Science Friday - Medical And Recreational Cannabis, Ocean Viruses, The Sound of Wi-Fi. June 3, 2022, Part 2

Episode Date: June 3, 2022

20,000 Viruses Under The Sea: Mapping The Ocean’s Viral Ecosystem The ocean is the largest region of the planet and remains a source of newly discovered species. But what do you do with a treasure trove of new viruses? A research team wrote in Science last month about finding thousands of new RNA viruses, and five new taxonomic phyla, in water samples from around the globe. The new species more than doubles the known number of RNA viruses on the planet, painting a clearer picture of the vast abundance and diversity of viruses in ocean ecosystems. Though they may be small, research on DNA viruses in the ocean has previously suggested tiny viruses may have a role in something as large as the global carbon cycle. Producer Christie Taylor interviews microbiologist and study co-author Ahmed Zayed about the importance of the ocean virome.   How Recreational Weed Transformed A Small California Town From the outside, Jose Rivas’s gray, one-story office building seems just as unassuming as Woodlake, the small Tulare County City where it’s located. But once you’ve been escorted inside the wrought iron gate and checked in at the security desk, you’ll see a chemistry lab of so many potheads’ dreams: bubbling evaporators, storage tanks of liquid nitrogen, and trays and trays of drying marijuana buds. But Rivas isn’t a pothead – he’s the CEO of a cannabis company known as Premium Extracts that squeezes, distills and steams everything it can from the flower. “Essentially what we’ve developed here is a methodology to isolate the components and molecules of the cannabis plant, which are responsible for its taste, its flavor, and all the nuanced aroma that comes from each individual cannabis strain,” Rivas said.   Read more at sciencefriday.com.   Meet The Doctor Trying To Bring Medical Marijuana Into The Mainstream An increasing number of states in the U.S. are legalizing medical cannabis, which means millions of people have access to medical marijuana cards. These can be used to buy cannabis to manage pain, treat mental health conditions, and help sleep issues. But a majority of U.S. medical schools offer no education about medical marijuana and its effects on the body. As a result, many physicians and medical professionals do not feel knowledgeable enough about cannabis to make recommendations to patients about what their options are: With so many methods of taking marijuana, and an endless combination of dosages and strains, many patients and doctors feel at a loss. Dr. Mikhail Kogan is trying to change that. As the medical director for the George Washington University Center for Integrative Medicine in Washington, D.C., Dr. Kogan is one of the foremost experts on using medical cannabis to treat a variety of conditions. A majority of his patients are geriatric and suffer from conditions as wide-ranging as cancer and Alzheimer’s. Dr. Kogan traces his experience using marijuana as an alternative medicine in his book, Medical Marijuana: Dr. Kogan’s Evidence-Based Guide to the Health Benefits of Cannabis and CBD. Ira chats with Dr. Kogan about why marijuana is successful as a treatment for so many medical conditions, and how interested patients should approach their physicians if they feel it could be right for them.   The World According to Sound: Listening to WiFi When you walk down a city street, you may not know it, but you’re being bombarded with WiFi data streaming from people’s home routers, phones, and businesses. Frank Swain and Daniel Jones recorded the WiFi signals while walking down a few streets in London. They used smartphones to capture the data and turn it into sounds. It’s like a geiger counter, but for WiFi instead of radiation. Faster clicks mean higher wifi signal strength, robotic beeps are the router ID numbers. They call this project “Phantom Terrains.” They want us to consider how much of our urban world is saturated by invisible streams of data.   Transcripts for each segment will be available the week after the show airs on sciencefriday.com.     Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

This is Science Friday. I'm Iroflato. Later in the hour, we'll talk about a small town with a big cannabis business and take a closer look at medical marijuana. But first, you know the oceans contain many mysteries, right? And every month, it seems, explorers find a new sea creature or two lurking in the deep. And in fact, earlier this year came word of an incredible treasure trove of new species. I mean, more than 5,000. It came with a surprise. They weren't octopuses or angel fish or anemones.

Instead, these researchers have found viruses, and not just any viruses. R&A viruses, that's the same type that our friend SARS-CoV-2 falls into. Here with more about the significance of this viral mother load is Cy-Fri's Christy Taylor. Hi there, Christy. Hey, Ira. You know, I was a bit shocked to hear how many RNA viruses they found. Should we be surprised that there are so many viruses in the day? Deep blue sea?

You know, step one, Ira, I would say don't panic. We've known about viruses in the ocean for a pretty long time. DNA viruses, that's the other major type, have been studied for decades. But the RNA viruses in the ocean are new and exciting because they've been so hard to pin down. The new research is the result of many, many water samples and some advanced machine learning tools to sort out all the RNA sequences these researchers found. Fair enough, but what are all these viruses doing down there? Why get so excited about viruses?

That's a really great question, Ira, especially given how much our lives have really been changed by just one virus in the last three years. I talked to Dr. Ahmed Zayed about this. He's a microbiologist and research scientist at Ohio State University. And what excites him about all these viruses is something that has nothing to do with us. But rather, the way viruses may be affecting the ecosystems when they infect plants and animals in the ocean. It may even connect to climate change at the end of the day. Here he is explaining that. So we know about DNA viruses that they can manipulate their host and can change the element cycling.

So the rates of element cycling in the ocean, one of these elements is carbon, which is really important because of how essential the ocean is for regulating the climate and for basically second carbon dioxide from the atmosphere. So that's for DNA viruses. The RNA virus discovery was lagging. for multiple reasons. One of them is that the tools were not there actually to see RNA viruses with enough confidence. And also because of the nature of these viruses. So these viruses are made of RNA, which is less stable in the environment than DNA. So DNA viruses and their particles, they can stay for longer than RNA viruses.

So that is kind of like why also it was hard to see RNA viruses in natural samples as compared to DNA viruses. And we had an amazing opportunity to explore these viruses in the ocean because we had this amazing data set that was collected by the Tara Oceans experts. We had samples from the surface down to 1,000 meters deep covering large geographic range. And it holds the answers for a lot of interesting questions. So you took this data set, which involves sampling seawater from dozens of locations all over the planet, deep water, shallow water, stretching from the data. north to the South Pole and you found lots and lots and lots of RNA viruses. Tell me about the

abundance of what you found. So we started first by looking at all of the RNA that is coming from the plankton in our samples. So we had different eukaryotic groups and also we had bacteria. And we looked across all of these. And we basically tried to distinguish between the RNA that belongs to the host and the RNA, which is, belongs to the virus, which is representing the viral genome. And we ended up having around 5,500 of these species rank clusters for RNA viruses. That's an incredible amount of viruses to find. That sounds like it. I mean, to put things into perspective, we know that there are around 3.5,000 virus species that are deposited in public databases. So that was an incredible number to see. Are you talking about 3,500 ocean viruses in public databases?

All RNA viruses. Okay. So you found more than double the known number of RNA viruses. Yeah, relative to what is deposited in public databases. Yeah. Okay. So that was an incredible number to see. And we started to explore the diversity of these, species, rain clusters at different taxonomic levels. And our viruses were not just so many, but they were really diverse. So they extend that we proposed five new phyla on top of the five that were already known. A phyla is a whole taxonomic category of organisms. For people who maybe don't understand how different that is,

how does that compare to things like we found another variant of COVID-19, for example? I would say if we would look at the phylao within the kingdom of animalia, they can be as different as arthropods from humans. So, and arthropods include ants, for example. Yeah, exactly, yeah. Well, then, you know, just looking at where you found these species, like, are there some parts of the ocean that seemed to have more virus than other parts of the ocean? So we actually looked at the abundance of these viruses across all of our samples. Not necessarily how abundant viruses in one ocean basin versus the other, but rather at how abundant different viral groups,

so these virus phyla across ocean basins. And to our surprise, we found that two of the novel phyla that we have suggested in our study to hold the most abundant viruses on average across the global ocean. So one phylum, which we called Tara Vericuda, was on average the most abundant across the temperate and tropical waters. And the other phylum that we also proposed Arctic Vricota, the viruses of this phylum were also on average the most abundant across the Atlantic Arctic part of the ocean.

that was also surprising because there have been studies for RNA viruses in the ocean before they were focusing on specific oceanic regions or just focus on specific ocean organisms. All of these previous studies never have seen the viruses that we found in our study before. So it was shocking for us to find such abundant viruses flying under the radar for so long. And what I think I'm hearing you say is that the most abundant viruses are ones we've never actually seen before. Yes, that's correct. That's incredible.

One question I feel like this very much begs. People are going to hear new viruses found in the ocean and maybe panic a little bit because we think about COVID-19 as a new virus that emerged from an animal host. These are not viruses that we need to worry about. Is that correct? Most probably, yeah, because the gap is really big between things that are, the set of hosts that we explore in the ocean and humans and primates. But also some of these viruses infect multicellular organisms,

and some of them infect fish larvae. And so infect fish and infect larvae. So there are multicellular organisms that can be infected by these viruses as well. And they can have several levels of ecological impacts. It's not just about cycling elements and changing the rate of the biological carbon bomb, for example. Well, yeah, and you keep mentioning, you've mentioned carbon a couple, times now. And I did want to get back to this idea that viruses are part of ecosystems. They're, you know, very numerous. They may be very small, but they are in all of these cells in these

ecosystems in the ocean. Can you talk a little bit more about what we know about the ways these viruses may be shaping their ecosystems? So our knowledge is mainly based on DNA viruses. We, we know about DNA viruses that they can influence their host in several ways and that can really impact the carbon cycling in the ocean. We know that some viruses can carry genes that we call auxiliary metabolic genes. They are similar to the metabolic genes that the host carry, and they can change the rates of this process. So you can imagine that they can slow down or speed up carbon transformation once it takes over the host metabolism. So that's one way. Other viruses can just infect the host and lice the cells, so it releases its content. So all of that carbon that was

fixed inside the cell is now available for other microbes that can respire. So it gets released back to the atmosphere as carbon dioxide. Other viruses, more interestingly, were found to blow up the cells and form a sticky material that actually makes bigger aggregates. So all of these blown up cells get stick together and these bigger aggregate and heavier aggregate sink to the ocean. So it's actually helping the carbon to get exported to the deep ocean. This is really important to a process as a process because ocean plankton are responsible for exporting around 25% of the carbon dioxide that is emitted by humans. So you can imagine the central role of viruses, potential central role of viruses for gluing these cells together and

making the export of these aggregate to the ocean and easier. So what I think I'm hearing you say is that depending on the virus, it could make the carbon that is within the cell get to the bottom of the ocean faster as opposed to being released into the atmosphere. Yes, yes, that's correct. So in 2016, there have been a study in nature that specifically looked at the contribution of different planktons to the process or the association was exporting carbon. into the deep ocean. And to our surprise, we found that viruses were actually the best predictors of carbon export across the global ocean. What other questions does this research create for you? And is answering them going to require more boats full of seawater samples? So, yeah, so there are so many different questions. So we are also trying to understand what is the ecological footprint of these

RNA viruses. Through the lens of the hosts that they infect, but also by just looking at how the virus communities form, what are kind of the environmental parameters that dictate the assemblage of these different viral communities, there are so many things that are still unanswered. And we might be able to answer some of these questions using the data sets that we have created and now made public to the entire scientific community. And some other questions would require us to collect more samples or sequencing, sequence them differently, or develop new tools to try to answer some of these new questions. Well, good luck with that. And thank you again so much for joining me on the show. Thank you so much, Christy, for having me.

Dr. Ahmed Zayed is a microbiologist and research scientist at the Ohio State University. He joined me from Columbus, Ohio. So there's a lot more the viruses than disease, it turns out. Thank you so much, Christy. Thank you, Ira. Syphrates Christy Taylor. We have to take a break, and when we come back, we'll take a look at two sides of the legal cannabis coin,

recreational weed and medical marijuana. Stay with us. This is Science Friday. I'm Ira Flato. And now it's time to check in on the state of science. This is KERNNO. St. Louis Public Radio News. Local science stories of national significance.

The town of Woodlake, California is a small city in the San Joaquin Valley. It's got 7,500 people, one fast food chain, and no stoplights. What it does have is seven cannabis businesses. That's right. The recreational marijuana industry has transformed Woodlake over the years, and the tax revenue that comes from it has funded public goods, especially parks. And as more and more states legalized recreational weed, Woodlake could be an example of the massive change the industry can bring to small towns.

Joining me to talk about this story is Carrie Klein, reporter for Valley Public Radio in Fresno, California. Welcome back to Science Friday. Thanks, Ira. You know, I always like to talk about following the money, no matter what this story. So give us a bit of a history lesson. When did Woodlake's cannabis industry start ramping up? Well, this all got sparked in 2016 when California voters approved of Prop 64. That legalized recreational cannabis for adults.

And it was pretty clear this would be a very highly regulated industry. And so Woodlake city officials immediately recognize that with regulations could also come the opportunity for revenue. So in 2017, a year after Prop 64 was passed, the city council put a measure on their ballot to levy taxes on these businesses, and then that ushered in ordinances and other regulations for how to actually allow these businesses to operate in the town. And then the first businesses started opening in 2018. I get it. And what makes Woodlake such a good place for the recreational marijuana industry? I mean, I think the first thing really was these tax measures. I mean, obviously some companies in industries would be really scared off by heavy taxes, but they signaled in this era, you know, a way for

the industry to operate legally for the first time. And so the city was able to attract, you know, not just dispensaries, but also cultivators, manufacturers, distributors, lots of folks on this cannabis supply chain. And so Woodlake became an oasis, kind of a beacon almost, in this huge region of about 10,000 square miles that at that time were served by no other legal dispensaries, at least for recreational cannabis. And so, of course, with all this, however, safety was also a major concern. And so the city did limit the dispensaries to only operating two at a time. And then to learn about the other safety measures, I spoke with Jason Waters. He's the city's community development director.

Background checks on people who work there, security cameras that we can access here at City Hall. So City Hall, Police Department, we can log into a website and look at the cameras that facility. You know, they keep logs of who goes in and out of there. Two permits from us, permits from the state. So there are a number of things that they have to do that. Most businesses would never have to do. So how does Woodlake capture tax revenue from cannabis businesses? Is it from charging the buyers, the people who come in a tax and then that gets passed through? Yes, that's the largest share, retail sales tax from dispensaries. That's 5% that goes to the city on every retail sale. There's also a property tax and a cultivation tax. And so in the four years, these businesses have

been in operation in Woodlake, the city has brought in more than $2 million in tax revenue, which is pretty big for a city, as you said, of just $7,500. Wow. Now, I said at the top that the tax revenue goes to parks. Is that what's happening there? Yes, the vast majority of it does, about two-thirds have gone to parks so far around the city, rehabilitating parks or bringing in new facilities, landscaping, things like that, bathrooms. There's a good chunk of that money that's gone toward fixing sidewalks and roads around the city, and then also a small amount on public safety. Some of that money also goes back into safety measures at these businesses and things like conducting inspections at the facilities.

Now, I would imagine when a town goes into the cannabis business, there's going to be some pushback from some of the residents. Did that happen there? Yeah, there were definitely some people who spoke out in public meetings prior to the passage of these sales or of these tax measures. But the tax measure did pass, but it barely squeaked by with the two-thirds vote it needed. So one-third of the town did still oppose it. And a few years into it, it is still easy to find residents who are uncomfortable with the industry. And some of those folks, it's just on principle.

But others feel that they're being inundated by out-of-towners. I mean, even high schoolers that we've spoken to, I've told us they used to recognize most cars in town. But now there's just a lot of unfamiliar, you know, foot traffic and cars. especially near the dispensaries. But those out-of-towners are really grateful for this, too. And here's an example, a customer I spoke to in the dispensary. His name is Jared Rossin. He injured his back in the Air Force.

And he even had trouble accessing medicinal marijuana for his back pain. Unfortunately, you know, the hospitals just kind of want to give you all the pain meds. And it doesn't, it's not good. This is a much better route. And this dispensary is about 20 minutes away from where he lives, which is much closer than the other options that he had had before. Interesting. We're going to get into medicinal marijuana in our next segment following this, so that's a good segue. But could Woodlake be a model for other small towns

who want to take advantage of increased interest in recreational cannabis? Yeah, I think absolutely it could. And I think it has been. I mean, again, Jason Waters with the city, he's told me that folks have called him to talk about how they crafted their tax rules and ordinances. I haven't done a deep dive into this, but it appears as though there have been no major patterns of increased crime, which many folks were concerned about bringing in this industry. And of course, other local businesses like cafes, restaurants, gas stations, they all get to benefit from this increased traffic around town. Terrific, Carrie, thank you for taking time to be with us today.

Yeah, thanks so much. It was a pleasure. Kerry Klein, reporter for Valley Public Radio in Fresno, California. And if you'd like to read Kerry's full story, you can head to our website, Science Friday. com slash state of science. And now for the rest of the hour, we're going to talk about the other side of the legal cannabis coin, medical marijuana. As you know, more states in the U.S. are legalizing medical and recreational cannabis. And that means that millions of people have medical marijuana cards, which can be used to buy cannabis to manage pain, treat mental conditions, and help

you sleep. There's a lot that cannabis can do. Yet many physicians and medical professionals do not feel knowledgeable enough to make recommendations to patients about what kinds of cannabis to use or just how much to take. That's because the majority of U.S. medical schools offer no education about medical marijuana and its effects on the body. Our next guest is trying to change that. As a doctor, he hopes to educate other medical practitioners about how medical marijuana can be an effective treatment for a wide variety of conditions. Dr. Mikhail Kogan is medical director of the George Washington Center for Integrative Medicine in Washington, D.C. He's the author of the book Medical Marijuana, Dr. Kogan's Evidence-Based Guide to the Health Benefits of Cannabis and CBD.

Welcome to Science Friday. Thank you. So great to be here. Nice to have you. In your book, you discussed treating your patients with medical marijuana in many different circumstances. What are the typical medical conditions where you recommend medical marijuana. Well, Ira, you already mentioned probably the most common one, and that's a pain, of course, or all kinds of different pain syndromes, particularly chronic pain syndrome. But I use it at this point probably for over a dozen conditions. Definitely sleep, chronic insomnia. In fact, in my practice, it's becoming probably first choice to use medical cannabis. It's just simply that effective with much less side effects compared to standard medications such as Ambien.

And also the other methods that treat chronic insomnia is just more complicated and more expensive. Definitely we're using it a lot in cancer patients and not just for pain, but for nausea, for vomiting, for sleep as well as anxiety, and just kind of a, when patients go through chemotherapy, generally speaking, they develop a lot of different symptoms. we have to treat those symptoms with different medications. You would have a cocktail of two, three, four, or even more medications. And cannabis often hits multiple targets at the same time. And frankly, the bigger issues, it's just often patients prefer it over other methods.

And since my practice is primarily more than 50% patients over 65, for older adults, cannabis is often a lot safer than other medication choices. So I've often, maybe not as a first line, but would start using cannabis for even conditions like Alzheimer's disease when patients get quite agitated. We know that if we try to use standard approaches like medications, they're pretty risky. But the cannabis seems to have some evidence for the efficacy. So we're probably going to have cannabis in the future shown to be effective for a large percent of all ailments that afflicts. us. And the reason for that is that we have our own and the cannabinoid system. So literally, we make our own pot. Our system constantly produce molecules that are similar to what we take

from weed. And so we can learn, you know, we don't have enough current scientific data, but I'm pretty sure in the future we'll learn what are the ways for us to augment deficiencies of our own and the cannabinoid system with an exogenous cannabinoids. So we have receptors in our brain. Exactly. And not just brains. We have receptors in almost every cell in our body. Actually, quiz, my favorite quiz. You ready for it?

I'm ready. Which part of the body does not have cannabinoid receptors, and why is it so important? Which part does not have cannabino. I'll say my toe. Actually, no, no, no. your toes actually have tons of receptors, right? Because the skin and muscles are actually pretty rich in receptors. No, it's actually a brainstem. And it's kind of shocking. It's not really clear evolutionary why. But brainstem is what controls our breathing. Brainstem is very heavy in opioid

receptors, but why there's no cannabinoid receptors. And that's why you really can't cause death by cannabis. You can't overdose cannabis to the point of stopping breathing. I mean, you can get so stoned and stupidly drive car into the tree, but you can't directly die from respiratory suppression by cannabis. And again, it's actually a little bit of mystery, but it tells you the story that basically our entire system is wired in the way that cannabinoid system basically and the cannabinoid system regulates almost, you know, most of our processes one way or another. And it seems to be evolutionary a lot older than endogenous opioid system. It's also a very interesting fact that often people don't know.

You know, I think that most people think of cannabis as just being weed. I'm smoking it. I'm, you know, I'm eating it just to get high. But you say medical marijuana, there's no other drug that can treat as such a wide range of medical conditions. it's a very complex drug. How many different forms or different, I don't know, the right way to call it, different varieties of cannabis is there? Right. Well, so you actually used perfect word.

So we used to use words strains. We used to use words like different species. This was all seemingly botanically incorrect. Variety is really the right term. seems to be over 20,000 by now that we know that we cataloged and probably going to have more. And, you know, they're all one species. We used to think there's sativa, there's indica, there's rudialis, the sort of most up-to-date information seems to point that it's just the cannabis setiva's one plant.

And the other categories are more just a broad varieties, but within then each one of those there are just so many thousands of different sub-varities, if you will, or just varieties. And I think that's partially explains why we have an explosion of commercial interest and growth, interest in agricultural processes and growth, because there's so many different ways it can be grown. There's so many different extractions methods now. It just seems like we're at this entry point into this field, which probably will end up at some point be called end the cannibinoid or just cannabinoid medicine.

There's a whole section of the medicine because as we learn more and as we understand more science clinically, we're probably going to realize complexity of it is such that one particular physician, if they want to, they'll have to specialize in it, literally. This is Science Friday from WNYC Studios. Yeah, and there are so many different ways it can be ingested. Right. Yeah. Right. It can be cream. It could be smoked. It can be eaten. It can be tinketure. Is there a danger if people smoke cannabis to their lungs? I like you'd be smoking cigarettes or tobacco. Right. So, great question. So it looks like that cannabis does not cause increases in lung cancer, which is a good news for those who prefer inhaled direct.

of intake. But it does cause a significant amount of lung problems. Mostly, they are relatively benign, so chronic cough bronchitis, but there has been some speculation that it could increase risk of chronic pulmonary lung disease. It's not actually very clear. But frankly, think of it this way. If you have multiple different ways of taking it in, and if there's even a slight risk of particular route causing side effects, why would you want to do it? Right. You know, if you look back historically 2030, whatever years ago, there was no topicals. And of course, nobody even thought of something like applying it rectally or vaginally.

So now we have methods that are not only safer in many ways, but they are more precise. So let me give an example. It's my favorite mantra with cannabis. Start low, go slow, deliver it where it needs to go and stop when you get there. So point being is you start at the lowest dose because you just don't want to overdose. You overdose and an experience is not pleasant. Side effects are actually pretty common. We can talk about that some more.

But especially in my population of patients and older adults, if they overdose with the first intake, it could be quite unpleasant. actually could be risky. If you dizzy, for example, and your chances are falling as high, you can break a hip and it can be disasters. So you have to start very slow. When you're gradually titrating up, there's a couple of things that happen. First of all, what we know for sure is that with most of the cannabinoids, there's something that's called a J-curve of efficacy. In the beginning, when you just start taking it, low doses don't usually work perceivably. They're doing something, but you're not going to feel your pain getting better, for example. But as you increase the dose, you're going to get to a certain point of a much better efficacy.

But if you keep taking more and more, eventually that efficacy will go away. So we call that a J-curve. You have this kind of the best your personal dose. Now, the problem here is that, and this is part of the clinical challenge with working with cannabis, that J-curf is very interviewed. So for some person, the best dose would be, say, 5 milligrams of THC at bedtime for sleep. And for somebody, it could be 20. And how do you know where your personal dose is?

Well, we don't know that yet. I mean, there may be genetics that involved at some point. We'll learn that. But in reality, it's a trial and error almost always. So you have to start low, go slow. Then, you know, you really want to try to put the cannabis where you have a problem. We have to take a break. and when we come back, more with Dr. Mikhail Kogan on the science behind medical marijuana.

Stay with us. This is Science Friday. I am I. Roflato. We're continuing our conversation about the medical uses of cannabis, marijuana, to treat patients. My guest, Dr. Mikhail Kogan, medical director of the George Washington Center for Integrative Medicine in Washington, D.C. He's the author of the book Medical Marijuana, Dr. Kogan's evidence-based guide, to the health benefits of cannabis and CBD. You mentioned that you work with elderly and frail people,

and you mentioned that it's safer, often more safe than prescription medications. What about on the other end of the curve? What about younger people? Is there any danger? You talk in the book about problems with young people and they're changing brains as they're growing up. What is the danger there? And do we know enough about it? Yeah, we do. We know significant amount of data. Thank God for some of the existing infrastructure

in science. We actually have been studying side effects and toxicity of cannabis for very thoroughly for a long time. So if I were to name sort of two or three major problems that cannabis users can run into it, I would definitely say that the young crowds, teenagers, even young adults, 20 up to probably 25. Very heavy use of continuous THC daily definitely is associated with a negative impact on brain. I don't think there's any doubt about it. And what's interesting that it's CBD seems to ameliorate most of the dangers, although I would say the science is inconclusive as to is that absolutely true. And what is the dose of CBD to remove those dangers? It's not very clear. But definitely I would advise the young listeners, you know, be careful, stay with balanced strains

if you have to use it, then best not to use it at all if you can't avoid it. The issue is what do you do with patients who are young and for whom it's effective for certain issues? I think it's a pretty complicated topic. I think the other side effect that always gets brought up is the psychosis or risk of schizophrenia. It's interesting that at low doses, THC can actually, or cannabis can actually, treat certain psychotic states and even be sort of beneficial in schizophrenia, but it also increases risk of early onset schizophrenia, although we think it's because it simply moves the

timeline forward, so if somebody would have developed schizophrenia anyway, but if they start using weed, then they're going to develop schizophrenia earlier or faster. You're using terms like think we're not sure. To me, how do we get to be more sure? about these things. And don't we need to as physicians to understand it more completely? Of course we do. And I hope some of the politicians are going to listen to this presentation. Well, the problem is it's still a schedule on control substance. So we really can't, on the federal level, research it easily. And there's a lot of physicians, a lot of researchers within academia who really want to study it. And unfortunately, it's very difficult because when it's a

Schedule 1 control substance, you only have access to a federated product. So the federal government has authorized growers, and those are the only ones you can use. The problem is that until very recently, their products had nothing to do with what's sold in dispensary. So I could study something that's 30, 40 years outdated, and then it's going to have zero clinical applications to what patients are actually buying from dispensaries nowadays. So we were very still very slow. Now, things are getting a little bit better. It was recently just the approval of expanding this program where more growers can apply, get licenses and start making products that are closer matching what's in dispensaries. But, you know, it's not going to be a fast shift. We're still going to,

we're still years behind. And unfortunately, it's a whole history here. We got set back in science of cannabis by so many decades, and it's unfortunate. I think back in 1937, American Medical Association was the only organization that stood up and said to the government, we should keep cannabis medical and we should not tax it heavily and we should allow patients to use it. But, you know, of course, most listeners know what happened. Nobody listened. And of course, now American Medical Association is against use of cannabis. I think it's kind of ironic. But do you think that there are a lot of doctors. Do you find among physicians, some are willing to suggest medical cannabis to patients, but they don't know enough about it? Well, that's absolutely true. And I actually find also

that a lot of doctors are not willing to suggest, and they're really afraid. There's even misconceptions among doctors who are afraid that if I'm going to recommend cannabis, that my license can be taken away, which, by the way, legally completely wrong. Nobody can take your license away if you're just recommending cannabis for appropriate indication. But there's a massive lock of education, and thanks for Ira for mentioning that we're trying to change that. We recently got a grant, and we're going to set up a process called Delphi Process

in which we will identify the competencies in medical education for medical cannabis. Medical education moves, it's a conservative field, move slowly. So in order for something to be uniformly adopted in every medical, school, we have to have a set of standards. And there are no set of standards for cannabis education. And that has to change first before we can go back to Association of American Medical Colleges and say, look, you have to really push that every medical student graduating from U.S. medical school has some basic knowledge. And that will gradually start the shift. Part of the problem right now, in a lot of academic institutions, there are simply no mentors.

The cannabis doctors who decided, look, we're going to be enthusiasts about this field. We're going to learn many of them on their own. And part of it is, you know, they've been afraid being in large academic centers because leadership often has been against this topic. And it's been difficult to move this field forward within large academic centers. But it's shifting. It's definitely shifting. I gave grand rounds at George Washington University on this topic every year or so.

And every year I ask the same question. So how many of you here today are recommending cannabis? And every time we get more hands. So it's definitely things are moving forward. They're slowly shifting. Because I feel from my experience that it's the bud tenders, the people who work in medical marijuana dispensaries, who seem to be at the forefront of advising people who come back time and time again

because these folks have been given good advice on cannabis. formulations that work, but it's these blood tenders who seem to be the practitioners here. Yeah, and, you know, it could be a blessing, it could be a curse. Not all of them are highly educated. The standards of what they're supposed to know is quite different. Some states require every dispensary to have medical director, and it's kind of going more that way, or just a medical personnel, doesn't have to be a physician, could be a nurse, somebody or a pharmacist. But some states don't have that and a quality of but tenders is kind of all over the place, unfortunately. We actually talk a little bit about this in the book. We also tried to discuss how do you deal

with this or even bigger issue. How do you deal with when your doctor says, oh, forget us. This is toxic for you. You shouldn't be using it. Well, how do you engage this doctor in a productive conversation? Well, how do you? Well, I mean, you show them the evidence. You can, the part of the way we wrote the book was that not just for the public, but because I've been as an educator in this for quite some time, and I see those pitfalls. And one of the best ways to convert the skeptic is just to show them the data and not walk away. It's just continuously engaged the person and saying, look, how about if you consider for this condition, okay, so for pain, for example, let's try it.

I'll give you a concrete example. In my own institution, in anesthesia department, chronic pain center, there was a lot of resistance. for a long time. And finally, after I treated some of their patients and they did really well, they finally said, okay, fine, come give us a talk. And now doors is open. So it's basically, education tends to trump the ignorance and misconceptions and the fear. I think there's still a ton of fear about this, not just fear of legality and then prosecutions for possession and use, but also So fear is that it's highly addictive, which, by the way, is total misconception. It's not totally not addictive, but it's minimally addictive, definitely way less addictive than

alcohol, for example. And there are many others. I mean, there are misconceptions that you have to smoke it, which is totally in 2022. I hope that in the future we're going to have less and less inhaled products. But there's an old saying that marijuana is a gateway drug. You know what I'm talking about, right? to more dangerous substance, but you're right in the book that cannabis could actually be in exit drug. Tell us about that. Yeah, yeah. So we actually have a large number of studies

pointing towards the fact that it seems to be an exit drug, at least an exit drug from two main categories of medications. One is the opioids and the other one is hypnotics or sleeping AIDS. The opioid exit strategy seems to be evidence at the pretty high level. We're talking about high-quality studies published in leading medical journals in the last couple of years. For sleep exit, it's a little less clear. We have more of a data collected from states that legalized medical cannabis. And in those states, the use of over-the-counter and prescription drugs drops by the degree of millions per day. So in each state. So we're, we're going to be. So, we're We're talking about massive decline.

And in terms of the opioid exit strategy, it seems like we're going to save upwards of 30 or 40% of all deaths from opioids if you institute cannabis in a particular area. That's incredible. It's incredible. And I personally find it a little baffling. Why is there no more talk about this on the high level of politics? Because people, you know, we're in the middle of opioid crisis and there are all kinds of interventions that have been trying. tried, and yet nobody at the level of politics talks about cannabis as one of the major strategy, which I just give you the numbers.

These numbers are not random numbers. This is a serious research done for multiple different institutions in multiple different states, and it's repeating itself over and over again. And it's a little unclear why this is happening. I don't want to speculate, and I hope it changes. Well, if there's so much money involved in the drug industry, and especially in sleep medications, right? And a lot of lobbying goes on and politicians are lobbied not to do things.

You know what I'm talking about. You said it. You said it. But it's true, right? You know, I don't want to sound that there's a conspiracy theory. I don't think there's any, but I think you're completely right. You know, I have a favorite expression to most of my patients. You're going to a butcher.

You're not going to buy a salad. it. So, you know, we're operating in this medical industrial complex, something threatening a massive infrastructure of income. Of course, it's going to delay the progress. So is it a good thing then that industry is getting more involved with cannabis because that may take, you know, some of the direction or move it in that direction? Or is it a bad thing? I have to give you a legal answer, maybe. It's both, of course. I mean, I think the benefit is that when industry gets involved into anything, it expedites the process of expansion here. But, of course, they're going to also try to make money out of this.

And there's a lot of talking about the other side, there are a lot of hype and wrong claims about cannabis. It's kind of wild, wild west out there. Well, especially the newer products like Delta H, TH, TH, for example, which is completely not research. There's basically no clinical evidence that Delta A does anything. at all. And yet, you can buy it online and ship it to your house and there are claims out there that it does exactly everything the THC does. You know, we're often industry tends to push the envelope way ahead of evidence. Is it good? Sometimes it actually may be reasonably good because it does enforce researchers to move faster. Yeah. But often it's just plantly, you know, making money out of

nothing out of thin air and making wrong claims altogether and causing problems in the process. This is Science Friday from WNYC Studios. One last question for you. Sure. There's speculation that cannabis may help COVID long haulers. What do we know about that? Is there any truth to that, any evidence-based data? Yeah, well, there's definitely truth to that. Data, no, data is probably just it's going to take a bit longer for data to come out. But long haulers have a lot of symptoms that we already talk about. They have a lot of sleep disturbances. They have a lot of symptoms around pain, whether it's neuropathic pain or other types of pain.

They have a lot of anxieties and a lot of instability of their nervous system. So they're, you know, triggered quite easily with a very minor triggers. And cannabis has role to play in everything I just mentioned. So it's basically as a help for symptoms, there is no doubt in my mind. And we've been already at our clinic, we started Longholler's subsection and partnering with George Washington University. And we're seeing a lot of patients benefit from cannabis because often there are really number of tools that the patients can use effectively is pretty limited.

and the symptoms can linger for a long time. Very interesting. Thank you for the work that you do and for taking time to be with us today. Thank you so much. It's pleasure. Dr. McIle Cogan, medical director of the George Washington Center for Integrative Medicine in Washington, D.C., author of the book Medical Marijuana, Dr. Cogan's Evidence-Based Guide to the Health Benefits of Cannabis and CBD. And before we go, here's a little sonic treat for you from our friend's Chris Hoff and Sam Harnett at The World According to Sound. These crackles and beeps are Wi-Fi networks.

They're coming from people's homes and businesses. Frank Swain and Daniel Jones recorded the Wi-Fi signals while walking down a few streets in London. They used smartphone-enabled hearing aids to capture the data, which they then turned into sound. Think of it like a Geiger counter, but measuring Wi-Fi instead of radiation. Faster clicks mean higher Wi-Fi's sense.

signal strength. And these robotic beeps are the router ID numbers. The guys who made this project call it phantom terrains. They want us to consider how much of our urban world is saturated by invisible streams of data. That soundscape is from The World According to Sound, a live audio show, online listening series, and miniature podcast created by Chris Huff and Sam Harnett. You can hear more at the world according to sound.org. And that's about it for this week. If you missed any part of the program or you would like to hear it again, subscribe to our podcasts or ask your smart speaker to play Science Friday. And of course, you can say hi to us all week on social media, Facebook, Twitter, Instagram, or you can

email us the old classic way, SciFri at Science Friday.com. Please send us feedback and tell us what you'd like us to cover. We'd like to hear from you. Have a great weekend. We'll see you next week. I'm Ira Flato.