The Joe Rogan Experience - #1246 - Pot Debate - Alex Berenson & Dr. Michael Hart

Episode Date: February 13, 2019

Alex Berenson is a former reporter for The New York Times and the author of several thriller novels and a book on corporate financial filings. His new book "Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence" is available now via Amazon. Dr. Michael Hart is the founder and medical director of Readytogo clinic, a medical cannabis clinic in London, Ontario, Canada.

two one and we're live ladies and gentlemen uh or gentlemen you two ladies and gentlemen listening but you two uh unless you have some non-binary handle that you enjoy it's it's a new world uh please please introduce yourself sure Sure. So I'm Dr. Mike Hart, originally from St. John's, Newfoundland. Now I'm residing in London, Ontario, and I'm a family doctor. And I've been practicing cannabis medicine for just over five years. And you, sir? My name's Alex Berenson. I used to be a New York Times reporter.

Then I became a spy novelist. And most recently, I wrote the book Tell Your Children, truth about marijuana mental illness and violence which came out last month and uh has not endeared me to the cannabis advocacy community i'd say have they uh attacked you mercilessly for this book yes they have and that's and that's okay um uh i've also heard from a lot of parents you know some users but parents who've told me uh that the book really encaps encapsulates their family's problems in the last couple of years. I suspect my real thoughts here, before we even get started, is that we're going to find that the truth is somewhere in the middle here. I don't think marijuana is 100% safe, honestly, for everybody. I really don't I know too many people that have had experiences where they took too much

particularly edibles and I don't I want to say I know anybody who had psychotic breaks but I know some people that freaked out for weeks you know in fact we just had a comedian here from Brazil a brazil um a couple days ago rafi bastos who said he took a couple of hits of a vape pen he was high for 14 days went to a psychiatrist and and he's a big guy he's like six foot five six six you know and you know they told him to keep taking it because you know he's like you're so big just keep smoking and so he doesn't smoke so he just kept hitting his vape pen he said i was high for fucking two weeks yeah so you need to do it properly right it needs to be held to the same standard as any other medicine so we need to

identify that there's risks and there's benefits to it yes and and some people are definitely you know going to be more susceptible to those risks yeah and we need to kind of you know tease out those people and make sure that those people don't put themselves at risk. Yeah, I think so as well. And this is one of the reasons why I want to state this because I'm a well-known marijuana advocate. But I believe absolutely there are great benefits to it.

I think there's great benefits in terms of relieving pressure, ocular pressure for people that have glaucoma, people with AIDS who are on medication, people with cancer that are going through chemotherapy find great benefit in terms of helping them. And then there's also some people with autism. I know people that their children have autism and they give them small amounts of edible marijuana and stop seizures. It's incredibly beneficial in the form of cbd for a lot of different ailments but i think with all things and this is a stance that i've kind of like really come to accept over the last few years with all things that affect the mind they affect everyone slightly differently absolutely yeah alex you want to say something no no well first of all

i i suspect you know there are people who said don't go on with Joe. He's just going to, you know, he's going to try to eat you alive. And especially, it'll be two on one. I told them the truth. First of all, I'll go on with anybody. And I'm glad you had me on or you're having me on because, you know, Bill Maher, he won't have me on. He's afraid to talk to me about this. Why? What did he say? Bill Maher, he won't have me on. He's afraid to talk to me about this. What did he say? Well, his people told the Simon & Schuster PR people, we just don't want to have him on. And NPR had a national NPR show, had an interview scheduled with me, an hour-long segment, and they canceled it.

They said, we don't believe in the conclusions of the book. Okay, you don't believe in the conclusions of the book? Have me on. Ask me anything. And that's why I'm so happy that you're not afraid to have me on, that we can have a conversation, that we can have a conversation. Come at me with any question you want about the science. I mean, I'll say right off the top, I don't think marijuana is medicine. It has a few medical uses that have been, you know, CBD has been shown to reduce seizures in kids. That's great.

THC has been shown to reduce the nausea associated with chemotherapy. That's nice. But for the most part, people use THC and cannabis as recreational intoxicants. They use them to get high the same way they use alcohol, the same way they use other drugs. And the sooner we accept that reality, the better off we'll all be. That this is a drug and it has risks and benefits. And the risks and benefits are different than alcohol. They're different than other drugs.

But I don't think if you look sort of on a population level basis, they're less than alcohol. I don't think you can even say that. I don't. I really strongly disagree with that. And I mean, you just have to look at the death rate, right? You know, more people die from alcohol than, you know, almost all drugs combined. But when we're looking about the lethal dose you cannot die from cannabis and just based upon that alone it makes it much much safer than alcohol how could you say that if that is the case so okay so that's a really good question uh the normal number that's used for u.s deaths from alcohol is about 90 000 now about 30 to 40 000 of those deaths are deaths from the physical

effects of alcohol, right? Essentially liver damage, either chronic liver damage, you get cirrhosis, you die. In some cases, you can drink so much that you kill yourself in a night. So, that's about 30,000 to 40,000 deaths. The other deaths are generally associated with alcohol, meaning somebody drank- Exactly. Violence, suicide, car accidents. And all those numbers are basically based on studies from the 90s and before where people looked at traffic accidents and there were a certain number of those accidents where people had a blood alcohol content of higher than 0.1.

They said, okay, that's an alcohol associated death. That's a fine way to count as far as I'm concerned. Nobody has ever done that count for cannabis. And I can tell you based on the talk screens that I've seen from Colorado where people had cannabis in their blood and committed suicide. People had cannabis in their, I should say THC in their blood and got into fatal confrontations with police officers. and got into fatal confrontations with police officers. If and when we do this number for cannabis, which we need to do as soon as possible, the number is going to be a lot higher than zero.

I suspect it will be in the 10,000 to 20,000 range. We won't know until we actually do it. Okay, but let's eliminate, let's go even over the alcohol. Let's eliminate all things like violence and let's eliminate suicide and let's assume those people would have committed violence and committed suicide without it you're still looking at a giant number of people who drink themselves to death thousands and thousands and thousands of people every year versus zero with marijuana and you're aware i'm sure that correlation does not equal causation and that especially in a place like colorado where you're dealing with cannabis something that stays in the system for many many weeks if you're testing with cannabis, something that stays in the system for many, many weeks.

If you're testing people and they test positive for marijuana and they wind up committing suicide or they wind up committing violence, they don't even necessarily have to have been under the influence of it. Well, as you know, when you test the blood, you can test both the active metabolite and the inactive metabolite of THC. So the test, when you do a blood test on somebody who's committed suicide, it's sophisticated enough to tease that out. tests the both the active metabolite and the inactive metabolite of thc so so the tests when you do a blood test on somebody who's you know who's committed suicide it's sophisticated enough to tease that out um so there's a lot of people who have the active metabolite in their blood

um i agree alcohol is a physically toxic substance cannabis is a neurotoxin for a lot of people but in addition to you know the death there's also also just morbidity that's associated with alcohol. I mean, it ruins people's lives. It ruins marriages. It leads to weight gain. It leads to a lot of metabolic disturbances. I think you could say that for some people with marijuana, too. I think you could say some people, especially weight gain, that some people smoke a lot of pot and they get lazy and they start eating Cheetos all day.

And you could also say that with some people, the wake Waken bakers that you know seem to be wasting their lives away and that's like the stereotypical negative con you know when you we talking about a negative description of a marijuana user it's the Waken baker right the person is high all the time you could absolutely say that could ruin relationships you could absolutely say that would ruin your job you could but again to you know we're using the term marijuana, and really we should be using THC or high THC when we're saying that. Okay.

Because people who use high CBD every day, as we know, or most people listening to this probably know, CBD is non-psychoactive. It does not get you high. Super beneficial. That can be extremely beneficial for a variety of different disorders that people have. So we really need to be careful about using cannabis versus using THC That can be extremely beneficial for a variety of different disorders that people have. So we really need to be careful about using cannabis versus using THC because it's really the THC that can do that. And to your point, you say THC can cause the munchies.

And of course, that's not good for someone who doesn't want to gain weight. And just so people know, the way that it does do that is when THC attaches to the CB1 receptor, you get an increase in a hormone called ghrelin and ghrelin can actually induce hunger. And that's why people get, get the munchies. But, you know, that is not necessarily a bad thing if you're someone who has cancer or if you're someone, you know, who, who's wasting away from, from, from a terrible illness. You know, so sometimes, you know. So sometimes having the munchies is definitely a good thing. And I know a lot of people have said to me, it's not available, so you should probably not talk about it as much, but there is another cannabinoid called THC-V. So there's over a hundred cannabinoids in cannabis. THC and CBD are only two of them.

Those are the main ones that people know about. So THC-V has been shown to actually reduce appetite. So if we can get that out there in the market, you know, like we have with CBD, then we can almost, you know, eliminate or potentially, you know, substantially reduce the problem that people have with THC by using it with THC-V. Dr. Hart, i have a question for you when people come into your practice did they do they want high cbd products or did they want to get intoxicated and no absolutely canada it's fully legal sure of course yeah so it's like if

they don't need to go to him to get intoxicated right so people so you're seeing a population that is genuinely interested in the health benefits absolutely because i mean if and i mean i'm glad that that uh that's legalized in canada because it does make my job a little bit easier because like basically everyone who's coming to me now i know that they want to use it medically because if they want to use it recreationally i mean they just go to the store right because it's kind of a pain to you know get in to see me come in and have the discussion all that type of stuff so you know the people who see me now um you know they get in to see me, come in and have the discussion, all that type of stuff. So, you know, the people who see me now, you know, they're all using it medically. And then, you know, to answer your question though, Alex, almost all my patients, as soon

as they come in, they say, I don't want to get high. I don't want to get high. Like that's almost what everyone says. So, you know, I think the word is out there that, you know, CBD is non-psychoactive and it doesn't get you high. And I think that a lot of people are really interested in that compound. And if the people didn't have the success that they've had over the past few years, it wouldn't be as popular as it is. So I think that we do need to look at the scientific evidence, but we do need to listen to others. And the anecdotal

evidence is something that we should consider because it is so strong. Alex, let me ask you this. Why don't you consider it medicine when it has proven medical benefits? Well, it obviously can be medicine for these narrow things that the FDA has approved it for. But as you know, I'm sure, when people talk about it as medicine, when the ballot initiatives that have gotten it approved as medicine have really essentially deceived voters about the process. Right? So you go to a pot doctor. You get an authorization. That authorization essentially enables you to buy as much cannabis as you want for the next year.

Most of the time, in reality, these doctors are not giving you a real medical examination. They're saying to you, hey, do you have pain? Do you have anxiety? Here's your authorization. I don't think you should speak for every single doctor. No, no, no, not every. We don't do that at my clinic. And I know that, you know, a lot of the clinics in Canada anyway, we definitely do not do that. And, you know, we provide a lot of education at my clinic and there's other clinics in Canada that also provide a lot of education at my clinic and there's other clinics in canada that also provide sure and and and i and i imagine there's a spectrum but in the u.s this was a and and i spoke to advocates for my book i spoke to rob campia who you know who ran

the marijuana policy project for a long time um for the book and he and he acknowledged you know advocates knew that this was a backdoor route to legalization in the u.s yeah i used to joke around about it yeah my doctor said uh why did he pot i said i get headaches he said when you get headaches i said whenever i think about the fact that pot's illegal so he wrote me a prescription i mean let's be honest about it i'm not look i say in the book at the end i don't think this should be this substance should be legal i favor decriminalization we're sort of jumping ahead here but if it's going to be legal i'd rather have should be legal. I favor decriminalization. We're sort of jumping ahead here. But if it's going to be legal, I'd rather have it be legal for recreational use. I'd rather that we don't pretend that THC high cannabis is a medicine, and I'd rather separate out. But why are you saying don't pretend?

Because there's many medicines that have horrific side effects. that have horrific side effects. Sure. The medicine THC in regards to children's autism is pretty significant and well-documented. Epilepsy, autism, those are two huge things that happen with children that they've been shown to severely mitigate with edible marijuana. So I have to push back on you a little bit. CBD has been shown to reduce seizures in children with epilepsy.

It's FDA-approved for that reason. on you a little bit cbd has been shown to reduce seizures in in children with epilepsy it's it's maybe anecdotal but i have a good friend who has a child who he uses it on and he showed it i mean it's been a game changer yeah i mean i let just let me interrupt for sex like i had uh a patient four or five years ago and uh she was 20 years old she couldn't drive a car because she had seizures right so you can imagine being 20 years old not being couldn't drive a car because she had seizures, right? So you can imagine being 20 years old, not being able to drive a car. All your friends are driving around. So she uses a little bit of CBD, not even every day.

She's never had a seizure since. And now she's able to drive her car. But this is, we're talking about CBD. He's talking about THC. So you're talking about a case okay and and i'm not saying that your friend's situation didn't happen i'm not saying it's not real what i'm saying is the reason we have clinical trials is because science the way you know whether a medicine works or not whether a chemical compound works whatever that compound is

the best way to know is you give the real medicine to one group of people and you give a placebo to the other group. And you see the changes in those two groups over time. And you find out whether or not your theory about whether this works on a population level basis is real or not. That is at the core of medical science. And we've basically thrown that rule out for THC. Well, that's not entirely correct you do know that there's were studies that were run during the nixon administration

that showed the efficacy of marijuana and the safety of it and those were all squashed and you also i'm sure you you know like when we're talking about marijuana you're talking about something that's federally illegal it's not something that's ego that's easy to run these fda studies on yes and i do and i say at the end of the book, I think we should drop that. I think anybody who's got a legitimate interest in researching either THC or cannabis or any of the compounds for a medical condition, let them run phase one, phase two, phase three trials. Let's see if this plant is good for these things. I think that's a great idea. But still, why are you saying that you don't think it is medicine when all these people find benefit in it? Do you think they're getting it from just

the CBD, the minimal amount of CBD in marijuana? No, I think that, again, there's been a lot of research done on THC and cannabis to see whether or not those, whether THC is a compound and whether smoke cannabis can treat these conditions. And for the most part, the studies have been negative. Again, there's – Negative in what way? Meaning they haven't shown any actual – Can you cite these studies? I mention them in my book.

Okay. Well, what were the conclusions of these studies when you're saying that they're not positive? That they – again, that they didn't work. That the drug didn't work. Didn't work, that the drug didn't work. Didn't work on what? On cancer, on Alzheimer's disease, on irritable bowel syndrome, on all kinds.

So, Alex, I mean, you're throwing a few different things out there, and I appreciate the fact that we can't be going around saying things like, you know, cannabis cures cancer, right? But, you know, I, you know, and I've done videos on this, even like recently, stating that. But if you know, I, you know, and I've done videos in this even like recently

stating that. But if you look at the research, I mean, specifically, if you look at specific cancers, there are studies that have shown that THC and CBD can help. Like, say if we're talking about breast cancer, and I did a video on this recently, you know, if you are HER2 positive and you use THC and CBD, it can, in fact, reduce tumor size and it can reduce tumor growth. Now, if you have… I'm sorry, can I interrupt you? Sure. What does that mean?

It's a subset of breast cancer. Right. So, there's different types of breast cancer, and that's just one subset of breast cancer. So, there are other breast cancers which do not express cannabinoid receptors. And I've seen one study, at least, again, it's only one study that showed that when they gave cheat seed in that animal model, it actually caused a proliferation of tumors. So it worsened them. So I do agree with you, Alex, in the fact that we have to be careful about using terms like that. But that just doesn't mean that we can't say that cannabis is no good for cancer at all. And I mean, even in the, um, national mechanics of science and

engineering report, you know, they said that cancer was, was great for, uh, chemotherapy induced nausea and vomiting. Right. So, you know, it's, it's definitely a really good, um, you know, medicine for, you know, a lot of different things. And, and when we're talking about THC, you know, I, uh, I said earlier, of course, you know, we need to be careful about talking about THC, you know, I said earlier, of course, we need to be careful about THC, but it definitely is still a medicine. And, you know, to your point with regards to, you know, not being a medicine, say for something like PTSD, you know, I come from it from a clinician's point of view. So I'm not a researcher. So I need to make sure that my patients are getting better. It's very frustrating for me just to say to someone,

oh, there's nothing I can do for you. There's nothing I can do for you. And I understand that doing something sometimes is not going to be beneficial just because you're doing something. You have to do something that actually works. But we do have epidemiological studies and we have other studies that have shown

that when patients are given cannabis it can reduce their symptoms of PTSD there's also another study you know I don't use this drug too often called called nabalone so nabalone is just pure THC nabalone was shown to reduce nightmares and people who have PTSD so you know it's just saying just so just because THC is psychoactive doesn't mean that it's not a medicine. And just to keep on the topic of, of PTSD, um, in addition to that, we've identified mechanisms of action. Um, I know, I know there's one study, I think Matt Hill was on the, uh, was one of the authors of that study. And he noted that in people who have ptsd there's an over 50 decrease in uh in levels

of anandamide so which is the naturally occurring yes which is which is naturally occurring in the cannabinoid correct um so you can get that through through exercise which is one excellent way to do it you know and that's part of the the high that you get when after you exercise but the other way you can get it is by using cannabis. So when THC attaches to those CB1 receptors, you can get a release of anandamide. And cannabidiol can actually increase anandamide by another mechanism of action as well. So there's different ways where we can raise a level of deficiency. So to me as a clinician,

you know, if I have someone who is not doing very well, you know, they've been on a bunch of different medications, I've identified that, you know, they have PTSD, we have a mechanism of action, we have studies. And then again, too, you know, don't discount my clinical experience, right? I've been working for over five years, you know, just with cannabis. I mean, I do other medicines. I prescribe other medicines as well, but I've been doing cannabis medicine for over five years. And, you know, there's a lot that I've learned, right? So as much as I've learned, you know, through reading studies and through going to conferences and things like that, you know, for sure the best resource as a clinician is to learn from

your patients and to hear what your patients tell me. And, you know, the things that my patients tell me is that THC is really effective for the sleep at night. And a lot of my patients, especially my veteran patients, have done really, really well with that. And just one further point too, you know, there was, I know it was in 2015, I believe it was, there was a meta-analysis done, I can pull it up if we need to, that indicated that a lot of the medicines that are being used now for PTSD are just simply ineffective. And the other thing too is that there's never been a medicine made specifically for PTSD. So all the medicines that people are using are for anxiety or they're for depression or

they're for insomnia or they're for something else. But when we look at like a study that says people with PTSD have a lower level of anandamide, and then if you can increase that level of anandamide, that's a good way to treat someone. It doesn't matter whether it's a vitamin, whether it's a hormone, as long as you are correcting a deficiency, you're generally going to get excellent clinical results. So let me sort of try to frame this a different way. Alcohol reduces blood pressure. Alcohol generally tends to reduce cardiovascular events for people.

And during prohibition, you could actually get a doctor's note for alcohol as a medicine. But alcohol is not a medicine. It's a recreational intoxicant. It has some positive biological qualities and some negative biological qualities. And, you know, there was an argument, I think in 10 to 20 years ago, should we recommend that people drink moderately one to two drinks a day? And I think for the most part, the medical profession has come down on the side of saying, let's not do that. There's too many non-cardiac negative side effects with alcohol. Just on that note though, Alex in Canada right now,

I know the safe alcohol drinking guidelines are 14 drinks a week for men and nine drinks a week for women. So, you know, basically two a day for men, one and a half for women. So you're saying, okay, like there's, we don't see huge negative consequences at that level.

Okay. That's, that's fine. Like that's a totally reasonable way to think about alcohol. But what we're not saying to people is this is a medicine. And I think that's where the confusion around really around high THC cannabis lies. And I, and again, I don't mean to say that your friend's child is not benefiting. If you say he or she's benefiting, I believe you. What I'm saying is that that's not good enough for science. We need randomized controlled trials. And when those

trials have been done, and a lot of them have been done, Joe, a lot of them have been done, they've almost unequivocally shown that cannabis doesn't work as a medicine. The only actual place where beyond these sort of very limited conditions like chemotherapy-associated nausea, which obviously is terrible for people who have it, but isn't that common, fortunately, cannabis has been shown to work as a pain reliever, right? Probably for the same reasons that alcohol works as a pain reliever. It sort of dulls your awareness of your pain. But even in that study or even in those studies, they're mostly done against placebo, not against opioids or against NSAIDs like ibuprofen. use in chronic pain over a multi-year period in Australia that came out last year that showed that people who used cannabis had more pain and used more opiates at the end of four years than people who didn't. So we're almost arguing about what medicine is. Yeah, that study though had a

lot of flaws in it. And the other thing is that you need to look at someone who is already using cannabis versus someone who is just using opioids. So if someone is just using opioids and they want to come off cannabis, you know, there's multiple... Come off opiates? Sorry, come off of opiates with cannabis. You know, multiple studies have shown that that can be effective. And that's not what was done in the Australian study that you're referring to. Right. It's a more naturalistic approach.

Right. And also, too, they didn't have access to medical marijuana during that whole time. Those are all self-reported, and they were getting it from recreational sources. They weren't getting it from – that's a big distinction, though, Alex. They weren't getting it from a doctor who prescribed it to them. This was a self-reported study and people were getting cannabis that they didn't really know what they were getting. They weren't given any information from a doctor. And that's why it's a medicine, Alex, because you can tell someone, you can tell a patient to take a know a certain amount of cbd every single day

and when you take a certain amount every single day it can reduce your symptoms and sometimes you need to increase that and sometimes you need to decrease that i think we do that with all medicines we should be really clear about the distinction though between cbd and marijuana i mean we're really talking about the psychoactive version of it and this is where where you're saying it's negative yes you're not you're not really arguing that cbd is and i think you know dr hart is talking about he's talking about using this as a medicine certainly using the cbd he's titrating his patients he's monitoring them he's not writing them an authorization and saying come back in a year when it when it's up he's he's he's being a physician and you know and i think to the extent that marijuana is medicine, we want people like him.

So you admit it's medicine? No, no, no. I don't admit that. But you just said that. I don't think I just said that. I think I said to the extent. I'm trying to meet you halfway, but I'll stop doing that. But, you know, I think you said something else that was really interesting to me.

And this came up in the book, too. So you're a clinician. You see sick people. And, you know, it's funny. something else that was really interesting to me. And this came up in the book, too. So you're a clinician. You see sick people. And it's funny. My wife's a doctor, too. She's a psychiatrist. That's how I sort of got in this. But my wife is a forensic psychiatrist, less than a clinician these days.

Her job is to evaluate people, not so much to treat people. Your job is to treat people. You see sick people. You want to help them feel better. And you don't want to tell them there's nothing I can do for you. There's nothing, there's no hope for your pain. There's no hope for your PTSD. You want to help them. And I totally get that. But if you're an epidemiologist or a researcher who's trying to guide the views and the medical practice of hundreds of thousands

of doctors, that's not good enough. So you need to step back. And I think, I think, you know, this, this epidemiologist in Britain, who I talked to, he said to me, he said, you know, I try not to draw conclusions because so often when I try to draw them, I'm wrong. Yeah. And we need to be, you know, careful about that. Right. And, and Alex, you know, you know, one thing that was mentioned in your book, you know, is that, mentioned in your book um you know was that you know you you often you often cited the national academies of science and engineering right but you know ziva cooper you know she's a member of that committee i mean she put out on on her twitter i mean you can go to it it's from january 9th of 2019 she says

in response in the recent new york times editorial on cannabis and as a committee member. Which, by the way, that came out of something that I wrote. Let me finish. Hold on. Let me finish. No, no. I'm just trying to give people context of where it came from. Right. But this is someone you cited.

No, I didn't cite her. I cited the report. Okay. You cited the report. And she's a member of that. Yes. Of that. Okay.

So she said, in response to the recent New York Times editorial on cannabis and as a committee member on NASM, which is that committee and cannabinoids report, we did not conclude that cannabis causes schizophrenia. Then the drug alliance policy also said the report did not reach that conclusion. So, you know, those are pretty two authoritative, uh, you know, sources that are saying that, you know, in your book, you know in your book you didn't cite the research properly right and then also they're saying that you left a lot out right they said that they have found an association between marijuana use and improved cognitive outcomes in individuals with psychotic disorders that's straight from the same report and you know you failed to mention that right so i think that you know when we're writing

books or when we're giving out information you know you want to do it from a balanced approach and you don't want to just select you know the small amount of material that's just going to support your study you know we want to be truthful here you know joe's show has always been very truthful i mean joe said right right at the beginning he doesn't think that uh that that cannabis is perfect for everyone and i don't't think that either. And in Canada, you know, we have really strict guidelines to follow. Um, you know, basically no one prescribes cheat seed anyone under the age of, of 25 and, you know, all the conferences and stuff that I go to, you know, we don't really have too many discussions about that like the doctors don't really have many you know much of a backlash about that um so why is the distinction the age

of 25 why they decide that age so 25 basically is when your your brain yeah it's it's fully developed and when you do look um at the studies that do show you know an association between between cannabis and psychosis it's almost all in adolescence you know i an association between, between cannabis and psychosis, it's almost all in adolescence. You know, I think that Alex only has one study, um, and, and his, and his book that shows an extremely weak correlation between, um, an adult using cannabis and then developing any type of, of mental illness later. So, you know, 25, um, is, is a, is a good age, but it's definitely a, you know, kind

of a conservative ish, ish age, but you's definitely kind of a conservative-ish age. But it's something that we follow, and I think that we've done well with that in Canada. So, Alex, why did you leave those conclusions? So I need to push back here. Okay. So the National Academy of Medicine report was drawn up by a committee of 16 researchers. was drawn up by a committee of 16 researchers. Ziva Cooper is the one who's publicly said the report said this,

but I think that we should have emphasized that it also said this. What I wrote in that New York Times op-ed, what I wrote in the book, is the plain language of the report, and the plain language is this. Cannabis use is associated with a risk of developing schizophrenia and other psychoses. The higher the use, the greater the risk. I may have a word or two wrong in that because I'm doing it from memory, but that's what it said. And by the way, the committee was very clear. They separated depression. They said we don't see nearly as high risk for depression as psychosis. Even though, by the way, today, just today, JAMA Psychiatry, the Journal of the American Medical Association Psychiatry, put out a meta-analysis showing that cannabis is associated with depression and suicidal thinking.

And actually, suicide attempts at a three and a half to one rate. This literally was released today. But to go back, Ziva is one of 16 members of that committee. So if you're going to say that I misquoted the report, which I didn't, I quoted it entirely accurately, you need to say, well, why aren't the other 15 members of that committee saying that I misquoted? Why is one person who works for the Cannabis Research Initiative at UCLA, which takes money from cannabis investors and users, she's the one who said that I misquoted it? Maybe we should ask why the other members of the committee are not speaking out against my book. Well, I think that she was just one of the 16 members that came out, but you can't really

expect all the other members to potentially come out with out with that as well why not well some people if i did something wrong if i misquoted them well some people will and some people won't you know some people have you know the personality some people have the platform like you know ziva has a bunch of followers on our twitter people know who she is you know a lot of people who do research actually are not into social media at all like i don't think you were at all before you you had your book were you uh yeah i mean i was an analyst so okay yeah so so you weren't in a social media at all so you know i don't think that most people on that committee are are into social media you know ziva just just happens to be and you know i even spoke to ziva uh on the phone about this and you know and and she and, and, and she said that, yeah, you know, I, I don't,

uh, that she agrees with everything that was in the report, but she doesn't agree with your conclusions. And to go back, my conclusions are quoted from the report, but you're only quoting there, but you're only quoting the parts that, that site or sorry,

that back your, uh, your opinions. You're not quoting the entire part. Like you left, like why did you leave out the part that said they have found an association between marijuana use and improved cognitive outcomes

in individuals with psychotic disorders, right? So you're leaving out that part. So why did you leave that part out? Why did you leave out that part? If you can find me a psychiatrist who thinks that it's a good idea for somebody with an active psychotic disorder to use,

why did you leave out that part? Well, my book presents, it makes a good idea for somebody with an active psychotic disorder to use CGC. Why did you leave out that part? Well, my book presents – it makes a case, right? It makes a case that this is a big issue that we have not heard about at all, and the reasons that we haven't heard about it have a lot to do with the advocacy community and the way they've presented this data for 25 years. I wrote a book that is trying to break through a lot of noise. I wrote a book that is trying to break through a lot of noise. So, but still, to get a balanced approach, did you decide that you were only going to write about things that confirm the belief that you held when you were writing this and what you were trying to push in the title of the book and in the conclusion of the book?

I think that's a really great question. I say in the introduction of the book and in the conclusion of the book? I think that's a really great question. I say in the introduction of the book, this book is not balanced. There's not a lot of evidence in there. That's fair. If you want to read about how indica and sativa strains are different, you're not going to read that in this book. But I also want to say this. I didn't come at this, and I say this in the introduction of the book, too, as an anti-cannabis crusader. In fact, when my wife said to me, as she said to me over and over

again in 2014 and 15 and 16, these are the cases that I'm seeing. These are the terrible things that people are doing after cannabis use. I sort of said to her, first of all, why do I always have to hear about this at the dinner table? But you know why why is it that maybe these people are using other drugs maybe maybe you're seeing a slice of the population that it's not representative why is it that i should believe this this sounds like reefer madness to me and you know ultimately my wife who's the one who went to you know she actually as i was talking to dr hart about this she grew up in uh in newfoundland too uh she this. She grew up in Newfoundland, too. She went to the Memorial University of Newfoundland Medical School, and she went to Harvard and Columbia for her postgraduate training.

Eventually, she got tired of me yapping back at her, and she said, why don't you go read the studies yourself? And it was that that led me to write this book, because when I read the studies, I could not believe the strength of the evidence, Joe. this book because when i read the studies i could not believe the strength of the evidence joe but you're still even saying that you you're still seeing positive results that you're you're excluding again there's there's this one there's this one sentence i mean it's not just one sentence but but there are a few sentences about how it may be that cannabis helps people's positive be that cannabis helps people's positive it helps it helps cognition in people with psychosis maybe maybe not wouldn't that qualify as medicine uh not if it's no it wouldn't be approved as medicine if it's causing to have other psychotic episodes but if these people have psychotic breaks and improves cognitive function and people with psychotic breaks so so wouldn't that be something

that you would prescribe to someone no again you need to think about how the fda is looking at medicine no i understand the fda's position sure but i mean looking at it as medicine i mean if we could prove this through studies and through some sort of clinical trials if it is improving your iq two points on a test i'm not saying it is i'm not i think we have we have to look i'd have to look at that i'm not sure but at the same time it's making you floridly nap right no no but at the same time it's making you floridly psychotic you're not that's not medicine well it's not necessarily at the same time one of the things that i read about schizophrenia was that there's people were trying to make a correlation between marijuana use and schizophrenia but the problem with that correlation

and what i read and maybe you could help me on this yeah was that it's the exact same number that you find the general population is essentially one percent of the general population has schizophrenia which is one out of a hundred people and when you have marijuana users you see essentially that same number mirrored and so they're saying a small number of people hold on but let me get in a small number of people hold on but let me get in a small number of people what they were saying essentially in what i read was that marijuana use was associated with the onset of schizophrenia they were disputing this in this study because they were saying because the same number is mirrored in the general population again correlation does

not equal causation right dr i think you got to tell them that's not true Tell me what that means Traditionally, yes When you look at the stats You'll see that the people who use cannabis Versus the people who don't use cannabis Have very similar rates But getting to the exact rates In the US, they say that

The range for schizophrenia Is between 0.25 to 0.64% Globally, they say it's 0.33 to 0.75 percent so you know right there it's you know apparently lower in in the u.s and the u.s is is has the highest uh percentage of cannabis consumption in the world and the u.s also has a lot of people that are using high potency thc so you know the i think that you know we really need to be be careful about throwing out you know stats like that because you know when you do look at at the stats that we have it shows that even though uh you know the there's a lot of cannabis

use in the united states schizophrenia rates have remained the same so i have to push back really hard on this this is one of the great myths of legalization. No one knows what the schizophrenia or psychosis rate is in the US. Right, because a lot of people aren't treated. People aren't treated. People get different diagnoses at different times. We have bad healthcare in this country, and we have a lot of protections around mental health. In fact, in 2017, the National Institutes of Mental Health suddenly changed its estimate for the percentage of people with schizophrenia in the US from 1.1% to 0.3%. They did it with no public notice. And then this researcher said, hey, this is a miracle. They just cured 2 million people

with schizophrenia. And then in response to that, the director of the NIMH said, well, we actually don't know how many people have schizophrenia in the United States. Nobody knows. Nobody knows if the rate is increasing. Nobody knows if it's decreasing. The only countries where they can count noses on this with any accuracy are in Northern Europe, because they have good healthcare, because they have slightly less protections around sort of individual privacy and mental health privacy. And so they are able to count cases. and mental health, privacy. And so they are able to count cases.

And in Denmark and Finland, which are the two places where they've actually done this research in the last 20 years, they've shown increasing rates of schizophrenia between about 1995 and about 2010. And that goes side by side with increasing rates of cannabis use in the 90s. So the people who are saying

that there's no evidence of population-wide increases in psychosis are just wrong that's just possible that there's other factors oh absolutely i mean environmental factors there's a bunch of other different things let me let me be clear on this we absolutely don't have the evidence at this point to say that cannabis use in the u.s is causing a population level increase in psychosis and schizophrenia which are by the way those are are sort of different illnesses, and we can talk about that too. So we don't have the evidence to say there's a definite increase. But what I'm saying is that what you have been told, that there is no increase in schizophrenia

or psychosis rates in the US. We don't know if that's true or not. We just don't know. Let me ask you this. There has been proven that there's an increase in marijuana use. Is that correct? Yes. Correct.

Absolutely. When did the increase begin and what percentage is that increase? So there was an increase in the 90s, an increase in use and in potency. Use sort of bottomed out around 1991. And then there was sort of a flat- Bottomed out? Meaning it hasn't increased since 91? No, no, no. It's gone about 50% since 92.

That's a lot. That's a lot. Wouldn't you expect a corresponding increase in schizophrenia if there was any sort of correlation? Hold on. Let me just walk you through. It bottomed out in the early 90s. Increased again.

Increased in the 90s. Flattened out between about 2000, 2006 and since then has been going up again. Especially in let's say the last three, four years. And the other thing is that potency in the last 15 years has gone way up. I don't think anybody would dispute that. Okay. Has schizophrenia gone up?

So what I'm saying to you is we don't know. There is evidence. There is now evidence on a population-level basis in those other countries that schizophrenia and psychosis has gone up. And there's for the first time in 2017, there's data showing that serious mental illness, which is not the same as psychosis or schizophrenia in the U.S., doubled between 2008 and 2017 in people aged 18 to 25. And those are the people who are most likely to be using. So for the first time, there's actually evidence of what you're talking about, which is a population wide increase. Now, again, I'm not going to say-

And then, can I get you to clarify it? Sure. When you say serious mental health, what are those? So serious mental illness, so this was defined, there's a study called the National Survey on Drug Use and Health. It's done every year, covers 70,000 people. Federal government funds it. It's sort of the best data source we have on all this stuff. It showed that – and they're not counting cases either. Let me just be as clear as I can on this. Nobody's counting schizophrenia cases on a national or even state-level basis in the U.S.

But you say to people, did you have depression so bad that you couldn't get out of bed? say to people, did you have depression so bad that you couldn't get out of bed? Were you hospitalized this year for any inpatient psychiatric reason? And if you look at those numbers, in 2008, 3.7%, I remember it was 3.8% of Americans 18 to 25 reported at least one symptom. So they were categorized as having serious mental illness that year. In 2017, that number was 7.5%. So that's a doubling. So again, I am not going to say that proves that the increase in cannabis use has caused this population level increase. But something bad has happened.

And if you look at kids 12 to 17, interestingly, they, over that time period, didn't have a big increase in cannabis use. In general, teenagers actually are pretty healthy now, although Juul and vaping may be undoing that. And those kids didn't have a population level increase in serious mental illness. Can I stop you for a second there? Because there's other factors.

Oh, sure. One of the big ones is Yuval Noah Haradi has a great book, 21 Lessons for the 21st Century. Yeah, I read that. It's great. And one of the things they talk about is the onset of social media. Jonathan Haidt talked about that as well. And that the onset of social media,

it was actually more Haidt than Yuval Haradi. But Jonathan Haid hay talks about it with young people yeah i think it's the coddling of the american mind yeah i think that social media and the pressures of social media have led an incredible amount of young people to uh serious mental distress and you know serious anxiety serious depression and suicide amongst young girls has increased some 50%, according to Haight, over the period of 2007 to, I think, 2000, whenever his book was written. And I think they're directly correlating that to the pressures of social media and to, you know, anonymous online bullying and all these different factors that are affecting kids yeah so i think that that could be considered a far more significant new uh form of of distress to children and young people than even marijuana i think it does it twofold because i think that you know what makes people really depressed maybe more so than anxious

but definitely both is that when you compare yourself to someone else and you know people you know obviously that we've done that you know all all humans have done that you know since since history began but now everything is online you can compare your life to everyone and people are doing all the time and even worse than that and you know we should talk about this too is that the income gap is getting is getting water so it's like people's lives not only are they getting you know better than than other people's lives but it's but now it's on it's on display so everyone can see it whereas before you know maybe you wouldn't have seen it because it wasn't on social media but now it's on social media so you have this huge income gap that just keeps getting bigger and bigger and bigger and then you have people going going on social media

and they're comparing themselves. And you're absolutely right. Especially in that, in that age population, I mean, people under, under the age of 30, you know, they're definitely, you know, they're being bullied online. Like I see it every day in my office, like literally every day people are being bullied online. And that's, you know, something that I never had, you know, to deal with growing up. Yeah.

And, you know, a lot of kids do have, do have to, never had to deal with growing up. And a lot of kids do have to deal with that. Just one more note, too. Since Colorado has legalized cannabis, this is important for this subject and this topic, they've actually seen marijuana rates decrease. So it's important for people to know that. No, no, no. I can pull up the study haven't teen use or overall use overall use has gone up teen use is flat overall use is up okay yeah i'm talking about teen use but that's that's the category that we're talking about under under 30

right so teen use you know would would classify as part of that category so you know in colorado we have seen a decrease do you think that's because of the lack of you know because it's not illegal it's not as exciting to them part of it for sure you know and i mean part of it like one worry i had you know i haven't looked into the statistics yet was you know when when you're growing up and uh when you're in high school you know if you want to be part of the you know cool crowd so to say to say, you usually drink or you smoke pot. That's what people do. I hope that that doesn't change because pot's seen as medicine.

I hope that people don't move on to or do something harsher because they don't see pot as cool anymore. There's no stigma attached to it because it's legal. so i i gotta push back on a couple of things um so everything you say about social media sound you know it sort of intuitively sounds correct right the problem is the data doesn't support this at all the data shows that teenagers another 12 to 17 those kids are healthier than they were 10 or 20 or 30 years ago. They drink less. They smoke less. They have sex later.

They have fewer abortions. They are healthier. And their mental health doesn't seem to have changed that much based on the NSDUH data. The data shows a big change in kids 18 to 25. They go to college, something goes wrong for a lot of those kids at least in the last few years now but wait a minute when you're talking about suicide rates suicide rates are they're especially with young girls who are apparently more affected by social media they have gone up significantly since the rise of social media that is the big factor people who are

mostly hold on a second more so than use, and then that's a fact. So you're talking about a tiny, tiny number. The people who commit- No, no, it's not a tiny number. It's a 50% increase of people that commit suicide that are young girls. The people who commit suicide in the United States are middle-aged white men. And that's a fact. But wait a minute.

You're discounting these young girls that are committing suicide to fit your statistics or to fit your conclusions. No, what I'm saying is that's a tiny, tiny number. But it's a 50% increase. It's not a tiny amount. This is something we can look up. Well, let's find out what the numbers are. Because when Jonathan Haidt was on the podcast and he discussed it, I mean, he showed this chart.

And it's an alarming increase directly correlating with the increase in use of social media. Sure. And by the way, I'm not saying – But why would you push back against that that seems to be a factor what what i'm what i'm pushing back against is the idea that kids 12 to 17 generally are less healthy than they were 10 or 20 years ago no one's saying they're less healthy you just said they're more healthy yeah i'm saying they're more healthy right we're saying that mental health has nothing to do with cardiovascular fitness. No, no, no, I mean mentally healthy. I mean they're less likely to use drugs, they're less likely to have sex.

But they're more likely to commit suicide. That is a tiny, tiny number. What are you talking about? If it's a 50% increase, that's a huge difference. We should look up the number. If we're going to actually... Look, Jonathan Haidt's work is very well respected. What I'm saying to you is that there's a clear increase in psychological distress in kids if we're gonna if we're gonna look jonathan hates work is like very well respected what what i'm

saying to you is that there's a clear increase in psychological distress in kids and young adults 18 to 25 okay there's a clear increase and those are the people who are most likely to be using cannabis those are the people that are most likely on social media as well sure and that's a stressful period of your life like 12 to 17 you're usually living at home like 18 to 25 then you got to go to university you got to deal with all these courses i'm willing to concede that and i've said at the beginning of the program that i think that marijuana with some people is not beneficial and in fact could be negative but i don't understand why you're not willing to admit that social media has a significant and unprecedented impact on young people that we've

never seen before i would totally agree with that but i don't think that you can say based on the population level data that the impact is all negative it may be listen it may be who's saying that the impact is all negative what we're saying is a 50 increase in suicide with young girls right but that's huge let me give you let me give an. When you were 15 or I was 15, maybe you got really drunk, right, and wound up in a bathtub. Like maybe kids today are less likely to do that because of social media because they know it's going to be on Instagram forever. I don't think that's true. I don't think that's proven. I don't think there's anything that would point to that.

I can tell you is proven is that kids today, I'm talking about teens, 12 to 17, have less psychological distress by all these measures. I'm talking about their actual behaviors are better, or better or worse, that's a moral judgment, but they're healthier than they were 10 or 20 or 30 years ago. They're less likely to have sex. They're less, when they're 14, which I think most people say is a good thing, they're less likely to be drinking. They're less likely to be smoking. Those are good things. Well, less likely to be drinking, less likely to be smoking, less likely to have sex does not correlate to positive mental outlook and less suicide. Well, yes. I agree.

Let's look at the numbers. But depression and suicide are very difficult things to measure, right? Depression – well, suicide is actually pretty easy to measure. Suicide is very easy to measure. It's a hard number. Depression is more complicated. Look at this spike. Bottom number is in females.

So, okay, I mean, this is what I'm saying. The death rate, first of all, this is, okay, the death rate for girls age 15 to 19 is 4 per 100,000, Joe. It's at a 40-year high. Right. So, I mean, you'd be hard put to say that's a huge spike. It was three per 100,000 in 1975, and it's a little bit over four in 2015. That's one case per 100,000 girls.

Yeah, I don't know what the actual facts are. I'm looking at this right now, suicide rates for teens 15 to 19 years old this is something that we'd have to study sure and we'll have this discussion what i'm telling you a giant spike for boys in the 1990s what the fuck is that about 95 what i'm telling you is if you put middle-aged men on this chart you'd have to you'd have to blow out the ceiling like people the suicide crisis is unfortunately a crisis of age okay i i would agree with that i think we actually talked about that yesterday with andrew yang that uh suicide

amongst men in their 50s and then they start to feel useless yeah yeah and especially if they lose their jobs um but what jonathan hate is pointing to is a direct correlation between social media use depression and suicide amongst young girls. Thank you for finding that. What is it? This is the article it's from. Suicide rate for teen girls, the highest it's been in 40 years, is social media to blame. Right.

Okay. New data released Thursday by the Atlanta-based Centers for Disease Control and Prevention. Suicide rates amongst 15- to 19-year-old girls doubled between 2007 and 2015 reaching a 40 year high i would say that's significant again i would and and it's obviously a terrible thing when anybody commits suicide but we're talking about two per 100,000 i understand actually it's it's five well went from two to four okay that means for every 100,000 american girls in 2015 five committed suicide that's not a very high number but i mean that's also someone who's pushed to the extreme of taking their life how many girls are experiencing

severe depression but don't commit suicide that's the real factor because this is what hate directly connects to social media again the 50 increase you're talking about a relatively small number because not as many girls commit suicide as men but still this, you're talking about a relatively small number because not as many girls commit suicide as men. But still, you're talking about, you were talking about depression. Right. And you were talking about these significant factors that would lead people to have poor mental health. Yeah. This could be a huge factor in this, right?

And I think that, too, it leads people to suicidal ideations and depression and anxiety. I mean, right here, we're just looking at suicide, which is the worst end point possible. Which is very rare amongst girls, period. Yes, absolutely. Or less common, I should say. It is, yes. Men do commit suicide more than women do. But we really have to be careful about that because, again, suicide is the end.

It's the worst thing that could possibly happen so what about you know all all the uh all the things leading up to it you know are there people who are who don't commit suicide but you know suffer from terrible depression suffer from terrible anxiety suffer from terrible insomnia you know those people are not accounted for in that graph i i agree and what i'm saying is that cannabis use has spiked in the United States in the last 15 years. And teens notwithstanding, we've seen a large degradation in a number of these social outcomes. And now just today, we have a JAMA psychiatry paper that looked at a bunch of other studies that said cannabis use in teenagers is associated with depression suicidal ideation and

suicide attempts in people once they get to 18 to 30 okay so it could possibly be a factor what's that it could possibly be a factor yes but it might it might also be that these kids are depressed because of social media and they're using cannabis or they're depressed because their friends died from opioid overdose there's a lot of potential. I agree. We are conceding the fact that, you know, you just said again, that study was done on adolescents. You know, Joe and I have both conceded multiple times that, you know,

we do not think high THC cannabis is good for people in that age category. But, you know, just to back up just a little bit again, you know, I don't, like I said earlier that, you know, I don't prescribe TTC generally to anyone under the age of 25 and most other doctors in Canada don't, but I think that we should be prescribing CBD to these kids. Like a lot of those kids, you know, who have suicidal ideations, depression, I mean, you know, you could never do a study on it, it but you know how many of those kids wouldn't have committed suicide or wouldn't be feeling this way if they were using cbd because we know ssri selective serotonin we have to take inhibitors you know which are the most commonly prescribed medication for depression and anxiety even in in adolescence we know that they they can

increase suicidal ideations that's been shown i I mean, it's written right on the package. So again, as a clinician, you have to treat your patients. If you're just treating people with something that's not effective or that has horrible side effects, you're going to look at other alternative treatments. A lot of people have had excellent results with CBD in that age category. You know, I've had it done in my practice and lots of other, you know, physicians have had it done in their practice. So it's really important that when we're talking about teenagers and when you're talking about that study, you're talking about high potency THC in adolescents.

You're talking about high potency THC in adolescence. That's where Joe and I both can see that THC is not a good medicine. Look, if GW Pharma or somebody else can do a study with CBD and depression or some other cannabinoids and non-intoxicating cannabinoid and depression and get it approved for that, that'd be great. We need all the treatments for depression and for, and boy, do we need treatments for psychosis that we can get. I totally agree with that. And I'm really glad to hear you say you don't think that adolescents should be using high potency or any hard drugs. Or any hard drugs.

Especially alcohol. No, and they should try to also, you know, stay away from the other medications. So I want to push back on this, on the alcohol versus cannabis for teens thing. And I know that this is a common feeling among people in Brooklyn, among people in LA, and sort of right, when I mean right thinking, I mean sort of the general center left to left view everywhere is that cannabis is better for teens than alcohol. I totally disagree with that. Cannabis, alcohol. No one's saying that. I'm just saying alcohol is bad too. Okay. everywhere is that cannabis is better for teens than alcohol i totally disagree with that cannabis alcohol but no one's saying that i'm just saying alcohol is bad too okay then we agree but no i mean i think you have heard this right oh i'd rather have my kids smoking pot my 16 year old

i think that's crazy i think you you have to really be careful with anything that severely perturbs your sense of reality when you're a young kid and you're trying to form your vision of the world i think to unpack what we're saying here is that there is an increase in mental health disorders amongst young kids that corresponds to the increased use of social media and may correspond to the use of cannabis but that's not necessarily proven. What we guarantee almost universally is these kids are on social media. Yeah, and also too, you know, I think much more likely that they're on social media than use cannabis. I think a lot of them use cannabis.

I don't think all of them do. I think all of them are on social media. Absolutely. Yeah. I think that, you know, almost every single kid these days has a cell phone and they have some type of social media account. I'm worried about kids using everything. I'm worried about them using Valium.

I'm worried about them using Xanax. They get prescribed benzos. Yes. I'm worried about them using Adderall. Yes. Prozac. I think psychiatrists give out add medicine much too frequently i 100 agree and i think that it has a severe impact on kids when

they're trying to study for tests when they're trying to take their sats when they're trying to get into a good college i know so many people that are on that shit i know so many people whether they're journalists i know comedians i know a lot of fucking people who are on add shit i know so many people whether they're journalists i know comedians i know a lot of fucking people who are on adderall yes yeah and you need to develop that kind of like toughness when you're young like you shouldn't just be like you know 14 years old and then you know you run into your first uh you know bit of trouble in your life and then you you reach for a pill that's terrible right that's a terrible coping coping mechanism so you know when you teach uh that to kids at an early age and when you tell them it's such a terrible thing

to tell someone oh you're 14 years old you have major depressive disorder you're going to take this pill you need it for the rest of your life and that's said to people all the time you know they say that oh you have a biochemical deficiency and this is what you need. We need kids to be tougher, right? So you need them to build up some resiliency so that when they do go through hard times, they have better coping mechanisms. Like Joe talks about diet and exercise all the time. I talk about diet and exercise all the time. Well, clearly you guys live it.

And that's kind of how I got my start on social media is through diet and exercise. Yeah, I think exercise is a big one for young kids. I mean, it was a gigantic factor for me personally. When I was 15 years old, I really got into martial arts, and it changed my life. It changed my life by alleviating so much anxiety, giving me so much more relaxation. My parents talk about it. They're like, there's two yous. There's you before martial arts, and there's you after martial arts.

But you have relatively young kids, I know. Yes. know yes and so do i and boy they love the devices i mean i mean we have to fight and we you know our kids fortunately they're three and six at this point they don't have their own ipad or iphone or any of that stuff but but you give it to them for five minutes it's like crack it's like yes you gotta tear it out of their hands oh yeah my kid will just turn their shoulder when i try to get the iPad from her. They're like, no, no, no, one more, one more. It's crazy. It's very fun and exciting for them.

And look, it's not entirely negative. We have this TV set up with this dance game that they play, and they're sweating and dancing, and after it's over, they're giggling and laughing. It's a massive alleviator of physical stress because it's like they're constantly got to follow this thing and it's it's an exercise routine yeah i mean they're really their cardio their their cardiovascular rate it gets up and they really feel good afterwards so it's not entirely negative but it's mostly negative

yeah yeah but if you have like uh I don't know, is it Nintendo Wii or whatever it is? Yeah, you can do some exercises. It's an Xbox with this little thing that scans it or you actually

can use your phone and if you hold a phone, like I'll give them my phone, my wife will give the other one her phone and like the phone

shows how you're moving. It's very weird. That's great. So like you mimic this thing that the person on the screen is doing but that i mean that's one thing that could could be considered positive i think for the most part the real issue is social pressure and anxiety that comes from kids talking shit about each other and they they push buttons they push buttons on each other because they know

that they can but they don't understand the that they can. But don't you think that's always been part of high school? Don't you think? It has, but you would get free from it when you went home. You're not free from it ever now. These kids are waking up in the middle of the night and checking their Twitter account and finding their friends are talking shit about them, whether it's on Facebook or whatever. And this girl from school, that fucking bitch, and she commented on my YouTube video. This is what they're dealing with.

You know, look at her with her fat face lol and then those little 12 year olds like oh that is that's a severe severe factor that no one had to consider before yes and it makes you almost not want to go to school like those kids who don't go to school because of that because they don't want to have to deal with you know someone said some i see it in my office all the time someone said something to them last night on social media so i didn't go to school today because they don't want to have to face that like that's something that you know my generation never ever had to face but but i do i mean i do i think we're a little bit off topic here in terms of so we're talking about depression and anxiety we're talking about a factor that could be considered as big if not bigger but social media does not cause people to get psychotic okay i don't know about that

well i don't listen this is why i don't know about that severe anxiety lack of sleep um depression absolutely are correlated with altercations on social media sure but social interactions that are severely negative they're correlated with poor mental health the good news is the brain is a relatively strong and powerful for some people but and if you look at sort of worldwide it's not for everybody some people are in a really bad situation levels of psychosis okay again it's less than one percent for schizophrenia which is the most severe version you You had bipolar disorder with psychosis, depressive psychosis, other kinds of psychosis. Maybe you get to about 3% to 4% of the population is going to be diagnosed clinically with one of these illnesses over the course of their life.

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

to break people are depressed all over the place. Depressed, yes. But I'm talking about the kind of- Do you know that fucking antipsychotic medication was the number one prescribed medication in the country? It's crazy. People say to me, people used to say, oh, I'm on antidepressants, I'm on anti-anxiety medication. Now people, I hear them at parties and stuff saying, oh, I'm on Seroquel.

I'm just thinking, that person just tell a bunch of people that like they're on an anti-psychotic right well it's weird that people don't know that saraquel and adam billify are anti-psychotics right because they've been sort of marketed as outside the class when in reality they're part of the class but i i got to push back on you a little bit sales numbers for those drugs those are expensive drugs they're not the most prescribed drugs in the country hold on um abilify was the most prescribed drug in the United States. We should look that up. No, we have looked that up. We've talked about it on the podcast because it's insane.

That is insane. And we do know, too, this is a good time, too, to talk a little bit about genetics after we kind of look at this. Because we can tease out a few things by looking at genetics. The antipsychotic Abilify is the biggest selling prescription drug in the U.S. To be a top seller drug has to be expensive and also widely used. Abilify is both. It's the 14th most prescribed brand name medication.

So it's 14th. But fucking that's crazy. Right, I agree. Out of all the people with actual diseases, this is the 14th most prescribed brand name medication that retails for about $30 a pill. Well, Dr. Hart can probably tell you, this is getting prescribed as

an add-on antidepressant for some people. What that means though, too, is that people are struggling, man. Life is hard for a lot of people. Very hard, Alex. Very difficult. So a lot of people need something sometimes at the end

of the day or during the day to help them get through the day. Cannabis, you know, especially the CBD component and also the THC component when used properly is okay. Like I tell people all the time, I've made, I've made social media posts about it that like, you know, if you need to use a little bit of cannabis at the end of the day, just to help you sleep, man, you're doing great. And you're staying away from like drugs and like you know prostitution gambling all these other brutal if you're doing all that then like you're doing you're doing pretty good overall right so gambling is not bad bro a little bit of gambling you want to bet on some fights. You want to bet on some fights. Absolutely.

By the way, I think giving people handheld devices that are inherently addictive where they can bet on sports every 15 seconds is a super bad idea. I 100% agree. We can talk about that too. Look, man, you know what's one thing that's benefited me with social media is my eyesight is going. As I've gotten older, I can't even read my Twitter feed. Ah, fuck these people. I don't read it. If I don't put my glasses on glasses i don't know what the fuck they're saying oh my god so so so good but but i'm not i'm not saying people don't get depressed and get anxious i'm saying

psychosis is a different thing okay okay i think we're we are though discussing overall mental health yes i mean i look i'm saying this because i really think that this is something that i've made a big turn over the last few years uh with myself that i don't think bathroom break yeah please go i don't think marijuana is as safe as i used to think it is i used to think it was benign i really used to think there was no big deal but i have a friend that i discussed the other day who was a really confident fucking muscular handsome man that never did anything and he took a marijuana edible to go to sleep and for two weeks this guy was this is a different guy not the guy i was talking about not rafi no a different guy he took it and he experienced suicidal thoughts

and and all these he had like severe consequences i think that the the human beings we vary so much biologically that to just make this overall blanket statement what's good for you is good for me is irresponsible and i've been irresponsible saying that before well one reason it's interesting one reason i think that alcohol is so widely accepted despite all the problems it causes and again alcohol can certainly cause problems yeah is that alcohol affects most people pretty much the same way you know if and you sort of know if what somebody looks like when they have one drink when they have five drinks i've got some friends i've got some friends that get those gerbil eyes you ever see when people get shark eyes they just go and then they start talking

crazy and like whoa but you sort of know that and you sort of know how long it's going to take to clear your body. Cannabis is so different. It's a really complicated drug. And it does affect different people in different ways. And also the tolerance has changed radically. Yeah. So people say, well, two and a half milligrams of THC, you vape it. That's like one drink for somebody who doesn't use.

But then if you're a tolerant user, you can use 200 milligrams in a day that's 80 drinks yes it's a weird drug and then there's the issue of eating it yes when you eat it your body produces something called 11 hydroxy metabolite it's a far more psychoactive you are all along for the ride when that happens yes you are yes and it can take days for it to get out of your system. I know many people have eaten marijuana edibles and then they call me up the next day like, dude, I'm still high. Yeah. Yeah. So I think the legalization community has sort of said for years like, oh, there's basically no downsides to this.

There's only upsides. The cops will bust smokers. There'll be tax revenue. All these people have a way to get high that's clearly safer than alcohol and unfortunately that's just not true i think you're right and i think um the the issue that people from what i've read are having with your book are people that are marijuana advocates that think that your position is unbalanced and that you've ignored the positive aspects of thc in terms of like what he was

talking about cognitive benefits for people with psychotic episodes and that you're only focusing on the negative i guess i will plead guilty to that yeah because i think that for 20 years people have only heard the positives right i i think that's uh i think that's also i'll plead guilty to that myself because i think that i've only been discussing the positives. And one of the things that I've tried very hard to do and one of the things I've learned how to do from doing this podcast and experiencing criticism and communicating with a bunch of different people with a lot of different viewpoints is examine my own positions and try to figure out, am I coming at this from a truly balanced position or am I trying to support a conclusion that I started out with

and I'm trying to you know somehow or another back up my own work or back up my own my own statements and and and sort of prop them up instead of being really honest and objective right and it's very difficult to do listen i wrote a book called tell your children the truth about marijuana mental illness and violence you're i don't think you can you can think that that book is going to be a compendium of the pros and cons of marijuana. Well, if you want to tell your children the truth, though, you really do want to tell them the pros and cons.

Right. And you did indicate, Alex, you said, you know, we should tell people the truth in the book, right? So, you know, I think that when you're telling, and you're saying that you're telling the truth, and Alex, I'm agreeing with you that you're telling part of the truth. But part of the truth is a little bit deceiving and deceptive in some ways, right? You want to tell the whole truth.

When you tell the whole truth, then you give the whole story and then people can actually make a good informed decision based upon that. If people are going to just read one part of the story, then of course they're going to make a decision just based upon that one part. They're not going to make, you know, an informed decision based upon all of the parts. And because of that, people are going to make, you know, some very poor choices.

I completely agree with that. But to me, the last 20 years have been an exercise in the other side, the legalization side doing a very very good job talking up its arguments and essentially there's there's almost nobody on the other side there's this one guy kevin sabette who's gotten killed sessions i mean we had the fucking goddamn attorney general who's telling people that good people don't smoke marijuana that's literally a quote yeah and yeah thank god that little moron's not in office anymore. But that's a terrible thing to say. Good people don't smoke marijuana. There's a lot of wonderful people who smoke marijuana.

That's just not true. And by the way, I think this is a personal choice, okay? Especially for adults. Yes. Okay? And you can make bad personal choices. You go, look, I play cards. I love to play poker.

I'm sad that on this trip to LA, I didn't get to go to a poker room. But you can go into a casino and you can see people who've lost. You can change your flight. A lot of places close by, I've directed to them. My friend Ari, he used to make a living doing that. He was struggling with comedy. Don't encourage me. But you can go to a casino and see people who've lost their houses.

It doesn't mean that gambling should be illegal. I agree. It also means that there's less and more dangerous forms. That device in your hand where you can bet on what the next pitch is going to be if it's going to be a ball or strike yeah that's more dangerous than my having to drive to the commerce and play there and 100 or 98 thc that an 18 year old vapes is a lot more dangerous than a five percent you know cbd 15 thc product that. Hart might suggest his patient uses once a night to go to sleep. Agreed.

But that's the message that we should be putting out there, right? We shouldn't just be focusing on one side of the story. That part should also be included in the book. And your book, in some ways, has made me rethink the way that I write. Because my first book was co-authored with Jeremy Cawson called Friendly Fire. You know, my second book that I'm writing now is called Cannabis for PTG. So it's how to transform post-traumatic stress into post-traumatic growth, right? Because I feel that, and you know, we all know examples of people that have,

you know, encountered really difficult obstacles in their life. And some people have, you know, succumbed to that stress and they've gone down, you know, the wrong path kind of thing. And then other people have used that stress to their advantage and they've actually become, you know, better because of it. And, you know, CBD and THC can both help facilitate that process. You know, when you're looking at someone like a veteran, for example, the hallmark of someone who has PTSD is someone who doesn't leave their home and they can't sleep at night. So when I see

a vet in my office, a lot of the times they'll be leaving their home like five to 10 days a month. So when you give them CBD, and this is really important for people to understand, CBD has been shown to decrease learned fear. That's incredible. Right. So, um, if you can get people outside of their home, because I'm not talking about, again, you know, someone who's, you know, um, too nervous to like go to a, uh, you know, uh, the bar with like their friends or something like that. I'm talking to people who like, you know, it's difficult for them to go to the grocery

store, just like pick up a few things. So, you know, those are the type of people that I see in my practice. CBD is really excellent for that. Then when you look at, you know, the, the nighttime component, um, you know, THC again is excellent for reducing nightmares. That's been shown in studies and it was even shown with one pharmaceutical drug, Nablone. Again, I don't really, um, use Nablone very much because it's only one, um, cannabinoid. And I do believe in, in, in the entourage effect and using all um, cannabinoid. And I do believe in, in,

in the entourage effect and using all of the cannabinoids. So I don't use that that much, but that shows that she, she can reduce nightmares. And, you know, if you have, you have, if you have PTSD, I mean, if you talk to someone who has PTSD, and again, this is, this comes from a clinician's point of view, they will tell you, I will try anything. And that's the same way when you get with like, you know, um, the parents of, of, of, of kids who have seizures all day, nobody wants to see that. Yeah. And like, like Alex, you know, if your kids, you know, ever started getting, getting seizures, which, you know, I hope, I hope they don't because it's, it's terrible, you know, what,

what it can do to people. But, you know, when, when, if that ever happened, you know what it can do to people but you know when if that ever happened you know i would hope that you would consider you know cbd as a potential treatment i think he's he's not against that i think we have to be really clear of this distinction like cbd you're not against cbd at all and i don't think anybody is i think no one really is arguing except maybe the federal government in certain levels is arguing against cbd that's probably some pushback from the pharmaceutical industry. The reality is CBD has proven to be, at least as far as I've read,

very safe and very effective for a bunch of different disorders, especially those that are about reducing and have something to do with inflammation. Or seizures. Yeah, one of my good friends, his son has developed seizures, and CBD knocked it out, just killed it entirely. This is very recent. You're somebody who's a cannabis user. His son has developed seizures and CBD knocked it out, just killed it entirely. Well, let me ask you. This is very recent. You're somebody who's a cannabis user.

You obviously know a lot of users. Why do you think it is that people in legal states where they can really express a preference, they can go into a dispensary and know exactly what they're buying, why is it that they want such high-potency THC product? Because they get used to it. Your tolerance develops uh it builds up you know every year we do this thing called sober october where we don't do any no drinking no no pot and we do some sort of crazy challenge uh me and three of my buddies and uh when we do it uh

what it's it's very interesting how your tolerance is radically reduced. Like, I'll smoke pot at the end of that month, and I'm like, holy shit. Like, I don't even know what I'm talking about in the mid-sentence, and I'm just blitzkrieged. Whereas, you know, now, like, I smoked a little weed last night, did some stand-up, had a great old time. There was no issues with it at all, but I'm used to it. And if the weed that I smoked last night, I assume you don't smoke marijuana. I do not.

Okay, if you and me were together last night night and I gave you a hit of my joint, you'd be still there in the corner in the fetal position going, what in the fuck is going on? Because the marijuana is ridiculously powerful. But once you're accustomed to it, once your body acclimates, it's really not that big of a deal. The problem is you're dealing with a lot of habitual daily users. And for those people, like my friend Joey Diaz,

there's a video of him giving this other comedian, how many milligrams are those stars of death? Oh, a tally? When we give Owen, what did he give Owen? Oh, I think just one. He ruined his life. It would have been about 200 to 250. Yeah, he ruined his life.

I heard that podcast. He was saying like 250. The guy opened the door and went out. Joey made a video, but the day changed Owen's life. Like literally fucked the guy's head up. Like he went outside and he vanished. He's gone. That's cannabis psychosis.

Well, I think there's a real argument to be made, particularly with him. Well, I was going to make two points on that. So you definitely can develop a tolerance. And I tell people all the time, try and take at least one three-week break. But the evidence does show that if you stop for four weeks, generally all your receptors return. And it'll be like you've never used cannabis before. Yeah, that's my experience. And that's even with people who are are really really um heavy users i can go

back and get the study um but i mean these people are using i'm pretty sure it was like close to like seven joints a day well really heavy users and snoop dog's a good example of that you know my friend tony hitchcliff is good buddies with snoop dog and he said snoop dog just smokes all day and he just like is always high and you know you're like well what do you do when you're not high he's like what he's like i'm never not high so everything he does he is high as fuck literally everything he does like for that guy it's not that big of a deal and for the way he lives his life like he's just a relaxed easygoing guy it's no problem you can be high all day and live his life and he's obviously wildly successful with this strategy. Yeah

Second point I was gonna I was gonna make on that too though was There does not appear to be any Tolerance at the cb2 receptor so Tc attaches to the cb1 receptor and that's and that's where we know we can get tolerance You know some people, you know, they they have some pain They use some THC and sometimes they need a little bit more same sometimes people, you know, they, they have some pain, they use some THC and sometimes they need a little bit more same, sometimes asleep, you know, they use THC, it'll work and then it'll stop working. With CBD too, we haven't seen that. Meaning like the people who, you know, get, get seizure control, generally they don't need to increase the dose. Like the girl I was talking about earlier, you know, I first described her, I think when she was 20 when she was about 20 she's 25 now

um she's never increased her dose now she's just used the same amount of cbd for the last five years that's a medicine right like it works for you i think we should really stop talking about cbd i just wanted to make a note on the uh on the tolerance of the cb1 i just wanted to make a note that cb2 there doesn't appear to be tolerance it's all yeah it's just there's just such a significant impact um when when it comes to especially edible thc uh it's a there's a significant impact on people's state of mind and it's not always good no that's just a fact we i mean we were talking about this when when you were out but you know it's know, so I had an interview. I was that guy.

I was doing the radio interview on the Acela from D.C. to New York last month. And this woman came in, and it was Baltimore. She sat down next to me, and I finished the interview. And she said, I couldn't help overhearing. I thought, oh, Jesus, like, she's a pothead, or she's just annoyed that I was doing this. But no, she said, you know, I was in Seattle last month. This woman was in her early 30s. She was a lawyer, married.

She said, and a friend of mine said to me, let's do an edible. She said, we bought a small dose. We asked them for a small dose. I took half of it. So I think she took like five milligrams, if that. And she said, I got so paranoid. She said, I couldn't sleep all night. Fortunately, my friend took and didn't have any problem and sort of watched over me.

But she said, the worst part was it took me weeks, weeks for the anxiety to fade. And I said, do you have a history of mental health problems? And she said, no, I don't. She said, and I have a history of mental health problems? And she said, no, I don't. She said, and I'd used, you know, I'd smoked in college. But this was just a totally different experience for her. I think there's a big problem with education. A big problem with the education that edible marijuana, as we talked about before, I think you were in the bathroom, the 11-hydroxy metabolite as it's processed by the liver. It's a radically different drug. Radically different.

And it's really a psychedelic. It's a radically different drug Radically different And it's really a psychedelic And a very For me personally Edible marijuana And flotation tanks I might as well be taking

A fucking bucket of acid Because it is a crazy God damn experience Now I personally enjoy Being paranoid And I know this sounds crazy But I think with me It gives me

And I think I live A pretty blessed life And I know this sounds crazy, but I think with me, it gives me, and I think I live a pretty blessed life. And I like the feeling of paranoia because it allows me to explore maybe some area. Is it a specific paranoia that you have? It's a freak out, man. I think I have maybe an abundance of confidence. Maybe I have too much. Maybe I'm too successful what i like about the paranoia that comes with edible marijuana is it allows me to check myself

it allows me to put myself examine all of my behavior in the darkest recesses of my mind my thoughts and and it gives me a perspective and it makes me a nicer person it might knock down the ego just a little tiny bit just like just nicer person it might knock down the ego just a little tiny bit just like just like the other psychedelics i think it just it gives you just a little it knocks down the ego just a little i mean some people use it and like at the end of the day and then you know like like joe said i think it makes you reflect sometimes better and more objectively meaning that like you know maybe you had an encounter with someone earlier in the day and then you know late at night you know you took up a bit and you're like oh man

i probably should have done things a little bit different you know like that happens to people all all the time it just it forces you to reflect in a different state and sometimes when you reflect in that state you come up with thoughts that that you just wouldn't have come up with before. And like my patients say to me all the time, like, it just kind of breaks this like negative state that I have. I'm just able to break out of a negative state and think logically. You know, people say that to me all the time. But see, to me, you're talking about something different and it works for you, you your paranoia is it sounds more almost existential it's how can i be a better person what am i doing wrong in my life it's not

my wife is poisoning me no no no joke no joke like this is funny when you're schizophrenic and you yeah no i understand and or you know or the cops are going to bust through the fucking door and shoot me. Yes. Okay, that's a different thing. And that's why marijuana drives this extreme violence in some people. Or those people need to get their fucking shit together. That's possible too. Well, I mean, listen.

They may need to go to. The aliens aren't really coming, bro. But they may need to be intervened before. And to Joe's point, though, they have shown in studies that if you make an intervention outside of the psychotic symptoms, you can actually reduce the incidence of violence. Yes. And also, too, I think it's a good point I was going to mention earlier to bring up genetics because we are teasing out genetics for people and we are discovering that certain people do have certain genetics that do predispose

them to certain cannabis disorders, right? So, you know, I'm involved with a company that's doing that right now. We're trying to create cannabis genetic tests for people, right? And there's three genes that we've identified so far. You know, one of them is the MAPK14 genotype, and that has been shown to be associated with a deficit in brain volume when you do use cannabis. And then there's two other genes, the AKT1 and the CADM2 genotype. You know, both of those have also been shown to be associated with cannabis. But again, how many people have them?

The MAPK-14 is roughly about 8% is what we're seeing. The AKT-1 is around 4%. And the CAD-M2 is around 5%. But you add that up, that's almost 20% of the population. But if we can identify, I love that stuff, lines mean. Yeah. Yeah. It's wicked.

Um, so if we can identify, you know, the, the people who are at risk, then we can maybe, uh, potentially, you know, use the medicine in a way where only the people who don't have these, these genetics are using the medicine. And then, you know, for the people who do have these genetics, you know, they stick mostly to CBD. I just think, you know, that that's a better approach than, you know, just, just kind of prohibiting cannabis or saying that, you know, we shouldn't, we shouldn't use it at all or saying that it's not medicine.

I think that it should be held to the same standard as any other medicine. And I think that if we had an incredible medicine that worked for some people and that didn't work for others, then what we would do is we would try to figure out why. And, you know, I've been doing that. My company's been doing that. It's called EnantLife, you know, full disclosure, I am on the board, enantlife.com. And, you know, when we use these different strategies, you know, then we can actually reduce the overall harm. And that should be another thing that we can add into the mix because for sure there's people who are definitely more predisposed to mental illness and definitely more predisposed to psychosis.

I mean, there do seem to be some people who just, it breaks really fast. And I'm not sure why. I mean, again, it's probably genetic there's yeah i think but but you know but it's funny you you mentioned uh you know your your friend who's uh whose child has autism and and you said well you know i if that if that were my child of course i would want to do anything possible but i have to tell you in the last month since the book came out i've heard the other side of this. I've heard from so many parents whose children, and in many cases, high-functioning children, college graduates, because by the way, those are the people who've read the book or heard about the book and who have the resources to stay involved with their kids when they

have these terrible breaks, who've gone completely off the rails. And the worst story that I've heard so far came from a woman in Connecticut whose son graduated from Haverford, you know, it's a college in the East. And, you know, sounds like a really good guy. He wanted to, you know, teach disadvantaged kids. He had a girlfriend who was going to med or was a pre-med trying to go to med school. They moved to New Mexico. And for some reason, the guy decided to start smoking. This was 2012. And within a few months, he'd lost everything. The girlfriend had left. He'd lost his job. He had his first inpatient hospitalization. Now, this is a family with money. This is Connecticut, suburban. And they have spent

the last six years trying to save their son, and they have failed. She told me that they've spent more than half a million dollars. He was hospitalized at Harvard. He had the best treatment. None of it's made a difference to him. And what is some of the symptoms? So he's completely schizophrenic now, and he's completely paranoid, and he believes, and this is the, so his girlfriend is long gone. Has he tried CBD?

That's a good question. I think he's continued to use cannabis. I don't know if he's used CBD. But let me just tell you where he is now, okay? So he's one of these guys who has a really bad delusion. His delusion is that his girlfriend has died and been replaced by a robot. So that's the kind of delusion that leads you to kill people. And so this guy has been now hospitalized 17 times

he's he's gone he's he's on the streets of houston she doesn't know where he is and i'll tell you you know you read beautiful boy you see the movie and you think well the worst i'm not familiar oh beautiful boy is about um a beautiful mind isn't it no no beautiful boy is the is a book that came out i think a couple years ago and got turned into a movie. You should have him on, Nick Sheff and David Sheff, father and son. And the son became a meth addict and essentially almost died. He started smoking cannabis when he was 12, and within a couple years it had all gone completely downhill for him. I'm surprised. It's a pretty popular book.

But anyway. Have you heard of it? No. Jamie? I've never heard of it? No. Jamie? I've never heard of the movie, yeah. Yeah. So you think, well, okay, the worst thing that can happen to you as a parent, the worst thing is your child becomes an opioid addict and you wait for the call that he overdosed and died. It turns out that that's the second worst thing.

the second worst thing. The worst thing that can happen is your son, the college graduate, the want-to-be-do-gooder becomes a schizophrenic living on the streets, and then you're waiting for the call that he killed himself or he killed somebody else. And so my view of this is in a couple more years, probably, I mean, this book has taken over my life, obviously, but in a couple years, I'm going to be back to writing novels. I'm going to be – this will still be part of my life. But this woman, these parents, they are going to spend their lives trying to destroy the cannabis industry. And that is real. Well, I think that would be a foolish thing to do. But I think there is a real possibility that some people who have a tendency to schizophrenia could be triggered by cannabis.

I don't think there's any denying't there's no question about that but i think it's also possible that guy would have gotten schizophrenia anyway look it's possible but he was sort of at the outer edge of the window and he had no out of the other edge of the window it's usually for for for boys it's sort of 17 to 23 24 was he showing any issues before at all no according to her i mean this is from her so she's the mother but but well i'm sure she'd be the one who knows the most there are people though too who just kind of have a decline with or without cannabis you do hear of people with schizophrenia it's just a breakup yeah it's just they just can't handle life yeah you know i i mean i know people you know that have gone to medical and stuff that have gone to medical school and then one semester they just can't handle the course load and then their life just goes to shit.

They drop out of school. No one ever hears from them again. They don't get back into school. That's it. That does happen all the time. That speaks to the fragility of the human mind. This is a terrible disease. It's a terrible disease to have.

It is. And it affects a certain percentage of the population regardless of cannabis use um there's a lot of people out there that have schizophrenia that have never used cannabis ever and they've gone completely you know off off the edge um i don't know if you can necessarily blame cannabis for that uh and it would be really interesting to find out if there was some form of a treatment like you were saying with cbd that uh could counteract that or so so cbd has been shown uh in early stage studies to have some moderate impact on psychosis i i don't think from the the numbers that i've seen suggest it really isn't that strong as an antipsychotic but i do think

that if i were a researcher in schizophrenia i would be looking at the endocannabinoid system yeah you have to look at this again i look at it you know from a clinical perspective like the antipsychotics that we have out there are not good they have terrible side effects they have terrible side effects and most of them do have some initial benefit but after two to three years there's almost no benefit right and they have as you said really bad side effects weight gain metabolic disturbances like people want to get off of them so if you have something like cbd that doesn't have any of those side effects of course as a clinician you're going to want to try it right because you know that the other tools that you

have are not really that effective yes right so you? So CBD should definitely be utilized for people who have psychosis and schizophrenia. Well, I think we talked about life changes, like things that happen badly in your life, losing your job, losing your girlfriend, deaths in the family can trigger these breaks with some folks, but psychedelic drugs can as well. I mean, it's a fact. For some people, psychedelic drugs have tremendous benefits for PTSD. Quitting alcohol, quitting hard drugs. There's a lot of people that have used mushrooms, MDMA for PTSD is a huge thing that MAPS is studying right now.

But you can't deny that there's other people, well-documented, that have taken LSD, that have taken psilocybin and taken them in large doses and gone yes and never recovered yeah you know and that's why too i forget who it was maybe it was um mckenna who is on and you guys were saying that like you know we need to use um psychedelic medicines but we need to use them properly right and that's the same way with with uh with cannabis as well i consider cannabis a psychedelic yeah particularly when you eat it absolutely you know it is it is a mild psychedelic and you know so there's risks and benefits to that and you know we need to tease out the risks and tease out the benefits and make sure that people are but alex we need to make sure that people are informed and they get the entire

picture right so you know does your book have some truth in it yes of course it does but does it tell the whole truth absolutely not right and that's the message that you know, does your book have some truth in it? Yes, of course it does. But does it tell the whole truth? Absolutely not, right? And that's the message that, you know, I think people should be hearing. People shouldn't be hearing just part of the truth. They should be hearing the whole truth. And again, you know, like in your book, like you compared, you know, the Mexico and India, right? And, you know, I talked to German Lopez on the phone about this and, you know, who talked to Isaac Campos, right? And he said that.

Who are these folks? So Isaac Campos, he's the guy who basically told the story of how in Mexico people were blaming marijuana, people were blaming marijuana on causing psychosis during kind of like the early 1900s. And then there was some evidence as well in india at that time so i was kind of made the connection you know 9 000 miles apart you know they're both saying the same thing but you know he said that you know you did misinterpret the evidence on it right and and german told me that on the phone and i mean all the cannabis that was

used in mexico at that time was in really marginalized environments. And then when you look at the India study, and I know that you addressed this in your book, because I did read your book. It sounds like you did. I bought your book. So in some ways, I did support you. So I read your book. And like I said, you did address in in the part on india that um yeah you know some of the report um was wrong but i mean the fact is that all almost a lot of those cases

in india were were actually attributed to alcohol or opiates or other things and then the other thing in in uh in mexico is that it was in those environments so you know basically what i'm kind of getting out here is like you know that the national um academy of sciences and engineering you know they you know disagree with how you interpret it their findings and then no they didn't these people disagree with how you interpreted their finds okay but ziva is only one of the 16 members i get that but if we asked other members i think that they would all say the same thing because Alex, wouldn't you be upset if someone just quoted one part of your book and then left out all the other parts? I mean, I would think that would be a huge disservice to my work. I would not want, I would not have put one, put in a ton of effort into something.

And then for someone to only have, you know know just to pick out the part that you know honestly if i had written the nas em report the nam report and came out in 2017 and nobody had paid any attention to it which nobody did and nobody did for two years and suddenly people were paying attention to it i'd be pretty happy about that but what uh what dr hart is talking about is in the first chapter of the book which which I guess you haven't read, and I really should have a copy for you, stupid of me. I got a copy in my bag. So, this is fascinating to me. The British, you know, they colonized India, and they set up what they called lunatic asylums,

really psychiatric hospitals, sort of very primitive psychiatric hospitals. And they were really initially for soldiers in the Indian army and they were run by British doctors. And what these doctors really as early as like the late 1850s, 1860s noticed was that a lot of the people who showed up in these hospitals were showing up with what they called ganja, actually. In India, it's called ganja or bhang, which is a very weak preparation of basically Indian hemp, just sort of low-grade cannabis. And so they started counting, and they realized that 20 to 30 percent of the people who were coming to asylums were heavy cannabis users. And that was way more than alcohol. It was more than opium.

And this really fascinating doctor named George Francis William Ewins wrote a book in 1908. And he looked at the evidence. And it is amazing to hear how he describes schizophrenia, how he describes cannabis, how he describes the cases of violence around cannabis. It's like any psychiatrist today, certainly any forensic psychiatrist like my wife, everything in the book would ring completely true. And it was so fascinating to me to stumble on this and realize this is something people have been talking about for more than 100 years. years so could we agree that there are some people where cannabis is not a good idea absolutely oh yeah right we could agree that i think i think we all agree um we also agree that some people can't eat peanuts absolutely yeah

yeah right and yeah it's not the same thing though well but yeah you know why peanuts kill you that's yeah it's more dangerous so at least like 7 600 a year yeah people die from peanuts so yeah i think more people die from cannabis as a result of the homicide and the suicide okay well there's no correlation that there's no paper that i know somebody's got to do the work wait a minute but why are you saying that then because i've looked at enough data to tell me you think marijuana is causing homicides oh yeah this is what the book is about but in how so because it causes paranoia and psychosis in people and paranoia and psychosis are huge risks for homicide and schizophrenia studies that refute that there's multiple studies there are no studies that refute that paranoia and psychosis are huge risks for homicide schizophrenia Schizophrenia is a 20x, 20 times, Joe. Jamie, I sent you a document yesterday.

I mean, there's multiple studies that show that marijuana laws are not associated with any type of violence. Okay, but let's not forget about marijuana laws. Let's just talk about marijuana use. The use of the drug, yes. So the use of the drug, which could possibly trigger psychosis psychosis and schizophrenia which are correlated with murder is that what you're saying they're not correlated they're triggers that's an absolute fact yes triggers because of the paranoia and delusions and you

think that someone's out to get you and they're not absolutely i mean the the what are the numbers okay so the numbers are if you're if you have a diagnosis of schizophrenia uh you are 20 times as likely to commit homicide as somebody who's healthy. Now, it's actually worse than that for cannabis, okay? And here's why. So the National Alliance for Mental Illness and the mental illness advocacy groups hate talking about this. Why do they hate talking about it? Obviously, because it stigmatizes people with mental illness. So what they say, and this is true, is if you have a diagnosis, but you're taking your antipsychotics, even though the side effects might be unpleasant, you're in treatment, you're not using recreational drugs, your risk for violence isn't that high. It's not that much higher than a healthy person.

And fortunately, healthy people don't commit murder that often. that often. The problem is, if you think about the math for half a second, if there's this one group of people who don't have a very high risk for murder or serious violence, who because they're not using, because they're on antipsychotics, it means that the excess risk in the people who are using and whose psychosis is untreated, it must be spectacularly high. And the numbers bear that out. So there's a really good study from last year, 2018, a small group of patients in Switzerland. Now, Switzerland is a safe country. It has a low base crime rate.

But 50% of the people who were using cannabis and had psychosis over a three-year period committed violence in that group of people. That's mostly 20-something men. Well, you know, there's a study here, and I just sent it to you, Jamie, and it's titled Risk Factors for Violence and Psychosis, a Systemic Review and Meta-Analysis of 110 Studies. So, you know, it's quite a few studies, okay? So, you know, let me just a part of it out to you.

So violence was strongly associated with the history of polysubstance abuse, strongly associated with diagnostic correlated substance use disorder and recent substance misuse and moderately associated with a history of alcohols misuse, a history of substance misuse, uh, recent alcohol misuse, recent drug misuse, and a history of drug misuse. It was unclear if there was an association between violence and a history of cannabis misuse. So again, this is 110 studies. They very carefully looked at all of the different risk factors as to what could trigger violence.

Just let me finish, Alex. And what they said, again, it was unclear if there was an association between violence and a history of cannabis misuse. So that's 110 studies. So cannabis use in there is going to get locked in with polysubstance use, because a lot of people who use are going to be using other drugs.

Polysubstance means multiple substances, alcohol, cannabis. Exactly. But everything else was found to have significant statistical significance. Without, and I have not, I do not know the study that Dr. Hart is talking about. I'd like to look at it. Without looking at it, I can't push back as hard as I would like. What I can tell you is that I have many studies in the book that show that cannabis use is associated with violence in people with psychosis.

And more broadly, it's associated with violence in the general population in large studies, in studies of high school students and bullying, in studies of people who were vacationing in Ibiza, in studies of young men in china and the uk there are big studies out there that show cannabis use is associated with violence abiza abiza i've been to abiza i know wouldn't you like to be the guy do it are you supposed to say abitha i got grilled over there for that they get mad at you yeah you're supposed to supposed to say a beef I got grilled over there for that they get mad at you yeah you're supposed to I can't believe I just said it yeah some some dignitary or royal person had a lisp right isn't that how it all started is that true yeah yeah I believe so noted yeah the way the people in Spain pronounce uh words was directly uh affected by this one person apparently but um so this uh this this correlation um between people that have schizophrenia and using cannabis how do you is is schizophrenia a diagnosis that's purely based on

behavior basically yes it's a clinic there's no blood test you can't do a brain scan it's basically how you behave and and what you tell the doctor about how you're feeling. Right. And what about fMRIs? It's very subjective. How so? Because you're asking someone basically a series of questions. I mean, it's no different than depression, really.

I mean, you're just asking someone a series of questions. And then based upon that, which is very subjective, then you're going to make a clinical decision. Whereas when it's like a blood test, like if someone passes a certain amount of hemoglobin A1C, depending on which chart you're looking at, then you're going to call that person pre-diabetic or diabetic. But unfortunately, we just don't have those objective measurements. And again, that's why Alex was saying earlier that they couldn't really figure out how many people in the United States had schizophrenia. And I understand that. But at the same time, too, I mean, it's okay to adjust the way that you diagnose someone over the course of the years and you learn things.

Because you could easily say that almost everyone has some type of mental illness. And I mean, people should understand that, you know, there's seven different basic human emotions. You know, I've talked with this before. There's anger, there's contempt, there's disgust, there's fear, sadness, surprise, and happiness. That's seven. So, you know, depending on which way surprise goes,

I mean, six out of those seven are negative, right? Because we're wired to basically detect threats. So, you know, when we're making, you know, all these diagnoses, I think we have to be careful because, you know, some people are calling themselves depressed and some people are calling themselves anxious when really, you know, they're just not dealing with basic human emotions that they need to understand and need to deal with. Like people are getting angry about being angry or like depressed about being depressed.

Like if you feel one of these emotions, just kind of sit with it and just kind of reflect on it. And I think, you know, that's a much, much better way to kind of tease things out. But, you know, to come back to my original point, I think that, you know, more people are understanding that, you know, we don't just need to give out a pill for everything and that you know everyone shouldn't just be labeled as having a mental

health diagnosis because if things just keep you know going the way they are you know what's by 2040 it's going to be like 50 of people are going to have like a mental health disorder so people just need to understand that life is hard you got to deal with these emotions sometimes it's not that big of a deal and that's why for some folks and that's why yeah for some folks and that's why i'm such a big fan of jordan peterson because you know he's he's he's kind of tough on people and he said let me stop you there because jordan peterson was on ssris for years yeah that's interesting yeah for a long long time i mean like for a long long time as was his family and what's crazy about him is what got him off is a carnivore diet. I know.

I know. Elimination diet where he only eats meat with salt and drinks water. And he's healthier than he's ever been in his life. And that is another massively controversial subject. So let me push back a little bit. Because I think people, you know, as controversial as the book has been about cannabis and psychosis, this violence issue is even more controversial. And obviously for a fair number of people, it doesn't really – It doesn't sync with the stereotype.

And it doesn't sync with how they've experienced cannabis use, right? So I think alcohol is a really interesting comparison. Blame the Canadian. Why do you have to go national on them? We were talking about my wife's actually from Newfoundland. Newfoundland. Newfoundland, as in understand. Marijuana increases.

No, Newfoundland is how you say it. You can't say Newfoundland. I've trained myself to say it that way. You're telling me I'm wrong? Newfoundland. Look you say it. Really? You can't say Newfoundland. I've trained myself to say it that way. You're telling me I'm wrong? Newfoundland. Look what Jamie just pulled up. Marijuana use increases violent behavior. 50-year study finds casual link between cannabis and subsequent violent behavior.

New research published online in advance of print of the journal Psychological Medicine concludes that continued use of cannabis causes violent behavior as a direct result of changes in brain function that are caused by smoking weed over many years. Researchers have long debated a possible link between the use of marijuana and violent crime. In contrast to alcohol, meth, and many other illegal drugs, the mellowing effects of cannabis seem unsuited to promoting violent behavior. However, ample previous research has linked marijuana use to increased violent behavior. The sticky problem in such studies are that many confounding factors, co-founding factors involved in interpreting this correlation. So, okay. Difficult to determine whether or not any statistical correlation between marijuana use and violent behavior are causally linked or instead the two are associated through some other factors such as socioeconomic status, personality traits, or many other variables that are related to the propensity to use marijuana.

So I think that's a fairly good summary of the issues. What's up, James? To add, the study came from 411 boys who were born in 1953 in London, 97% of which were Caucasian, and all of them are raised in two-parent households. So those people are relatively stable if they're in two-parent households. Unless their parents beat the shit out of them. That's also – no, it's possible. So let me – so I think the alcohol comparison is, again, a good one because anybody who's ever been in a bar at 9 p.m. and gone back at 2 a.m. knows that alcohol disinhibits people, right?

It causes fights, right? It makes people loud. It causes a lot of fucking too. It does, does. does no it really does right it's good and bad i don't know if that's good i mean sometimes it makes people some people think alcohol and sex are a terrible idea right i mean it certainly causes some sexual violence so okay but at the same time everybody knows that you can have a drink you know you can have a beer at the back of your barbecue you can have a glass of wine at dinner that's right and it doesn't mean that

you're going to get in a fight and it actually might enhance your conversation social lubricant all that good stuff all that good stuff and you might even know people i mean i do know people who i would say have a problem with drinking okay but it's mostly they're sitting at home drinking scotch watching baseball until they fall asleep that night. Now, that's obviously not a healthy way to use alcohol, but it doesn't make them violent. But we know on a population basis that alcohol causes violence. It causes drunk driving. It causes problems. And it said that in the study that I quoted earlier, but it said that alcohol, again, they didn't – or sorry, cannabis, they weren't sure.

Right. that alcohol again they they didn't or sorry cannabis they weren't sure right so okay but so this is again i would like to read the paper that you're quoting from because i have so much other research but here's here's what i'm saying about cannabis okay cannabis for a lot of people yeah they can just smoke it and as people you know as many people have tweeted at me the only thing i attacked was a bowl of nachos right like and so and so that's true for some people but that could be said with alcohol as well that's exactly biological like and so and so that's true for some people but that could be said with alcohol as well that's exactly biological variability there's so many studies that say that that the cannabis laws have actually decreased crime i mean i'm looking at a study right now

you gotta let me finish you gotta let me finish you gotta let me finish okay go ahead alex um so so even though for many people cannabis isn't going to cause violence, that doesn't mean it can't cause violence in some people, especially, or at least could be a fact, or at least could be a factor, especially with the kind of violence that I am talking about. And then I write about in the book,

which is again, so alcohol, it maybe makes a argument into a brawl. It makes a brawl into something where somebody picks up a stick. It makes that into something where somebody pulls out a knife it escalates right cannabis is different cannabis causes paranoia and psychosis and it certainly causes those things temporarily even if it doesn't cause them permanently so a distortion in reality that could lead to you doing something terrible and it's usually to somebody you're not actually fighting with it's

a family member. The worst cases that I've, and I've really seen a lot of these cases are basically innocent family members who are just in the way when somebody loses touch with the reality and literally thinks like this, my 85 year old grandmother is going to kill me. So I better stab her to death first. That happens. It happens a lot. And if you look at the amount of violence that people with psychosis commit on a population level basis, it looks like people with schizophrenia commit about six to 10% of all the murders in this

country. And it looks like people with sort of broader, more broadly defined psychosis, again, bipolar with psychosis, other psychotic conditions, with psychosis other psychotic conditions temporary psychosis they might be responsible for as much as 20 of the violent crime in the united states that's a lot of violent crime and what i'm saying is that it is quite clear that drug use mediates that violent crime in other words if you're not using you can keep your impulses in check but when you do use you become dangerous so when we're talking about biological variability if we factor in schizophrenia essentially what you're saying is that there are people that have schizophrenia that don't commit violence but that they're much

more likely to commit violence if you add some sort of psych medication whether it's marijuana whether it's something else that perturbs reality for them and particularly antipsychotics bring down the use but you said medication yeah so recreational drugs the worst the worst cases of all are cannabis and a stimulant because to the they both like cocaine or meth exactly yeah so when you get that you get paranoia from two sources and you get the only good thing about cannabis from this point of view is it kind of knocks people down a little bit, but meth brings them right back up. So is it fair to say that what we don't know is that we don't know whether or not these people, like this young man with this terrible story from Connecticut,

we don't know whether or not he would have become a schizophrenic and exhibited those symptoms without the marijuana. We really don't know, but we do know he did with it. That's correct. And what I would also say is that for somebody like that and this is quite clear on a population level basis with people with schizophrenia is you've got to discourage them from using they really have to be discouraged because it brings out the worst right and and you know somebody said this a friend of mine an old friend of mine from the new york times said so every time there's a hurricane, some people on the right say, well, you can't prove that global warming caused that one hurricane. That would have happened anyway.

And they're right. You can't prove it. And you can't prove that any one case of psychosis was caused by marijuana. But when you look at the big studies at the population level data, the association is really clear. And everything points the same way. And the synthetic cannabinoids, K2 and Spice, those can clearly produce psychosis in people. And people with psychosis tend to slip back into it if they use. At some point, you've got to start to say to yourself, why does everything go the same way?

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

And this was not the case before. I mean, whatever it was that triggered him, I mean, when I was around him when he was younger, I would have said he's a total normal guy and I would have never saw that coming. He was a heavy marijuana user. Heavy, heavy. I don't know how he's doing now.

I hope he's okay. But we have mutual friends. Yeah. And he became a schizophrenic. know how he's doing now i hope he's okay but we're you know we have mutual friends yeah and uh he became a schizophrenic and and you know you will see you know cases like that but you know when you do look at a lot of the larger data on on cannabis and violence i mean it's just it's just not there like there's lots of data that suggests that you know medical marijuana laws for example can actually have a decrease in overall crime.

They could. I mean, there's a study that says that. That gives no comfort to the people who lose their children because of these psychotic breaks. That's right. And those studies are really bad. So the place that you can criticize...

Why are they bad, though? Because state-level data is not great. The place the book has been criticized... There was a Rand review, though, in 2013. And I mean, again, that stated that... So a state-level data... the book has been criticized the rand there was a rand review though in 2013 and i mean that that's again that stated that state level data marijuana use does not induce violent crime and the links between marijuana use and property client crime are thin so can we stop right there i think we all agree that marijuana use by itself with people that aren't schizophrenic probably doesn't induce

violent crime but with people that are schizophrenic or people where it triggers schizophrenia it could potentially induce violent crime my friend did not get violent although he did do a violent thing it wasn't to a person yeah um i think i think we have to be really careful because there's no just like with diet just like with the food and you know like allergies all these different variabilities when it comes to human beings i think we have to be really really careful about lumping all people together when it comes to how they get affected by various compounds yeah so so the state level thing if you want i'll i'll so the place the book has been criticized in my mind sort of the most fairly is it points out that in the four states that legalized first which is alaska washington oregon colorado um if you look at 2013 and then you compare that to 2017

murders and ag assaults violent crime um are up substantially in those states and substantially more than in the u.s can i stop you there but is there a possibility there's a correlation between organized crime because one of the things about selling marijuana is the people that have always been selling marijuana have been criminals when you make things legal in a state the people that were selling it illegal flock to that state and that's been proven to be true so that there's there's a direct correlation between people being robbed that there was also a significant problem with credit cards and banks where everyone was having to do all their transactions with cash there was a lot of violence that was associated with marijuana in regards to that and also massive

increase in population yeah so so and that's part of the reason why trump is actually not really against uh cannabis in some ways is because he feels that if we have medical marijuana laws that especially the states that are that that are border states that the crime is going to drop drops out tremendously and it has dropped they they did a study uh last year and it dropped over 15 percent in colorado and it dropped seven percent in arizona so and then again you know benjamin uh hansen who's who's an economist the wrong data so let's talk okay so he he said that the murder rate did not demonstrate that marijuana legalization increases violence and then it may have actually demonstrated that legalization slightly decreased

violence and he thinks that the reason that there was an increase in the murder rate particularly in washington is because there is a large income gap. They say that Washington has the 10th largest income gap in the United States. And that's why. How did that change, though, that corresponds to the murder rate? Good question, Darrell. So I didn't get to speak with Benjamin about this. That sounds like confirmation bias.

Well, I mean, that is one thing that has been shown to, you know, um, increase mental illness, like we talked about and can definitely increase violence is when you have, um, an income gap. Right.

But how, but how's the income gap shifted that directly correlates to the legalization of marijuana? Because during the same, because during the same period, the income gap, particularly in Washington and increased. Okay.

So he feels that, you know, the washington and increased okay so he feels that you know the corresponding number right so he feels that that it's it's likely more more to that and i mean he i mean i understand but i mean you have to respect this guy but i don't respect him because i know what he did with his data and tell me what his data is so so joe this this is maddening to me okay okay okay violent crime in those four states increased more rapidly than in the U.S., period, between 2013 and 2017. Here, Jamie just posted this up here. Conjecture aside, no credible data exists that supports a significant association between

the increased violent crime and marijuana legalization. Furthermore, studies suggest that, so far, violent crime decreases in states with legalized medical marijuana until new research credibly suggests otherwise the claim that a demonstratable link between the two exists will remain classified as false. Okay, so that's just not true. Okay, I know it's Snopes, okay, and I know we trust Snopes. I don't trust them that much. Okay.

I was going to say that too, but they give all of their links right here if you'd like to. So again, my data. What are these? There's a lot i was gonna say that too but they're they give all of their their sources right here if you'd like to so again what are these do you are you a lot of where are these sources yeah i've read this stuff and what's wrong with them okay here let me just go back to what i'm saying yeah please do 2013 oregon washington colorado alaska There are 450 murders in those four states. There are 30,000 ag assaults, period. 2017, Oregon, Washington, Colorado, Alaska. There are 620 murders in those four states. That's an almost 40% increase. There are 38,000 ag assaults. That's a 25% increase. If you adjust for population, you still get big increases. In Denver, 2018, almost 70 murders. There were about 35 in 2013. Seattle, 2018, there were 34 or 35 murders. There were, I think, 19 in 2013. These increases are real. Okay. Now, can we say that marijuana legalization caused those increases. We cannot yet.

There are other possibilities. What are those? Well, first of all, population did increase. It's also possible that these states, quote-unquote, imported violent crime. In other words, that you've got a population of transients coming in, in part, because marijuana was legal, and those people are likely to commit violent crime. And on top of that, organized crime people that are selling. selling absolutely there may have been some people who are exporting to to nebraska

to minnesota to other states there's crime associated with that but what i am saying is that unequivocally unequivocally the people who said legalization is going to decrease violent crime and people did say that and cory booker in 2017 said it. He said that it actually had decreased violent crime in states that legalize. And he didn't say it randomly. He said it when he was introducing legislation to legalize marijuana on the federal level. Those people are wrong and they need to stop saying it. I know. And by the way, that Oregon economist used, he used the wrong data set for his charts, okay? He used, I used the real numbers, okay?

The FBI homicide numbers. He used numbers that include justifiable homicides and police homicides. No, that's not right. Because the FBI reported that the murder rate went up 1% from 2015 to 2016 as compared to the nationwide, which went up 7.9%. And then it dropped by 11.6 between 2016 and 2017 with respect you do not know what you're talking about okay those are fbi numbers i'm reading not know what you're talking about the numbers are clear okay i use i'm reading them right now 2016 release of fbi uniform crime reports from oregon okay yes o. You're not reading the reports from the United States.

You're picking one state for one year. Jamie's showing something. The state that has legalized medical cannabis. It's over the entire country from that time period, too. So to pick those four states where marijuana was legalized is sort of cherry-picking data. No, it's not. It's picking every state where they were legalized and comparing it to the whole country. The whole country erased.

But the whole country is similar? Is it a similar increase a similar increase that's what i'm trying to show yes if i'm trying to show something wrong we'll pull back so we can see the whole the whole so first of all that's a that's violent crime not murders and violent crime right be in there well violent crime and ag assaults aren't they no so so so the four categories of violent crime are murder, ag assault, robbery, and rape. Rape has sort of gone sideways the last few years. Robberies actually have gone down. It's murders and ag assaults that are interpersonal violent crime. Okay, just to go back to this Oregon economist because this maddens me.

He used a data set that is not the standard data set to report murder rates. What is the difference? He used a data set that includes justifiable homicides, meaning I'm in my house, you come in, I shoot you and kill you, the police don't charge me with anything, and police homicides. But the data sets you use in your book aren't even published. Let's not interrupt. Let me finish. Those two categories of crime are not likely to be impacted by cannabis use.

Cops are not smoking when they're on patrol, I hope. And if you are using, you're very unlikely to have your murder viewed as justifiable homicide. The fair comparison is the base murder rate in the U.S. And that's the number that I used. And I am telling you, I mean, I know these numbers. I sleep, you know, I wake up with these numbers. I am telling you, I mean, I know these numbers. I sleep, you know, I wake up with these numbers.

Cannabis, the four cannabis legal states on a per capita basis, crime murders rose 31% on a per capita basis in those four states over the 2013, 2017 period. Maybe, I'm sorry, I said 31, maybe it's 29%. So maybe I say I woke up with, anyway for the u.s it's 18 29 versus 18 that's the gap and i am not saying that i know that cannabis legalization caused that gap what i'm saying is people need to stop claiming that cannabis legalization reduces violent crime it in it has increased in those states i asked you ask you, in those states, was it universal, the increase? Was it almost identical? Yes, Alaska was the most.

Then I think MERS went up more in Washington. And what's also interesting, Joe, if you really want to go into the numbers, is the gap actually widened year by year. So that's sort of what you would expect if this is the result of a psychomimetic effect. In other words, a psychosis-causing effect effect because cannabis doesn't cause psychosis right away. People break down, but if it's causing heavy use and some of those people are sliding into,

you know, paranoia and psychosis, you'd sort of expect the gap to increase over time. And that's what's happened. Okay. So, you know, I'm going to go back again to the Netherlands, okay? Because they've had, you know, cannabis legalized forever. And they have one-fifth of the homicide rate that the United States does. Right. But they also have a lower cannabis use. That's true. They also have very few guns.

But still, you know, one-fifth. They do a lot of kickboxers, though. They do a lot of kickboxers. But one-fifth, I mean, mean it's still it's pretty drastic overall and and again you know alex you know you know i appreciate some of the when we're talking about the correlation between cannabis use one of the things that we have to accept in america is that when you're in a place like the netherlands that has a long and accepted history of use people are accustomed to it. So I think things kind of even out.

I think one of the things that we're dealing with with the United States is people that have just, they don't have a long history of experience and it becomes legal and then they use it and maybe some of them, like we're talking about, don't have a tolerance for it, have too much. And like I was talking about with my friend who's like this really cotton the the one who uh

had an edible and became suicidal and was fucked up for weeks that is very confident very articulate very intelligent he's not a not a weirdo not a not a transient extreme extremely successful you know i think there are there are variables that we need to take into consideration there's certain human beings that exhibit a pattern of behavior that's directly correlated to cannabis use that I don't experience. So if I could say from my own personal biases that that's bullshit, that's nothing, it doesn't do anything. I've been smoking for years. It doesn't do shit. Well, you probably don't have one of those three genes that we were talking about earlier.

You're clearly pretty psychiatrically healthy. And you probably also too, you know, don't overuse or you have some type of, you know, legitimacy as, as to why you, you are, you are using it.

And, you know, one, I want to keep going with this, but you know, at the end of the show, I think that we should make some type of like recommendations for people just because I hate when,

you know, you have this big, you know, three hour podcast. And then at the end of it, it people just because I hate when you know you have this big you know three hour podcast and then at the end of it it's just like hey guys just be safe you have some type of recommendations. Like, I love the podcast with Cressor and Joel, right? But at the end of it, it was just sort of like, hey, guys, don't eat the American diet. I think most people realize that one person was going on data and the other person was, you know. Yeah. For sure.

I mean, I find it so fascinating that now when you think back through your life, you've thought of somebody who was affected. I have several people. I'll bet as you think about it, you'll think of more people. Maybe, but those are the big ones. And like I said, my friend who is a martial arts instructor, it was a pretty significant issue with a lot of our friends. We were trying to figure out what was wrong with him beforehand. He was sending me these videos that didn't make any sense. And I was like, what in the fuck is this?

I'll explain to you more off air so I don't have to out this guy. But a lot of people that were close to him were really seriously concerned. Now, is it something that would have happened anyway? I don't know. I don't know. How old was he? He's in his 20s. Late 20s?

How old exactly? Late 20s, 20, you know. That old was he? He's in his 20s. Late 20s? How old exactly? Late 20s, 20, you know. That's right around the age. Well, it's sort of at that. It is a little bit late-ish. Because like I said, a lot of the studies, even when you look at the ones on adolescence, for sure it's below, they have done studies,

below 18 is worse than say below 25. Below 15 is worse than say 18 like the younger you go um the worse and he seems to be fine now that's good that's good is he using now i don't know i have to find out and it's uh you know i'm not an expert on this subject but it's because of this um of something called pruning that we go through so everyone goes uh through this and basically if you're adolescents you're going to drop off some some weak neural connections to kind of pick up some stronger ones you know it's the best way to kind of explain it um when you use cannabis you can potentially accelerate that process and then

because you accelerate that process you don't get those good neural connections and then you know people unfortunately you know develop things like like, like psychosis and, um, and, and schizophrenia. So, you know, that's kind of where, where the, where the issue lies. So, you know, one thing that I am, you know, very happy, uh, that we're talking about, and I know Alex will be too, is that, you know, we want to discuss the benefits in, in this podcast, make sure that people understand that, you know, I believe that marijuana is medicine. It's an excellent medicine um but the other thing though too is we do want to mitigate the risks because there are real risks out there so you know i i do appreciate you know um us talking about adolescence and making sure that

they do stay away from cannabis yeah and i mean especially that's like i read these you know these cases there's a case file sometimes these cases, the case files sometimes. You know, the kid started using when he was 11, and it's like, that kid never had a chance, right? And obviously, oftentimes, these are kids coming from disadvantaged backgrounds anyway. But, you know, they're using by 11, and at 16, they put a gun to somebody's head and pull the trigger. I mean, the pre-adolescent and early teen use we got to do everything we can to stop the problem is yeah like if you if you smoke pot in junior high like say seven eight nine like you're probably going to smoke pot in high school like that's i mean that's what i saw when i when i was growing up and you know even when i was uh home for christmas for a few days

like yeah a couple of my friends even talked about you know um some people that we knew you know smoked a ton of pot in high school and like now like they're they're they're crazy or they're not really doing too too much you know so but there's you do have to be careful with that i think we're dealing with a lot of ignorance we're dealing with a lot of ignorance when it comes to biological variability, right? We don't really understand how a lot of these different things affect people, including just diet and what causes depression, like how much of what we constitute or what we decide is depression is inflammation, poor gut health.

There's a lot of variables. There's a lot of them. Marijuana is absolutely one of those variables. And again, I don't have an issue with it. I liked it. I love the stuff. But it doesn't fuck with me. lot of variables there's a lot of them marijuana is absolutely one of those variables and uh again i don't have an issue with it i liked it i love the stuff but it does it doesn't fuck with me but i'm also honest and so i see these people where it's pretty obvious to me that something's going on and that marijuana is not a good idea for them and i i just think you know like i said in the past i myself have been guilty of using this uh this sort of uh

blanket description of it as being a positive influence and that it's a good thing for people i don't think it's a good thing for everybody no it's definitely not a good thing for everybody and it's definitely not a good thing for the people who have um those genetics that i discussed earlier and you know also too like you know if you you need to have some type of like self-awareness like the people who you know don't do well with cannabis you know you you shouldn't have you to have your friends tell you that okay man like you're not doing too well you should be able to figure out yourself like but that's hard for people i mean that's one of the most difficult things for people to do is a self self-assess you know to be objective you

know and and that it's a really i've obviously i've heard from a lot of people who used heavily and seen other people who've used heavily in the last month and i think it's very interesting why people continue to use when they're getting paranoid and and you know the the most cogent argument and again i'm i'm not you know i've smoked a handful of times in college in africa i actually don't think i'd be comfortable using high THC cannabis now knowing what I know. But anyway, so the people – I got some right here. I'm going to get hot boxed.

I'll give you the shit to put Elon on the moon. But the most cogent argument – I thought it was so interesting. This guy said, well, you know, my friends, I would talk to them and say, I'm paranoid now, but I'm going to smoke through it. I'm going to smoke so much that I'm almost comfortable being paranoid. And I think that's a dangerous thing to do to your mind. Because you're sort of counting on being able to step back from that and stop using. Yeah, that's a silly way of looking at it. I think that some of what we call paranoia, just normal paranoia, is hypersensitivity and hyperawareness.

And awareness to a lot of things that you're putting off in the back of your head. Because in order to function as a normal person and get through this life you can't really be aware of everything otherwise you'd be yes look you're paralyzed by fear we're in space okay we are on a gigantic ball that's spinning a thousand miles an hour hurling through infinity this this is reality and that's and take us out thin layer of gas that's protecting us from everything that's flying around in our solar system. And by the way, at best you get 85 years and then it's all shit anyway. And even if you make it to 100, the last 15 are dog shit.

You can't really, you can't think too much about this stuff. Making the stem cells and stuff will be too too bad. Maybe. Yeah, maybe you're going to live to be 300. What do you do? The universe is infinite. You're going to die. The sun is going to end. Imagine if people do live to an infinite number where we realize our fucking sun is dying.

You're going to freak out about that. I mean, it's all relative, right? So there's only so much you really can think about. And some of what paranoia is, is this hyper-awareness of all these variables that you really haven't considered. And then also, what we were talking about before, the things that can be beneficial, the hyper-awareness of how you communicate with people, and maybe you could have done a better job with that. Maybe you came in hot.

Maybe you were upset about something else when you ran into them. You were already at a seven, and they brought you to a ten, and it was totally unnecessary. Within a normal situation, you would have only been at a two. Those things are real, and sometimes marijuana helps highlight all the errors in your way i think it can be a tool but my description of it is like any other tool with like a hammer you can build a house with a hammer or you could just hit yourself in the dick if you're fucking

crazy and this this is something that i think we should consider when we're discussing almost any psychedelic medicine and i think that i really do believe that marijuana is a psychedelic. And I don't even think it's a mild one, especially when it's in edible form. I don't think it's mild at all. Yeah, I mean, there's some people that come in to my office, for example, and just when I meet them,

after one or two minutes, I just got it to the side of my head, this person's not using THC. Right, right. You know, like this person is anxious what what what gives you that is that what it is anxious yeah it's just a feeling of um they're not really they're not someone who can just sit and kind of like be by themselves you know they just kind of give me the impression that um you know they're not going to do well with cannabis because if

they have any type of change in their, um, in their psyche, they're going to see that as bad. That's bad. You know? And like, you got it when you're using cannabis, you, you have to be someone who, who knows that, okay, I'm going to get a little bit of maybe paranoia now, or at least my psyche is going to change a little bit. I am using, you know, psych wax of substance and not be able to freak out. Right. But some people, um, you know, I know that if, if they use a little bit of THC,

they probably would have a freak out. They probably would have a bad experience. Generally, it's people who are, you know, very, very fearful. Now the other side of that coin though, is that if you use CBD and like we discussed earlier, that can decrease learned fear. Right. So, so that, so, you know, that's something that's, that can decrease learned fear, right? So that's something that's really helpful for those patients. But I do agree that we have to be careful about using high THC in certain groups of people, for sure. You know, I think one of the, and it's great to hear Dr. Hart say this, one of the real disappointments for me with this book has been, really the biggest disappointment for me, has been that the DPA, the Drug Policy Alliance, and that some of the other advocates, they just want to yell at me. And they want to say that I don't understand correlation and causation and that I'm cherry-picking studies.

Let's acknowledge that a lot of people use this drug. And that's true whether it's legal or not and let's acknowledge that probably in 2020 certainly if there's a democrat elected most of the democratic candidates have said they favor legalization there will legalized cannabis will probably be the law in the united states okay and let's talk about what we're going to tell people who are using and and and you know i had this round table with uh the executive director of the DPA and some other people. This was about a month ago, shortly after the book came out. And I proposed what I thought were really common sense warnings.

And she basically wouldn't agree. I mean, she agreed to like one of the five of them. What were the warnings you proposed? It was stuff like if you have a family history of severe mental illness, you probably should not use cannabis. You probably – you should not use – or try to delay your use until you're in your 20s I think was one of them. And one of them – I mean I thought – I couldn't believe I was getting pushed back on this was something like if you're having strange thoughts, especially paranoid thoughts while using cannabis, the drug may be increasing your risk for severe mental illness and you should not use it. I mean, I think that's, I think if, you know, now look, we can argue about how severe, severe

is, right? But certainly if you wind up in the ER even once, that's a bad sign. And I just, I just don't understand why the legalization can be, look, I can understand why people who are selling this drug don't care, right? We know if, you know, if tobacco has taught us one thing, it's that when you're selling a product, you will sell it to people even if it kills them. But I don't understand why these people who are supposed to be science-driven and supposed to be thinking about the greater good won't agree to reasonable discussions about what the warning should be on this. I think you did yourself a slight Disservice by not including Some of the beneficial aspects of cannabis

I understand your perspective, I understand why You were doing that because you really wanted to highlight the dangers But I think that's one of the things that they can Point to when they say you cherry pick data But I think that also It's really important to When you're having these kind of conversations To have a long one

We've really covered the full gamut, right? And I think that's probably one of the reasons why Bill Maher didn't want to have you on because he's got five other people on the panel. Everybody's talking over everybody, and you have five minutes to get your case out. And I don't think it's possible. I think this is a long, complicated discussion that has to do with biological variabilities. complicated discussion that has to do with biological variabilities it has to do with unique situations with human uh just human psychology the way the brain functions whether or not it can act as a trigger to schizophrenia where someone may not have ever experienced that

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

body yes yeah what one thing though too you know i noted in your book, Alex, is that you said that you didn't think that cannabis can help the opioid epidemic. Is that true? I certainly don't think it's a good idea for people who are at risk of opioid use. Okay. So I have seen a lot of people in my practice come off of opioids with cannabis use. And there are you know various medical studies that do show that people who use cannabis can um can replace opioids uh with with

cannabis a lot of folks feel though that that's a pen in you know in defensive that that's just a patch and they're really the best way to get off of opiates is ibogaine and that ibogaine just the the repeat rate of addiction or people try it again afterwards is really low i i think i you know one of the things with that is just the accessibility the affordability like i've never administered ibogaine before um well it's just because it's illegal in the united states but i mean and it's a particularly ruthless medication that i've never tried personally but the people that i know that have tried it have had spectacular results, especially people that have had problems with pills. In fact, a friend of mine, my friend Ed Clay, he opened up a clinic in Mexico based on his own interaction with pills.

He had an injury. He got hooked on the pills and really had a fucking problem. So he went down to Mexico and went through an ibogaine uh session and cured him just whacked it out it changed literally changes the way your brain interfaces with your addiction it's not it's not simply a perspective enhancer it it changes how you your body and your brain deal with with opiates i think uh tim ferris has actually talked about that before yeah as well yeah um but i mean you know i've seen it in my practice and there are medical studies. So I don't think that we should throw out the fact that, you know, cannabis can help the opioid crisis.

And then also to, you know, you want to look at it from a clinical perspective, right? So we know that opioids can kill people, right? Because it acts on the brainstem, whereas, you know, cannabis doesn't. So, you know, you might be saying, you know, you're just substituting one for the other. And, you know, sometimes that is true. But if you're using a less harmful substance, you know, to me, that's like a huge win, right? So if someone, you know, has to drink, you know, 12 beers a night versus smoking like one joint, man, that's awesome.

And I mean, you look at all these clinics, like you look at like methadone clinics. I mean, what are they doing? They're, they're trying to get people off one substance to, you know, a substance that is a little bit less harmful. And I think that when you, when you use cannabis, you know, it can be effective for, for opioids. It can also be effective for, for benzodiazepines and for other medicines as well. So, you know, I, it'd be awesome if everyone would just, you know, feel happy and great all the time by just exercise and nutrition. And, you know, that's what I advocate and that's what I try to do personally. And that's what I try to, you know, say to my patients all the time.

But I understand though that, you know, sometimes life is hard. Sometimes things hit you. You have crisis in your life. You have personal crisis that can throw off your mental health. And then you get into a car accident and you could be in really severe pain. And in those times, sometimes diet, exercise, meditation, doing all the right things just isn't quite enough. And, you know, I think that it's great that we have cannabis for those situations because it does seem to be, you know, very effective and has less side effects compared to some of the other medicines that we have traditionally used. And, you know, even though, you know, I'm talking about opiates and deaths,

you know, we can also talk about NSAIDs, right? Like non-steroidal anti-inflammatory drugs. So, you know, these drugs can also, you know, wreak havoc on your GI system. I saw one study, actually, I tweeted out, Rhonda Patrick tweeted out, said that if you use NSAIDs, it was really short. I got to look it up again, but it was like two weeks. It can decrease your gonadotropins, which can stimulate your testosterone level by like 25%. And on that note too, we should talk about, I can't believe I forgot to talk about this, but opiates can drastically inhibit your testosterone production, right? Which is a huge thing for depression. Because I've had

guys come in to me before that have been really, really depressed. You just give them a small amount of testosterone, and man, they're off their antidepressants and they're off to the races. They're doing great. So are we creating a lot of people who are depressed because they're using opiates and their testosterone levels are low?

And for men, having low testosterone is horrible. Your libido goes. You're going to have low motivation. You're not going to feel as well. You're not going to want to do things. So if you're giving someone a medicine that nails their testosterone levels down, that's going to really wreak havoc on their mental health. And I just want to make a note, too, because Ben Greenfield, who, again, I really, really

respect. I like that guy a lot. You know, he was talking a little bit with you about testosterone and cannabis and how it can drop it. So I think there was three studies I saw done on humans, and two of them noted no statistical difference in dropping testosterone levels. And one study, the other study noted a small statistical difference. So, you know, I think that, you know, it may drop your testosterone levels a little bit,

but it's not going to, you know, substantially drop them. So just so people, people know, know that, because I know that comes up all the time, you know. So people, people know, know that because I know that comes up, um, all the time, you know? Oh, yes. As the, as the, as the dumb anti-drug advocates like to say, doobies cause boobies. Oh yeah. Yeah.

That is, that is, that is not, that is not right. There's no, there's no. No, I'm joking. Um, Risperdal causes boobies, but that's a different a different issue um risperdal is an antipsychotic the spirit yeah so so look i think i think the issue of whether cannabis is a gateway drug there it's 100 clear that cannabis is a gateway drug the argument is why. Did you say it was 100% clear? 100% clear. The argument is why. Okay. So it's quite clear that cannabis use oftentimes precedes other drug use, whether it's opioids, cocaine, other drugs. Now, one argument, and this is actually a pro-legalization argument, is one reason it's a gateway is that if it's illegal, you've got to buy it from your friendly neighborhood dealer. He might have access to heroin or cocaine, other drugs.

And so eventually maybe you decide to try one of those other drugs. So actually that's really why the Dutch legalized. They wanted to create an avenue for people to use cannabis that wasn't connected to other drugs. Okay. Another possibility is that using an addictive intoxicating substance, you might like it and you might want to try other addictive intoxicating substances and it might prime your brain. And then the third possibility really is that there are just some people who are risk takers out there, right?

They use, they're going to use cannabis, they're going to gamble, they're going to, and cannabis is a little bit easier to access than other drugs. So they're probably going to try cannabis first. So it's not really that cannabis drives the use. It's just that cannabis is first they're just curious people but what's your thoughts on well what i will say i mean i'm just going to go back to the nam report right i mean i mean you quoted these people yes in your book um you know so this committee couldn't find sufficient data demonstrating an association

between cannabis use and initiating opioid use they found no compelling evidence to support the gateway drug theory so so again but that's the people that you quoted in your book so there's been more research done since then but things have radically changed i would say things have changed some here's here's here's what i would rather say i think that probably it's a combination of these things right it's there's certainly an environmental factor where again if you're buying from somebody who's got access to other illegal drugs, maybe you try those drugs. At the same time, getting high feels good, and maybe you want to try other drugs. And at the same time, you're just a risk taker. Okay. What nobody seriously ever said until about the last five years is that cannabis could be an off rampramp for opioids. And there's a lot of

reasons to believe that's a really bad idea. First of all, cannabis, if you actually need opioids for pain relief, cannabis is not a good enough pain reliever. It's like alcohol. It's a mild pain reliever. It's not strong enough. If you're dying from cancer, cannabis probably is not the pain reliever that you need. You need opioids. And again, the state level data is not as good. If you want to really figure out what's happening to an individual, the best way to do that is to follow that individual. And there's a really good paper that came out in 2017 after the NAM report, so they didn't have it, that shows that people who used cannabis in 2001, this is based on a large national study in the US. were three times as likely

to be using opioids three years later. Okay. And that just intuitively makes sense to me. And the other thing that people on the legalization side don't ever talk about is who are the two countries that have the most cannabis use in the West, the U.S. and Canada? Who are the two countries that have by far the worst opioid epidemic? The U.S. and Canada. Okay, but there's a real issue with that because the United States is also the only country other than New Zealand that allows pharmaceutical companies to advertise. I mean, there's a – Yes, but Canada doesn't. The amount of opiates that are prescribed in the United States is fucking preposterous.

I agree. Particularly, I don't know if you ever saw the documentary, The OxyContin Express, but the way Florida used to be structured, where they didn't have a database. And you could just literally go from pharmacy to pharmacy. No, we have a problem with the way we prescribe drugs in this country. Opioids, ADD drugs, benzos, SSRIs, all of them. And we're connected to cannabis, so it makes sense that it would filter over there. Yes, but what I would say is that people who think that cannabis is not part of that over-prescribing problem

are deluding themselves. And what do you think to that? Sorry, can you repeat the question again? So I agree with Joe. The way the access to opioids in the U.S., I mean, certainly it's come down a little bit in the last couple of years, but, you know, Purdue Pharma,

there's a special place in hell for those guys, but it's not just opioids. We prescribe too many benzos. We prescribe too many ADD drugs. We probably prescribe too many SSRIs. We prescribe too much in this country. I think we all agree on that. I agree with that. I think that cannabis is another example of us looking for a drug to solve our problems. But what I'm, okay, again, just from a clinical perspective, you know, I can't just rely on diet and exercise for all my patients.

I have to use other tools. And again, like everyone here in this room, like we're all pretty healthy. I don't have, you know, a bad back or, you know, I don't have a mental health diagnosis or anything going on. So, you know, I have to look at patients that are coming to me, right? So the way I see it is that, you know, we just mentioned a bunch of other drugs, you know, antidepressants, amphetamines, all these types of things, you know, cannabis. And again, you know, I'm going to separate the THC and the CBD. It's an incredible medicine and it doesn't kill people, right? So as a clinician, you know, that that's so comforting for me to know that

every single night I go to bed, I killed zero people. I know that, right? So that's really, really comforting for me to know. Also, I feel, you know, we just talking about amphetamines and we were just talking about, you know, SSRIs. I feel that cannabis, you know, particularly the CBD component can actually be more effective. You know, that's what I've seen a lot in my practice and other people have seen that as well. So, you know, I think that we need to take that into consideration when we're using all these drugs. And Alex, you know, some of the things that you're saying, you know, they're quite, you

know, admirable and a lot of things like researchers say, you know, are quite admirable as well. And, you know, they feel that they can, you know, tell clinicians, you know, are quite admirable as well. And, and, you know, they, they feel that they can, you know, tell clinicians, um, you know, give them really good advice, but they're not the ones in the trenches. They're not the ones in front of the people. They're not the ones that, that have to have to chat with patients. You know, I have an obligation to do something for my patients to make them better. I really feel, you know, we just listed a bunch of drugs that cannabis is a really, really effective tool and, and it doesn't kill anybody. So, you know, because of that, you know, I'm going to, I'm going to keep, keep using it. But like I said, I'm always looking for other drugs. I'm always looking for other, you know, alternatives to also, um, help my patients. But

I think that, you know, using cannabis is a really effective tool for a lot of clinicians and it's helped a lot of patients. But what do you think about his argument about it being a gateway drug, other than what these people said in the study that there's no evidence that supports it, it's a gateway drug. What are your personal feelings about that argument? So I don't feel that cannabis is a gateway drug. I do feel that, you know, that you mentioned earlier is that some people kind of have this personality where they're like an experimenter, right? And they just want to try something. So the fact is that alcohol and cannabis just get introduced first most of the time. Most people don't do Coke or LSD andsd and then hey say hey man let's

try some some cannabis right so it's just that that's the very first one there so if we so you could say anything that that that was easier access if there was some new drug that you know did something similar to alcohol or similar to cannabis that was introduced in in our society you'd be calling that the gateway drug. And I do feel, and I do believe that. Well, alcohol has clearly been demonstrated as being the gateway drug to almost all hard drugs because of the loosening of inhibitions, whereas the opposite could be said about cannabis, that it makes you paranoid you might actually be less likely

to try cocaine afterwards. And I know that the name, you know, they don't feel that cannabis is a gateway drug either. I mean, again, the name uh you know they don't they don't feel that the cannabis is a gateway drug either i mean again they said you know they found no compelling evidence to support the gateway theory and again i mean these are the people that you are quoting in your book let me just go a little bit further they said in a retrospective cohort study um may it from etal and the 2016 examined the transition from cannabis use to the use of other illicit drugs they found that the probability of initiating other illicit drugs after cannabis

did not differ significantly from the probability of of starting with other illicit drugs so it's just that cannabis is there first it's definitely not a gateway drug in any stretch of the imagination again i i just I totally disagree. And again, there's 50 years of data on this. I know the studies that he's quoting, but there are many others. And I think the argument is as to why. And again, I think the argument that to some extent having access to this drug illegally tends to open you up to other illegal stuff, which to me is an argument for legalization. So, but I do want to throw one thing out there.

You know, I don't know how many of your viewers have teenage kids or, you know, it's probably more likely to be teenage kids than to have teenage kids. The one thing that really worries me, if we're talking about gateway drugs, is that Juul and vaping are really a gateway to THC vaping. So you can – Why do you say that? Because, well, first of all, it gets people – it gets kids, teenagers used to inhaling this illicit substance. And you can actually retrofit a Juul pod with THC. They don't sell them, but you can easily gofit a Juul pod with THC. They don't sell them, but you can easily go online and look up how to do it. And I think it really worries me, and I've heard from a lot of parents in the last month, that there is an epidemic of nicotine

vaping and THC vaping going on right now. And that, I think, and we're talking about 15, 16, 17-year-olds inhaling pure THC, the most dangerous form of this drug. And I think, and we're talking about 15, 16, 17-year-olds inhaling pure THC, the most dangerous form of this drug. And I think, unfortunately, it's not going to take long before the mental health consequences of that become apparent. And I really do hope that the book gives parents some tools to talk to their kids about that, if nothing else. Last words? I would actually want to go over a few things that maybe i thought you might be interested in okay okay so um you know you're a dude you're over 50 so prostate cancer so uh you know it's been shown that cbd may actually be beneficial for prostate cancer and one thing

within that too in the same study they actually found that um people who used CBD and were on chemotherapeutics has actually augmented the efficacy of chemotherapeutics. When you say good for prostate cancer, do you mean to prevent it? Yes. Do you mean to treat it? Prevent and treat. Yeah. Mm-hmm.

Yeah. And then they say, you know, THC may actually be a little bit effective because it can, and this comes back to testosterone a little bit, it can antagonize DHT. can, and this comes back to testosterone a little bit, it can antagonize DHT. So DHT is another testosterone hormone, as you know, and that's more linked to prostate cancer. One thing too, we didn't really get to talk about was CTE and concussions. I know a lot of your viewers are into MMA and all about that. And I tweeted out a study the other day that you retweeted. I really appreciate that. And just as a three- the other day that you were tweeting. I really appreciate that. And just as a three-year study showed that the mortality rate overall was 9.5% for people who had suffered a TBI.

People who tested, I know we talked about correlation causation, but the THC users only had a 2.4% mortality rate. The non-THC users had 11.5% mortality rate. I mean, that's really really significant right like this is just thc and not cbd because cbd has been shown to be very beneficial for people with traumatic brain injuries yeah yeah exactly cbd and thc are both beneficial yes so that was you know again a correlation equal causation but i mean that that the stats are so over overwhelming like if it was you know non-cheat c was like 3.5 percent i

would have bring it up but it's 11.5 11.5 compared to 2.4 percent um and again cbd yes and there's even you know mechanisms of action have even been identified with that it decreases uh you know inflammation in your brain um post concussion um you know one one last thing too, again, there's only one study on it. So, and it was done on rats, but you know, I'm, I'm a keto guy too. But the study on rats, interestingly, it showed that if you have, if you do have a high fat diet, that you can actually decrease sensitivity at the CB1 receptor. And they think that that's just because there's an increase in your endogenous cannabinoids, 2-AG and anandamide when you do have a high fat diet. And then Alzheimer's, you know, again, I know you're plus 50.

So, you know, THC. St. Joe has Alzheimer's? No, I'm not saying plus 50, so THC. St. Joe has Alzheimer's? No, I'm not saying. It's probably on its way. I know that he wants to keep doing this podcast forever. Maybe that would be an excuse to stop. So THC has been shown to inhibit the formation of beta amyloid plaques. That's the hallmark of Alzheimer's disease.

And then CBD has also been shown to be effective for Alzheimer's disease as well. You know, there's a rat study that I was going to get into, but it's fairly, fairly, it's fairly detailed. So, you know, it might be best just to say that it can, you know, help with rescue memory in patients if you do use CBD, meaning

that it may actually reverse. And that's been shown before too. They've done that in mice. I got to interrupt you for one second. Okay. And I think you would agree. This data is some of it's sort of epidemiological. Some of it's preclinical.

It's very, very early. None of it really proves much. But Alex, just let me say, I'm a clinician. Okay. If someone comes to me and they have a concussion, it's very frustrating just to say to them, hey, physical, cognitive rest, go home, okay? It's really frustrating to say that to someone.

Also, too, the high-fat diet thing, Joe and I both follow a very, very similar diet, so that's something I want to share. With regards to the Alzheimer's disease, we have really, really poor medications for that. And we have an aging population. So again, Alex, you want to look at everything, which is what I'm doing.

I'm looking at everything and I'm trying to make a clinical decision. Am I using some things without randomized control trials? Of course I am. But again, I'm a clinician, so I'm using mechanisms of action. I'm using what I see in clinic and I'm using epidemiological studies. And I'm also taking into account what other medicines do I have based upon all the data. This seems to be an effective

treatment. And I am absolutely not saying that you as a clinician shouldn't do that, especially you're in Canada. Cannabis is legal. You should use your best judgment. What I'm saying is that when we're talking about policy decisions around cannabis and THC, and to a much lesser extent CBD, the advocacy groups have seized on this very, very preliminary data to say a lot of things about cannabis and THC that have not been proven. And a guy I know named Peter Bach, who very smart, he's a pulmonologist, he's at Memorial Sloan Kettering in New York, you know, a guy I know named Peter Bach, who very smart, he's a pulmonologist, he's at Memorial Sloan Kettering in New York, and he wrote a piece in the Wall Street Journal a few, a couple weeks ago, talking about cannabis's limits as medicine. And he said

something that I thought was so well put, which is the reason why people want cannabis to work for Alzheimer's and cancer, and a bunch of things where there's really no evidence that it works is that we don't have good treatments. We want cures. We want help. If we're clinicians, I mean, I'm not a clinician, you're a clinician, want to be able to give people who come into our offices something. But that hope is not a substitute for science. It doesn't mean that it works. And even you want your patients to have hope okay but the advocates the people who are using this to push especially to push thc and to capitalize on the public confusion around thc and cbd i think that is a real it's a real disservice to people

okay um listen i think we covered everything it's a it's a complicated subject it really is and uh i think it's really important to discuss how complicated it is i don't i don't think there's uh i've never heard such a detailed analysis of all this stuff in in a way where you can get two opposing people that are you know very civil about it but agree on certain aspects of it i think i think we really highlighted all those things joe thank you so much for having us thank opposing people that are, you know, very civil about it, but agree on certain aspects of it. I think, I think we really highlighted all those things. Joe, thank you so much for having us. Thank you. Thank you.

Thank you so much. Really appreciate it. Dr. Hart, thanks. Give out your social media, please. Sure. So I'm at Dr. Mike Hart on Twitter. I'm at Dr. Mike Hart on Instagram and I'm at Dr. Mike Hart on, uh, on Facebook. So it's D-R-M-I-K-E-H-A-R-T.

And Alex, your book is Tell Your Children. It's available now. It's available everywhere. It's available now. And if I had a copy, I'd give you a copy. That's okay. I'll give you the copy I have. Okay.

All right. Well, thank you guys. Both of you. Thank you very much. Thanks.