It's not necessarily good for you.
Now that it's legal, it can actually be studied, right?
And the natural population, natural studies will start
to come out and I'm not optimistic that it's going to be good news.
Stick to gummies, maybe.
Yeah, if you need it.
Yeah.
Okay, smoking weed, definitely not without its bodily consequences from a vascular biology
standpoint.
Sorry to say.
And for more on this, you can see the 2019 paper, harmful effects of smoking cannabis,
a cerebrovascular and neurological perspective.
And also, news came out in 2022 that if you're an adult who has a bleeding stroke
and you have enjoyed the ganja in the last month.
You're twice as likely to die or have serious injury from that stroke.
But it's really hard to determine what's caused by the smoking or the vaping factor, right?
So I did this deep dive on edibles.
And you don't want to hear this.
Neither do I.
But I have a responsibility to tell us that a 2019 annals of internal medicine paper,
acute illness associated with cannabis use by route of exposure,
did find that according to the Colorado behavioral risk factor,
surveillance system. About half of THC users just smoke and about 4% just do edibles. And the rest
are kind of a combo of both. But edible cannabis did account for more ER visits for acute psychiatric
symptoms. So don't let your mom eat the whole brownie. And visits for cardiovascular symptoms.
So that's concerning. Does it have to do with all the snacks you like to eat when you're cooked?
Jury's still very much out. And more research needs to be done. And doctors and scientists still need more
questions answered. As to you. Hence, here we are. And again, more on those psychiatric symptoms
and also some additional context on the rates of them later than the episode, I promise. But those
studies that Dr. Cooper mentioned were the 2024 paper in the Journal of the American Heart Association
titled Association of Cannabis Use with Cardiovascular Outcomes among U.S. adults, which found
that cannabis use is associated with adverse cardiovascular outcomes, with heavier use
associated with higher odds of adverse outcomes.
So more smoking is worse for you?
Who could have predicted that?
But a subsequent 2025 study that compiled a bunch of other studies titled
Cardiovascular Risk associated with the use of cannabis and cannabinoids,
a systematic review and meta-analyses in the journal Hart said that findings reveal
positive associations between cannabis use and cardiovascular death,
as well as non-fatal acute coronary syndrome, including heart attacks or non-fatal strokes.
And these findings, they say, should encourage investigating cannabis use in all patients presenting
with serious cardiovascular disorders. And the American Academy of Cardiology also published a 2025
article titled, Cannabis Users Face Substantially Higher Risk of Heart Attack, which blessedly
is the opposite of clickbait, as the headline reveals that, yes, cannabis users,
substantially higher risks of heart attack. Now, if you have your heart set on more info,
we have an excellent cardiology episode with Dr. Herman Taylor, and we're going to link that in the show
notes. But to my gummy comrades, I'm sorry, but the news gets worse via the 2025 Journal of the
American Medical Association's Cardiology Report titled Association of Endothelial Disfunction with
Chronic Marijuana Smoking and THC Edible Use, which looked at 55 San Francisco Marijuana Partakers,
and they found that the artery's ability to open up,
to accommodate more blood flow was hampered in weed smokers the most, as well as, to a degree,
edible users as compared to non-THC using controls. So smoking anything, definitely not loved by
cardiologists and vascular surgeons and, like, people whose job it is to keep you alive longer.
But, you know, it's really important to study, especially because one of the fastest growing
demographic groups of cannabis users are people who are 55 and older, people who are already
at a higher risk for cardiovascular disease. And so this is a really important thing to look at.
Now, whether or not, you know, inhaling it is going to be different than orally administering it,
like the vascular expert that you were talking to said it's not good to inhale anything.
Yeah. Right? Especially, you know, when you think about combustion, what we know about
combustion and the toxins that can be produced from combustion. You know, we know that those can't be
good for you. There is tar that that is present in combustive cannabis. And with respect to the vaping,
the vapes that are available now that people are using, those cartridges, we have very little
information about the acute or the long-term effects, about what the different solvents, you know,
the different chemicals that are in those cartridges. What are the effects of those?
know, on lung health, that itself, forgetting about the cannabinoids, that itself, we don't really
know. And so I think that for me, that seems like a very scary area because we know that people
are increasing their use of vapes at a population level. People tend to think of vapes as being
safer, right? So there's this like kind of harm reduction approach to them, but we really don't
know what the effects are on cardiovascular health. I can tell you that there's a condition called
Evali. It stands for e-cigarette or vaping product use-associated lung injury. And it can put up to
50% of people who have it in the ICU. And it includes diseases like acute respiratory distress syndrome
and hypersensitivity pneumoniaitis and bronchialitis obliterons, which is a terrifying name for something
that's also whimsically referred to as popcorn lung. Because factory workers who inhaled
artificial butter flavorings came down with the same thing. It's damaged to the tiniest crevices of the lungs
and it's not good. So if you are a smoker or two who turns to vaping thinking it's healthier,
without the actual visual measure of like how many centimeters of this roach are left,
it can be easier to overconsume THC because a vape is much more portable and more discreet than blazing up a bowl of skunk.
according to first person anecdotal reports from me.
Now, with respect to oral cannabis, in the past I've always said,
if somebody's thinking about or we're talking about using cannabis for medical purposes,
of course, you know, you wouldn't tell somebody to like pick up a joint and smoke it, you know,
right?
Like who smokes their medicine, right?
So using it orally seems to make most sense.
But at the same time, what we saw when Canada started legalizing cannabis at the national level,
and as different states have started legalizing cannabis,
the research has shown that people who are showing up in the eds
for acute intoxication from cannabis.
I'm freaking out.
They're usually showing up because they've used an edible or an oral product,
not because they're inhaling it, right?
Now, if you think about it, anybody who's used cannabis
or knows something about pharmacology and pharmacokinetics,
one of the reasons why is probably because if you're inhaling cannabis
and you're uncomfortable or you're paranoid or you're very, very anxious, by the time you get to
the ED, those effects are going to have dissipated. It's very short acting when you inhale it.
But when you use a oral cannabis product and in some cases, you don't feel the effects for the
first 45 minutes, so you take some more, right? You eat another gummy or another chocolate bar,
another brownie because you don't feel the effects. You know, you keep on exposing yourself to more
and more THC, and oral THC lasts a long time, much longer than inhaled cannabis. And so what ends up
happening is that people mistakenly, unintentionally expose themselves to more THC than probably what's on
the label. So they get to the ED, they are experiencing those effects, and they last for a while.
So that's all to say that there is some words of caution that should be expressed when talking.
talking about modes of administration, you know. There are risks to both. And the aspect of the
mode of inhalation is that, you know, you feel the effects. People can titrate it more easily.
And even if somebody is feeling uncomfortable, it will dissipate more quickly than with oral
administration. Yeah. And whether or not it's going to have the same effect on cardiovascular
endpoints, hopefully if you come back in a couple of years, we'll be able to answer that question.
And smoking versus an edible feels really like trying to get off a subway versus trying to get off an airplane.
Like you're in it, dude.
And you're just like, I don't know where this is going.
Right. You're stuck. Yeah.
Which, yeah, we did have people that are like, why when I have an edible do I go to outer space?
Yeah, Izzy wanted to know what science says about metabolism and absorption.
Becca, first time question, ask her, why the hell do gummies blast me into another dimension every time?
and immediately regret my decision to take it.
This was also on the minds of Aaron Dewberry,
Ali V, Adi Capello, Melanchica K., Julia Abbott-Bobbins, Anna Wolf, and Goblin Prince.
So is it a higher concentration of THC in the blood,
or is it just because you're able to get more from it in your intestines and your lungs?
Interesting, because THC is metabolized in very different ways,
whether you're inhaling it or whether you're taking it orally.
Okay.
So when you're taking THC orally, it's going to go through the liver.
It's going to go through the natural metabolic pathway that most therapeutics that you take orally goes through.
Down the hatch.
And so what's interesting with inhalation versus oral is that if you look at people's blood after they smoke a joint or a pre-roll or eat a brownie,
is that you can have two people that are very intoxicated and maybe even impaired.
and when you draw the blood from the person who smoked,
you're going to see high levels of THC.
When you draw blood from the person that used it orally,
they ate a gummy or something like that,
the blood levels of THC are actually surprisingly low.
Oh.
What's high, though, is the active metabolite of THC,
which is actually thought to be what's called more efficacious.
So it acts at that cannabinoid receptor in a more powerful way,
than THC itself.
This whole thing had me gagged.
And so what you'll see is that if you were to draw blood from somebody who just had a brownie
and looked at THC, you'd be like, oh, this person didn't have much at all.
Like, why are they so intoxicated?
But when you look at that metabolite, you'll see that the metabolite levels are actually
quite high.
And so the body processes cannabis and cannabinoids in very different ways depending on how
people are taking it in, which is understandable.
That's just how drugs work.
So to the audience member's question about, you know, why when she had the cannabis gummy,
she's blasted off into outer space and, you know, she always regrets it. Well, I mean, that's probably
because the amount of THC and that gummy is very high. And so it's going to have that impact.
Although if somebody were to take her blood, they probably wouldn't see very high levels of
THC. They would see high levels of that metabolite. Wow. It's so interesting, too, stigma-wise,
it's like, yeah, I just smoked a joint before going into dinner with my friends would be like,
okay stoner but if you're like i had a i had a gummy before it came out it's like oh fun so interesting
you know the idea of stigma and being in los angeles and the fact that stigma is still a part
of the conversation around cannabis is really interesting because again i mean you walk down the
street and you see the billboards right or you see the dispensaries or you see the delivery carts
and it's all in our face but interesting that you mentioned how like
the gummies is not stigmatized. And I do wonder, you know, Ali, is that because you're like
part of a certain, you know, demographic group, right? You know, you think about like, oh, the soccer
moms, they're all like having gummies and glasses of wine. Yeah. Versus like other populations,
they're not into the gummies, right? Yeah, yeah. And so I think it has to do with the communities
in which were seated. For sure. Right. So I'll break that down for you in less formal terms.
But what Dr. Cooper is saying is that white ladies get away with a lot of shit.
that other people don't, both culturally and from the law.
So let's check in again with part one cannabinologist and Smith College weed anthropologist,
Dr. Caroline Melly.
Can we talk a little bit about xenophobia and racism in cannabis?
I'm curious, like, what crackdowns were had and what those were a red herring for,
if that occurred, or what was the stigma as attached to?
to, you know, people call them jazz cigarettes.
Was that tied to, like, underground cultures or certain types of musical cultures or where
does racism factor in?
Yeah, there are some really great historians who are actually writing extensively on the
history of it, especially around, say, 1900 to 1970.
There are lots of stigmatized groups that were sort of caught up, I think, in the larger
mythology about what cannabis was and what it would do to society's, like, fabric, right?
So some of it was about Mexican farm workers who were arriving and purported to be using it.
Some of it has to do with, you know, black and brown urban folks who were using it, say, in the 1920s,
even though, of course, we know it was used much more widespread than that, right?
But it became associated with particular social groups that at the time were seen to be degrading society in some kind of way.
even within Nixon's announcements in the 1970s, it was embedded within there as well, right?
Historians have argued at least that it was carrying forth these ideas about a kind of underclass that was ready and poised to kind of take the world over.
This is public enemy, number one, fundamentally, it is essential for the American people to be alerted of this danger,
to recognize that it is a danger that will not pass with the passing of the war in Vietnam.
which has brought to our attention the fact that a number of young Americans have become addicts as they serve abroad, whether in Vietnam or Europe or other places.
And as we talked about in the intro of part one, the term marijuana is now a bit contentious because it's a throwback to this villainization of Mexican migrant workers who were blamed for bringing into the country and all the racism folded into the scare tactics of the war on drugs.
And privately, side note, Nixon later admitted that he didn't think cannabis was the biggest threat, even as far as street drugs go and that heroin was a greater concern. But as John Hudak wrote in his book, Marijuana, a short history, quote, for decades, the war on drugs has been a tool to target black and brown Americans and change life trajectories in those communities for millions of people. And Hudak echoes anthropologists and political analysts who for years pointed out that smoking a plan,
was a red herring to cause divides and fears among classes and races. But as it's become legal in
several countries in many U.S. States, weed culture has sprouted from the underground and into
shiny dispensaries that look like apple stores and amber bottles of these high-end tinctures
that are promising a cure for anything that ails you. I think that some people, you know,
we ask in our particular laboratory where we recruit people who use cannabis, we'll have
people who are using cannabis many times a day every single day and we ask them questions related
to is it impacting their daily lives? Is it impairing in any kind of way? And they'll frequently say,
you know, no, it's like it's, it's just part of my daily life. And you think about, okay, well,
their social circle that's probably with other people who are similarly using cannabis at the same
rate. Just like, you know, some people go to the bar every night or some people have a glass
of wine with dinner every night. Right. So I think it matters about like social norm.
where I think this matters the most is when we think about patient care and we think about
how people interface with their physicians in the health care system.
And I think that this is a really important area where stigma definitely has to be addressed.
It is absolutely critical if somebody is thinking about using cannabis and they're a patient,
they're thinking about using cannabis for any one of their disorders or some symptoms.
Having that conversation with their physician is so important so that,
the physician can be informed so that the physician can share with them information about how to
reduce risk or if that patient is taking other medications, how will their cannabis use impact
their other medications? Having that conversation is so important and the thought that stigma
might impact the ability of the patient to be candid and open and feel comfortable talking to their
physician is not beneficial in this day and age when cannabis is all over the place.
is solid advice. It's backed by science, like the 2023 paper, the highs and lows of cannabis
stigma, a vignette study of factors that influence stigma toward cannabis consumers. It's in the
journal, drugs, education, prevention, and policy. And it concluded that the stigma toward
cannabis consumption increased when cannabis was used recreationally or by smoking joints or was purchased
locally in the neighborhood. And that, yeah, the impact of that stigma may be a barrier to
help seeking for people who use what's seen as riskier methods of administration. And this is especially
important not seeking help when it comes to your psychiatrist folks. Sarah King asked,
what are the effects on underdeveloped brains? And mental health and cannabis was also on the brains of
Donnie Needham, Sarah King, Paul S, his home, and Erica Gormley, whose name I'm about to mispronounce
because Gomley is what I call my dog. Sorry. Oh, and Becca, first time question asker.
know, is it true that marijuana can put you in psychosis? And I myself have many friends who have
bipolar disorder and a few will not touch cannabis because of the risk of psychosis, but not all of them.
I have other friends who don't disclose to their psychiatrists that they are using it to self-regulate.
And I wanted to ask about that. Maggie wrote in to say I was in the hospital a few weeks ago
for paranoia and mild psychosis related to stress and increased marijuana use.
Erica Gomley wanted to know what do they think is behind the increase in marijuana-induced psychosis.
And now I'm like 30% free rolls.
Howdy Krabb, Marisa, all asked about, Marisa asked, my brother smoked a lot of weed in his late teens in early 20s and developed schizophrenia.
To this day, 50 years later, he's had a lot of difficulty giving it up because it doesn't interact well with his meds.
But when it comes to psychosis and other mental health disorders, I've seen that smoking under a certain age can put you at risk for others.
I myself, am very glad I didn't ever really try it until I was in my late 30s, but I'm also like, what does that say that I'm, you know, engaging in it here and there?
But yeah, what are the risks long term to mental health?
So with respect to psychosis, we can say that using cannabis at a younger age especially can increase the risk of developing a psychotic disorder.
order. Now, that's in a small percent of the population. This is not causal. We think that there are
underlying factors that might predispose people to being nudged in that direction, right? So you mentioned
how you have friends who have bipolar and they stay away from cannabis. And so generally speaking,
people who have, let's say, family risk of psychosis, of schizophrenia, it's generally advised,
especially at a younger age, to stay away from cannabis, especially
during this like sensitive developmental period. There have been studies demonstrating that there's an
association between cannabis use and other mental health issues such as suicidal ideation, anxiety,
depression, and there seems to be a period during late adolescence where this association is stronger.
It's kind of hard to tease out what's happening there because we see that a lot of youth or
adolescents are using cannabis. You know, they might have had.
had anxiety or depression beforehand and they start using cannabis. And so is it that the increased
use of cannabis is causing a increased severity of depression or anxiety? Or is it that, you know,
they're using cannabis to help alleviate some of the symptomology around that? So we know that
there are associations there. We know, you know, there are studies that have looked at cannabinoids
for some of these mental illnesses. So for example, for schizophrenia, there's.
There have been placebo-controlled studies, rigorous studies, looking at, let's say, cannabodial
in people with schizophrenia and demonstrating that cannabino might actually be helpful for some
symptoms of schizophrenia.
So how interesting is that?
Very interesting.
There have been other studies, again, an association study, that people with schizophrenia who
use cannabis have improved cognition.
And if you're like, what was that last part?
Seymour in the 2024 paper, which is inquisitively titled,
Does cannabis affect cognitive functioning in patients with schizophrenia?
In the journal Schizophrenia research.
And the intro notes that while cannabis impairs cognitive performance in healthy subjects,
several studies have shown improved cognitive outcomes in schizophrenic patients using cannabis.
And they recruited around 100 participants.
They found that patients with schizophrenia who did not use cannabis perform better in certain tests
like psychomotor function and attention and verbal memory,
while cannabis using schizophrenia patients performed better in tests on working memory and visual memory and emotional regulation.
But this study is not an invitation to just spark it up.
Rather, it's kind of a jumping off point for researchers to figure out what parts of the brain are affected by which molecules.
Speaking of molecular structures, just a reminder, because I know it gets very confusing.
Part one, we talk a lot about the definitions of THC versus CBD, CBN, CBN,
CBG, THCV, etc. But the non-high-causing cannabinoid, CBD, is also known as cannabodial. But a cannabinoid can be any of those
various compounds. Also, THC is known as Delta 9, is sometimes referred to. And of course, Delta 9 highly
regulated in most of the world, THC. Now, Delta 8, however, you may have heard of, that's a compound
similar to THC. It produces a milder high, but it's found in way.
smaller quantities in the cannabis plant. But because of the U.S. Farm Bill from 2018, Delta
8 is more loosely regulated, kind of lumped in with hemp. And Delta 8 can be synthesized from
CPD, although sometimes it's done with really dodgy backyard chemistry. And there was a 2024
journal of cannabis and cannabinoids research paper titled Delta 8 THC Retail Availability, Price and Minimum Purchase
age, and it noted that Delta 8 THC retail outlets were disproportionately located in areas with
more socioeconomic deprivation, which is a risk to those communities because this stuff can be
formulated using what they called, quote, unsafe household chemicals. So, TLDR on that is do not
buy gas station knockoff weed. Good. Also, if your country doesn't even allow THC sales,
does your CBD even do anything or does it need to be paired with THC to even work?
So pairing THC with CBD is called alluringly the entourage effect.
And according to the 2024 paper, the entourage effect in cannabis medicinal products, a comprehensive review.
The concept of CBD and THC working better together is plausible.
It says current research suggests a potential overlap.
and the therapeutic benefits between the cannabinoids and terpenes, but the hypothesis that these
effects are additive or better together remains unproven. And they say further research is
expected to understand which factors are enhancing cannabinoid efficacy. So for the handful of
of people who told me that I didn't address that CBD only works in the presence of THC,
sorry babes but that's not true you're bullying the wrong bitch here now this aside is already
too long but i'm going to loop back really quick to bipolar disorder and weed and a 2023
industrial psychology journal paper titled cannabis use and its relationship with bipolar disorder
a systematic review and meta-analysis says that yeah cannabis has been stated as a causal risk factor
for schizophrenia and other psychotic disorders and it says that there's a dearth of literature
stating the association of cannabis with bipolar disorder. And I was like, great, there's a
dearth of research. I'm going to dive into it. And then I remember that dearth means not a lot.
It means it's the opposite of a glut. So there's not a lot of research on it. But the study did
propose that cannabis use may worsen or precipitate bipolar disorder, which means we got to look at it
more. So please be honest with your doctors and be good to your brains. The point being is that
it's a very complex relationship between mental health and cannabis use, especially now that
people are using cannabis for a variety of mental health indications. In general, it's thought
that waiting to use cannabis until, you know, brain maturation. And so people say, oh, this is not
until you're 25, right? You know, waiting to use cannabis until later age is definitely preferable
because there's less risk for developing cannabis use disorder. There's less risk with respect to
schizophrenia, less risk for alcohol.
whole bunch of other mental health conditions. So there is some evidence and some words of caution
around that, not using the high potency cannabis products, right? And so we think that there is evidence
suggesting that there's an association between psychotic like disorders or psychotic like
experiences and that very high potency cannabis products. So we know that those are associations.
Whether they're causal, we don't know that yet. I don't know if we'll ever know that necessarily.
And, you know, keep in mind that cannabis isn't special in this respect. I mean, there are other
substances that people use that carry the same type of risks. The tricky thing about cannabis,
as you mentioned before, Allie, is that people are using cannabis as medicine, as therapeutics,
right? And so what does that mean that makes the picture much more complicated? Yeah. It really does
blur the line between recreational and medicinal because self-medicating, not under a doctor's
supervision to alleviate symptoms of something is still medicating. It's just perhaps not
in the right dosage. So it's interesting what is recreation and what is trying to alleviate
symptoms that either haven't been addressed or haven't been successful at being addressed otherwise.
But I wanted to ask when you're talking about psychosis, I don't know if this applies to paranoia
as well. Is there a button kind of getting jammed, you know, like at a crosswalk like ding,
with the THC and a certain part of our brains that causes that paranoia, that intense anxiety
or that psychosis in extreme cases.
This was also bouncing around the minds of possibly anxious patrons, cool next door, Janet R.,
Matt Thompson, Madeline Fox, Claire, and Mariel, who asked, how do you measure or explain
that threshold where a relaxed high turns into an anxious panic attack?
So it's interesting because what we see with THC is,
that some people will say that it helps with their anxiety. Other people say, oh, it makes them
anxious. And usually if people have a bad experience with cannabis, they're usually not going back
to it, right? Until maybe a later age and they're trying it out again. But in the same human being,
we know that THC can have a very different effect on this endpoint. It could reduce anxiety and it could
make that person anxious. It all depends on dose and probably also route of administration,
how they're using it. And so what happens as a function of the THC concentration in the brain? It's a complicated
story with respect to which neurotransmitters are being activated or being tamped down. I mean,
similar to, let's say, alcohol, where some people, as you say, they'll feel very stimulated when they
have lower doses, but then when they drink too much, oh my gosh, you know, they can't stay awake, right? So it's a very
similar type of thing where you have certain neurotransmitters that play a role in this anxiety-like
response or calming-like response. But then when there's more THC on board, there's a complicated
relationship between how different neurotransmitters are being released and activated in certain
parts of the brain that are really important for anxiety relief or anxiety provocation.
So different levels of cannabis can stop and start signals in the brain.
it can be dose dependent. It might be timing or every individual may be different because of brain
chemistry. It's funny. A little bit of THC and I'm like, I've never felt less anxious and then a little
bit more and I'm making out with the Grim Reaper. And I'm like, I can see my own death. What's going to
happen to my bones? Like it's so interesting. Yeah, the window is very small. It's so narrow. And so
you can imagine that if you're taking a product and it hasn't been labeled correctly or if you're taking a product
and it's been labeled correctly, but let's say it's been, you know, not refrigerated or sitting
out for too long. All of a sudden, it's a very different type of experience.
Yeah. And that's really tricky. It can feel like the scariest nightmare. And it's so interesting,
too, that the doses can be so high. And to know, like, why didn't that affect me so much?
And then take a drag off a completely different, you know, and then, again, your whole world is
collapsing. A lot of people, Shelley Bean, Melenka, Kay, Van Sheff,
Amphus, anonymous, Ellie Dick's first-time question asker, wanted to know about, and Melancho-Ka-Ka-K-K ask,
are all those calming CBD products actually doing anything? Or is it a placebo, like, $72
CBD shampoo sold on goop.com? Like, does it do anything? I guess the question is, I mean,
for me, I'm always like, if it is placebo, does it matter? Like, if people are feeling more
calm, you know, doesn't matter. And probably the more expensive it is, if it is a placebo response,
then you're going to have more of a response to it, right? Because you're like investing into it.
The only time that I think a placebo response is not beneficial is when there are the risks
associated with it, right? And so you don't really see so many risks with CBD. There are issues
with liver enzymes and some gastrointestinal distress. But in general, with CBD, you don't really see
the adverse effects. And so what is the evidence that the CBD product that your listener is
using is actually helping with anxiety or with sleep? Probably pretty minimal. The evidence that we have
that CBD is actually helpful for anxiety is with mega doses. I'm talking like 300 milligrams,
600 milligrams far higher than what people are generally getting from dispensaries. That being said,
a lot of CBD products also have some THC in it. And so the question is, is the comment
effect actually coming from the CBD, the little bit of THC, which we know, you know, you can have
five milligrams of THC and it produces an effect versus like five milligrams of CBD doesn't really do
anything. Or like you said, could it possibly be a placebo. So, you know, it could be any one of
those things. But with respect to anxiety, again, like I said, we know that in certain situations,
THC can help to alleviate anxiety, although when you get too high of a dose, it can actually be
quite anxiogenic.
Meaning you'll freak out.
And with CBD, very high doses have been shown in certain situations to help alleviate anxiety
in different populations in people who are healthy, who are put in situations where they're
meant to feel anxious.
It's been found in people who have, you know, an opioid addiction and they're presented
with stimuli that remind them of the opioids that they use and they find to have reduced anxiety
around those types of cues, reduce craving. So it seems like CBD at certain doses, high doses,
could actually be helpful for anxiety. If you are currently like white knuckle gripping a stress ball
and asking how much, why, where do I get it? I see you and I am you. So I looked at the
2020 paper use of cannabodial for the treatment of anxiety, which blasts right out of the gate
with the statement, anxiety disorders have the highest lifetime prevalence of any mental illness.
this worldwide, leading to high societal costs and economic burden, which, okay, well, sorry,
fuck me, I guess, but it continues that current pharmacotherapies for anxiety disorders are associated
with adverse effects and low efficacy, which is a conclusion I like to call no shit Sherlock,
but the paper reports that for people with social anxiety disorder and PTSD, doses of 400 to 600
milligrams of cannabidial or CBD significantly reduced subjective symptoms of anxiety and decreased
the cognitive impairment and speech performance discomfort. So that's amazing. The paper continues that the
majority of preclinical and clinical research has been conducted using males only. Thus, future research
should focus on this area due to the lack of research in females in the effectiveness of CBD as a
potential treatment for anxiety. So I wonder if being excluded from major medical studies of disorders
that affect your gender more is causal to why we are so anxious. We'll never know because maybe
no one will ever fund that study. Flames? Flames? On the side of my face. Speaking of inflammation,
Alice Rubin, Lillian Rolfe, Bonnie M. Rutherford, Don Smallcheck, and Dr. Lena Carpenter wanted to know
about conditions ranging from Crohn's to Hashimoto's to rheumatoid arthritis and getting relief
from cannabis products where other pharmaceuticals just ain't doing the trick. What about many people,
Jan O'Hubbard and a ton of people wanted to know about the immune system and the autoimmune system
and the effect on inflammation in general? This is so complicated. When we think about the immune
system and inflammation. And this is not my area of expertise for one reason in that it's,
I've tried. I've tried to look at inflammation and inflammatory markers. And we actually do that
in our lab to some degree. But it is extremely complicated. So when we think about inflammation
or immune response is that a good thing or a bad thing. And immune response is actually really
important, right? It's your body's natural defense. So you want to have an immune response
if there's a foreign virus or if there's a bacteria, you really want that.
And so I know people were really interested if CBD could be helpful for COVID.
And I think that there was one study that actually found.
It was like an analysis of people who were using CBD for those seizure disorders.
And they found that fewer people actually got the COVID infection.
This was a long time ago.
Listen, global quarantine was an era of dark, lonely, weird, scary couch lock in and of itself.
but add legal recreational weed to it and no reason not to wear elastic wasted pants and order desserts.
And you have got yourself plenty of time for some scientific speculation.
One of them was touted by an anonymous source, I'm going to call my spouse, who asserted that our very stony binges of TV and pie were why we never caught COVID.
But he got it in 2024.
I am still a novid.
Haven't gotten it yet.
I'm knocking on wood.
Okay. But headlines were made with one 2022 study titled Cannabinoids Block Cellular Entry of SARS-Cobie-2 and the Emerging Variants. And it did find that certain cannabinoids helped prevent the infection of human epithelial cells by the SARS-CoB-2 spike proteins. And it prevented entry of live virus into the cells. Oh my God. Jared was right. However, it's not the THC. The compounds in cannibate.
that were actually preventing entry of the live virus via those spike proteins into cells
were something called CBGA and a precursor to CBD.
And both of those you can put in your body legally without getting toasted.
Now, if you are smoking weed to prevent getting COVID, I'm sorry, but I must dig up a weedy
study.
Cannabis use is associated with lower COVID-19 susceptibility, but poorer survival, which
looked at 13,000 cases and it held our hand to tell us that regular cannabis users who smoked more
than once per month had significantly poor COVID-19 related survival after adjusting for other
risk factors in coma riddies. So if you were looking toward cannabis to help with other health
risks or issues, again, smoking is bad. Consider alternate methods of administration, just PSA.
And so it was thought, okay, well, maybe it protects people. But it is really complicated. And I am not convinced, probably because of the complexity, that we know for sure if CBD or THC has a positive effect on the immune system, meaning like it's maximizing our immune system so that it's protecting ourselves in the maximum way while reducing the unnecessary inflammation. I haven't seen data on that. There's a lot of, you know,
know, signals in the animal literature showing that multiple cannabinoids can have an impact on
inflammation. But what situation are we talking about? And so there's really a lot more work that
has to be done in this area. You know, I did an episode on concussions the week that I fell down
the stairs at my in-laws house. It was Christmas Eve. We flew in early to surprise them.
And I was like, surprise. And just ate shit down a flight of stairs and socks. And I lived.
But a neuroscientist friend was like, you should get some CBD, like high concentrations of CBD for your brain inflammation.
And I think my sister-in-law happened to have some.
And is there actually any research?
This is a long story to get to it.
But I was like, if it can't hurt, fine.
But do they use it for neurological inflammation for accidents or anything?
They, no.
They don't.
Like if you go to UCLA Health, they're not going to be telling you to go out and get CBD.
Okay.
I think that, you know, there is suggestions.
that cannabinoids might be actually helpful for traumatic brain injury,
like right after the insult, in fact.
But the data in humans is far behind animals.
So, you know, maybe it could have a negative effect.
What's in the product that you're using?
Yeah.
I mean, it seems like a no-brainer.
Like, why not just try it?
But, you know, what's in the product?
What are the potential downstream effects?
Like, couldn't mess things up.
You know, if your brain is supposed to have a certain response
to an insult. Do you want to interrupt that effect, right? Yeah. So patrons with neuro questions,
Elise, Susie Q, Beth, and first-time question asker Maddox, who asked specifically about concussions,
I hope out of pure curiosity and not concussiosity, but in the TBI episode I made while
recovering from a TBI episode, I found a study called review of the neurological benefits
of phyto-canabinoids, neuroprotective, anti-inflammatory, and immunomodular benefits. And I was
like, okay, but then all the way at the bottom in the conflicts of interest section, there was a
disclosure that the leading researcher was a shareholder in a CBD gummy startup. But maybe he just
really believes in it, which is totally fine too. But in a 2023 journal of neuroinflammation paper,
cannabinoids in traumatic brain injury and related neuropathologies, scientists note that the only
cannabinoid-based synthetic pharmaceutical that's undergone the right kind of controlled trials in TBI was
found not effective. And it also states that cannabinoids that target the CB2 receptor we talked about
last week show the strongest evidence for neuroprotection. But plant extracts with a variety of
phyto-canabinoids may be the most helpful. Like every other cannabis study I seem to look at
in the last several weeks, it just says more research is warranted. But at least there wasn't a
conflict of interest on that one. Wait, at the bottom, yeah, it declares that the study was
funded by a company that sells cannabis nutraceuticals, foods, and other hemp-based wellness products.
But none of them are Rick Simpson. Remind me to talk about a guy named Rick Simpson in a minute.
But once again, a lot of the research is emerging. A lot of it has merit. A lot of non-industry
funded research remains unfunded and undone. And last I checked, I'm just a lady recording her podcast
decides in a rented house for her mother-in-law's birthday. And I'm not your doctor.
What about Dylan V. Chloe Marshallowitz, Ricky G. wanted to know. Dylan said, I've heard from
unreputable sources that cannabis can treat any type of cancer. Chloe said my grandma claims it cured
her breast cancer. She's been in remission for six years, obviously very dodgy and prone to
misinformation in general. But yeah, anything on that? Right. So in general, the idea that cannabis
can cure cancer, I think is dangerous, primarily because people might think that they can forego
the evidence-based approaches that we have right now, that if you can think about what has been
accomplished over the last 60 years in cancer therapeutics, I mean, it is astounding.
And so the idea that cannabis can cure cancer, there is a danger to that.
We know that certain cannabinoids might be helpful for some simpsomase.
in cancer patients. For example, you know, proving appetite, reducing nausea, and vomiting,
the FDA approved THC for those indications. But with respect to how it impacts tumor growth,
again, we are in the infancy stages of this type of research. And another really important
aspect to this that patients should feel very comfortable talking to their physicians about
is the fact that is it possible that the cannabinoids that people are taking, especially if they're
taking it orally because it goes through first past metabolism, all those kinds of things,
could it actually have an indirect negative impact on the chemotherapeutics that they're using?
Right. And so that's really important. Again, those chemotherapeutics, the anti-cancer agents,
have been studied through rigorous FDA authorized trials. I'm not an oncologist, but, you know,
I think that the adverse effects are fairly well known, the therapeutic profiles fairly well known,
pairing that up with cannabinoid products where we know very little and also the integrity,
the labeling, the manufacturing of those cannabinoid products is dodgy.
Right.
So, you know, you look in California or Los Angeles where only 20% of the dispensaries are regulated,
those other dispensaries, what do those products look like?
What types of mold or pesticides or other types of chemicals are present in those products that
if you're a cancer patient, if you're any type of patient, you don't want to be exposed
to. Right? So there's a lot of things to consider here. Oh, yes. Rick Simpson. Thank you. So this is a guy who in the
1990s was living in Nova Scotia and working as an engineer. When he fell, he bonked his head,
had lasting headaches and tinnitus and ended up making a highly concentrated rocket fuel
cannabis extract oil that is almost 90% THC. It has a bunch of other terpenes and cannabinoids in it too.
He felt much better taking it. And when some basal cell carcinoma,
popped up on his skin. He had seen a study about cannabis slowing tumor growth and mice. So we put some of
that magic oil on it and a bandage and claimed that the tumors disappeared. So he has become kind of a
legendary folk hero on the cannabis scene, like a bearded Paul Bunyan on the horizon of this stuff
cures everything, man, kind of remedy. Little dab will absolutely do you because in every millimeter
of this dark, goopy stuff, you're looking at up to 600.
milligrams of THC. I can't fathom that. That's five of those cookies I told you about in last week's
secret or eating 120 moderate dosage weed gummies at once. The recommended starting dosage of this
RSO, Rick Simpson Oil, is half the size of a grain of rice. Does this stuff cure cancer, though?
Guess what? Not a lot of studies on it, folks. But there are a lot of studies on chemotherapy.
therapy and radiation and immunoncology. So see a real doctor and not a guy named Rick first.
But there was a 2015 Journal of Investigative Dermatology study exploiting cannabinoid-induced
cytotoxic autophagy to drive melanoma cell death, which injected sweet little mice with melanoma
and then injected that injection with cannabinoids or fed the mice a tincture of them
and found that THC activates non-canonical autophagy-mediated apoptosis of melanoma cells.
gobbledy gook to most of us, I get that, but it means that THC kind of helped the body gobble up
and destroy tumor cells, at least on small studies involving mice. But if you're facing a life
or death health crisis and you find yourself deep into message boards for Rick Simpson oil,
you might be convinced to use it on everything from zits to those orange stains that lasagna leaves
on Tupperware. So take this all with one half of a grain of rice of salt, and please don't use
hemp oil instead of an oncologist. But what about an emergency medical team? Well, if you ever
find yourself dialing an ambulance or wishing for the sweet breath of death to take you,
let's chat about CHS, shall we? Honeydew, El Rieve, Kristen DeMarquez, soapy, in honor of their
gruevy grandfather, first-time question askers, Izzy, Abby Taylor, Olivia,
Cuccup and patron J. Dean Lannin, who wrote in Cannabis Hyper-MIS syndrome. My friend got this,
and he really suffers. What causes it? Is it more common in some people than others? What are the
risk factors? Let's see. Well, you know, you mentioned cancer patients, though, in helping with
appetite, which brings me to the munchies. Many people wanted to know, as a researcher, as a
scientist, what is the munchies? And why do some people run through their cabinet like a locust
and others have cannabinoid hyper-emesis syndrome, which a lot of people asked about, which news to me,
some people can have a gummy or smoke a joint and cannot stop barfing? Right, right, right.
No, so why these munchies are barfing? Right. So, you know, it's funny because I was just talking about
how cannabis can help improve appetite. And we know, this has been an effect that we've known about for
decades and decades and decades, you know, probably before, you know, Angelino entrepreneurs were
like cultivating cannabis, right? So one of the profound effects of cannabis is that it increases
appetite. We know that this could be a therapeutic end point. And we know that people who use
for non-medical reasons probably also it helps, you know, they enjoy their food more for people
who don't necessarily have an appetite but are healthy. You know, it helps them eat more.
This is the best thing I've ever had. So we know it acts in certain areas of the brain that control
hunger and food regulation. I mean, it's been study time and time again. The weird thing that
has happened, you know, and I think that this is probably not going to be the last that we see of
this type of thing, unexpected, where we have cannabis legalization, more people are using it.
Cannabis products have higher amounts of THC in it. People are using it in multitude of different
ways. We're starting to see this adverse effect of cannabinoid hyper-emesis syndrome, where people have
very painful vomiting. Gastrointestinal distress. Some people call it scromitting because it hurts
so much. They're screaming while they're vomiting. They go to the ER. There's really no remedy except
abstaining from cannabis. Some people report that they feel better when they take hot showers
for some weird reason. And I think that that some physicians usually use that as a marker to indicate
that that person has cannabide hypermysis syndrome rather than like cyclical vomiting syndrome.
or something like that. So this is something that I don't think anybody would have predicted.
And we don't necessarily know the mechanism. Research is just starting to touch on who's at risk
or what factors might predict that this happens. And we're still not clear on that,
except for the fact that we know that it usually happens in people who are using cannabis at very
high frequencies. So it's not necessarily going to happen for people who are using it once a month
or once a week. Although, you know, one of the effects of high doses of THC, even in somebody who
doesn't use it regularly, is nausea and vomiting. I mean, that's at, you know, pretty high doses.
Generally, at lower doses, you have the munchies or you have increased hunger, increased appetite.
But so how we have these very opposite things, you know, the increased hunger and then the
cannabina hyper-hypousis syndrome, it's not similar to what we see with anxiety where low doses of
THC can help anxiety, higher doses can make people more anxious. But it's a pattern that we see
emerge with drugs in general is that no drug does one thing, right? You know, you're always going
to have the yin and the yang. There's no therapeutic that is all good. And this is an indication,
this is the case where we see this very unusual, unexpected outcome that people can develop
this cannabinide hyper-emesis syndrome.
Generally speaking, people have an episode,
and they'll abstain from using cannabis for a while
because it is very disruptive.
And those people can report being very sensitive,
even just to the smell of cannabis.
And it can actually be upsetting,
because if somebody was in a community or a circle
that was very much involved in cannabis,
you know, instead of going out to the bar,
they're sharing pre-rolls or something like that,
Well, then now they can't, you know, be part of that anymore. So in that respect, there's also
that type of factor that isn't usually thought about in this case. But with respect to cannabina
hypermysis syndrome, I think over time we're going to figure out who is at risk. What is the
mechanism? Like, why is this happening? And also, what can we do to help treat these people? Because
it's not pleasant. Oh, I can't even inscrombating. Oh, that's not a word I ever needed to know.
Now I just feel so bad, but they need a telethon.
I had this tug of empathy and like a dark curiosity.
It was so strong that I found myself reading through first person accounts of this herbal horror.
And on message boards, sufferers of cannabis hyper-emesis syndrome, aka weeds scromitting, found solace in each other's company and wrote things like, every morning I would wake up, take my dog outside, and puke basically just bile into.
the grass. I essentially didn't eat for the 30 days it took to get out of my system. I had to carry a
trash bag around with me at all times to puke into. My wife got so used to it. We'd have full
conversations with just little pauses for me to puke. A guy named CFO Charles said,
nearly two weeks of the most of the most of that time, barely able to keep fluids down,
couldn't sleep for days on end. The pain was so intense, basically just lived in the bathroom for
10 days and did nothing but shower. Someone calling themselves your mom's pimp wrote,
anyone who denies this is real is a fool. It's definitely real and it's absolutely horrible. It's
what I imagine torture to be like all-consuming. Okay, evidence wrote, I thought I was dying or had
rabies, lull. Did anything bite me? No. And one patron, Jennifer Douglas, asked us if we could
please talk about cannabinoid hyper-emesis syndrome, adding that they're a nurse and that they see it a lot.
So one University of Colorado-based toxicologist and emergency medicine professor, Dr. Cannon-Hard, said that when patients present with CHS, which is usually worse in the morning and can last for weeks on end, the ER will give them emergency fluids due to the extreme dehydration it causes. And doctors have seen patients go into kidney failure or need surgery for a torn esophagus. But can't you just give them an anti-nauseum med?
Dr. Hurd says those don't even work, but the staff has tried some older nausea meds and off-label psychiatric
drugs to help, but often the patients come back a few days or even hours later. And yes, emergency
departments are seeing far more cases of this, especially where recreational cannabis is legal and people
don't realize how much THC is in their usual pre-roll or edible. And one, Ologies patron,
identifying themselves as Dr. Primo Delacotta, retired organ grinder.
asked any thoughts on the treatment of a hot shower or topical capsaicin?
Doctor, I gotcha.
I spent several hours on a train from Madrid to Sevilla, Spain, as my in-laws napped,
and I dug into a pot of vomit info on my laptop.
And there was one 2021 study, efficacy of topical capsacin for cannabinoid hyper-emesis syndrome
in a pediatric and adult emergency department.
And doctors tried applying a 0.0.0.
2.25 capsaic cream, like a hot pepper cream, topically to patients presenting with CHS and found that
significantly more patients in the capsacin group experienced relief compared to patients who did not
get the hot pepper capsaicin cream. But future research is needed to determine capsacin's
efficacy when utilized earlier in therapy, ideally upon diagnosis. And the study also gives a
heads up to others looking to try it. It says, quote, wear gloves and apply to an area specified
by the ordering clinician, usually the abdomen, wash hands after applying, and avoid contact with
eyes or other sensitive areas of the body. Now, how is this even working? How is hot chili pepper
cream working on intractable vomiting? I found a 2020 Journal of Neuroscience paper, THC, and
cannabinol activate Capsacin-sensitive sensory nerves via the CB1 and Cb2 cannabinoid receptor independent
mechanism. And it explains that THC and other cannabinoids cause a release of these sensory
neuropeptides and open up blood vessels. And they don't act on the same molecular target as
capsaicin, but they have an effect on some sensory nerves similar to those of capsacin. And there's
also some calcitronin gene-related peptide from Capsation.
and sensitive pervascular set, don't worry about that. Don't worry about all those words when your
face is in a spattered trash bag. Also, if you smell rank, don't worry about it. The Mayo Clinic study
cannabinoid hyper-emesis relieved by compulsive bathing explained that type 1 cannabinoid receptors in your
intestines can inhibit the motility of your intestines, which may lead to the hyperemesis
or lots of barfing in marijuana users.
But they say that the thermoregulatory role of endocannabinoids,
stuff you already make,
may be responsible for the patients need to take these hot showers that help.
And in this paper, the doctors wrote,
in a tone, honestly, it's a little like lunch break gossip.
They described one patient, a daily weed smoker,
who spent much of her hospitalization in the shower,
noting that this was the only thing that controlled her symptoms.
And they say she showered as much as four hours at a time
and even left her room to use her neighbor shower.
When her shower stall broke.
And they described another patient.
They said he noted having similar symptoms several times during the past two years.
And on these occasions, he would come to the emergency department
only after exhausting all the hot water in his shower at home.
So see that paper for more of the gossip.
But some folks say that temperatures between like a hot water,
105, 110 Fahrenheit, or around 43 degrees Celsius may provide relief. So you could also hang out in
an Arizona if you have one handy or better for the planet and for your pruny hag fingers is a simple
heating pad on your tummy that may help. Now, what if your belly is fine? No barfing, but you have
foolishly followed up with a second edible and now you are high and everything gives you the ick
and you think people hate you. Dadward, you ask me, your literal father, just tell me how to get
less high right now. So some old nice hippies say that you should try chewing a few black peppercorns,
and if they didn't also tell me that my moon sign mattered, I would believe them. So I consulted
literature instead, and it turns out, boy howdy, there is something to that. A 2011 British
Journal of Pharmacology Paper, Taming THC, potential cannabis synergy, and
Phytocannabinoid, turpenoid, entourage effects, takes us on a tour of too much THC through
the ages, and it explains that other terpenes like ones in black pepper can complement or inhibit
THC intoxication because it helps your brain lean into the anti-anxiety effects of the CBD
enough to calm the paranoia of the THC for a few minutes and help ground yourself through
a wave of the scleries. And it explains that the black pepper may offer mental clarity,
from something called pining, which is a terpen. It's also found in pistachio nuts and pine nuts,
pine tar, and it can help clear your mind enough to get through it. Also, eating a mango,
which has mercing, might help dial up the couch lock sedation and sleepiness if you need to
sleep it off. Now, another helpful remedy, if you have a case of the oh no's, is a lemon wedge.
So says generations of our ancestors who have your back and also the 20,
24 Journal of Drug and Alcohol Dependentance Paper, which found that when subjects were given a pretty
big dose of 30 milligrams of THC together with 15 milligrams of limine, they had significantly
reduced ratings of anxious and nervous and paranoid symptoms compared to people who just were given
the 30 milligrams of THC alone. The paper ends with a familiar refrain. Future research is needed.
But yes, if you're needing to dial up the chill effects, you can drink.
some water, you can recline somewhere comfy, maybe order a black peppercorn lemon chicken dish,
and have a pistachio-baclova dessert. It'll pass, kiddo. Patron Bobbins, I hope these ones work out for you.
Now, one listener wanted to let me know after listening to last week's part one that, quote,
I've been a hospital doctor for decades and never have I admitted a patient because of cannabis
intoxication or withdrawal, only for vomiting. And those people shouldn't use it or
use it too much. On the other hand, they say, I've admitted thousands of patients with alcohol-related,
life-threatening medical conditions from severe detoxes, which go straight to the ICU, or liver
failure or GI bleeding, liver cancer, severe anemia, etc. But alcohol, they write, is sold at grocery
stores when cannabis puts you in jail. Political hypocrisy, they say, doctor, thank you for those
words and your service. And on that note, let's donate to a relevant cause. And
And this week we're giving again to the last prisoner project, a nonprofit organization dedicated
to cannabis criminal justice reform. And they say as the United States moves away from the criminalization
of cannabis, giving rise to a major new industry, there remains the fundamental injustice
inflicted upon those who have suffered criminal convictions and the consequences of those convictions.
And through legal intervention, education, and legislative advocacy, the last prisoner project
works to redress past and continuing harms of our country's unjust and ineffective approach to
drug policy. So thank you to sponsors of the show for making that donation possible. After the break,
we will address the munchies. Okay, patron Ricky G noted that when their pro-in-law got cancer,
weed was the only thing that could help him eat and stay healthy. But Lauren Harder and Erica Gormley
asked, how do people mitigate munchies? For munchies, anything that can be done for munchies?
people who don't want the munchies? Yeah. For people who are like, you know what I mean? Like,
they're like my my door dash bill for Hagen-Doss is too high. Anything that can be done.
You know, it's interesting because I usually think of, I guess probably because we do these
studies in our lab, where we're actually looking at how improvements in appetite and hunger
and food intake is actually a good outcome for cannabis. But I guess that isn't the case for
everybody. Right. So what can be done? Gosh, that is a good question. What can I guess be prepared
and understand that even if you're hungry, you know, it depends on the person. If they get enjoyment
out of eating the food, that's part of the experience. Yeah. Maybe they need to stim a different way,
like knitting or something, you know. So yeah, sometimes try another activity that gives you like a physical
or a tactile sensation, like play with some slime or one of those needo squishy cubes that are sold
out everywhere, but you can steal one from your grade school niece. Or lie down and do a body scan meditation.
Feel your toes, feel the air on your face, how the blanket feels on your arms. And if you're like,
this isn't helping. And your version of the Buddha is less mindfulness and more just smiling,
happy belly man, try to look for strains of weed that are maybe lower in that mercerine
turpine and higher in one called humylene. There are strains like sour diesel or Atlantis or one called
gelato, which isn't helping. But as for the munchies, another thing that works for me is I tell
myself, Ward, you can either be a little stoned or you can snack. You pick one. So yeah, try that.
Or physically distract yourself, like make a rag rug or sculpt something or hit a rock with a stick.
On the topic of stimming some, a lot of people wanted to know about ADHD and weed.
Eli Dick said, can you speak on the beneficial effects of cannabis on ADHD symptom?
And a few people said, you know, my husband sometimes calls it nighttime adderall.
He has ADHD and he's like sometimes do a little bit and then boom, he's got an editing project he's got to get through.
or he's like, can focus more.
But specifically in the nighttime.
Yeah, like, because he takes Adderall during the daytime.
But sometimes if he's got to, like, get through a project, he's like,
a little nighttime Adderall.
Huh.
Because it doesn't keep him up.
Yeah, it doesn't keep him up.
Oh.
But a lot of people asked about ADHD and why it can help their focus sometimes.
Bass Pugmire, Anna, Kate, Ellie Dix, Bopi, Alson Clark, and Julio Rehelt,
and a patron by the name of Poo-Part Goblin, who asked,
why do all my neurodiversion friends and I basically rely on weed to get by?
So why it can help their focus is a big question in part because even though we hear these reports
that people who have ADHD, a lot of them don't want to take the stimulants for whatever reason.
The stimulants don't help them. They make them feel jittery and people do turn to cannabis for ADHD.
Some people say that it does help them focus. Probably it's dependent on the dose and dependent on how
people are taking it, right? Exactly. But, you know, there have been a couple of studies that have, like,
really probed this. And those particular studies, just a couple. Those placebo control trials haven't
really panned out, you know, to demonstrate that it is very helpful. So it's hard to know, like,
what the mechanism might be. But it's not unusual to hear that it does help certain people. And
specifically in people who don't react well with stimulants either, you know, they're opting for
cannabis because for whatever reason, it's,
helpful, doesn't have the same type of side effect profile as the stimulants do.
Patron Jenamina, first-time question asker, mentioned that they use regularly and intentionally
as part of my mental health self-care plan. It's not prescribed, but it's definitely medicine,
they say. And a 2017 study cannabinoids in attention deficit hyperactivity disorder,
a randomized controlled trial in the journal European neuropsychoparmacology gave some
weed nasal spray to volunteers with ADHD during a six-week double-blind, randomized, placebo-controlled
experimental trial. Pretty legit. Each participant got a one-to-one THC CBD squirt a day of about 2.5 milligrams
each, so low dose. And the researchers checked cognitive performance and activity level and behavioral
symptoms of ADHD and behavioral and emotional symptoms of ADHD. And in the active group, they
found improvements for hyperactivity, impulsivity, and more trends toward improvements for
inattention and emotional liability. And they concluded that, yes, quote, adults with ADHD may
represent a subgroup of individuals who experience a reduction of symptoms and no cognitive
impairments following cannabinoid use. And it says, well, not definitive, this study provides
preliminary evidence supporting the self-medication theory of cannabis use in ADHD and the need
for further studies of the endocannabinoid system in ADHD. Now patron Madison Hartman asked
THC and autism, why do so many tistic baddies love weed? Let's ask the 2021 paper cannabis and
cannabinoid use in autism spectrum disorder in the journal Trends Psychiatry, Psychotherapy. And it told me that
cannabis and cannabinoids may have promising effects in the treatment of symptoms related to autism
spectrum disorder. And it can be used as a therapeutic alternative in the relief of those symptoms.
And it told me that cannabis may have promising effects in the treatment of symptoms related to autism
spectrum disorder, like including hyperactivity, attacks of self-mutilation and anger, sleep
problems, anxiety, restlessness, psychomotor, agitation, irritability, and depression.
And moreover, the researchers found an improvement in cognition, sensory sensitivity, attention,
social interaction, and language.
But they said that the most common adverse effects were sleep disorders, restlessness,
nervousness, and a change, probably an increase in appetite.
But of course, the paper warned that more randomized blind placebo-controlled clinical trials
are necessary to clarify findings on the effects of cannabis and its cannabinoids in individuals,
with ASD. No surprise there. There was another 2025 Nature article which used surveys from self-identified
and diagnosed autistic adults, and that found that cannabis provided temporary relief from symptoms
associated with ASD. But there are other studies suggesting that autistic folks or people
with ADHD are way more likely to have cannabis use disorder, where the frequency or the
consequences of THC use impair aspects of life, like work and self-care.
relationships. But as we discussed in our three-part ADHD episode, and as many studies already
recognize, are these neurodivergent people turning to cannabis to relieve symptoms of ADHD or ASD,
or does the impulsivity seen in ADHD folks keep them from resisting it? You can ask your
neighborhood neurodivergent, how they feel about it. But if you are trying to resist the cannabis
that's calling to you from an old lunchbox under your bed.
What is the best method?
Patron D asked, I'm curious to know how long it actually stays in your system,
which is a great question knowing how strong some oils and strains can be.
Will we ever not be a little high?
Who knows?
Maybe Dr. Cooper.
Well, I'm wondering, too, I mean, with it being so prevalent, so available, so strong,
so widely used, so much research still jury out on just because time,
What do you see is most effective for titrating off of it or recognizing when it is addictive
or you mentioned some withdrawal symptoms earlier?
But for someone who is like, I think I'm done, any good way to get your brain off on the off ramp?
Right.
So this is an area that I think has been an important one to tackle and will continue to be
an important one to tackle with increased legalization across the United States.
You know, we're seeing more states become legal.
and that's generally been associated with greater frequency of use is what can we do for people
who do have a use disorder where their use is impairing socially, professionally, physically,
and they want to stop using.
So we don't have a therapeutic like we do for, let's say, people who have opioid use disorder,
for people who are trying to quit tobacco.
We don't have one of those.
There are some behavioral treatments that have been employed that have been shown to be
successful. We do know that people are starting to take what's called tolerance breaks,
right, where they don't necessarily want to stop completely, but they feel like their tolerance
has just gotten out of control. And so they'll wean themselves off a little bit at a time,
be absent in for a period, and then maybe, you know, start up again. But those are people who don't
necessarily find that the cannabis use is disruptive to their life. They just feel like they've become
tolerant to the effects. So generally speaking, if people want to stop using, they should very much
be aware of the fact that there are withdrawal symptoms that do occur, again, in a subset of the
population. These withdrawal symptoms are not easily recognizable. It's not like, you know,
if you drink coffee every day, 8 a.m., you have your morning cup of coffee. You know that at 9 a.m.
the next day, if you don't have your cup of coffee, you're grouchy. Nobody wants to be around you.
You don't feel well. You know that it's because you haven't had the coffee. With cannabis
withdrawal, it's much more subtle. Generally speaking, the symptoms, which include increased anxiety,
increase irritability, reduce sleep, reduced appetite. Those don't necessarily start even happening
until 24 hours after somebody stopped using. And they generally don't peak until three days after.
And so it's hard for people to recognize that they're feeling crappy and, oh, yeah,
it might be because they haven't had cannabis. And so without knowing that and acknowledging that,
it could make the path to continued abstinence or being able to cut down much more difficult.
Understanding that there is that connection there and being prepared for it could be helpful in achieving, you know, either reduced use or no use at all.
And so that's an important factor.
Patrons Cruton, Zoe Bookbinder, Sam DeHollander asked about neuroplasticity.
And among the research is a 2023 frontier study.
effects of inhaled cannabis high in the delta nine THC or CBD on the aging brain.
And it said that chronic inhaled CBD resulted in enhanced global network connectivity that persisted after drug cessation, but that the behavioral consequences of this change in brain connectivity remained to be determined.
So more neuroplasticity, but what does that actually mean?
We're not sure yet.
Now, stoners are usually known for their hacky-sac-sac skills.
or their creativity when it comes to microwave nachos.
But Quincy Robeshoe asked,
Can it actually make you dumber?
Serena Palmer, Mitchell L. Elahoma, and Goblin Prince also pondered this.
Peyton Nill took us back, writing,
The frying egg in a pan imagery of the 70s and 80s
seems like a gross oversimplification to the point of bald-faced inaccuracy
when it comes to cannabis,
but it's apparently a core memory for my mom,
and she still takes it as gospel.
And Lauren Reed wanted to know, does it really fry your brain?
If your memory is not so good or you're feeling like, is weed making me not so sharp?
Are those reversible?
If you're like, I feel like I'm getting more stupid.
Like, does your brain bounce back or have you just torched certain neurons?
So it is reversible.
But I do want to say that there's an interesting phenomenon where, you know, for somebody who doesn't use cannabis regularly,
if they use cannabis, you see those cognitive deficits, those memory deficits very clearly.
For somebody who's using cannabis every day, you might not see those deficits, in part because
they might be tolerant to those effects. And what might happen is that when they're going
through withdrawal, then you might actually see some cognitive impairing effects because they're
going through withdrawal. And that's been shown before that there's actually some decline in cognitive
capabilities. There hasn't been a whole bunch of research in that area, but that has been shown
to resolve over time. And for patrons Crouton, Amelia Diaz-Edinger, and Penelope McCavitt, yes,
cannabinoids do show promise for potential protective effects against Alzheimer's. There was a 2025,
six-month Brazilian study, a randomized clinical trial of low-dose cannabis extract in Alzheimer's
disease, and it gave participants 0.35 milligrams, tiny low dose of THC and CBD daily,
and it found that it can be an effective and safe therapeutic option for Alzheimer's, and it
related dementia. Guess what? Though, it continues, nonetheless, larger and longer trials are
necessary to confirm this finding. But those benefits may come later in life, offering the
protective benefits while starting on cannabis at a younger, more tender age can come with some
lasting cognitive risks. So says the 2025 JAMA piece, brain function outcomes of recent and
lifetime cannabis use, which found that heavy lifetime cannabis use,
was associated with lower brain activation during a working memory task.
But I don't know, maybe more research is needed.
Why aren't there more studies?
What's the hardest thing about what you do?
Is it getting funding?
Is it stigma?
The hardest thing.
I love, I love science.
I love what we do.
I think it's so important because it's developing the evidence that can potentially
help guide public policy on the one hand.
but also just like telling people, like what they have these questions, like all of your listeners,
they have these questions. So I really love what we do.
But now I do call myself a scientist, but I have to say that a small percentage of my time is actually
doing science. A large part of what I do is dealing with funding, trying to get funding for the work.
The work is not cheap. It's really important. The work that we do, we want to keep the participants
healthy. We want to keep it risk-free. So there's a lot of.
lot of resource that goes into screening participants to make sure they're healthy, to getting the
appropriate drug that we want to give them, the appropriate cannabis that's clean, pesticide-free,
et cetera, et cetera. So we need to apply for the funding, which actually I love. I mean, I love
thinking about, you know, what are the most important areas that we should be tackling right now.
But it's also like the regulatory aspect. And so part of ensuring the safety and the ethics of
these studies, and rightly so, we have to get approval from a lot of different boards.
If you're going to study a cancer therapeutic, you have to get approval from the IRB, the
Institutional Review Board of your university, and they check out on the ethics of the actual
study. And you also have to get approval from the Food and Drug Administration. The Food
and Drug Administration is very interested in making sure that the drug you're giving is safe and that
you're doing it in a safe way. For cannabis, it's a whole other level because we also have to bring
in the Drug Enforcement Administration.
Okay, so the DEA has to say, okay, yes, you are legally able to have in your possession an
illegal substance and the place that you're getting it is also approved to give it to you,
right?
I can't go down to the dispensary and pick up cannabis down there, right?
And then in California and in many other states, there's an additional level of approval.
So in California, we have four boards that have to be able to approve our work that can take
months, that can take years.
And then we also have to get the product.
Oh my gosh, can you imagine how frustrating it is?
You had a whole beautiful grant that really tackles a critical public health issue.
And then you find out that the company that was going to make you the product or that had the product all of a sudden it dissolved or they're not able to make it anymore or all these other things can happen.
So getting products, whether it's cannabis or whether it's oral formulations, is really,
hard. I mean, it's fun in a way because you get to meet people and collaborate with people and
there's no better joy of, you know, doing science other than, you know, meeting people and
talking to them and brainstorming, but it is really hard. I can't even imagine. Because if you were
studying sunflower seeds or something like not a problem, you know, but yeah, the effects of almonds.
Really different. What about the thing that just lights you up? What do you love about this work?
I mean, so much of it. And I think that that's what keeps me going is I love, I love teaching.
You know, I love mentoring students. We have so many students that volunteer in the lab that are really excited about the work. And it's so fun to teach them and hear about what they're interested in, you know, what they think are the most pressing issues. I love being with other scientists and collaborating with people who have never even thought about studying cannabis.
or any drugs itself.
You know, there's so many ways
that you can connect with people
over this one topic.
So I love that.
And then at the end of the day,
I also really love the fact
that we are able to generate,
even though it takes a very long time,
we are able to generate evidence
that is important
that can potentially help guide policy
or at least consumer knowledge.
So I love that.
And of course,
I love speaking to people like you.
It's so fun.
So there's a lot of really great aspects of this.
This is a dream episode.
I cannot thank you enough. Honestly, we've talked about you every single week for years. Can we get Dr. Cooper? Can we get her? So this is a big day for me. And the Ologies team, thank you so much for everything you do. It's just such a wild west right now. And it's good and bad. So thank you for doing the work to understand it. And I feel so honored that I've been top of mind. This has been really a pleasure. Thank you. Thank you. Yay. What a way to have a Friday.
So ask smart people not smart questions because your brain.
is hungry for answers. And thank you so much to UCLA's Dr. Ziva Cooper for letting me hang out in
her office and peppering her with so much well-intentioned absurdity. She's a real one.
Also, thank you to Dr. Caroline Melly for sharing historical knowledge about cannabis.
You can find out more about them and their work, as well as the nonprofit, the last prisoner
project at the links in the show notes. I have never in over 500 episodes of ologies compiled
as much research as we did for these.
episode. So please delight yourself with honestly like 11 pages worth of links we posted at
Alleyward.com slash ology slash cannabinology. Part of the reason I did that also is because if I didn't
cite studies, some of you may not have believed the research. So studies are all cited.
Bibliographies up. We are at Ologies on Instagram and Blue Sky. I'm at Allie Ward on both.
Allie has just one L. You can join our Patreon at patreon.com slash ologies and merch.
is available at ologiesmerch.com.
We have shorter kid-friendly episodes
called Smologies available
wherever you get podcasts.
That's S-M-O-L-O-G-I-E-S.
Thank you so much to Aaron Talbert
who admins The Ologies Podcasts Facebook group.
Avaline Malick makes our professional transcripts.
Kelly R. Dwyer does the website.
Noel Dilworth keeps an eye on the clock
as scheduling producer,
huge research assistants from our queen,
Susan Hale, who's also our managing director
and keeps the hot peppers out of our eyes every week.
And once again, the CBD-THC duo who edit this altogether are Jake Chafee and lead editor, Mercedes Maitland of Maitland Audio.
Nick Thorburn jam banded the theme music.
And if you stick around till the very end, you know, I may tell you a secret.
And this week it's that, yeah, I'm in Spain for a family trip with my husband and his family.
And everyone sports like, they eat really late there.
And I was like, okay.
Honestly, it's like it'll be 10.30 on a weeknight.
Restaurants packed.
It makes no sense to me. It's great, but I've become nocturnal. I keep going to bed at like two and three in the morning. It's so weird. And then I sleep late. Right now, as I'm recording this, it's 6.15 in the morning. Local time in Spain. This episode is going up in a few hours. I am whisper recording it from a bedroom and a rented home. Everyone is asleep.
I do not know what I'm doing, but I know I'm on the other side of the world, and this episode
is going out. So I'll nap, and then I'll eat some cheese, probably, and then maybe I'll nap again.
Who's to say? Not me. I'm along for the ride. Okay, I hope you enjoyed this. Happy 420, everyone.
I'm trying to think of a better closer route. Good night. Bye.
Lottology. Meteorology.
Oh, yes. Dooby-do-do-do.
