The Liz Moody Podcast - The Health Effects of Cannabis: Sleep, Fertility, CBD vs THC, & More

Episode Date: February 12, 2025

Do you ever wonder if your cannabis use is having negative consequences? And how do you know if you’re using cannabis in a healthy way? Dr. Matt Hill teaches us about the components, risks, and potential benefits of cannabis use, including how THC, CBD, CBN, & CBG may affect your endocannabinoid system, sleep, respiratory health, adrenals, anxiety, and more. Liz and Matt discuss everything from the chemical makeup of cannabis, the ideal dosage and consumption methods, and the warning signs for cannabis use disorder. As always, this episode will leave you with actionable tips to help you understand your cannabis use and reduce the potential risks. 03:20 THC vs CBD’s Effects & Mechanisms 10:03 The Endocannabinoid System 24:04 Withdrawal, Sleep, & Anxiety 32:18 Edibles, Tinctures, Vaping, Or Smoking 38:33 Dosing Guidelines & Recommendations 46:46 Cannabis & Mental Health Risks 57:59 Legalization & Regulatory Issues 01:02:13 Addiction & Use Disorder 01:09:58 The Munchies Explained 01:15:14 Cannabis, Cortisol, & Stress Responses 01:25:46 Cannabis For Pain Management: Mechanisms and Benefits 01:34:45 Cannabis For Anxiety: Comparing to Traditional Medications For more from Dr. Hill, visit the Hill Lab at University of Calgary to read his current research and publications. Ready to uplevel every part of your life? Order Liz’s book 100 Ways to Change Your Life: The Science of Leveling Up Health, Happiness, Relationships & Success now!  To join The Liz Moody Podcast Club Facebook group, go to www.facebook.com/groups/thelizmoodypodcast. Connect with Liz on Instagram @lizmoody or online at www.lizmoody.com. Subscribe to the substack by visiting https://lizmoody.substack.com/welcome. This episode is sponsored by: IQ Bar: Text LIZ to 64000 for 20% off all IQBAR products plus FREE shipping. Pique: go to piquelife.com/LIZMOODY for up to 20% off plus a special gift. Shopify: sign up for a one-dollar-per-month trial period at shopify.com/lizm. Goodles: available nationwide at major grocery stores, Target, and Walmart or visit www.goodles.com. Wildgrain: go to Wildgrain.com/LIZMOODY for $30 off the first box - PLUS a free item in every box. The Liz Moody Podcast cover art by Zack. The Liz Moody Podcast music by Alex Ruimy. Formerly the Healthier Together Podcast.  This podcast and website represents the opinions of Liz Moody and her guests to the show. The content here should not be taken as medical advice. The content here is for information purposes only, and because each person is so unique, please consult your healthcare professional for any medical questions. The Liz Moody Podcast Episode 303. Learn more about your ad choices. Visit megaphone.fm/adchoices

What are the pros and cons of the different ways of consuming cannabis? It's very rare from any analysis that I've ever seen that you get a CBD product that is just CBD. I've gone and had conversations in recovery facilities with people dealing with cannabis use disorder, so it just might look a little different. In every state that's gone legal and in Canada, we don't see elevations in teenage use. It's affecting the pain perception in your brain. It's affecting the emotional component of pain, which is a huge aspect of pain, and it's affecting the inflammation. If there's any family history of schizophrenia or bipolar, I always tell people just don't go near

cannabis. Just avoid it. It has a impact on fertility from a male perspective and a female perspective. Hello, friends, and welcome to the Liz Moody podcast, where every week we're sharing real science, real stories, and realistic tools that actually level up every part of your life. I'm your host, Liz Moody, and I'm a best-selling author and longtime journalist. I am so excited for today's episode.

I have been searching for the perfect guest to do a positive. and negative health effects of cannabis episode forever. And I finally, finally found Dr. Matthew Hill and he was willing to fly all the way over here from Canada just to share his incredible wisdom with all of us. Dr. Hill has a PhD in behavioral neuroscience and he runs the Hill lab at UC Calgary, which focuses on the endocannabinoid system in our bodies and particularly how cannabis affects the system and how it regulates stress responses, behavior, metabolism, and more. He has won tons of awards for his research on cannabis and our body's responses to it. And today we are going to get such a clear picture of where the science stands at present on

cannabis. There is clearly a lot going on in this episode. So make sure that you head over to Liz Moody.substack.com and sign up for our newsletter where you're going to get action steps, key takeaways, bonus interviews, meal plans, workout plans, and more. Dr. Matt Hill, welcome to the podcast. Thanks for having me. There's a lot to get into. But let's start with when we say cannabis, we mean all of these different compounds in the plant. There's THC, there's CBD, there's CBG, CBN. Can you talk us through all of the different components and what components are having these psychological and physical effects? When you really kind of boil cannabis down, a lot of what it is that it does to us, both psychologically and biologically, is really just

through THC. That's the main component of cannabis that exerts a lot of the effects. And the other one, you mentioned CBD is the other component of cannabis that's had a lot of research done to it. CBD is kind of an interesting one because when a cannabis plant makes THC, by default, if it makes more THC, it ends up making less CBD because the two molecules are almost in competition with one another. So as people learned that THC was the part of cannabis that made it psychoactive and that was what people liked, cannabis was bred to be enriched in THC. And by default, CBD was basically bred out of cannabis. So I've always found it so fascinating that there's such a cultural shift towards CBD in the last decade because

it's not like anyone would have really experienced it naturally for using cannabis, just simply because of the fact that it's not there in street cannabis. You have to almost explicitly breed the cannabis to have CBD in it. And that was really only done after CBD took a lot of hold culturally after the Sanjay Gupta thing about Charlotte's Webb and this idea, the early idea, which has been well supported by a lot of data that it can treat certain forms of pediatric epilepsy. But CBD itself is inert psychologically in the sense that people can't hell they're on it if they get it. Even at really high doses, it doesn't really produce overt

psychological effects. Is that true even with like anxiety or feeling calm? Because that's a big use case I hear for CBD is people are like, it calms me down. It calms me down. With something like anxiety, it's a bit challenging because most of the stuff that's actually been done with CBD is in the context of like epilepsy or even anxiety, the dosing is really quite high that they do in clinical studies and in a medical context. And in those situations, it's kind of mixed about anxiety. If you take someone who doesn't have an anxiety disorder and you just look at emotional reactions, you don't see much from giving them CBD. There is some limited evidence that in people who might have high anxiety, it might be able to bring it down a bit,

but that's usually pretty high doses, not like the majority of the dosing that people take from like taking an oil that they get at a store where there's only like 10 migs or something in it. Those doses are like very low and probably most of the effects that come out of that are placebo effects. Oh, interesting. It made sense to me, though, because a drug like Clonopin works on C. seizures, but a lot of people take it for anxiety. And so I was like, oh, this thing, is, is there a mechanism of action that'd be happening in the brain by which it would function on seizures and also on anxiety in a similar way? So something like Clonopin is really largely just a central nervous system

depressant. So a lot of what it does is just calm down neural activity. And so that's why it could be good for something like a seizure, but also anxiety where you have a lot of neural activity in different parts of the brain. CBD is kind of a mystery. No one really knows how it works. It doesn't have a clear mechanism of action. We've been trying to find it for years, like as a field. Yeah. No one. It doesn't bind to cannabinoid receptors the same way THC does. So that's why it's not psychoactive like THC. Clonopin and most anxiolytics, they kind of bind GABA receptors and they act to calm down the brain. Doesn't seem to interact with GABA receptors either. It's a little bit of a mystery. Can we not like give it to somebody and then scan their brain and be like, what's it happening?

Yeah, you can see. I mean, you can look at patterns of brain activity. And even in those situations, the effects of CBD are pretty subtle. but that doesn't give us insight into like what neurochemical system it's interacting with per se, but there's been a lot of work that's gone into screening, like does it bind a receptors, what does it do to various neural circuits in the brain? And it's been very challenging to actually figure it out. The only thing that I've seen that's pretty convincing and actually makes sense with what a lot of people report about CBD is this idea that it might boost this neurochemical called adenosine. The only way people would really know it is if you think of caffeine, like in coffee, caffeine inhibits adenosine. And so CBD kind of does the opposite. So it'll boost

adenicine levels. If you elevate adenicine, generally that can be, you know, help you sleep, reduce anxiety, maybe be a bit anti-inflammatory. That mechanism fits with most of what we understand about, what CBD does. And so I think that's kind of the mechanism a lot of us lean towards saying that's probably what's driving most of the effects of CBD, but it's realistically, it's a mystery. That's so interesting. Okay. So in my mind, I have THHC3. is the thing that gives you the psychoactive effects, it makes you high. And then all of the therapeutic health benefits come from, in my mind, CBD, CBN, CBG, all these other things. And so when somebody's trying to take cannabis for health benefits, I picture them, like,

you can get all of those with a tincture, an edible, whatever, that doesn't have the THC. Is that an okay way to think about it? Or I can be totally wrong. You can tell me I'm totally wrong. Yeah, I don't, I mean, I don't think I would say that. And I mean, the reason I wouldn't say that is, So first, a lot of the stuff in terms of therapeutically that we know about cannabis has come from grassroots movements. Like that's what happened with Charlotte's Webb and the CBD stuff. But that's also what happened with like multiple sclerosis and pain throughout centuries of people using it.

And because of the fact that native growing cannabis that's been cultivated and bred by humans has really enriched in THC, not CBD, if we even leverage that historical aspect of the medical uses of cannabis, it had to have been THC that was driving it because that's what was in there. And because we know the biology of THC because it binds to cannabinoid receptors, we've been able to study cannabinoid receptors and almost all of the effects that we attribute potential medical benefit from cannabis from relate to activation of cannabinoid receptors, which is likely being done by THC. CBD definitely has medical benefit for pediatric epilepsy. That's pretty well established at this point. The clinical data is very convincing.

Those are super high doses, though, like really, really high doses. Is there any danger in taking a really high dose? The only thing that they've been able to find is at really, really high doses, like the ones they give kids for seizure disorders, it can inhibit some liver enzymes. And so as a consequence of that, if someone's on other medications, it's kind of like there's a compound in grapefruit called naringin, that can also affect liver enzymes. So people who are on like blood thinners or some stuff like this are recommended to not, where you have to calibrate dosing.

So there's some potential there. They have found in a few human trials when they've given them high dose. just to see, they do see elevations in like some liver enzymes suggestive of maybe low-grade liver inflammation just because it's getting hit with a lot of drugs that are saturating the enzymes in there. But that's kind of the only thing that I've seen come out of it. Okay. So we have pediatric epilepsy. Is there anything else that you're like, I think the science holds for these health benefits, for CBD specifically? I don't think anything has the amount of data behind it in humans that we have for the pediatric epilepsy. There's certainly suggestions for things like

potentially pain, potentially anxiety, potentially sleep. I don't definitely. that there is benefit of CBD in some conditions and some capacities, I'm just a little reluctant to believe it at the low dosing that people tend to use because it just has really poor bioavailability out of the gut. And most people taking CBD take it as an oil tincture. And so not a lot of it actually gets into your bloodstream. Would you recommend a topical absorption mechanism then? I don't know if I'd say in terms of absorption. I think it depends on the vehicle it's in, how well it absorbs through the skin. But certainly because it could be anti-inflammatory for sure, if there's external skin conditions, for example. I know there are some people that use CBD creams or things for that.

And I don't think that's been like super tested in enough of a capacity to say, yeah, that's a good way to go. But I could certainly see that working. The other one would be things like inflammatory bowel. So because so much of the CBD stays in the gut, again, I could see there being a bit more potential for something like that, having some benefit from it. This is like maybe a little bit silly, but I used to be a huge fan of taking CBD. And one of the reasons for that is I was like, we have this endocannabnoid system in our body. And why would we have this thing if it didn't need to have something impacted in some way? Essentially, like, do we need to tone our endocannabinoid system to, like, bring our body into a state of homeostasis? I was kind of like, oh, it's bringing me back into balance by interacting with this body system I have.

Is that, like, completely off base? Like, why do we have the system in our bodies? I totally agree with you about the system. Yeah. Like, I think for endocannabinoids, that's really what we would often say the main function of it, biologically is this homeostasis. So like I'm a stress researcher and I look at endocannabinoids in the context if we get stressed and what we've learned from years of work is we know that when we get stress, stress hormones trigger the release of endocannabinoids and that then calms you back down.

That's part of like the stress recovery process. So again, homeostasis. So you kind of leave homeostasis when you get stressed endocannabinoids bring you back. A lot of the role of endocannabinoids is kind of keeping your biology in its like happy space, let's say. Now whether CBD is doing that is unclear. THC is kind of a way to override that because THC will just outright activate the receptor. So let's say someone had what we call quote unquote an endocannabinoid deficiency, which it's hard to define that because it's not been established as a clinical phenomenon, but it's something that we've theorized just because biology is on a spectrum. So there's going to be some people that are at the low end. And in that situation, maybe adding THC into the mix

could help restore some deficient endocannabinoid function. But the problem is THC has no specificity, because as soon as you consume it, it just hits every cannabinoid receptor everywhere in the brain, whereas endocannabinoids are kind of released in very intentional and patterned ways. So that's one of the reasons why we're not sure it's necessarily the best replacement. But that being said, for someone who has like anxiety or something, which could be associated with reduced endocannabinoid function, maybe for the purposes of what they're doing, it's restoring function in the system in that capacity. And that's why it helps relax them and kind of bring them back to a normative state.

Could there be an argument to be made that we're all in kind of the state of chronic stress these days? So we all are operating in an endocannabinoid deficient state that we haven't historically been in. Possibly, yeah. I mean, that was one of the main things that we've discovered of the work we've done is that, yeah, chronic stress really burns the system out. It's like anything else in biology. If you use it too much, it breaks down. Because every time you get stressed, the endocannabinoid system is trying to bring you back down to normal. If you're just stressed all the time, the system just kind of falls apart. And that capacity, yeah, I do think a lot of, lot of people under conditions of chronic stress probably do have kind of underactive endocannabinoid systems. And in those situations, some people may find benefit from using cannabis as well just to help restore things. But again, cannabis can be highly variable. Like some people go the other direction

and get very anxious and panicky when they use cannabis. So we're going to talk about that because that's me. And it didn't used to be, which is really interesting. So we'll get into that later, but I'm curious, are there other ways to bring your endocannabinoid system into that state of homeostasis outside of cannabis? Exercise is the one that's been studied the most. We know, like, just aerobic exercise going for a run is a really efficient way of boosting endocannabinoids. In fact, a lot of the research in the last few years has kind of overridden the old school belief that runners high was endorphins and actually found that it's really endocannids. So yeah, that's been one of the interesting things that we've learned. That's cool. A lot of the rewarding effects of exercise seem to be

driven by endocannabinoids. Like, we've learned that through a lot of a lot of the animal work where we can do very detailed manipulations and demonstrate that if we take cannabinoid receptors out of reward circuits in the brain, then animals just don't like running anymore the same way that they normally do. And we know in humans that, yeah, you really get a solid engagement of the endocannabinoid system from running. I think there's been some studies with like yoga that have also found it can elevate endocannabinoids. And I think there was even one random one where people like sang, like singing elevated it. So it seems to relate. I mean, I've always kind of looked at endocannabinoid functionality as being reflective of someone's state.

Like if they're in an aversive state, like they're chronically stressed or they're depressed or they're anxious, the system seems to be a little bit broken down. But things that people find rewarding and positive seem to elevate it at the same time. So I think a lot of the kind of yin and yang around emotional states and stress and our well-being tethers to endocanninoids to some degree. But whether or not that would mean that like boosting your endocannabinoids all the time would be like some, you know, magic drug that would make everyone in a good state. That's kind of not known. We don't, we've never really been able to ask that question. But there is an interesting thing where there is a genetic mutation in one of these enzymes that breaks down endocannabinoids. And so people

who have this, which is about a third of the population, they don't have the enzymes that break down any cannabinoids as efficiently. And as a consequence, they just kind of have higher levels of endocannabinoids all the time. And they definitely are less anxious and more stress resilient and seem to enjoy some things more. There's some suggestion they might be a little bit more prone to like drug use and enjoying food and things like that. But again, it's kind of this. They're kind of living in more of a hedonic state all the time. They seem to be a little less stress and a little happier and enjoy things that are more rewarding a little bit more. Can you splice those jeans into me? You get genotype yourself. I mean, like, I do not have it.

I've checked. I do not have it. One of my colleagues studies this morning, she was saying when they were doing this study, one of the people in the lab genotyped and was positive, and she's like, we all just kind of watched them to see what they were like. Were they happy? Yeah, she said they were very happy, go lucky, easygoing. So I thought that was kind of interesting. That is really interesting. And then I've also mentioned CBN, CBG. These are things that like, when you go into a weed shop, they'll be like, oh, this is really good for sleep because it has CBN in it. Is there any truth to those types of statements? So there's a few groups that have looked at this. There's definitely something going on with CBG, CBN. Again, they're not really binding to cannabinoid receptors like THC, but there is some

work that's come out of Australia. I think, I'm pretty sure it was CBN. They were looking at where they did find some ability to enhance sleep. And there was a recent study out of Ziva Cooper, who's here at UCLA with a group at Washington State. I was looking at inhaled CBG in vape pens. And they did find that it seemed to have some effects on reducing anxiety as well. So even though it wasn't producing kind of a high. And then there's a group at Hopkins run by Ryan Vandry, and they've looked at, like, adding turpines with THC in a really controlled lab manner. And they found, like, for example, if you had limine, which is one of these turpines, it gives it kind of citrusy flavor to cannabis, that that can actually dampen some of the

anxiety associated with higher dose THC that people have. There's probably a lot of interactions that are going on amongst all these, like, host of chemicals that are in cannabis outside of THC. And trying to study how these interact with each other is really challenging, because you've got to control one dose and then add the other molecules and then really if you do this in a stepwise manner, even if you just added each one with THC, that alone is like dozens of studies. And then you start looking at like high level interactions between multiple molecules and I can get really challenging. But I think we're starting to get some insight into some of the possible molecules that are inert versus those that might actually be influencing some of the effects of cannabis.

Turpines are one of the reasons that being in nature makes us calm, right? Like we're breathing in the terpines from the trees. That's why forest bathing actually has these physiologic effects beyond what we're seeing. It's definitely one of the theories. I mean, there's some very interesting research that's been done that has been able to find links between like the olfactory cells that respond to various volatile molecules like lavender or things like this. And you can actually see that the neurons that those receptors talk to feed right into like

the amygdala and some of these emotion circuits in the brain. And so there has been work that has shown, yeah, you can, you know, the sense. certain scents that have some effect on the way that the brain process is emotionally relevant stimuli. So I wouldn't doubt that it's a part of it. The turpines are not unique to cannabis because, yeah, turpines are found in tons of things. Yeah, exactly. If somebody was looking to help with their sleep or help with their anxiety, is it worth them seeking out at this point? You think CBN, CBG to experiment with or no? I guess that depends on a person and what like level they'd want to play around with things on. If we're not talking THC, if we're talking these other molecules, people aren't going to get

grossly intoxicated in any way from them. So I think from that perspective, there's probably not a lot of risk of harm of trying them. And because of the fact that everyone's biology is so different, it's impossible to predict who's going to react to what and what people will find benefit from. So I don't think it's a bad thing. But yeah, I wouldn't be able to tell someone what to expect out of it. And the dosing is really kind of not well established either, like what level you'd need to consume. And if it would have to be inhaled or if it's taken orally because I don't think those parameters have really been worked out much. But if someone's open to trying something, then I don't see there being a lot of downside to these things because they just don't seem to produce a lot of other effects.

In general, do you think there's benefit to keeping the whole plant intact, though, versus isolating out these different compounds? Like, you'll see things that say full spectrum on them. Is there validity to that? I think if we're talking about it in the context of THC, probably there's something there. It's been hard to establish this, but there's certainly been work that has taken isolated THC versus kind of what you're saying, whole full spectrum THC, where you get other compounds of the plant extracted with it. And like without question, people can report differential responses to these. I don't think there's been any good clinical trials in any disease states that compared isolated THC from whole plant extractions, but definitely in other just subjective responses that people

will report is quite different. Like if someone has a vape pen that's, just THC isolate, the descriptions they have of the high from it is very different than if it's mixed in with the full plant extraction. Like what would I say? Often people say it's a little bit more activating, like, as opposed to kind of sedating. And once they get other things mixed in there, a lot of people report that they feel a little bit more sedated from it. And there is so much variance across different kind of types of cannabis. There is some potential to do some real large scale work. Like people have tried to tease this out to some degree. Like if you look at subjective reports of different types of cannabis and then try and look at the chemical compositions of them to see if

anything tracks. But I think the problem is they get so contaminated by subjective bias that people have because they're like, they'll go into a weed store and a bud tenderer bag. This strain will help you sleep. This strain will make you less anxious. And so because of that, they get kind of contaminated. It's not organic blind where someone's trying something and reporting a subjective output. So the group at Hopkins is trying to get started on some work where they can compare like things that are labeled as indica or things that are labeled as citia. and have different chemical compositions and blind people to them and see what they kind of report the reactions to. So I think that will be very informative when that stuff starts coming out,

because then we'll have a bit of a better handle on this. But I think there is definitely something to the whole plant. And in the field, it's typically referred to as an entourage effect that no one really understands what the biology is, but there's just some entourage of all these molecules being together as opposed to just THC. Interesting. And then you mentioned Indica and Sativa, those are both whole plants, but they're different strains of the same whole plants and what, or are they not? You're shaking your head. It's hard to say. Yeah.

Historically, Indicas and sativas were definitely like different things. One of them was very, very kind of low in THC and the other one was higher in THC. But because over time, people bred them to become high in THC, a lot of what made in Indica and Indica and a Sativa, Sativa was lost. And virtually everything that exists in the market, despite its labeling, is pretty much a hybrid of some capacity between the two. And even when people have tried doing some kind of biological analysis on what's labeled in Indica and labeled a Sativa, there's no chemical composition that's clear that says, this is what you find in Indica, this is what you find in a setiva. And so that has kind of become this part of like cannabis cultural folklore, I would

say, in the sense that there's just really not a lot of support for this being a real distinction in kind of real world terms, but again, because it's so deeply ingrained in cannabis culture, people are very strong in this opinion, and I'm always fascinated by it because people will say, well, Indicas make you tired and Sativas are uplifting, energizing, yeah. And there doesn't seem to be any, like, real biology behind that that could explain that in any capacity. And talking to the kind of botanist people who study cannabis, they're very strong that these are not real things. So the kind of scientific way they divide these is they have what they call chemovars. That's instead of strains, they call them chemovars. They say there's

three flavors essentially. There's THC dominant, CBD dominant, and then a THC CBD mix. And so you'll call those type one, type two, type three cannabis. And that's usually how from a scientific perspective, people will break those down. And that has much more to do with just the presence of THC and CBD. And so if you look at that, obviously something higher in THC is going to produce more intoxication, something high in CBD that has very low THC won't produce the same amount of intoxication. But I don't doubt that there is clearly differences between what we refer to as strains of cannabis, but what is driving that is at this point in mystery? Like, we don't really know because we've not ever been able to find a clear distinction biologically over what makes this strain that

someone claims is activating and this strain that they say is sedating different. Except for, I mean, what about the THC, CBD thing? So if you go to a weed store and the person there is like, this strain's going to help you sleep, this strain's going to help with anxiety, this strain is going to be really fun for a party. Maybe they think they're referencing Indica Sativa, but they're actually referencing high THC, high CBD strains? I mean, most of those will still all be high THC strains. Like, virtually all the strains sold in weed stores are high THC.

I mean, the only time people are really buying high CBD strains is if they are buying it for a medical purpose. More often than not, everything is just kind of high THC, the majority of stuff that's sold in stores. Now, the differences between, like, a strain that could be, you know, help you sleep or reduce anxiety. if this is legitimate, like even these are bona fide differences that do exist, they probably are more due to things like CBG, CBN, these other molecules that would track in there. Because you can take

kinds of cannabis that all have the same level of THC, and people will report very different subjective effects from them, even though the THC is held constant. And so it's got to be something else that's in there that's moderating the effect of the THC to cause these subjective differences. But what that is, we just don't know. Okay, I'm trying to figure out how we should use this in Like if we want help with sleep, which is a huge use of cannabis, I think in this listenership, we probably shouldn't go into a head shop and say, hey, I really want a high indica. It'd be more like just what helps with sleep. And they would anecdotally tell you because I assume they're not going to say, well, this one has this exact chemical.

It's going to vary state by state because in Canada, where I'm from, it's all federally regulated. So you have to have reporting on the package. We do too. Yeah. So you need at least THC and CBD. reporting in Canada, but some companies, and I've seen this in some of the stuff people have told me about the states, some states you do start getting the other ones. You'll get CBN, CBG reported as well as terpenes. So in that context, if someone's like trying to look for something

that would help them sleep, I would probably say off the limited amount of data that exists that they would want to find a strain that has more CBN in it. Just because that seems to be the one thing that has been found to relate to sleep. THC definitely has sedative properties. There's no question on that. Like THC, I mean, you know, you can do rodent studies with this and you'll find you give THC, you get less time, wakeful, more time and sleep. It does seem to have some effects on sleep architecture, like you'll get a bit less REM sleep with THC, which depending on the situation could be good or bad. So, for example, something like PTSD, where people have really violent nightmares and that's always in REM sleep. Where the benefit of cannabis seems to

largely play out in something like that is that its ability to suppress REMs turning off the nightmares. And that seems to actually be a benefit. And so the majority of individuals who use cannabis that have PTSD, they almost uniformly claim the benefits are from sleep because they're not nightmaring. That aspect of it could be good in a context where you have too much REM or altered REM in some capacity in a disease state. But for the average person, it may not be the best for sleep in the sense that if it's reducing your amount of REM, you might have some consequences from that. And so there are certainly mixed reports from people about sleep. and cannabis. Some people say it helps them sleep. Some say they don't feel rested in the morning.

Yeah. That could be due to the changes in REM. So I think if someone's looking for something to help them with their sleep, I would, like I said, probably suggest asking if they know products that are higher in CBN. I have a friend and she swore by cannabis for sleep. It was her go-to. And then she got an aura ring and she started tracking her stats and her heart rate was through the roof like every single night that she took cannabis to sleep. And so she was like, oh my gosh, my sleep score is so much worse every night I take cannabis, even though I felt like I needed it to sleep. One of the more classic physiological responses to THC and cannabis is elevated heart rate. So tachycardia is a very consistent response for the majority of people. And usually what happens is because cannabis can

cause vasodilation, so your blood vessels will open up a bit. That causes a bit of a drop in blood pressure. And as a consequence, your heart starts beating faster to try and compensate. For some people, they will reliably see elevated heart rate. And that probably is actually what your friend is picking up on is just this tachycardic response that comes out from them using cannabis. Whether or not that's a relation to their sleep quality, I have no idea because those things can dissociate from each other or they can be related. But I'm not surprised to hear that because that's an effect. It is a very reliable effect, yeah. In the most concise way possible, can you speak to somebody listening who's like, I use cannabis to sleep. Is that a good idea? I think it's a very personal and subjective response.

It's very hard to make a blanket statement at large. I would say the majority of the data that's out there generally suggests that people who use cannabis to help themselves sleep, it might benefit them in the short term, let's say, but over time it might compromise their sleep quality. Now, when that becomes really apparent is when people try to stop using cannabis. And then their sleep quality just deteriorates very fast. That's like cannabis withdrawals. isn't like opiate withdrawal or alcohol withdrawal or any of these other kind of drug withdrawal syndromes. It's more akin to like a coffee withdrawal in terms of how it manifests. Like it's not a super robust withdrawal syndrome, but the most reliable effect is sleep patterns just fall apart.

Why is that? Some of it is probably a rebound. There is a lot more REM sleep that happens. Like the most reliable thing you hear from people is that they have really lucid nightmares and lucid dreams when they stop using cannabis if they've been using for a long period of time. And that's probably some REM rebound. That's interesting. It's driving that. It's driving that. that what's interesting is that like for the majority of people this is about a week you get this peak of really bad sleep and then it kind of goes back to normal but there is some suggestion that with people who've used like chronically chronically when they stop even for long periods there might be some disrupted sleep architecture and sleep patterns now another possibility though

and this has not been properly explored but this is something I've talked about with a lot of the people who study this stuff in the sleep is if someone has an underlying issue that's driving their sleep problems. Like they are like an insomniac and it's an arousal issue. There's some other component that's contributing to this. There may be some aspects of cannabis that are calming that biological issue down that facilitates sleep. And so for that person, cannabis may represent a sleep aid that works long term. There are a lot of people who have used cannabis to sleep for years and they report that it doesn't develop tolerance. They maintain their efficacy with it. But large-scale studies don't generally support that. Most of them say that it really

kind of deteriorate sleep quality over time. So I think it really depends if it's someone who's not really a problematic sleeper, but kind of uses cannabis and has noticed some effects with it, versus someone who may have some actual biological issue driving their insomnia, that cannabis might be benefiting them in some way. What would be underlying issues that the cannabis could be treating on this root cause level that would make it potentially beneficial for sleep in the long term? We know that THC and cannabis can suppress the release of some catacolamines like adrenaline. And so people are kind of in this, like, lying there with their brain just buzzing and they can't kind of disengage and go to sleep. So if THC and cannabinoids are turning that mechanism down,

that could explain why it helps with the de-arousal and then facilitates them going to sleep because they're not in that buzzy state anymore. But that's kind of me tethering together a bunch of different bits of biology to make a theory because the field has done a lot of work showing you can suppress the release of things like noradrenaline in the frontal lobes with cannabular. apnoids, and we know that that can drive insomnia, and we know that there's this effects on sleep. So I'm kind of putting that all together to make a theory about what I think is going on in some people that have maybe some low-grade arousal issues where they're just like buzzing and they can't turn off at night.

So there might be these detrimental long-term effects where your sleep gets worse. Is there anything else that you would want people who are taking cannabis to help with their sleep to know? I mean, I think that's the biggest concern is if you have any kind of tracker that's tracking your sleep stages, I would pay attention. like you said your friend was looking at her heart rate, I would look at like my Fitbit, I don't know how accurate it is because these are pretty crude measures, but it does kind of break down REM and non-REM and different phases of sleep. If someone finds, for example,

the same way like when I have alcohol, my heart rate goes way up. If someone finds that, for example, if they're using cannabis, that they're like REM sleep crashes, so they have other noticeable things, I would say it's probably a sign to not continue using it because that's like telling you that maybe it's not affecting your sleep patterns in the way that you're hoping. if they really feel like they're getting better sleep, then it probably is helping them in some capacity. But they should just be careful about understanding that using this long term could be a bit of a double-edged sword. A lot of different things that we take, you say you need to kind of build it up in your system. So I don't know with your endocannabinoid system, if you need to

build it to a level of homeostasis before you have some sort of effect. If you have acute sleep issues, can you use cannabis for one night and then not use it for two weeks and then use it again? Or do you need to build up levels in your system? No, no. I mean, the effects of cannabis are pretty rapid acting. It's kind of like, THC gets in the brain, it activates the receptors, it does its thing, and then it gets metabolized and leave. So, I mean, more often than not, I'd say what you just described is usually how I hear people describe it is that they'll say, you know, if I'm not sleeping well, I'll use cannabis one night, and then it helps me sleep that night, and then I don't use it again for a few weeks. And I mean, certainly in a situation like that, where you're using

something more sparingly, the thought that you might actually have more detrimental effects are is going to be way down because usually it's just the chronic exposure to something that causes these detrimental effects to occur. So intermittency kind of helps prevent that to some degree. What are the pros and cons of the different ways of consuming cannabis, like edibles versus smoking versus vaping? Okay. So that's a good question, actually. This is like probably what I get asked the most from people. If we're talking about health risks, anything you smoke obviously possesses some risk to lungs. So even though there is not clear links between cannabis smoking and lung cancer the way there is of cigarettes. Some of that is probably just related to the

frequency just because people, I mean, a lot of the old school cigarette lung cancer data is really based on people who are like one to two packs a day. So you're kind of inhaling cigarettes nonstop. So the damage from that is not surprising. And people who, when they smoke cannabis, almost never smoke at that frequency. But that being said, it's smoke. There's combustion byproducts. There's certainly going to be lung damage. Long-term issue, even though it has been associated with cancer, it has been associated with chronic bronchitis, other indications of lung damage. There's always that risk with smoking. So if you take an oral version, like an edible, you bypass the risk of lung damage. So that's across the board. Vaping, again, it depends on what you mean by vaping, because you can

either vape plant matter, like using things like a volcano or these devices that people put the plant matter in and it kind of heats it up to a point that will vaporize the THC and cannabinoids out, but it doesn't combust the plant matter. So that has been studied and has been found that, yeah, you don't see carbon monoxide and the exhalation that people take afterwards. So there's no combustion byproducts. So the pens are a little less certain because certainly in the States right now, because they're not regulated. There's a lot of uncertainty about what's being used as the vehicle. And this became really apparent a few years ago when there was that cluster of people who died from the vape pens. Oh, I miss that. Yeah. So all there was, this would have been right before COVID, I think. And basically,

there was all these people that were using these vape pens and they were developing like popcorn lung or this massive lung inflammation and there was probably 40 odd people who ended up dying from this over a few years period. They realized in the aftermath, this seemed to be because a lot of the oil products that the cannabinoids and the THC were in that were in the pens were using vitamin E acetate. And people just assumed it was a nerd. But what they didn't realize is when it gets heated and it combusts, it creates an irritant to lung tissue. And so again, because none of the was studied because it's not regulated at a federal level and there was no pre a priori assumption that it was going to be damaging ultimately a lot of those vape pens there's a little bit of guinea

pigging in the population to some degree because people don't really know what's going to happen and so I'm always a little reluctant about those things because I'm like uncertain about what's in there what the extraction process has been what chemicals are in there what's going to happen to those chemicals when they get heated up so I can understand people using them in terms of the utility and ease, but I've always, myself, been cautious to ever say to people that's a better alternative, because I think it's a bit of an unknown. Well, and that would be probably with people who are vaping, like nicotine, too, correct? With nicotine, though, because that's always like a propylene glycol, vegetable glycerin that they use, because nicotine is really soluble. THC is not,

because it's a fatty molecule. So you have to, like, when you're baking with it, you have to like make the butter and all that stuff. It has to go into a fat vehicle for it to be able. And so nicotine is really easy to get into solution. And so for that. them to vape it. And that, again, because the nicotine side of things was regulated, they kind of knew what was the safe vehicle to use was. And so initially when they made vape pens, a lot of it was just the same solution they used for nicotine. And it works to some degree, but often what happens is the THC separates out. Kind of like if you think of you mix oil and vinegar and then let it sit, it'll separate. So that was what tended to start happening. So then people were like, oh, we need to

add fatty oils and other things in here, which is like vitamin acidate because it was a lipid. and they thought it would solubilize it better and make it easier the stand solution. But again, because this hasn't been properly tested necessarily always, I would always caution people about vape pens until there's some kind of formal regulatory standards that go around this. You just don't know. Okay. And then what about edibles or tinctures? Edibles and anything oral, safety profile is better in the sense that you don't have to worry about these kind of pulmonary effects that could happen. The downside to edibles is commonly as people eat it, wait half an hour and say it didn't work.

they double had the amount they eat. Because then it's like this freight train that just hits them and they don't realize it. And so I always try to be very clear with people. I'm like, yes, inhalation is very rapid onset. You will feel that in one to two minutes. So the thing with inhalation is it's very rare that someone over consumes cannabis when they're inhaling it to the point where they actually have like a highly aversive reaction. Because of how fast it hits you, they can usually titrate pretty cleanly to the level they want to.

Edibles can be 30 minutes, 45 minutes, sometimes 90 minutes. minutes to hit in. And so because of that, people, if they don't know the dosing that they want or what's good for them, they can often overdose with it and take too much. And then when it hits you, the other problem with the oral is how long it lasts. So like inhalation is pretty fast on off kinetics. So you feel it one to two minutes. The high peaks 15, 30 minutes. Start coming down around 45 minutes an hour. Hour and a half, you're probably not noticeably high, even though you're still going to have some residual intoxicating effects that carry on for about a couple hours. Oral though, yeah, so 30 to 90 minutes to kick in, but I mean, that can last eight hours.

So if you have a bad reaction to that, you're in that for several hours. And so when legalization happened in Canada, it was actually really interesting because for the first year, they didn't allow edibles. It was only flour that was sold. Oh, that's interesting. And what was... I also imagine there's like a appeal to kids component. Yeah.

So this was a big problem because you, I mean, part of the legalization process was to try and keep it out of kids' hands. And so we knew from like advertising approaches used for cereal and stuff, those like ways you make things flashy and colorful and look like candy and kids are going to want to eat it more. And most edibles are gummies or like chocolates. And so it is stuff that kids want. And so they had to figure out exactly how to bring in edibles into the market. And I thought what was really interesting and I was not surprised at this at all is there was very few ER visits about people having adverse reactions to cannabis in the first year. Because there was no edible. Yeah. As soon as edibles came on the market, there was a big spike. And

And that wasn't too surprising because, again, people were not being properly educated about how to titrate this or the dosing. So we came up with like a dosing guide. So first thing in Canada, this may be changing now, but at least initially when it came out, no package of edibles could have more than 10 milligrams of THC in it. Oh, wow. And so that was either one edible with 10 migs in it or like four edibles with two and a half migs or two with five or you get the basic idea. What is like a dose of THC that would likely make a normal person high for context? The rationale of that is it varies a bit from person to person. So if someone's asking like what the structure to do this is, I would always say, look, you start low and go slow and figure out what works for you before you kind of go.

So because one milligram to two milligrams is like very rarely, I don't think that would ever produce an adverse reaction in people. Most people wouldn't feel a dose that low. It's pretty low. But some will. Some people are really, really sensitive to THC and they'll feel two migs. So I always tell people if you're going to do this, start low at like one to two migs, take that, wait two hours, see how you feel. I wouldn't ever suggest they add more to it on that time. It's like, hey, you're going to have to go through a bit of trial and error here.

But better to do it slow and figure out what a dose range for a person is than to just jump in and have a really adverse reaction and then become scared by what the consequences of that are. So I would say kind of start at two migs and go up sequentially from there if people are going to try it. most people will feel five migs. So at least 50% of people, it seems, if you give them five migs of THC orally, they will feel that. Whether it's like really high or just noticeable is a different story, but most people will feel that. You get to the 10 milligram range and there is definitely a subset of people that's too much. So up to 10 migs, there are probably about a 30 people who aren't regular cannabis users or are pretty naive to it are going to have a bad reaction to about 10 migs. The majority of people I know who really like edibles, they almost always live in the 5 to 10

milligram range. That seems to be pretty standard. While you can have an adverse reaction at 10 migs, it's very unlikely you'll have a super adverse reaction at 10 migs. And that's kind of why the Canadian government used that as the threshold with the thought that even if a kid gets into it, they may have a bad reaction, but it's not going to be a really, really bad reaction. And so that was kind of why we capped them at 10mig. So, but that tends to be for most people the standard range. someone who's a chronic user, they're probably a bit tolerant already, so they're going to go up and scale. I know people who are like, oh, I take 50 milligrams. I'm like, impressive. That's quite a lot of. I have a girlfriend and she says that like in her mom group, they call

three milligrams the mom dose. And they're just like, that's where I don't feel high, but at the end of a day, it just she's like, she literally is like, it takes me a better mom. It takes the edge off. What do you think? What do you think about that like subclinical, like maybe you don't feel high, but you feel like the edge of off. At that level, you're almost certainly, especially in someone who's not a regular user. At three migs, you're almost certainly going to have some biological effects of that. Now, that's probably going to be pretty calming. If anything, like, you may not feel subjectively high, but you'll probably will take the edge off some things for at least a lot of people. That makes sense to me. Because I know a lot of people that, like, yes, most people I know who are

regular edible users are five to ten, but I know people that stick at 2.5. Okay, that's so interesting. Is there anything else that's like the sleep where it might have, we would call them, like, medium-term effects where maybe your anxiety feels down because you're taking this little gummy at the end of the day to take the edge off. But overall, you're increasing your anxiety for a little bit. Is there any of these other medium-term? Yeah, I mean, I've never seen any data that would be suggestive of that. Especially to dose that low. Yeah, and the sleep, again, we're not talking about three-made gommies. The sleep is almost all based on people who are chronic smokers. Okay. So these are people that are consuming a fair amount pretty consistently over a period of several

years. Okay. So you're kind of giving permission to the three meg gummy listeners out there. Well, I guess what I would say is if you wanted to put this side to side of the potential harms, I'd say there's less harms with that than there is with alcohol. Yeah. And alcohol, the research is pretty robust at this point about the negative health impacts of alcohol. Yeah. And I mean, we used to kind of think that a glass a day was probably not a huge health impact. And I can't imagine a single glass a day. I know the signal is starting to come out that even low level alcohol consumption does relate to higher rates of cancers and some other health impact. And I can't imagine. And I can't imagine. I can't imagine. I can't. I know the signal is starting to come out that. I know the signal is starting to, it's consequences. I'm not super surprised about that because we've long known that the harms from alcohol, like it's cannabis isn't harm free. No drug is harm free. That's just the reality of it. So there's a guy in Britain, David Nutt, who was a big psychopharmacology, drug researcher and he worked for the British Parliament for a period in time. He ironically actually was fired from that job because he did this large-scale analysis of harms and said across the board, alcohol is the most damaging drug to society and to the individual, and cannabis is way down the list. And so this was related to things like its relationship to developing disease. Like, I mean, if you look at alcohol

in the short term alcohol, you can die from an over, like consuming too much. You can die from withdrawal if you're a very heavy chronic alcohol drinker and you suddenly stop. Chronic use, especially at a relatively high levels, very clearly associated with like liver cirrhosis and a whole bunch of physiological breakdowns of cancer, neurodegenerative disease like Korsikovs due to vitamin deficiencies that happen. So there's all these very well-established health consequences of chronic alcoholism. And there certainly is some risks associated with chronic cannabis use. So if you're smoking, especially, like I said, you have potential lung issues. The other one that I would say that is emerging, it's hard to say it's the same level of evidence

at this point, but it's something there's enough of a signal that I would caution people about it is there does seem to be, and this is probably related to its ability to increase heart rate, there is some relationship that seems between chronic cannabis use and some cardiovascular events and people later on. So there seems to be slightly higher rates of heart attacks or strokes that can happen to people who've been chronic cannabis users. And some of this, there's some work that sort of come out that's shown like you get increased arterial stiffness. And that might, again, be happening because your heart's beating faster. So you're getting more of a toll in the cardiovascular system. Is that mitigated at all by not smoking it? Because I imagine

And like I associate cardiovascular risk really strongly with smoking. And I also would imagine that a lot of the long term studies are people who are heavily smoking. I don't think we've really got any data sets on long term edible users. So just because historically, this has been much more of a kind of inhaled drug. But that being said, if you take a psychoactive dose of an edible, like if you're taking 10 migs or five migs and you're getting high from it, you are almost certainly getting tachycardia from that still. Okay. Like that, the effect on heart rate is not due to smoking.

It's due to a vascular response where you get vasodilatia. and then like I said, your heart kind of kicks in to compensate. It's one of the reasons, like, people will notice sometimes if they've consumed cannabis and they're sitting down and they stand up really fast, they get really lightheaded, and sometimes people even faint. And that's because their blood vessels have dilated so much that when they stand up, you need this hit in blood pressure to make sure that the blood can still profuse your brain fighting against gravity.

And because cannabis causes this vasodilation, sometimes if people stand up too quickly, the blood pressure can't match gravity, and so they don't get enough blood in the brain and they go down. So it's a very well-established effective cannabis that you get this hypotensive response, but the kind of consequence of the elevated heart rate could be doing some, like, just think of it over long term. If you're constantly doing something that's going to elevate your basal heart rate, I'm not surprised that there would be potentially some relationship with the emergence of cardiovascular disease down the road. Is that something that we could monitor if we're concerned about it?

Like if our heart rate is stable with our low-dose cannabis consumption on an aura ring, a fit bit of whoop, would that be a good sign that we're not having these long-term effects? I think that I would probably reduce the likelihood of there being harms associated with it. Because again, there's variants. Some people get very robust tachycardic responses and some have very little. And so if you're not having much of a tachycardic response, you're probably not going to have the same risk level as someone who has a very robust tachycardic response. So now that like most of us have some kind of tracker of our heart rate,

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Masterclass.com slash Liz Moody. That's 15% off at Masterclass.com slash Liz Moody. Masterclass.com slash Liz Moody. And then are there other long term? You said cardiovascular. And then what else? Is there other? Yeah. So pulmonary from inhalation, cardiovascular. If someone has a risk for some mental illness issues, certainly there's concern that. Those usually come up pretty quick. Pretty quick, meaning the first few times that you consume. Yeah, like, there's a lot of discussion around the link between cannabis and psychosis. I'd say this is probably the single biggest concern of cannabis and the biggest health risk associated with it. It's definitely more prevalent in adolescence.

And also that is probably because schizophrenia as a disease tends to emerge in adolescence. It's a neurodevelopmental disease. Schizophrenia emerges between 15 and 25. That's very stable. So, yeah, usually after 25, it's unlikely it's going to come out. There is a strange relationship with cannabis and psychosis. There are people that can have acute psychotic reactions to cannabis. And sometimes that's it.

It's a drug-induced psychosis. And as soon as the drugs out of their system, they're fine. And if that ever happens, don't ever touch the drug again. That's a bad idea. What does that look like? Usually paranoia. Like usually kind of somewhat of a dissociation from reality, but a lot of like paranoid, delusional thinking.

Like, people are staring at me. Someone's out to get me. It's... I had a bad mushroom trip that was like that once. And I literally, like, we were in a hotel room and I went to the window and I thought that I saw like an apocalyptic scene outside and it was so scary. So something like that would be a sign to not trust that's out again. But with cannabis, for some people, they do have these acute psychotic reactions. It's kind of the worst case, acute adverse response you can have the cannabis because you can't, you can't fatally overdose on cannabis.

Like you can do stupid shit if you're high and you could die from that. But unlike opioids or alcohol or most of the drugs, you actually can't overdose because there's no mechanism to acutely kill you. that's fatal with cannabis with THC because it doesn't turn off breathing and heart rate the way opiates does and it doesn't depress neural activity the way alcohol does. Will you just fall asleep usually? Yeah. If you usually, if people have consumed too much, they just get so lethargic they pass out. But psychosis, like an acute psychotic reaction is definitely a real thing. This happens with people. And like I said, for some people, this is just a drug-induced psychosis. And once it's out of their system,

they're done. It's not indicative of anything else. There are also, though, a subset of people that seem to have a vulnerability to develop schizophrenia, it just may not have presented itself yet. And so when they're using cannabis as a teenager, it might trigger a psychotic episode, but that might just be the beginning of opening the floodgates. And then the disease itself might take form in the aftermath of that. And that has been pretty well documented, that this is a thing. The problem is there's no way to predict who's going to develop schizophrenia and who isn't. It's hereditary a little bit, right? Yeah, for the most part. I mean, the biggest predictor of risk for schizophrenia is a first degree relative. And like, if you really look at family trees, bipolar and schizophrenia tend to

track together. Although it's so hard because obviously diagnostics were so much worse even a generation ago. Yeah, definitely. But usually schizophrenia, I mean, bipolar may be less so, just because bipolar can be really devastating, but schizophrenia is very apparent. If there's any family history of schizophrenia or bipolar, I always tell people, just don't go near cannabis. Just avoid it. You will have a much greater risk of having a really adverse response to it. So I think, Like, that's the biggest one that I think people have to be careful about because it can. And the problem with those diseases is once they manifest and come out, they can be devastating. It's hard to manage.

They can be really challenging. And most likely the disease would likely occur anyways because schizophrenia doesn't just come out of nowhere. Like, it's got a neurodevelopmental component to it. We just don't totally understand the biology of it. But from a risk perspective, yeah, schizophrenia bipolar, that is a big one that I would say avoid. Okay. So pulmonary, cardiovascular, which we can. perhaps monitor and get some information there and then any sort of family history of schizophrenia

or bipolar, anything else that we should cover in terms of risk that people are not talking about or that we should know about. I mean, those are the main ones. Those are the ones that I think that we have the most substantive kind of evidence behind that are the things for people to really kind of be aware of and pay attention to. I mean, there's some association between, especially in adolescence, using cannabis a lot and kind of, you know, being prone to develop depression later in life. That one's a little dicier just because it's not entirely clear if someone's, you know, really stressed out for other reasons and they're using cannabis. And so you see this association. Yeah. So the depression one is a little harder to associate. The schizophrenia, psychosis one is very clear. Like,

that's a very robust relationship that exists there. The depression one is there, but I, yeah, I would agree it's chicken and eggy a little bit. It's not clear if someone's trying to use cannabis to mitigate some stress or emotional changes and maybe they're just developing in tandem and they're not necessarily causally related to each other in any way. It does exist, so it's worth mentioning. Okay, so the last thing we didn't talk about in terms of way to consume cannabis with sublingually. What are the pros and cons of sublingual consumption? I mean, it's going to be pretty similar to oral in general, like edibles. It's faster, though, isn't it? It's a bit faster because you'll go through the mucous membranes. Some of that's going to be dependent a bit on the vehicle it's in,

because these are fatty molecules. They don't absorb super easily. For example, there's been these studies with CBD, where they found you can eat CBD edibles or CBD tincture. Unlike alcohol, if you do it on an empty stomach, it actually has pretty poor absorption. And if you eat a fatty meal right before you consume it, you get way better bioavailability. They learned this when they were doing the studies for the CBD tincture that's used for the pediatric epilepsy. It's droplets. It's not an edible. So it is getting some absorption through the mucose in the mouth, but most of it is swallowed. Most of it just gets swallowed into the stomach and that's with the absorption options. And when they did the original studies and they were looking at blood levels of CBD,

if they just gave it to someone on an empty stomach, the blood levels were very low. And if they got them to eat a fatty meal in advance, it was like a fourfold increase in the blood levels. Again, going back to you talking about making weed brownies, you put it in the butter because it makes it much more bioavailable. So it just seems that if there's like a fatty coating in the stomach, because there's fatty food in there, that somehow really facilitates the absorption, at least of CBD. T. T.C., again, it's fatty, but there's just something slightly different about the structure of the molecules that seems to have influenced this. I'm not sure why. But CBD definitely has better absorption if it's consumed after eating a fatty meal. So if people are taking CBD,

that would be one recommendation I would have if you wanted to amp up the bioavailability of it. Make sure you got more in your system is to not eat it on an empty stomach, but eat it after you eat something fatty. That's super interesting. If somebody listening was just trying to pick the healthiest way to consume cannabis, what would you have them go for? If they were doing the edible dosing properly and carefully, I would say, edibles are the safest way to go. The actual amount of T-CHs you consume is pretty low, so the harms associated with that are going to be pretty low. You can avoid the lung damage. Like I said, you can't necessarily avoid the cardiovascular effects because you're going to get the elevated

heart rate. And if you are prone to mental illness responses to it, then you're, that's intact as well. But because you're removing the pulmonary component of it, I would say that's probably the lowest level of harm is through edibles, as long as you know your dose range, you know what you're going for. if you want to have inhalation approaches because you want to have more kind of titrating control over the dosing or you don't like the high of the edibles. A lot of people report they don't like the kind of high they get from edibles. They prefer the inhaled high. Then I would say the inhaled vape of the plant matter would be the root I would say is the least harmful. And to be clear, not like a pre-prepared vape, but something where you're taking the plant. Yeah. So like a volcano like you were saying. Something they, the volcano is a brand. I want to like plug volcanoes. I'm also kind of impressed they're still around because I had it years ago. No, no, they have staying power. Congratulations, volcano.

Yeah, there are people that really swear by them. But there are a lot of knockoffs and they all use the same basic idea that you use a heating element that goes to, I don't know what the exact temperature is, but it's enough that it will cause the lift so the cannabinoids come off, but the plant matter doesn't combust. And so whatever mechanism someone will use that, be it a volcano or a knockoff of the same approach, you don't have the combustion byproduct, so you'll reduce the pulmonary harms that would be associated with that, but it's still inhaled, so it still has the titration ability. So people do tend to like that. So that would be my recommendation for the least harmful way of consuming it if it was

going through an inhaled route. Do you have any concern, especially as there's becoming more and more cannabis companies, that these companies are almost like manipulating cannabis within an inch of its life and we're getting like ultra-processed cannabis versus having it in the whole plant form, which would be healthier for us in some way? I'm not a fan of the ultra-processed versions. To do any of these extractions or any of this processing, it involves chemicals. I'm just never a fan of chemicals being mixed into something because it just adds unknown harms. In the edibles you buy, though, are those usually like they've gone through some sort of chemical

process, created an extract of some sort, and then they're putting that into a dummy. Again, it depends on how they make it. Because if you talk about like how you would do weed brownies, you're just putting and a fatty substance. Yeah, that's not what you're buying at the family stores. Yeah, gummies are going to be a bit different. There's definitely some chemistry behind that. In that situation, though, ultimately it's going to be a bit different than what's in

the vape pen. For one, because in the vape pens, you're going to get an actual vehicle in there that some of the residual chemicals may be in, and when that heats, you're going to get combustion of those chemicals. So that's why I would think that's a bit more concerning than maybe what you get in edibles. And again, in edibles, whatever would be in there would be very, very low levels of whatever else is in there.

Do you know how they're usually, like, what, if they're normally, like, taking the full spectrum of planet and, like, boiling it in butter? I mean, I'd say it's pretty rare that the gummies are going to be full spectrum, at least in Canada. I can't reference the states because I don't know because everything's different state by state, but I know in Canada the way this works, but because you can get just THC or THC with CBD or THC with CBN or CBG. So you can play with the composition of it. But there's two ways to do that, right? One, there's isolating the compound, putting them together in something, and the other is breeding plant. that have these sort of measurements and then taking that plant and turning it into something? I mean, if you're using the whole plant extract, even if you've played with measurements,

it's still going to have a host of other molecules in it. For the most part, you'll get the kind of isolated and then reintroduced. Because again, in Canada, it has to be regulated. So the dosing has to be pretty accurate. And that I know is not true. I mean, maybe in some states it is. But certainly I remember when things kind of started in Colorado, that was not the case. I remember there was one analysis where someone got a chocolate bar and broke off bits on different sides.

and they had totally different levels of THC in them because it had just not been properly homogenized. Oh, interesting. And so, again, because— That's kind of scary. Yeah, because of the fact that—I mean, it's not even just that. I mean, to be honest, in the States, every spot check analysis I've ever seen that's been done on any oil-based product almost never has in it what's reported on the package. There's no regulatory oversight, so why would you?

So, I mean, even these things— Wait, so there's not regulatory oversight, like in California where it's legal. California is not regulating? As far as I'm aware, there's no. regulatory body that actually does spot checks to say this has this in it. Oh. And so because of that, every study I've ever seen that they've taken what someone calls a CBD product, like an oil or a tincture, when they analyze it, it has THC in it, almost always.

It's pretty rare it doesn't. And that's one of the reasons why a lot of people fail drug tests. Oh, that's interesting. But I'm also like, no wonder people are reporting these psychoactive effects from CBD. I think that's the other reason why so many people think CBD is doing so much for them is because it's probably cut with THC because it's pretty rare. It's very rare from any analysis that I've ever seen that you get a CBD product that is just CBD. It's very rare.

Wow, that is something to be aware of. Yes. I know. This is, again, it's one of like, I'm a strong proponent of legalization, not in the sense of advocating for cannabis, but because of the consequences of things that can happen in the absence of a regulatory framework. So for me, the big one, again, this is a consequence of growing up in BC and understanding what the culture behind this is is the use of pesticides. If you're buying flour in an unregulated market, you have no idea the concentration of pesticides that are being used on that plant. The potential harms of the combustion of those pesticides are entirely unknown.

So in Canada, one of the big things that was brought in was the pesticide control. And to me, that was a big thing. You can think of like, oh, well, there may not be harms with cannabis in this capacity that I'm concerned about, but as soon as you roll in the unknown component of that, then that changes your perspective on it. That's one aspect is the removal of pesticides. The second, or at least the limiting of it, I think it's allowed to a certain point in the grow process,

but not afterwards because then it's not detectable at the same levels. The other one is that you actually, obviously nothing's perfect, but at least in a federal regulatory system, if something claims it has X in it, it has to roughly have X in it. It can't be wildly divergent. If something says it's CBD with no THC, it can't have THC in it. So that's the benefits of like a federal regulatory process.

The other thing is this whole idea of like gateway cannabis is a gateway drug has always been like debating between people on different sides of it. And so the way that I've always described it to people is I say it's not a gateway drug. It's an entry level drug. And the reason I say that is if people want to get access to alcohol, historically they've almost always just stolen it off their parents or gotten older sibling to go boot for them and buy it from a liquor store or something. But with cannabis, because if it's illegal, someone has to interact with a drug dealer to get access to it. And the second they interact with that drug dealer, then they're going to access to a host of other drugs. And so then you'll get introduced to hallucinogens, stimulants, opioids, other things. And you have no idea what's in any of the products you're doing. By making something a legal source,

in Canada, at least, it has really effectively killed the cannabis black market. Like, it does not really exist. There's a small percentage of very heavy cannabis users who have, like, relationships with their grower, that that's who they want it from. And that represents maybe 5% of the population who use cannabis. But the overwhelming majority of people who use cannabis in Canada now, it's all purchased through the legal market. And every state that's gone legal and in Canada, we don't see elevations in teenage use. That was one of the concerns a lot of people have was all making it accessible means teenagers are going to use it more.

I'm like, sorry to tell you, but like our teenage population uses cannabis pretty regularly to begin with. So it has not gone up. That's very clear that it hasn't gone up. So there's not more teenagers using cannabis once it gets legalized. I think that's a plus. But again, it kind of reinforces the aspects of the rationale for legalization. And then the other one was obviously a social justice issue.

Yeah. And so, and this is true in the States and it's true in Canada as well. Regardless of the fact that white, black, indigenous populations in Canada, we're all using cannabis at roughly the same rate. Black and indigenous were getting arrested at five times the rate and getting charged at five times the rate of white. That is very obvious. Maybe not with the indigenous in the States, but certainly between the white and black

population, there's a very clear bias. The social justice component of that is very important because you're taking a community that's already been marginalized in other capacities. and then making it worse by adding all these charges on. And so there's been some attempts at restorative justice, but you can kind of take away the charges for people. But the problem is even if you've done that, it doesn't take it away in other countries.

So like if you were a Canadian, for example, that had a cannabis charge and you go to cross the border, which you can't do once you have a cannabis charge, you can't come into the States. That has not been removed. It's not perfect. I do think it's moved in the right direction. I think that legalization of cannabis

makes way more sense than a prohibition model for a host of reason. So that's why I thought it was good that Canada did it. And I'm never quite sure what the states is going to do because you guys are at a point now. We don't know either. Because that's the thing, like there are enough states now that have legal access to cannabis that I am pretty sure over 50% of the U.S. population lives in a state that has legal access to cannabis. Yeah.

And yet you still like you can't take it over the border from one legal state to another legal state. Like you can't fly with it because on your own federal plant. Whereas in Canada, you can. You can board a plane in Canada with cannabis in your bag and it's not an issue. you're not crossing a border. So interesting. I know we touched on addiction, but can you speak really clearly to if cannabis is addictive in any way, both psychologically and physically? I think there was a lot of struggling with people because of the way people kind of conceptualize

what addiction looks like. The field is kind of shifted to using the phrase like developing a use disorder as opposed to saying someone's addicted to something, but it's the same concept. So yes, you can develop cannabis use disorder. It's a very real thing that happens. It just might look a little different. But if you look at the way you define someone who has a use disorder, whether it's opiates or alcohol or cannabis, it's basically that it has a negative impact on that person's life. It influences their personal relationships, their social relationships, their professional relationships. They spend an inordinate amount of time trying to seek access to it. They will put themselves at risk to seek access to it. Someone has asked me, like, what does someone who has like a

cannabis, quote unquote addiction look like? I would say, well, that's probably someone who's a wake in baker. So they wake up in the morning. They're probably using cannabis throughout the day. If it's having a negative impact on other relationships in their life, they're choosing to continue using it despite the influence it's having. If they traveled somewhere where it was illegal, or they lived somewhere where it was illegal, and therefore could suffer pretty significant consequences for using it. They choose to continue using it in light of that. All of those variables would qualify as someone developing a cannabis use disorder because of the way it's influencing them. Now, again, the withdrawal component was really an aspect that a lot of people

rejected the idea that cannabis could be addictive because the withdrawal syndrome is so different looking. So part of it is, again, because like I was saying before, cannabis is a fatty molecule. So what it does is it actually stores in our fat. Our brain is a very fatty organ. That's one of the reasons why THC gets into the brain so easily. So our brain, our fat, and like our reproductive glands, like testicles or ovaries, which have a lot of fat tissue in them are steroids. They're very fatty, friendly environments. THC will just kind of rush into those environments and sit there. And so what we know happens is if someone's using cannabis chronically, if they stop, there's a fair amount of reservoir cannabis that's just in their fat. And so that kind of slowly leaks back out.

So your body naturally sort of titrates you down. It kind of weans you off a little bit. And that seems to be one of the reasons why the withdrawal syndrome is more moderate than for a lot of other drugs because something like alcohol or cocaine or opiates have really fast turnover and metabolism. So once you stop, it's like very fast and hard. And it's dangerous. Yeah. And whereas is there any case in which stopping cannabis is dangerous? I don't think I would say dangerous. I think even in people who are pretty heavy users, they'll have a few bad days. The most robust symptom withdrawals, the sleep problems are very apparent. And that's almost always what motivates people to start using again.

So that's the other way you get diagnosed with the cannabis use disorder is you've actually tried stopping and been unable to. Like that's a big qualifying criteria. And in the context of cannabis, that almost always people report it's the sleep issues because they'll have days and days where they've had really bad sleep or almost no sleep at all. And then they're just like, I can't do this. And they go back to the cannabis. But according to what you said earlier, they're prolonging how long they're probably going to have sleep issues in the long run by going back to cannabis. Yeah. And that's why I was saying it's like a double-edged sword because it might be, you know, it's a bit of a crutch. It might help them manage themselves. But long term, it's not helping them get better necessarily. Yeah, that's interesting.

But just to be super clear, there isn't a chemical addiction component where like I got to have it. or X will happen with cannabis, you're more addicted to the effects it's having on your body? It's kind of hard to separate those in some ways because, I mean, obviously some of the rebound effects that are going to emerge. So sleep's the number one, irritability, similar to like caffeine withdrawal. Like if people have been drinking coffee nonstop, if they go and just stop, they're going to be very cranky, they're going to have headaches. It physically would manifest kind of similar to a caffeine withdrawal, but with the addition of the sleep problems. That would be the other component to it. But it's not like, like, alcohol withdrawal can be horrendous. Opiate

withdrawal can be horrendous. So cannabis withdrawal isn't really quite like that robust. So it's definitely doing something to trigger that, but because again of the kind of self-weening, because of the way that T. She leaks back out of the fat stores, I mean, maybe if we took a drug that just blocked cannabinoid receptors, a cannabinoid version of Narcan. Like if you have someone who has a dependency on opioids and you give them Narcan or an oloxone, like a drug that blocks the receptors, that will throw them immediately into a very robust withdrawal syndrome that's horrific. So if you're you, you're just a So if you gave someone a drug that blocked cannabinoid receptors, it might do the same. That's just never been tested.

It's so interesting because this conversation is making me think about like almost the function of what being addicted means on a societal level. And I think that we have the societal notion like, oh, they're addicted. It's not their fault. They can get treatment. They can get help. But it's not their fault. It's something happening almost outside of their control.

And then if they're not addicted, and I think people say this with cannabis all the time, it's like, oh, it's within your control. you could quit if you had enough willpower, which is a different. And I think that's how people mean it. Yes. And this is one of the reasons why there's been like no one has really debated whether alcohol or opiates or cocaine and stimulants are addictive because everyone has the classic way we view addiction, people have said that. People may recognize like caffeine's addictive, but they joke about it. Yeah. They don't talk about it seriously the same way. If we're having a conversation with somebody, this is an imaginary thing. I want you to quit cannabis. I can't. It's out of my control. I'm addicted.

How do we think about that type of dynamic? It's a real thing. I mean, people do go into recovery facilities for cannabis use disorder. It's not uncommon. I've gone and had conversations in recovery facilities with people dealing with cannabis use disorder. So it is a real thing. It tends to not impair people or manifest the same way as a lot of other substances do. And so that's why I think people just don't think of it the same way.

And this is always the thing that you see all the time on social media and in debates coming up all the time, people are like, oh, I always talk to people who are chronic cannabis users and they definitively say I'm not addicted and therefore it's not addicting and then the person's like well then stop using it they're like well I don't want to it's not that I have to I just don't want to and that's a very common debate that goes back and forth between chronic users and non-users if they try having a conversation about this the big thing that a lot of people say especially if they're really chronic cannabis users is certainly with things like food they don't find they enjoy it as much if they're not using cannabis. And so it seems like a lot of people use cannabis as like an enhancement. Like it makes things better. It makes food better. It makes sex better. It makes watching movies better. Because of that,

they tend to continue using it because they find it amplifies the kind of experiential component of a whole bunch of stuff. And so again, in their head, it's not an addiction. It's not a dependency because they're choosing to use it to make something better. You could make that argument for a lot of drugs, just they would manifest a little differently. Is there an argument that using cannabis regularly is making the experience worse when you're not on it? And I'm wondering, a lot of people asked what cannabis's impact on dopamine was. And so if it was making your dopamine imbalance in a way that the regular pleasures

of everyday life weren't hitting in the same way? Cannabine receptors are, they're not on dopamine neurons in their brain, but they are around them and they regulate their activity. So THC will turn off what we call inhibitor. tone on dopamine neurons, which means it allows dopamine neurons to fire more readily and easily. You're not getting like a big hit, like a stimulant causes big dumps of dopamine. Like cocaine causes big dumps of dopamine. Now you don't quite get that from THC, but what it seems to be able to do is it might

amplify like a dopamine response to another rewarding signal, like something that's tasty, food-wise. So it could just augment the experience that someone has in terms of how pleasurable they find it. Now, whether that results in someone being unable to experience pleasure in the aftermath if they try going off it, I don't think anyone's really looked at that explicitly. And that's not, if it is there, it's not coming out in any of the reports in these withdrawal studies where people have found it. Really, I think the sleep effect is so overwhelming that that seems to dominate the majority

of the discussion of withdrawal. But it is a common thing to hear people say, like, the big thing you see is a drop in caloric intake. If they are regular users and they stop using, they're californ. calories go down about two-thirds. I don't have any motivation to eat food because I don't find it's as pleasurable. Well, and that's a therapeutic use, too, is people going through chemotherapy chemotherapy, we'll use cannabis to... That was actually one of the first medical uses they had for cannabis was that it was an appetite stimulant for people that, yeah, going through chemotherapy or

from kakeasy associated with AIDS. A lot of people asked me if there's any type of cannabis they could consume or a form of cannabis that they could consume it in that would not lead to the munchies. I know. Here's a lot of people because they're always like, oh, you know, that's why I don't like it because I can't stop myself from eating? I don't think so. THC is going to activate cannabiner receptors and those receptors are very integrated into feeding circuits to drive feeding behavior. So, okay, so no way to avoid the munches. Yeah, I think it's pretty hard to kind of avoid those. It is interesting, though, because in the bodybuilding community, cannabis seems to be a drug of choice for a lot of bodybuilders because if they're trying to like bulk and consume a high

amount of calories, they can use cannabis as an appetite stimulant to make them eat more. But if they're going through like a cutting phase where they're trying to restrict their calories, it's a substance they can use that doesn't have calories associated with it. As long as they can fight the willpower of the munchies, unlike alcohol, which consumption of alcohol comes with calories, you can't avoid it. And so it's kind of an interesting thing. It's actually one of the reasons why cannabis seems to track a lot more in kind of quote unquote healthy communities or very active and fit and exercise-driven communities because they just tend to prefer cannabis. Like that crowd is much less an alcohol drinking crowd.

Which, to your point earlier, I mean, the health effects of alcohol seem to be greater than the health negative impacts of cannabis. Yeah. So I've always found this interesting because there's a lot of large-scale studies that have been done that have replicated that have found across the board, cannabis users have lower rates of obesity and lower rates of type 2 diabetes than non-canabis users. And so there's always been this, is this an effect of cannabis, which is kind of contrary to

what people would assume given the munchies, or is it? Is it just that a lot of people who use cannabis recreationally also engage in healthy lifestyle decisions? What do you think? Because there's also, we talked about like cannabis can potentially lower inflammation levels. Do you think it's correlative or do you think it's cognitive? I think you could make an argument for both. Depending on the degree of the munchies that people get. I mean, I think generally a lot of people who consume cannabis are probably not like binge eating tons of shit food.

In my cannabis phase, I did eggo French toast waffles. I mean, they were so good. Yeah. French does well, when I do like a whole box. Yeah. Yeah, I think it's the off switch. That's the problem. It's interesting, though, because even in, like, we've done studies with rats.

My buddy Ryan McLaughlin's at Washington State has done these studies where rats will self-administer themselves cannabis vape pits. So you'll give them access to this and they'll go in and they'll take cannabis vape hits like willingly and they'll work to get access to it. And they do eat a little bit more. But what's interesting is they actually seem to have a slight alteration of their metabolism. so they seem to burn things a bit faster. So at the end of the day, they don't gain any more weight,

even though there's a slight increase in caloric intake. Do you think that's because of like the toning of our endocannabinoid system or just our body trying to balance itself? So the one thing that came out in his study when he looked at the data, and I thought this was really interesting, is that when you consume cannabis, one of the effects it does is it causes a slight reduction in body temperature. As a consequence of that, as the THC kind of dissipates out,

you get a slight rebound where body temperature will go back up and may overshoot slightly. But what he found in his study was that normally our body temperature rhythm hits its lowest point when we sleep. And a lot of people use cannabis before bed as a sleep aid. What seems to happen, at least in the rodent study, what we saw was that throughout the night, as the THC seemed to dissipate, normally the body temperature would go down. But it didn't go down as much because there was this kind of rebound body temperature kickback

as the THC came off. And so there was more heat emission that came out of the body during. from these rats that had been self-administering cannabis. And so heat emission is a form of energy expenditure. And so it seemed like maybe the reason that they weren't gaining any weight, despite having a slight increase in calories, was because their body was exerting more energy expenditures through this heat dissipation during the sleep phase.

And could that also be what wakes one up after they sleep for a little bit? And then they would like... It's possible. Heat up and then wake up. Yeah. Because, I mean, you don't want to be hot when you sleep. Yeah. People want to be cool because that helps you sleep.

And so I wouldn't be surprised. surprised if that's a part of it. It's a hard question to test scientifically, so it would be a guess. But yeah, I could see that playing a role. I thought about this when you said the raised heart rate, but I wonder if there's like a hormetic effect where you're having this good stress on your body, similar to going in a sauna or something like that, where if you go in a sauna, you can see your heart rate go up and you're having all these benefits of putting your body in this stress state acutely and then ending the stress state, essentially, having your body reach homeostasis again? Do you think that could be part of what's contributing to?

It's possible. I mean, you do see like some elevations in cortisol from cannabis. Like you do reliably see that. And as a consequence, Ryan has done these other studies in humans where they've looked at chronic cannabis users and they do see some slight elevations in basal cortisol, but then if you

stress them, you see a blunted stress-induced cortisol response. Oh, like you're going to be a little bit more stress all the time, but you'll respond to acute stress a little bit better. Yeah, at a hormonal level, yeah, that seems to be one of the things. And we've done this. We just had a paper that just got published like last week, where we did this with Ryan in rats

and found the same thing that you get them expose the cannabis vapor, they do get these slight elevations in their court, and then if you stress them, they have a blunted response. That's interesting. I'm trying to, like, picture how that would play out in a human life, you know?

The thing with stress is it's so subjective. And so some people, you can actually, like, see, they appear like they would be stressed, but if you look at their hormonal responses, they don't really evoke much of a hormonal change. And then other people might have really robust hormonal responses. So I think it's a little hard to look at that kind of across the board. Usually when we think of fight or flight, like fight or flight is definitely adrenaline.

Like that's an adrenaline response. And that you feel like your stomach tightens. You kind of get very alert with things. That's very detectable. And I think most of the time when people feel like they're chronically stressed, what they're really feeling is adrenaline because they're just like jacked up and they're kind of very vigilant and ready to go because their body is just in the state of alertness. But, I mean, like I said, we do know that cannabis, like THC, can dampen sympathetic responses.

Like, it can suppress adrenaline release from your sympathetic terminals throughout your body. So you probably are bringing down the adrenaline response a bit if someone's using cannabis. The mattress that you sleep on is one of the highest exposures that you have. Like, if it's off-gassing, you're breathing that in for basically a third of your life. And most conventional mattresses are loaded with synthetic foams, flame retardants, microplastics, and more. Plus, if it's not comfy, you're going to be tossing and turning, you're going to be really hot. And sleep is the foundation of health. It is so important. Because of all of this, if I were not going to invest in any other part of my house, no other things in my house, I would invest in my mattress.

And in fact, I have four years well before I had much money to spend on any of these things because it is such a big needle mover. The birch mattress is incredible. It is made with organic cotton, natural latex, and ethically sourced wool. So it has literally no off gassing. You can not smell anything right when you unbox it. It has no microplastics, no synthetic foams or flame retardants. And the wool makes it so breathable, which if you've listened to this podcast for more than five minutes, you know that I run very, very hot. Like I am a furnace. Zach has basically accepted that sleepy next to me is like sleeping next to like a little fire. And the birch mattress has been a game changer for that. It's made me sleep so much better like I can see my sleep score going up because I'm

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Dopamine is a very big thing that's been studied. I think it's just been misconstrued a little bit what dopamine really does. If I ask my friends who study dopamine, the majority of them would say that dopamine is really much more a signal of like, it's like a teaching signal or a salient signal. The biggest thing you see dopamine response, too, is if you have an unexpected reward. Often when I talk to people in the public about dopamine, they kind of almost associate with like an orgasmic response. Like that's dopamine. Like, ooh, that's a big rush of dopamine.

And it's like, that's unclear, actually. I mean, you get a dopamine response to that. But you also get a big endorphin response and an oxytocin response. There's a whole bunch of other things that go on. Yeah. So there's this like really interesting bidirectional relationship there, too. Dopamine's engaged with pleasure because we're motivated to seek out more pleasure. Because it's this big debate, like in the neuroscience field, a lot of the ways people talk about this is wanting versus liking.

And there's a big difference that comes out there. And those concepts often blur in the general public when people talk about this. Like they just think anything that's rewarding must be dopaminergic. The point I try and make to people a lot of the time is I say, well, if we look at something like schizophrenia as a disease, the main underlying neurochemical abnormality in schizophrenia is excess of dopamine response. Like people who have schizophrenia, drugs that antipsychotics are dopamine receptor antagonists. Like they're blocking dopamine. So if dopamine in and of itself was just driving pleasure, schizophrenia would manifest very differently than it does. Whereas if you think of what schizophrenia is, is this aberrant saliency. Individuals who have schizophrenia tend to attribute salience to a lot of inert cues

and therefore start reading into them having more significance than they do. And that's where a lot of the delusional thought patterns come from. And a lot of people would argue that dopamine is much more about salience and like how robustly something is as a salience cue as opposed to it being overtly pleasurable. I mean, you get big dopamine. responsive with aversive cues. If you get like an electric shock or some kind of aversive signal, you'll get a dopamine response to that. So connected to motivation though, like in a very simple way

that dopamine is related to motivation pretty straightforwardly. And we think of cannabis as pretty strongly related to motivation. Is cannabis impacting our dopamine in a way that impacts our drive or motivation? Probably. So we've done some studies where we've got an animal stone and we've got them to do what we call progressive ratio, which is they have to work. So this is not quite like, a slot machine, but like they like sugar pellets. Like rats will like sugar pellets. So they'll have to lever press and they'll like lever. First time they lever press once they get a sugar palette. Second time they have to hit twice. Third time they have to it four times, then 16 times. And so it's the scaled, the amount they have to work to get access to something. And that is probably the best

way to measure motivation because it's like how much effort are you willing to put in to get a reward. And if we get them stoned, they will go to town. Like they work. Even though everyone's like, oh, it makes them lazy and they don't want to engage them like, no, no, rats are clearly high and they're getting stone, but they will work harder to get a rewarding stimuli when they're high. And that's somewhat true in humans as well. And so that seems to be... Wait, how does that play out in humans? Like, is it, I want a French toast, egg or waffle? And so I'll do anything for that. And so the flip side of this, again, I would say it's not a general principle to everyone, but this is something that a lot of people used to talk a lot more was this a motivational syndrome that

occurs in some individuals that smoke cannabis like are chronic users. What happens there is, whatever this is likely engaging dopamine to some degree to drive motivational responses through chronic use, that burns out. And so as a consequence of that, motivational drive can go down. And so that's like what a lot of people are very concerned about in like teenage users, is that they'll burn out. And then they're at like a critical point in their life where they can really kind of mess up their trajectory if they stop engaging in the outside world and pushing themselves forward. And so that I would not say is a general thing that happens with chronic cannabis use, but it definitely happens to some people. There are some people that seem to be very susceptible to this, and it's not

clear why. But my guess is it probably does intersect with the dopamine system. Does that rebound with cessation abuse? I don't think it's been studied well enough because it's not as widespread as people made it seem like 10 years ago. Like people used to really talk about this as like a thing with cannabis that people developed a motivational syndrome. Yeah. And I was like, okay, there are certainly a sum that happens with, but it's not that that common. And so I think it's been hard to kind of isolate the individuals, because the other problem is a lot of people attribute issues in their life to cannabis as well. Yeah. So I'm thinking about like the listener who's like, my partner gets stoned all the time. They're not motivated to do anything. I need to get them to quit getting stoned so they will

get their motivation back. Is there truth to that or are we just like blaming things on cannabis? It depends on the person. But for some people, they were, let's call it lazy in advance. And then cannabis comes into the mix and maybe it makes them a bit lazier. but it's probably not the cause of it. And taking it away, maybe they'll rebound a bit, but maybe not. There are some people that it does seem to make them not want to engage and stuff. And so if it's one of those people, perhaps them stopping would get a rebound where they would kind of come back and start engaging again.

So I think it's hard to say as a rule, but I don't doubt that for certain individuals stopping cannabis would take that away. Okay. So if your partner was not this way before, that would be a good sign. Yeah. So if you had known someone for a long time and they initially, cannabis, and this was a very noticeable change that came about within them, then, yeah, I would say taking cannabis away would probably take that negative effect away and they would go back.

What impact does cannabis have on male hormones? Variable. It's not clean. There's some studies that say acutely it might reduce testosterone levels a little bit, but there's also studies that have found like chronic cannabis users have slightly elevated basal testosterone. So it's not entirely clear. There is some suggestions and some of the work that you can affect sperm. I always say to people that are like, oh, you know, if someone's having trouble having a kid and they want to have a kid and they've been struggling

and one or both of them are using cannabis, I would always be like, try stopping. And that's because you said earlier that fat, it accumulates in fat in the body. That's found in testes and in the ovaries. But like for just to be super clear, it has a impact on fertility from a male perspective and a female perspective.

Depending. I would say with the females, there is some interaction with progesterone that probably doesn't have a huge effect on fertility to become pregnant, but there's obvious reasons why a woman would not use cannabis while they're pregnant, just because we don't really know what the impacts of that are, but there's some suggestions that could relate to things like higher risk of autism and some other adverse consequences, although it's not really well fleshed out. But one thing it seems to relate more to is that it might stunt the rise in progesterone that's required to maintain a pregnancy. And so there might be a higher degree of spontaneous miscarriages that could occur. So in that sense,

fertility-wise, it may not be good. But there's always this subset of the men in the studies that do reliably show suppression of testosterone in response to cannabis or reductions in sperm quality or sperm content. Again, it's impossible to say as a hard and fast rule, but there's enough evidence out there to suggest it could negatively affect male hormones or it could negatively affect male sperm quality, that if someone was trying to get pregnant, I would probably say cut the cannabis on both sides just to increase your likelihood in your odds. What about postpartum? I got a lot of questions about cannabis and breastfeeding. Well, it will go in the milk because milk is fatty. So there's a lot of fat content in milk. So we do know for sure it's going to transmit to the baby

through consumption in the milk. It's probably not the highest levels. I think it would depend on how frequently the person was using. In terms of regulating postpartum responses, I've never seen any data out there in terms of looking at this. Like does it affect mood or other kind of consequences of the hormonal changes that happen in postpartum? I've never seen any research done in that capacity. But I do know there has been a fair amount of work to look, is it in the milk? And it definitely gets in the milk. So it would transmit. And then you said it has this effect on progesterone, which is one of the reasons it's impacting female fertility. I know a lot of people who use cannabis around their period to help with painful cramps, so with PCOS, with things like that. Would that

progesterone effect have beyond just sort of this pain relief effect? Are we having a hormonal impact that would impact our body? I'm not sure it would affect the hormones as much at that point because the changes that you're getting in like progesterone levels during like a normal cycle are way less than the, the elevations in progesterone during pregnancy are massive. Any of the data I've seen, I've not seen like acyclicity or like changes in a normal cycle in women if they use cannabis. Like it's not affecting hormonal levels in a way that's detectable to influence a normal cycle. Okay. But that being said, I do know a lot of women who use cannabis to manage menstrual cramps, PCOS, exactly what you're saying. That is probably an inflammation pain component that it's working on, not a hormonal component.

Oh, that's interesting. So are all of cannabis's benefits for pain via inflammation? No, not all of them, but it's a big part of it depending. Because you can have non-inflammatory pain where cannabis still has some analgesic properties, but it affects the whole somatosensory system in terms of pain processing. There's even work to suggest that it can affect the afference that detect pain at the skin level, basically. but it affects every level of the pain processing from the cortex to the brain stem down through the spinal cord.

I always find it interesting, like, is the pain relief that I'm using impacting my perception of pain in my brain or is it impacting like the inflammation in my uterus that is causing said pain? Both. Yeah. So it's affecting the pain perception in your brain. It's affecting the emotional component of pain, which is a huge aspect of pain and it's affecting the inflammation.

So people underscore the emotional component of pain. And that actually is probably where cannabis is having the biggest effect. So if you talk to people who have chronic pain and use cannabis, across the board, almost never do they say it obliterates their pain. What I have heard time and again is cannabis turns pain into background noise. And I've had various states of chronic pain for different things where when you're in chronic pain, it just like infects your brain. Like you just become so consumed by the pain that it affects the way that you think about

things. It affects your emotional state. You become upset. You become irritable because you're just. you're just always in pain. And cannabis seems to somehow like separate this. So that the pain is there, but it's like background noise. And that phrase has been used so many times in people I've talked to that it's just kind of become a thing that I think of it like a buzzing in the background that's annoying and it's there, but it doesn't affect you the same way. This is really apparent when you

look at something like sleep, because one of the big problems that people with chronic pain have is that they don't sleep well. And the main benefit people report is that when they use cannabis for pain, it takes pain out of the forefront so they're able to go to sleep. And just sleeping will make them feel better. And so kind of going back to what we're saying at the beginning about sleep, that's another one. It's kind of a chronic pain state. It's very different than just someone using cannabis to go to sleep if they don't have any issues. But if someone's having trouble sleeping because of a chronic pain state, cannabis might be able to benefit that because that really does seem to help a lot of people in that situation. But it's not like cannabis is obliterating

the pain sensation a lot of the time. It's just making it so you don't think about it as much and it's affecting your emotional state a lot less. Oh, that's so interesting. What do you think about, we talked a little bit about topical cannabis and if it has something that actually allows it to absorb transdermally, do you think that's good for cramps? I've seen a lot of like patches that have transdermal absorption. Would you say that's better or worse? I've never seen any actual pharmacokinetic data in humans about like what the blood levels are. Yeah, well, I've seen patches that go like on your uterus and I'm like, is that silly? I find it hard to believe that something would be able to concentrate because it's going to go through all the dermal layers of the skin. And after that,

it's, I mean, it most likely would go into the blood, but it could move right into the uterus. I don't think anyone has ever done a study that would be able to tell you. And even if you did that in humans, you'd actually have to biopsy the uterus out to be able to look at local concentrations in uterine tissue versus blood levels to really know if the localization of that makes a big difference. Because, I mean, like, nicotine patches, people just put anywhere. Oh, that's interesting. The whole point is it just gets into the blood and it offsets the withdrawal. And you're not trying to, like, give nicotine to your uterus. Yeah, exactly.

So, I mean, most of the situations that I've heard of these things is more like a vaginal suppository, where it kind of is used in an inserted manner. And that makes sense because you've got mucous membranes. You can have local absorption that would take it up, as opposed to trying to target an organ under the skin and so placing it there. I don't know about how that would be efficacious or not. For topical, is there any benefit for, like, muscle pain? I buy THC and I rub it on, like, my sore shoulders.

Is that psychosomatic? Again, I think a lot of that would be determined by the vehicle it's in. Because it is a fatty substance, its ability, it's not going to be as easy as like nicotine or even like opiate patches that people will use. Those molecules just kind of move in. They're like almost salts. So they move around so easily because they can absorb into almost any liquid base. But because cannabinoids are so fatty, they're going to choose whatever environment

is the fattiest environment, that's where they're going to go. So my muscles probably aren't very fatty. Probably not. Okay. If you had a teenager, would you be concerned about them using cannabis? Depends on how they were using it and how young they started using it. Anytime someone's using something super young, any substance I think is a little bit concerning, just because you're never quite sure about what it's going to do.

If I had a teenager that was like smoking a joint at parties on the weekend, I probably wouldn't be very concerned about that. I don't think there's very compelling evidence that intermittent and infrequent use of cannabis is going to relate. The problem is these studies are all so poorly done, and they're all retrospective, that it's really hard to really understand it. But generally, from everything that I've seen, something like that, I probably wouldn't be too concerned about it. If my kid was wake and making, I'd be concerned about that.

If parents are asking me, I would say, it's kind of hard. The window beyond that of where harms are going to come into play is hard to assess. There are definitely some teenagers that can use cannabis semi-regularly and it not affect them adversely, or at least seemingly affect them adversely in any way. Whereas the ones who are kind of waking, baking tends to be the bigger risk. I would realistically say the biggest concern about teenage cannabis use is its relationship to someone developing cannabis use disorder or messing up their kind of life trajectory. One of the consequences that you could have, and this is not uncommon.

I knew a lot of people in high school that this happened to is they started smoking pot as teenagers and then they were having trouble getting up in the morning and they were missing class. And so that started having an academic effect on them and then that then affected their ability to go to college and then that domino effect on other aspects of their life. So that component of it is the most tangible harm. I would say that's associated with cannabis use as a teenager is the younger the start, the more frequent they use, the greater the risk they're going to have to develop cannabis use disorder and the greater that's going to have on an impact of their life trajectory. If I was a parent and I had no idea my teenager was using cannabis and they were maintaining their grades and going to

school and all the other aspects of their life were completely normal and I suddenly found out they're using cannabis, I don't think I would be that concerned about it because I'm like they've been able to manage everything that they're doing. You wouldn't be concerned about the long-term impacts on their brain. It's variable. It's very hard to predict this because the large body of data that's out there is not consistent at all. So there have been kind of singular studies that have found teenagers when they smoke pot. They may have slightly altered brain structure when they're older. But then there's also much larger studies that either have far more subjects in them that don't find this. And so it's really hard to understand. I mean, we know cannabinoid receptors are kind of positioned

in the brain to affect various developmental processes. The potential is certainly there for there to be some damage or harm. It's just whether that actually manifests as a real effect or not is very hard to say. And because the data is so all over the place and the human studies that have been done, it's been very challenging to understand this. Every study's done differently and maybe some are in vulnerable populations where you see a bigger effect. And we don't really. We don't really. understand why some people might be affected by it, and others aren't. Like, we don't get what the variables are. The easiest way I always say is, look, if you want to have no risk, don't use cannabis. If you're choosing to use cannabis, the guidelines we're using Canada is try and delay your

onset until you're later, because the younger you are, the more brain development that's going on, the greater the likelihood if something bad is going to happen could happen. If you start later, there's less developmental processes happening. So if there is an impact, it could be less. And you try and meet people where they're at. So like if someone is a wake and baker, the advice is to try and get them to cut back to only use at night. If someone's a daily user at night, you try and get them to cut back to four or five days a week.

If someone uses four or five days a week, you try and get them to cut back to weekend. So it's always trying to meet someone where they're at to kind of, I'm a big fan of harm reduction. So that's kind of the approach that we use when talking to teenagers, much more so instead of saying, it's going to melt your brain. Your brain's not going to develop properly. You're going to lose IQ and be stupid because I don't think that's an effective way to approach this. I feel like we already have a little bit of a crisis in people trusting science nowadays,

especially after the pandemic, that I'm very strong with my colleagues that I'm like, we should not be saying things definitively if we do not have like an overabundance of evidence to support what we're saying. And everyone's like, oh, but people don't understand nuance. And I'm like, I get it. Nuance is hard. Like it is challenging to convey nuance to a population. But at the same time, I think we have to be honest about the reality of things and say, there is some evidence that it could harm brain development. And there's some evidence that it could harm cognitive processes as we age, but it's not clean cut. And it certainly doesn't seem to be everyone. And the large scale data doesn't say this is a definitive outcome that happens.

That's why I would lean much more on the cannabis use disorder risk and the impacts on academic performance and engagement in life as a teenager and how that can affect their life trajectory. And so that to me is the much more tangible right in front of you effect that can tell you if you should be concerned or not. That's really helpful. The last thing I want to touch on that. We've kind of danced around a little bit. I struggle with anxiety. That's like a big thing for me. We've talked about like you can have your little three milligram gummy take the edge off. And we've talked about that for some people, cannabis can cause like paranoia and these types of things. Can you compare though in the same way we compared a glass of wine to some

cannabis? How would you compare cannabis to like taking a Xanax for anxiety? It's going to be very different. Yeah. So I mean a Xanax, almost all anxiolytic drugs, like I was saying earlier, they all hit the GABA system. And so GABA is a neurochemical. that is inhibitory. It kind of calms down neural activity and it quietes everything down on the brain. So people who are anxious tend to have a little bit too much neural activity and parts of their brain involved in emotional processing and that's what makes them feel like they're in a bit of a state of panic and anxiety. So Xanax and Clonopin and all these drugs that hit the GABA system tend to just calm down neuroactivity indiscriminately. So yes, it does reduce anxiety, but it also

kind of reduces a lot of, it slows people down generally. There's usually some cognitive side affects with it as well because it's kind of slowing everything down. Cannabinoids like THC don't work that way. What cannabinoids do is they affect the ability of a neuron to release chemicals. And so some of those chemicals are excitatory, some are inhibitory, some are serotonin, some are like acetylcholine. So it affects a whole bunch of different neurochemical systems. And that's one of the reasons why cannabis is so variable from person to person. And so it's really hard to know. Like Xanax, I don't think there's any kind of accounts of as Xanax or benzodiazepines, for example, making people get more.

anxious. I mean, maybe in withdrawal. Yeah, but I mean, acutely. Yeah. Whereas cannabis acutely can either reduce anxiety in people or make it worse in other people. And that's one of these things that we've never been able to fully explain. I feel like people almost always, they'll often attribute that to like, oh, I got this strain or I got this weird thing or whatever, but you think it's just our unique biology. Well, in a given individual, they've used cannabis a fair amount and found that it reduces anxiety and suddenly try something different and it enhances it. My guess is realistically that the one that made it worse was just a more potent higher THC strain. Okay.

Therefore, they just flooded their brain with more THC than they were used to, and that produced an adverse effect. The best model we have for how this works is, like I was saying, THC can suppress excitatory neurochemicals and inhibitory neurochemicals. It seems to be able to suppress excitatory neurochemicals at lower doses, and as you go to higher doses, it turns off the inhibitory neurochemicals. And so what that means at like a brain circuit level is if a low, If no dose is turning off excitatory neurochemicals, it's going to calm down brain activity.

So if we're talking about something like the amygdala or a part of the brain that's involved in generating anxiety, if we reduce neural activity in that area, we're going to bring anxiety down. And so that seems to be why lower doses of THC are uniformly anxiety reducing. As people go up and dosing, then it's going to start hitting the inhibitory neurochemicals and turning those off. And when you turn off GABA, for example, the consequence of that is more neural activity. So if you turn off GABA release in the amygdala, then your amygdala is going to become more active and you're going to feel more anxious and stressed. Oh, that's interesting. But what's interesting is different people are going to have different expression patterns of cannabinoid receptors on excitatory versus inhibitori neurons. So I don't think it's a difference of some people are going to have always adverse responses.

I think what it is is some people are more sensitive to THC. when they consume it, if they consume, let's say, two to three toaks, because most cannabis nowadays is pretty potent. So there's a lot of THC in it, which does make titration a bit challenging for people who are pretty naive to it. If some people have more receptors on the inhibitory neurons, if they take like three hits and that's enough THC to start saturating those receptors, their outcome is going to be adverse. They're going to be panicky and anxious. Whereas other people might more likely have it on the excitatory terminals. So when they consume, it's calming things down and making them feel less anxious.

Now, you made a comment earlier that I thought was interesting because this is a very common comment where you said, oh, I used to like it, I don't like it now. So there's an aging effect here. At least in rodent studies, what we've learned is after the adolescent window, as you go into kind of adulthood and aging, one of the things that happens is there is a redistribution

of the proportion of cannabinary receptors that are on these excitatory versus inhibitory neurons so that you get less on the excitatory and more on the inhibitory. And so if you think about the fact that it's the cannabinary receptor, on the excitatory that drive the kind of anti-anxiety effects, and on the inhibitory, it seems to be what relates to the pro-anxiety effects. That, I think, is kind of why so many people, as they

age and go from adolescence into their 20s and into adulthood say that, like, cannabis turned on them, and they used to think that it was good, they enjoyed it, and now they find it aversive. And so I don't think it's necessarily outright that that's the case, but it could just more so be that the doses they use to feel positive effects when they're younger might be too high a dose now when they're older because it's going to preferentially turn off GABA and turn off the inhibition and therefore produce more aversive, anxious-like responses. So if we're looking to use cannabis for anxiety, the key would just be low doses. Yeah. Yeah, definitely low doses are safer in terms of having a much less likelihood of

an adverse response and easier to control. So as I was saying, because cannabis has become more potent, the problem is that that makes that window of titration so much more challenging. And so this is one of the things that was like old school cannabis from the 70s and 80s because it was so much lower in THHC. Like it was like 2 to 5 percent, whereas nowadays it's like 25 to 30 percent. So they were like mellow summer of love and like now we're like, ah. But that was the thing. You look at like an old Cheech and Chong movie and you see them smoke this blunt that's like a foot long and like you could never do stuff like that nowadays because the cannabis is too potent. But what I think the less potent cannabis allows for is a bigger titration window.

So it's much less likely that someone's going to over consume and have an adverse response because the THC is so much lower that the amount that goes into the brain and body off of a single toke is going to be way less off low potency cannabis than it is off high potency cannabis. So the advice I would give to people if they are using cannabis in a way to manage anxiety or if they're going to reintroduce cannabis as an adult after not using it for years when they as a teenager is definitely take the dosing down because it's probably a different beast than what they used to use. it's probably a lot more potent. There's a lot more THC in it. And so their ability to titrate to a level that would be positive and not negative is going to be a much narrower window. Are there any final thoughts that you want to leave people with? Everybody listening to this episode is trying to figure out, are there enough positive health effects of cannabis that I should be even trying to incorporate this if I wouldn't otherwise? Or are there enough negative health effects of cannabis that I should be avoiding this even if it feels good in my body? So are there

kind of any final thoughts you'd leave us with on either of those sides? I mean, I would say it's a very personal decision for someone, what they choose to do. And like some people are very clean. They don't like putting any substances in their body. And that's a choice they make. And then there are some people that are the opposite and just like to use a lot of substances. Like I said before, I mean, there's always going to be some degree of risk and harm with using any drug. And cannabis is no exception to this. So there's definitely, as we've talked about, some potential harms that people may incur if they use cannabis. Now, the decisions most people make about whether or not they're going to use something is kind of a cost benefit ratio. And so if you are someone,

for example, who is really stressed out and really has trouble sleeping, for example, which is a big motivating factor for a lot of people to use cannabis, and you find that when you try cannabis, it does help you sleep and you feel much more restored in the morning and you're feeling better and therefore it helps you function better day to day, then for you, that cost benefit ratio is going to be probably favoring more trying it and continuing using it to some capacity. The only thing I would say is to try and avoid escalation. That's the best advice I can use for anyone who is using cannabis because it doesn't have escalation the way that like cocaine or alcohol often does just because tolerance,

you do get tolerance to some aspects of cannabis, but it's not as robust. But it's just the more frequent and heavier someone uses, obviously the greater the risks start compounding. So I know a lot of the PTSD population, especially in the war vets that I've talked to who use this, they really limit. A lot of them say they smoke a half gram joint before bed and they never do. change. They don't start smoking during the day. They don't escalate their use. So if they can maintain limited use to manage the symptom that they're using it to help improve their life, then that's great.

In my view, if you find something that works, there's always going to be some potential harm with any drug you take, whether it's a pharmaceutical or something like cannabis. But if at the end of the day, it's helping you function better in improving aspects of your life, then I think that that's probably a net win that would reinforce your choice to use it. On the other side of the coin, some people try cannabis and immediately are like, this is not for me. They do not like the way it makes them feel. Some people don't like the kind of dissociating aspect of it. They find that that's really an uncomfortable response. And so it just doesn't work for them. So I think a lot of it is about what the nature of it that you want to use is. I would never just say someone should use cannabis as like a

well-being drug because I don't know how that would play out. But I think that- including CBD? Like you don't think that we should be taking CBD just to lower inflammation levels without the psychoactive effects. Like you don't think the research is robust enough to suggest that. To be completely honest, the doses that most people are taking CBD, it's inert. I have yet to see a single human-blinded study that has ever found any benefit of CBD under 300 migs. Okay. And the majority of people are using it is 10 to 20 migs. Yeah.

So if you're taking any sort of cannabis in any sort of dose that's really available, you should be liking how it is making you acutely feel, whether it is pain relief, whether it is stress relief, whether it is sleep, which we want to use probably intermittently. so we're not having that negative sleep effect, etc. But if you don't like how it's making you feel in the acute sense, don't take it as like a multi-bid. Listen to your body. Like the same thing, like we were saying, if you're looking at you, you're tracking your data and you see changes in your heart rate

or your sleep quality and stuff, then maybe that's a sign that your body's telling you that doesn't gel well with cannabis. But if you really look at the majority of the people who use cannabis, there's this weird blurring of whether it's recreational or medical because people only consider it medical if they're getting a prescription. But if you ask people why they're using it, the overwhelming majority people will say, I'm using it to regulate my stress and anxiety. I'm using it to

regulate my sleep and I'm using it to regulate low grade pain. And so you're like, well, that kind of is medical. Even though it's not prescribed, you're using it as a means to mitigate symptoms of something you're experiencing. So yes, they are enjoying it as well. And that's where these lines blur between recreational and medical. I think that's why it makes it confusing for a lot of people to understand the nature in which they're using it. But the majority of people who use cannabis are using it to regulate some component of themselves, not because they find it overtly rewarding and they just love being high around the clock. Okay.

Amazing. Well, thank you so much. We really, really appreciate this conversation and you being willing to share so much information. Oh, thanks for having me. And hope it was productive to people listening and that they can take something from it. Unfortunately, that is all for this episode of the Liz Moody podcast. If you enjoyed the episode, I would so appreciate if you would share it with somebody that you

think would enjoy it too. There is so much misinformation out there about cannabis, and I really appreciate Matt's explanation of the science, including sharing what the science isn't conclusive about yet, which is so important. Send it to a friend and help clear up some of the tons of misinformation that's just floating around. Also, make sure that you are following the podcast on Apple Podcasts, on Spotify, or on YouTube, because in our next episode, we have a little solo episode. I am sharing eight questions to improve every relationship in your life, including your romantic relationships, your relationships with your friends, and your relationship with yourself. So trust me,

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You can also come hang out on Instagram. I am at Liz Moody. I share tons of inspiring and always very real content, and exactly how I'm using everything that we learn on the podcast. in my real life. Okay, I love you, and I will see you on the next episode of the Liz Moody podcast. Oh, just one more thing. It's the legal language.

This podcast is presented solely for educational and entertainment purposes. It is not intended as a substitute for the advice of a physician, a psychotherapist, or any other qualified professional.