Ep. 48 - Is Weed Really as Harmless as Everyone Says?

Dr. David Gross and Dr. Andrew Rosen have been watching the marijuana conversation shift for decades and they're not buying the hype. They dig into why so many people are convinced marijuana is harmless, or even healing, when the clinical picture tells a much messier story. Confirmation bias plays a starring role: we tend to seek out what confirms what we already want to believe, and the marijuana industry has been very good at giving people exactly that.

The conversation covers what actually happens in the brain when cannabinoids move in and why THC's fat-soluble nature means it sticks around far longer than most users realize. They talk about state-dependent learning, the subtle but real effects on driving, and why today's marijuana is nowhere near what it was in the 1960s. Same name, very different drug.

There's a lot of ground covered on the developing brain too. Why teenage use hits differently than starting in your 30s or 40s, what the research actually shows about schizophrenia risk, and why the frontal lobe matters more than most people appreciate.

The tobacco comparison runs throughout, and it's hard to shake. It took decades and a mountain of lawsuits before the public caught up with what science was already saying. They're worried we're on the same road with marijuana, just further behind than we should be.

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Email: twoshrinksandamic@gmail.com

Transcript

SPEAKER_00 0:05

Hi, I'm uh Dr. David Gross and I'm a psychiatrist.

SPEAKER_01 0:08

And I'm Dr. Andrew Rosen, I'm a psychologist.

SPEAKER_00 0:11

And today we're going to talk about uh marijuana. And we are not Chi Chinchang, but we are uh two uh clinicians who have been uh dealing with uh the issues with marijuana for many years, uh decades at this point, uh as we've seen the whole uh uh marijuana situation change as it's been uh legalized for medical purposes in most states and legalized for recreational use in a number of states. Um we're gonna be talking about uh the pros and cons of of this agent.

SPEAKER_01 0:45

The thing that comes to mind is uh a concept called confirmation bias. I learned about this uh a number of years ago. I was at a graduation at a Northwestern uh uh university, the business school, and the dean brought up this concept called confirmation bias. And quickly, he gave a story about this guy who was having breakfast in Chicago, and his favorite breakfast was bacon, eggs, and toast. And while he's eating, he decides, you know, I really love toast, and but I'm sure everybody loves toast. So he goes on his phone and he calls up a bunch of friends to see if anybody likes toast, and they all said yes. And then he googles to see if there are any toast restaurants in Chicago, and there weren't any. So he decides he's got the answer. He's gonna open up a toast restaurant, an expensive toast restaurant. Well, he spent millions of dollars and it failed. So why am I bringing this up? Because a lot of times we look for what we want to believe in and answers for things that confirm what we want. And I think that's the case with marijuana. I think uh over the generations, many people have wanted marijuana to be no big deal, wanted it to be not only uh uh healthy or not unhealthy, but healthy and actually curative for certain things. And then you have people who thought, well, here's a good way to make m a lot of bucks. And I think that's what's happened. I think people have overvalued the idea of marijuana, and that's why we have so much of it now, and so many people are using it, whether they're smoking it or or having gummies, and I think that uh the wanting of it has caused a lot of problems, and we see it in our office where people are coming in with anxiety, depression, even psychosis as a result of use of marijuana.

SPEAKER_00 2:38

And you know, the the uh the comparison is always to alcohol. Um and with uh excessive alcohol, you can see people uh uh have liver damage and uh and die because of cirrhosis, um get into car accidents because of clear-cut signs of intoxication and lack of uh judgment, coordination. Um see a dramatic change in their personality when they're drinking, um oftentimes for worsening change in their personality. But with marijuana, uh you don't see a whole lot. And that's the problem because the effects of marijuana on function are very, very subtle. Um states that have uh a longer history of uh recreational use and medical use are beginning to see that the number of car accidents related to marijuana intoxication has gone sky high. Um the effects on on driving are very subtle. Your reaction time slows down, um your ability to uh problem solve in a driving situation is not as good as it used to be, and and uh you'll often make uh mistakes. Um uh you're you're too mellow and laid back to to be on guard and be defensive when you're driving. Um we don't know of uh of lasting medical problems in terms of like alcohol with the liver um or uh alcohol toxic effects on the brain. And so that's made the whole marijuana case easier for people to sell. And I use the word sell seriously because it's uh a big industry uh and a lot of money is made, and it became very much of a a dog and pony show when you look at the states where they had referenda to uh let the people vote on marijuana, they'd have uh uh town hall meetings where individuals will come in and say, I've I've had MS and it's cured me. Uh in fact, a recent uh uh uh edited, peer-reviewed uh paper in one of our more respected journals, uh Journal of the American Medical Association, reviewed many, if not all, of the studies that looked at the medical benefits of marijuana and demonstrated that they really didn't prove the concept, that that the belief that there are medical benefits has not been held. You know, the whole situation with medical marijuana started with the use of uh marijuana for epilepsy in children. And there may be some data there to suggest that it could that plays a role, but that just mushroomed into uses for everything, and and as as most people have seen, the marijuana dispensaries uh across the state uh will have uh indications for any variety of of medical type of issue, from uh migrant headaches to post-traumatic stress to uh stomach ulcers. And uh and uh it's it's used widely and unfortunately used when it should not be used.

SPEAKER_01 5:29

And typically people will say, what's the difference between having a glass of wine or two at night and smoking a joint? Why is that why is wine okay and smoking a joint isn't okay? And some of that's uh a kind of a rebound effect from the fact that not too long ago, if you were caught with marijuana, you'd go to jail. And so, well, going to jail for having small amounts of marijuana, or I guess any amount, seemed to be uh unfair, overkill, and it's why would you send somebody to jail because they're smoking marijuana? So there I think the rebound, the reaction to that has been completely the other extreme, which is not only is it wrong to send somebody to jail and it should be legal, but it's promoted it, it's promoted the use of it indirectly and directly. It it but it is different than having a glass of wine or two, partially because of the effects on the body and and there being more insidious changes on the brain and the nervous system, but also because there's not a real good control factor. I mean, when you have a glass of wine, you kind of know what you're getting, and you kind of learn what your tolerance is. Different with marijuana. It's so much of it is different, and so much of it has become much, much more concentrated and intense. And as a result, we see somebody who maybe had smoked for years, and all of a sudden they're smoking and they have not just a panic attack, but some people actually can come in with a psychotic episode which they've never had before. It's rare to see somebody have a glass of wine or two at dinner and all of a sudden have a psychotic episode. So there is a difference, no matter what people might want to say or how they may want to convince themselves that marijuana is innocuous, harmless, no big deal. They used to say that about cocaine in the 1980s, in the early 80s. I think we talked about it last week. That cocaine was seen as no big deal. And we obviously know it is a big deal. Marijuana is a big deal. Not always can uh is uh what we call a gateway drug, but very often it is. And the use of marijuana at different age spans is a another significant variable. And when a teenager starts smoking pot regularly, we know that has dramatic impact on their brain, their nervous system, and other organ systems in their body. David, you could probably talk more about the organ systems.

SPEAKER_00 8:07

Sure. But the the you know, the analogy right now is to the tobacco industry. Just think about how many decades um smoking went unchecked, uh, despite some warnings from individuals, uh, but it got to a point was accepted as being normal. And uh uh even the American Medical Association uh got involved in in promoting cigarettes. Uh there was a commercial years ago in black and white on television promoting cool cigarettes by a physician stating that if you have a sore throat, smoke cool or mentholated cigarettes instead of the regular cigarette. And it wasn't until enough data came along and lawsuits that they finally educated the public. And and unfortunately, we're all give very gullible in the public. And now in the era of social media, we're even more gullible. We we we don't question what we're seeing, and and and that's the problem. But it's important to recognize that um cannabis, um uh the marijuana plant, when when utilized and consumed, breaks down into 80 some odd cannabinoids. And the cannabinoids are all biologically active in the body and the brain. Uh we now know that the body contains naturally occurring cannabinoids, but what's happening when you either smoke or or ingest a marijuana uh gummy or or or a joint um or vape for that matter, um you're releasing uh a whole slew of these uh cannabinoids that all do different things. And I tell people regularly that, you know, you're turning your brain into a toxic waste jump, waste dump, um, because of all these circulating cannabinoids. And uh when I see somebody who's been using marijuana regularly, and for example, if they uh have been diagnosed with attention deficit disorder and the grades have gone downhill, uh I tell them that, you know, I I can't really evaluate what your brain is like and what your mental state is like and what what level your attention deficit disorder is is functioning at until I get to see what your brain is like off of marijuana, uh, because it just confounds everything. Uh studies have now demonstrated that um marijuana itself interferes with new learning uh and can lead to something called state-dependent learning, which is uh a type of learning where you'll only be able to recall information if you're in the same state that you were in physiologically when when you were learning the information. So that if you're smoking marijuana, you need to have a fair amount of level in your brain to be able to recall the information that you learned. And that's really of con that's tremendous concern. It's been demonstrated scientifically without without a doubt. But uh unfortunately in our society now, science is not as important as it used to be, and people have begun to uh really question it. Um uh it's mainly the brain that we're concerned about, more than anything else, in terms of the body. There are some studies that suggest testosterone can be lowered uh because of the influence of marijuana. Um but we don't know of any other major uh heart, lung, kidney issues related to marijuana compared to alcohol, for example. Um it's more subtle, and and I think people are going to find out the hard way over time, the negative uh health effects and functional health effects of marijuana use. Um also should be understood that the marijuana stays in the brain. The the cannabinoids, THC, especially tetrahydrocannabinol, is lipid soluble. What that means is it's fat soluble. And our brains are fatty organs, a lot of fat, because the lining of our all our cells, the the insulation of our uh circuitry is made from cholesterol. They're myelin sheaths, and the cholesterol is one of the fats. And so because the brain is so fatty and we've got the cannabinoids that easily dissolve in fat, they absorb all the cannabinoids. And so even i if you've been smoking marijuana regularly and you stop and a week later you have a job interview and you know they're going to be doing a urine drug test to look for marijuana and other illicit drugs, you'll be positive. And some people suggest that you need to be off of marijuana for at least two months before the brain, the bloodstream will clear out uh from the marijuana that you've utilized. So that's a that's a real issue. So even if you say, well, I only smoke on Saturday and Sunday, and then I go to work or I go to school on Monday, and I don't worry about it because the marijuana is out of my system, that's just not true. It it continues. And so these are some of the facts. Uh but unfortunately the uh the lay public has not really paid attention to it, as we've seen. The the number of dispensaries and number of uh uh medical uses of marijuana increase.

SPEAKER_01 12:45

And the lay public has also not been informed very well uh about the negative aspects of of uh marijuana. I mean, there is new research that has come out about the negative impact on the cardiovascular system, on the pulmonary system, and it just makes sense. If you sit every day and smoke a joint, you are inhaling a toxin that goes into your lungs, and the lungs and the cardiovascular system are related. People tend to not do the other things that they might uh uh should be doing, like working out or doing other kinds of physical activity, when they smoke marijuana, they tend to be more sedentary. So there there's a lot of uh collateral problems that come from it. There's another aspect we we know, and this is hard science, we know that adolescents who smoke pot regularly, and and adolescents, when we see them as adults, they say, oh yeah, I started smoking when I was fifteen or sixteen. We know that the brain is still growing at that age, as it doesn't finish growing until uh a few years later, and the impact on the growing nervous system on the growing brain has been demonstrated. And there's a correlation with increased uh risk of uh onset of schizophrenia as a result of smoking marijuana. So there's a lot of correlational data uh that exists, but due to confirmation bias, people don't want to hear what they don't want to hear. And so it's much more palatable to the person if they if they know a friend who says, you know what, I just have a little bit of pot before I go to sleep, and I sleep so well, you should try it. Or, you know, I don't smoke it, I use a gummy, and it just really relaxes me after a tough day. That's the anecdotal information that most people hear about, and it becomes validating so that it becomes like a good idea to do these things, and then of course the it's reinforces, but I don't do that much of it. But that ignores the fact that it is a drug that over time people use more and more of. So the person who may start out small over a short period of time, because they feel pleasure from it, will start doing it more and more. They'll start on a nightly basis, let's say, and then, well, you know, during the day, what's the big deal if I just have one hit? It doesn't really impact on my functioning, nobody at work knows, and so on and so forth. It's been known to have, by many people's uh accounts, a calming effect on anxiety, but then on the other hand, we see people who are uh in the throes of anxiety disorder who can't stop thinking and overthinking, and we know marijuana helps a person think more, and they get really, as they say, into their head, which is not a good thing if you're a person who worries and overthinks. Uh so lots and lots of data, lots and lots of anecdotal data, lots and lots of clinical experience just uh on our part over the years that says marijuana ain't such a nice thing, it's not simple, and people really do need to be very aware of it. Parents as well, who we often hear smoke with their kids. We say, Well, I don't want them to get marijuana from some stranger. Well and I get it from a dispensary, so we'll just share it with the kids. How crazy is that?

SPEAKER_00 16:11

You know, the um effects of THC on the brain leads to what's called a dissociative reaction. Um the the feeling of feeling high is almost like you feel like you're not connected to your body or that you're not in reality at the level that you're normally at. We've seen a whole bunch of individuals who've had their first panic attack because of that dissociative effect. And it didn't cause the panic disorder, just it brought it to the surface and and and demonstrated its pr its presence. Um but that dissociative effect also is what interferes with uh driving, uh going to school, uh going to work for that matter. Um and you're really talking about peer pressure when talk about how how you're influenced to use it. I mean, all of us remember when we were teens in college, uh the the peer pressure to drink, you know, is part of the high school college experience, and you want to keep up with the Joneses, you don't want to be a nerd and stand out, so you'll give in to the peer pressure. And it's the same story with marijuana. Um uh peer pressure can be very, very powerful, um, especially if you're going to parties and marijuana's being used there. The other fact about about marijuana itself, when it's smoked, whether it be a joint or a bowl, for example, um, is is the particulate matter uh that's released in your lungs is greater than that of a cigarette. Uh there have been estimates that one joint is equivalent in terms of particulate matter to about five cigarettes. Um and so that that can't be ignored because it's that inflammation that occurs for the particulate matter may be part of the uh cancer genic uh risks of of of smoking. Um and then there's the passive uh uh inhalation of marijuana. They have demonstrated that uh if you're in the same room with somebody who's uh smoking a joint or s or or or m u utilizing a bowl or a bond for that matter and exhaling the smoke, um that smoke stays around. They've even demonstrated that um cannabinoids, THC especially, can link cling to clothes. And so that you know, you then touch the clothes and it gets on your skin. And you know, I'm not trying to make you all paranoid, but there's a r there's a r real f concern about that because individuals who may not be marijuana users but live in a household or in a college dorm where the marijuana is used regularly, um that that floating marijuana THC in the in the air is gonna potentially affect your brain and influence your mental state. Um and that has to be uh of concern as well. We know with cigarettes the passive uh passive smoke is also a risk to people, which is why most restaurants uh banned cigarette smoking now and only allow it outdoors where the the smoke can be diluted. And so um the health risks of marijuana, especially the the risks of THC on the brain are are significant. Um and I'm I'm afraid that we're not gonna really see the full impact of this probably for another 10 or 20 years when enough data is gathered to recognize the the hole that we've dug for ourselves, somewhat similar to the whole tobacco industry and how it took so long for people to f finally recognize that the cigarettes were basically a uh a major health risk for most individuals who use it.

SPEAKER_01 19:35

And there's two aspects of uh that just come to mind from what you're saying. Um we went we we were in college in the 1960s and uh giving away your age. And the marijuana that existed then is kind of like uh the analogy would be the computer that I bought in 1980. And compare that computer to the computer that I have on my desk now. It's the same thing. The marijuana that's out there is like the computer now, and the marijuana that was out there in the sixties is like that old computer. It's not the same by any s other than that it's the same chemical, the it's a different drug. And the effect on the brain is different. We also don't know the effect of uh intergenerational effect. We don't know if people are smoking regularly, especially this intense version of it, what the effect it has on the male sperm and the female egg. We don't do was any do we really know? And has it really been examined well? Does it have an impact on on uh illnesses or or genetic defects that occur from generation to generation? Uh so it it's something that hasn't been studied well, but in spite of that, we've gone ahead and said it's a good drug, don't worry about it. We'll give you prescriptions for it, uh we'll give you these cards, you just come in, no problem, and we're not gonna really check to see if you give it to anybody else w in your family, whether it be your kids or anybody else. It's just a bad thing. It's turned into a bad thing. And the idea that uh you know, it used to be used for with cancer patients in chemo for nausea or for pain patients that would reduce pain, that was part of the hype that made it seem like why would we not let people have as as much marijuana as possible?

SPEAKER_00 21:46

Uh they they want it's wishful thinking, they want it to do what it it doesn't do. Um but if you have the belief system, you're gonna continue with it. Um you know, there have been lots of cures for cancer that when people are sick. They uh they they do whatever they can to get better and you'll they'll reach for things that may be illogical or not make any sense. But uh unfortunately the whole marijuana story has been influenced by um making major claims about the medical uses of it, and that when you look at the studies themselves, they're not born out to be as accurate and and and have the same kind of results that you believe they have. Um so it it's uh it it's a matter of educating people. Um I've been part of the process of trying to educate over the years, uh uh uh uh lecturing to various groups, but unfortunately, um many of these referenda, many of these town hall meetings have become more like dog and pony shows where somebody will come in in a wheelchair uh saying they've had MS and marijuana dramatically improved their function. Um and uh people could believe that one case story rather than taking a look at scientific studies. And um eventually I think our society will get back to being scientifically oriented, but right now uh science unfortunately is not being uh respected like it needs to be respected for a whole bunch of political reasons.

SPEAKER_01 23:15

Yeah, and it's just like anything else, it's usually somehow about money and money mixing with people's need for something to make them feel better or make them feel like their day has meaning and uh that life is not just drudgery and going to work or you know, without some extra nice feeling. So if you can put money together with the need that people have for something and look, f forever people have had the need for something, whether it be marijuana or cigarettes or alcohol or whatever other substances people have looked to for since the beginning of time, it it's it's just always going to be a problem. But I just think it was important for you and I to do s some piece like we did today about marijuana in particular, because it is so prevalent now, it is so out there. Actually, alcohol use is down as and and ironically, alcohol use is down while marijuana uses up. So something's wrong.

SPEAKER_00 24:21

You know, you raised a real critical issue before about the developmental brain. This is becoming a major area of uh of of of neuroscience, of understanding how the human brain develops over time. We're not born with a perfectly formed brain. We're born with a very immature brain. In fact, uh up until the uh early twenties to late twenties, the part of the brain that's most active and influential is the limbic system. That's the deep part of the brain that exists in crocodiles and humans, and is responsible in humans for drug, sex, and rock and roll. And that that's an area that just influences behavior tremendously. The part of the brain that can that can influence that is called the frontal lobe. And that part of the brain is not fully mature until mid to late twenties, sometimes even later, which is why all of us can think back to our teenage years and say, gee, no, I was a real wild and crazy guy back then. What happened? Well, what happened was our frontal lobe began to take over and and and and and and utilize some common sense and control that limbic system that uh made us run amok at times.

SPEAKER_01 25:30

So, Dave, are you saying that my frontal lobe is more important now than my limbic system?

SPEAKER_00 25:36

It it influences a limbic system and and has greater control over it compared to when you were younger. Oh well. Yeah, sorry. Many of us look back at the wild and crazy years and and and and and think that that was a exciting time, and and in many respects it was. But um we now know that various drugs, marijuana included, can influence the trajectory of brain maturation. So that if if uh marijuana starts at the time that that the brain is maturing and and going through some of the changes of uh circuitry changes, connections being made, it can negatively influence that. And and that's a major concern. When marijuana started at an older age, uh 30s and 40s, it doesn't have the same kind of influence on brain development. So that needs to be taken into account as well. And and this is going to be a whole new field in in mental health care because of the recognition of that. And so in many respects, parents knowing this information about the maturity of the brain, we protect our kids from teaching them how to cross the street and look both ways and only cross when the light's green, but we also need to protect them from utilizing substances that can negatively impact upon their brain.

SPEAKER_01 26:49

Very true. Well, we hope this little piece today on marijuana was helpful and uh for anybody who hears it might spread the word about it a little bit to other people because we're very concerned about it, and you know, we see the results very often in our office, and it ain't pretty. So thank you for listening.

SPEAKER_00 27:09

And I'm Dr. David Gross, psychiatrist.

SPEAKER_01 27:12

Dr. Andrew Rosen, psychologist, and this has been two shrinks in a mic.

SPEAKER_00 27:15

Shrinks in a mic.

SPEAKER_01 27:16

Bye-bye. The Two Shrinks in a Mike podcast is for informational and entertainment purposes only. The views expressed are those of the hosts and guests and do not constitute medical, legal, or professional advice.

SPEAKER_00 27:32

Please always consult a qualified healthcare provider before making any medical or wellness decisions. Our content is not a substitute for professional medical guidance, even though our mothers tell us we have the best advice possible.