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The Effects of Cannabis (Marijuana) on the Brain & Body | Huberman Lab Podcast #92



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Welcome to the Huberman Lab Podcast,
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where we discuss science and science-based tools
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for everyday life.
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I'm Andrew Huberman,
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and I'm a professor of neurobiology and ophthalmology
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at Stanford School of Medicine.
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Today, we are discussing cannabis,
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also referred to as marijuana.
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Cannabis includes many different compounds
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that have profound impact on the brain and body.
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So while many of you have probably heard of THC,
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there are also compounds in cannabis
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such as CBD, and of course there are different types
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or strains of cannabis, including sativa strains
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and indica strains and hybrid strains.
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And believe it or not,
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nowadays there is also an entire literature,
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meaning a scientific and medicinal literature
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about type one, type two, and type three strains.
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I'll explain what all of that is and how they work.
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I'll talk about some of the medicinal applications
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of different strains of cannabis
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and combinations of cannabis strains,
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as well as some of the potential health hazards
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of cannabis use.
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I want to emphasize that any discussion about cannabis
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has to be framed within the context
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that the legality of cannabis varies tremendously
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depending on where you are in the world.
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So depending on which country you're in
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and even which state you're in
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or which area within a country,
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possessing and using and certainly selling cannabis
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can be either highly illegal or entirely legal
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or decriminalized or largely overlooked.
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You of course are obligated to know
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what those local laws are for you,
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where you live and where you travel.
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With that said, today's discussion really will include
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a full picture as to where cannabis
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and the various and even very specific compounds
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within cannabis can be extremely useful
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in the treatment of some ailments
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and where certain compounds in cannabis
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can be extremely dangerous for certain individuals to use,
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in particular individuals that have pre-existing
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genetic propensity for psychosis.
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That theme is going to come up again and again,
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but we are also going to talk about the role of cannabis
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in anxiety, in depression,
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both positive and negative effects.
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We'll talk about sex differences
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in terms of women versus men
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and how they react differently to cannabis.
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And I would be entirely remiss
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if I didn't include a conversation about cannabis,
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meaning THC, CBD, hybrid strains, et cetera,
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in creativity and different modes of thinking.
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Because as many of you probably know
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or at least have heard about,
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cannabis can impact the way that we think,
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the types of memory systems we can access
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and what's called convergent and divergent thinking,
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which is one way of conceptualizing
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what is commonly referred to as creativity.
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So today's discussion is going to include
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a lot of information,
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but I promise to make it clear and accessible to all of you,
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regardless of whether or not
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you have a background in biology or not.
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And today's discussion will also be quite nuanced.
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You'll find me routinely reading
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directly from specific research papers,
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something that of course we always do on this podcast.
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But today I'm really going to dig into
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some of the finer points of the methodology in papers
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and some of the statistics that were used
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and the specific populations of people that were studied.
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Because as it turns out,
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there are instances that we will discuss
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in which the use of cannabis
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can be immensely beneficial to one group
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and yet can be entirely detrimental to another group,
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even at equivalent dosages
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and depending on a number of different factors.
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So we will discuss what those factors are.
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Just to give you a brief overview
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of the kind of structure I'm going to put on today's episode,
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we will review, of course, cannabis and its various forms.
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I'll talk about some of the biology,
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but we are going to really drill into how dosage,
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that is the concentration of THC relative to CBD,
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impacts whether or not cannabis
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is going to have one effect or another.
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We will also talk about the frequency of use,
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daily use, multiple times per day use,
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weekly use or monthly or occasional use.
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We will also talk about different professions
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and how some people may have a little bit more leeway
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in terms of whether or not they decide to use cannabis
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or any of its various component chemical constituents,
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that is CBD or THC, et cetera.
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And for other professions,
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it might be entirely inappropriate
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because of the particular kinds of cognitive tasks
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those professions demand.
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We will also talk about genetic predisposition,
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again, sex differences, hormone effects.
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And I will also touch on
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what I think is the most important variable
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in determining whether or not cannabis
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is right or wrong for you.
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And that is your age at which you are considering
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starting or continuing use or ceasing use.
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What I can assure you is that by the end of today's podcast,
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you will have a quite thorough understanding of cannabis,
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how it works, what it does,
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what its potential benefits can be,
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what its potential hazards are,
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and whether or not it's right for you
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and the people that you know.
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I'm excited to announce that the Huberman Lab Podcast
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has now launched a premium channel.
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The purpose of the premium channel is several fold.
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First of all, I will be hosting regular AMAs,
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Ask Me Anythings, where you can ask me anything,
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and I will provide answers in depth
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to your specific questions about science
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and science-related tools for mental health,
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physical health, and performance.
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00:05:04.440
Now, there is a nominal cost to the premium channel.
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It's $10 per month, or you can pay $100 for the entire year.
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I should mention, however,
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that a significant portion of the funds
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raised through the premium channel
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are going to support not just the Huberman Lab Podcast,
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which we will continue to release every Monday on schedule,
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of zero cost to all consumers,
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content on mental health, physical health, and performance,
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but proceeds from the premium channel
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will also be used to fund research,
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in particular, research done on human beings,
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so not animal models, but on human beings,
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which I think we all agree is a species
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that we are most interested in,
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and we are going to specifically fund research
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that is aimed toward developing further protocols
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for mental health, physical health, and performance,
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and those protocols will be distributed
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through all channels, not just the premium channel,
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but through all channels, Huberman Lab Podcast
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and other media channels.
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So the idea here is to give you information
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to your burning questions in depth
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and allow you the opportunity to support
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the kind of research that provides those kinds of answers
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in the first place.
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Now, an especially exciting feature of the premium channel
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is that the Tiny Foundation has generously offered
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to do a dollar-for-dollar match
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on all funds raised for research through the premium channel.
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So this is a terrific way that they're going to amplify
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whatever funds come in through the premium channel
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to further support research for science
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and science-related tools for mental health,
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physical health, and performance.
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00:06:26.160
If you'd like to sign up
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for the Huberman Lab premium channel,
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again, there's a cost of $10 per month,
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00:06:30.820
or you can pay $100 upfront for the entire year.
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That will give you access to all the AMAs.
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You can ask questions and get answers to your questions,
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and you'll, of course, get answers to all the questions
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that other people ask as well.
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There will also be some premium content,
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such as transcripts of the AMAs
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and various transcripts and protocols
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of Huberman Lab podcast episodes not found elsewhere.
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And again, you'll be supporting research
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for mental health, physical health, and performance.
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You can sign up for the premium channel
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by going to HubermanLab.com slash premium.
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Again, that's HubermanLab.com slash premium.
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Before diving into all of that,
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I'd like to highlight a new,
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what I think is very useful and zero-cost resource.
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This resource is what's called non-sleep deep rest,
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or NSDR protocol.
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I've talked many times before on the Huberman Lab podcast
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about non-sleep deep rest, AKA NSDR.
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NSDR is sort of an umbrella term
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for a variety of different practices.
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So these are behavioral practices
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that allow you to direct your brain and body
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into a particular state.
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And most typically, that state is one of deep relaxation,
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but also one in which you can access your bodily
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and brain systems for teaching yourself
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how to relax in real time
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and how to recover some of the sleep
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that you may not be getting at night
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and to restore levels of dopamine
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in particular areas of the brain
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that are involved in motivation
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and cognitive and motor control.
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Basically, NSDR is a wonderfully restorative tool.
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This has been demonstrated many times over now
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through quality peer-reviewed science.
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And there are neurochemical benefits
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and there are physical benefits
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and there are certainly psychological benefits.
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I highly recommend NSDR to anybody
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that has trouble falling asleep
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or that wakes up in the middle of the night
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and needs to get better at falling back asleep,
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as well as to anyone out there
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that has issues with anxiety
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or sort of self-regulation of any kind.
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And if you don't have any of those issues,
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it's also immensely beneficial just as a restorative
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for leaning back into focus work of any kind.
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Now, a number of people have reached out
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about finding NSDR protocols
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and there are a number of different good ones out there
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floating around.
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I've decided to put a zero cost NSDR script
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out there on the internet for people to access.
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So you can find it by going to YouTube
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and simply put my last name Huberman and NSDR
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into the search function.
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This is a YouTube channel that's hosted by Virtusan,
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which has a terrific app that includes NSDR
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and a number of other health and wellness protocols.
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But they've been quite generous
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in hosting a 10 minute NSDR read by me.
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This NSDR is distinct from,
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although I should say similar to Yoga Nidra,
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which some of you are familiar with.
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This NSDR is different than Yoga Nidra
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in the sense that it doesn't have intentions,
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there's no mystical component.
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And I describe a little bit of the science
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and why specific components of the NSDR included,
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things like long exhale breathing,
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I talk about perceptual shifts
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and how to move from thinking and planning
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to pure sensation.
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If none of that makes sense right now,
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it'll make total sense after listening to the NSDR script.
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Again, it's a 10 minute NSDR script read by me.
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You can do this first thing in the morning when you wake up,
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especially if you didn't get enough sleep that night
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and you're feeling a little bit fatigued
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and you need to lean into the day with full vigor.
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You could do it at any point during the day,
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or if you wake up in the middle of the night.
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Again, this is a zero cost resource for you.
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You can find it by going to YouTube,
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put my last name in, and NSDR.
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I encourage you to try it.
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And if you like it, or frankly, if you don't,
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you can just put that in the comment section
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there on YouTube.
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And I've put it there as a free resource to you
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so that you can benefit from the research-backed,
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peer-reviewed studies that point to NSDR
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as a very useful practice.
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Before we begin, I'd like to emphasize
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that this podcast is separate
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from my teaching and research roles at Stanford.
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It is, however, part of my desire and effort
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to bring zero cost to consumer information
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about science and science-related tools
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to the general public.
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In keeping with that theme,
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I'd like to thank the sponsors of today's podcast.
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00:10:23.920
Our first sponsor is Levels.
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00:10:25.960
Levels is a program that lets you see
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how different foods affect your health
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by giving you real-time feedback on your diet
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using a continuous glucose monitor.
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One of the most important factors
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in your immediate and long-term health
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is how well you're managing your blood glucose
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or blood sugar.
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I started using Levels about a year ago
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as a way to see how different foods
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and different lifestyle factors
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were impacting my blood glucose levels.
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So for instance, it allowed me to see how different foods
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and particular macronutrients
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and combinations of macronutrients
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would either peak or trough my blood sugar
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or keep my blood sugar steady.
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It also allowed me to see how working out
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with weights or running, how that impacted my blood glucose.
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So for me, it was a fascinating experiment
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unto myself as to how my meal schedule,
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the specific foods I was eating,
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different combinations of food, as I mentioned before,
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and exercise were combining to regulate
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this thing that we call blood sugar
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I think anyone that tries Levels
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That's levels.link, L-I-N-K slash Huberman.
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00:12:48.700
Today's episode is also brought to us by Inside Tracker.
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00:12:51.660
Inside Tracker is a personalized nutrition platform
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00:12:54.180
that analyzes data from your blood and DNA
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00:12:56.820
to help you better understand your body
link |
00:12:58.420
and help you reach your health goals.
link |
00:13:00.420
I've long been a believer in getting regular blood work done
link |
00:13:03.220
for the simple reason that many of the factors
link |
00:13:05.120
that impact your immediate and long-term health
link |
00:13:07.180
can only be analyzed with a quality blood test.
link |
00:13:09.860
With a lot of blood tests and DNA tests out there, however,
link |
00:13:12.500
an issue is you get information back
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00:13:14.320
about lipids and hormones, et cetera,
link |
00:13:16.780
but you don't know what to do with that information.
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00:13:18.420
With Inside Tracker, they have a personalized platform
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00:13:20.980
that makes interpreting your data
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00:13:22.860
and then acting on that data very straightforward
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00:13:25.580
and very directed toward specific protocols.
link |
00:13:28.340
What I mean by that is you'll get information back
link |
00:13:30.580
about hormone levels and metabolic factors, lipids, et cetera,
link |
00:13:34.060
and then you can look to nutritional changes,
link |
00:13:37.200
supplementation changes, exercise protocol changes,
link |
00:13:40.580
and other lifestyle features that combine
link |
00:13:42.900
or work on their own to try and shift those numbers
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00:13:45.820
into the range that's appropriate for you.
link |
00:13:47.940
If you'd like to try Inside Tracker,
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00:13:54.540
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00:13:56.340
Again, that's insidetracker.com slash Huberman
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00:13:58.900
to get 20% off and use the code Huberman at checkout.
link |
00:14:02.260
On many episodes of the Huberman Lab Podcast,
link |
00:14:04.300
we talk about supplements.
link |
00:14:05.820
While supplements aren't necessary for everybody,
link |
00:14:07.960
many people derive tremendous benefit from them.
link |
00:14:10.500
Things like enhancing sleep and the depth of sleep,
link |
00:14:13.140
or for enhancing focus and cognitive ability,
link |
00:14:15.860
or for enhancing energy or adjusting hormone levels
link |
00:14:19.140
to optimal range for you.
link |
00:14:20.700
The Huberman Lab Podcast is now partnered
link |
00:14:22.440
with Momentus Supplements.
link |
00:14:23.780
We partnered with Momentus for a number of important reasons.
link |
00:14:26.460
First of all, the quality of their ingredients
link |
00:14:28.900
is exceptional, it's really second to none.
link |
00:14:31.180
Second of all, they ship internationally,
link |
00:14:32.960
and that was important to us because a number of you reside
link |
00:14:35.220
outside of the United States.
link |
00:14:36.780
Third, we've worked with Momentus very closely
link |
00:14:39.300
to develop single ingredient formulations.
link |
00:14:41.720
Now, this turns out to be very important
link |
00:14:43.620
because if you're going to take supplements,
link |
00:14:45.820
you want to know what's working for you and what isn't.
link |
00:14:48.260
And of course, you want to optimize the cost efficiency
link |
00:14:51.420
and the biological efficiency of those supplements.
link |
00:14:54.460
To find the supplements we discuss
link |
00:14:55.780
on the Huberman Lab Podcast,
link |
00:14:57.020
you can go to Live Momentus, spelled O-U-S,
link |
00:14:59.660
livemomentus.com slash Huberman.
link |
00:15:02.220
And I should just mention that the library
link |
00:15:03.600
of those supplements is constantly expanding.
link |
00:15:05.780
Again, that's livemomentus.com slash Huberman.
link |
00:15:08.920
Let's talk about cannabis.
link |
00:15:10.700
And when we refer to cannabis,
link |
00:15:12.420
we are indeed referring to marijuana or the marijuana plant.
link |
00:15:16.560
Now, cannabis plants come in different strains
link |
00:15:19.220
or different varieties, and those different strains
link |
00:15:22.300
are indeed different genetic strains.
link |
00:15:25.220
So just as animals and humans
link |
00:15:26.980
have different genetic backgrounds
link |
00:15:28.580
and they can be crossed to one another
link |
00:15:30.180
to yield further genetic variation in the offspring,
link |
00:15:34.820
plants can be hybridized to one another in various ways
link |
00:15:38.660
through grafting or through the use
link |
00:15:40.300
of different types of seed combinations, et cetera,
link |
00:15:43.120
in order to generate different strains.
link |
00:15:45.280
There are also naturally occurring differences
link |
00:15:47.860
in the strains of plants,
link |
00:15:49.540
and the cannabis plant is no exception.
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00:15:52.500
So for instance, in the context of a discussion
link |
00:15:55.220
about cannabis and its medicinal uses and recreational uses,
link |
00:15:59.500
we need to distinguish between the sativa variety,
link |
00:16:03.940
the indica variety, a variety called ruderalis,
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00:16:08.380
that's not often discussed,
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00:16:10.120
and hybrids of sativa, indica, and ruderalis.
link |
00:16:13.940
Before diving into the different strains of cannabis
link |
00:16:16.020
and how they impact the brain and body
link |
00:16:17.480
both similarly and differently,
link |
00:16:20.580
I want to emphasize that the cannabis plant
link |
00:16:22.860
contains a number of different psychoactive compounds.
link |
00:16:26.220
Now, the most powerful of those compounds is THC.
link |
00:16:29.980
The technical name for it is delta-9-tetrahydrocannabinol,
link |
00:16:35.140
but THC, as I'll refer to it,
link |
00:16:37.940
is just one of the psychoactive
link |
00:16:40.180
and biologically active compounds within cannabis plants.
link |
00:16:43.280
There's also CBD,
link |
00:16:46.540
which is technically referred to as cannabidiol,
link |
00:16:50.700
and cannabidiol, CBD,
link |
00:16:53.460
is known to be used for things like pain management,
link |
00:16:56.620
anxiety management, and other medicinal purposes.
link |
00:16:59.580
We will talk about the efficacy of CBD for those purposes,
link |
00:17:03.060
as well as some of, believe it or not,
link |
00:17:04.820
some of the dangers of CBD,
link |
00:17:06.520
depending on where it's sourced and the dosage, et cetera.
link |
00:17:09.420
So we've got THC, CBD,
link |
00:17:13.260
and also CBN or cannabidiol.
link |
00:17:16.540
CBN is less often discussed.
link |
00:17:18.380
You're going to hear a lot less
link |
00:17:19.620
about CBN-containing products out there,
link |
00:17:22.760
CBN-containing medicines,
link |
00:17:24.120
but it is relevant to today's discussion,
link |
00:17:25.860
so it will come up a bit.
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00:17:27.040
Now, I will be sure to provide more specificity
link |
00:17:29.380
to what I'm about to say,
link |
00:17:31.020
but very broadly speaking,
link |
00:17:33.420
THC is largely responsible
link |
00:17:35.620
for the psychoactive effects of cannabis.
link |
00:17:39.140
That is the changes in mood,
link |
00:17:40.540
the changes in bodily state and sensation, et cetera.
link |
00:17:44.660
Whereas CBD, and to some extent CBN,
link |
00:17:48.580
have profound effects on the brain and body,
link |
00:17:52.140
but they don't tend to give people the sensation
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00:17:54.380
of altered perception, altered mood, et cetera.
link |
00:17:58.080
Some people might say they are not the component of cannabis
link |
00:18:00.960
that quote unquote gets you high.
link |
00:18:03.100
Although today we will really drill
link |
00:18:04.380
into what the high itself represents
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00:18:06.660
in terms of chemical systems in the brain and body.
link |
00:18:09.360
And what we will soon learn is that
link |
00:18:12.500
what we think of as being high
link |
00:18:14.660
actually includes a number of different changes
link |
00:18:17.000
in the brain and body,
link |
00:18:17.840
some of which can be best explained by CBD, not by THC,
link |
00:18:22.460
which runs counter to what most people out there
link |
00:18:24.940
know and believe.
link |
00:18:26.380
So broadly speaking, we have THC, CBD, and CBN,
link |
00:18:30.880
but I want to point out that the cannabis plant
link |
00:18:33.140
has over 70, seven zero, 70 different psychoactive compounds
link |
00:18:37.260
many of which still have not been studied
link |
00:18:40.100
in isolation and in detail.
link |
00:18:42.140
So there's a big future of research for cannabis
link |
00:18:44.740
and for THC and THC related psychoactive compounds
link |
00:18:48.340
as well as for CBD and CBN.
link |
00:18:50.760
Today we're mainly going to focus on THC and CBD
link |
00:18:54.320
as I mentioned before.
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00:18:55.620
I should also point out that the cannabis plant
link |
00:18:57.300
has over 400 biologically active compounds.
link |
00:19:01.180
So these are biologically active compounds
link |
00:19:03.200
that may or may not have psychoactive properties
link |
00:19:06.660
that may or may not be useful for pain relief, et cetera.
link |
00:19:09.460
Again, there is a vast landscape for exploration
link |
00:19:12.780
of the cannabis plant and of hemp for what they include
link |
00:19:16.700
that could be beneficial to us or detrimental to us.
link |
00:19:20.000
So again, a lot more work to do.
link |
00:19:21.820
Today we're going to really try and stay on target
link |
00:19:23.880
with what we already know
link |
00:19:25.740
and where there are certain exciting mysteries
link |
00:19:28.380
or intriguing mysteries about what we ought to explore
link |
00:19:30.980
more I will certainly highlight those.
link |
00:19:34.380
Let's go back to the different strains of the cannabis plant
link |
00:19:36.980
sativa, indica and ruderalis
link |
00:19:39.220
and explore how each of those differentially impacts
link |
00:19:43.360
the brain and body because they're in
link |
00:19:45.180
I think we can start to learn a lot
link |
00:19:46.980
about this incredible plant that is the cannabis plant.
link |
00:19:50.280
And whether or not you are a user of cannabis
link |
00:19:53.120
or whether or not you are entirely opposed to cannabis use
link |
00:19:56.460
understanding how cannabis works in the brain and body
link |
00:19:59.540
itself is absolutely fascinating and can teach you a lot
link |
00:20:03.060
about how your brain and body work at a basic level.
link |
00:20:06.300
And can tell you a lot about how your brain and body
link |
00:20:08.580
will react to different life events
link |
00:20:10.240
and how your mood is established and stabilized
link |
00:20:13.220
and how your appetite is established and stabilized
link |
00:20:16.220
and so on.
link |
00:20:17.180
So we have the three major strains of cannabis,
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00:20:19.100
sativa, indica and ruderalis.
link |
00:20:21.900
And for sake of today's conversation,
link |
00:20:23.680
we can pretty much cross off ruderalis.
link |
00:20:26.000
It's not often consumed
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00:20:28.220
and components of ruderalis are not often consumed
link |
00:20:32.260
for medicinal recreational purposes.
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00:20:35.500
Let's focus on sativa and indica.
link |
00:20:38.860
People will consume the sativa variety of cannabis
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00:20:42.900
either by edible or by smoking cannabis
link |
00:20:47.260
or they will consume the indica variety of cannabis again
link |
00:20:50.580
by edible or by smoking cannabis
link |
00:20:53.360
or sometimes they will take it in a transdermal form
link |
00:20:56.340
or a sublingual form.
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00:20:58.360
There are a bunch of different ways to get the cannabis
link |
00:21:01.260
into the body.
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00:21:02.500
But there's a clear distinction between sativa and indica
link |
00:21:06.300
that actually shows up first in the structure of the plant.
link |
00:21:09.780
At their extremes, meaning in a pure strain of sativa,
link |
00:21:14.140
it tends to be a taller plant, a longer stock,
link |
00:21:16.660
believe it or not.
link |
00:21:17.640
And actually the length of the leaves
link |
00:21:19.460
is quite a bit longer.
link |
00:21:20.780
Whereas the indica plant tends to be more short and stout.
link |
00:21:25.020
And for those aficionados out there,
link |
00:21:27.860
I'm sure you know a lot of the other specific features
link |
00:21:29.860
of sativa versus indica.
link |
00:21:31.280
But already what we're talking about is the same plant,
link |
00:21:34.340
cannabis, with two very different morphologies or shapes.
link |
00:21:38.260
You might say, well, why is this interesting or important
link |
00:21:40.140
to how it affects me or affects other people
link |
00:21:43.020
for medicinal recreational purposes?
link |
00:21:44.780
Well, it turns out that even though they are the same plant,
link |
00:21:47.700
these two different genetic varieties,
link |
00:21:49.660
because of the way that they grow
link |
00:21:52.700
and the way they capture sunlight
link |
00:21:54.500
and the way, believe it or not,
link |
00:21:55.960
that the different plants within that strain
link |
00:21:58.660
interact with one another,
link |
00:21:59.780
because believe it or not,
link |
00:22:00.940
plants are interacting with one another,
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00:22:02.940
they actually bring different elements
link |
00:22:04.880
of the psychoactive compounds to different components
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00:22:07.300
within the leaves and the so-called buds.
link |
00:22:10.540
The takeaway is that when consumed,
link |
00:22:12.580
and when I say consumed, I want to be very clear,
link |
00:22:14.460
I don't necessarily just mean oral consumption
link |
00:22:17.900
or eating cannabis sativa by edible.
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00:22:22.060
I also mean smoking it,
link |
00:22:23.820
and that could be people will, just like with tobacco,
link |
00:22:27.740
the way that they bring the psychoactive components
link |
00:22:30.220
into their bloodstream and into their brain and body
link |
00:22:32.700
is to essentially heat the dried leaves
link |
00:22:36.260
of the cannabis plant.
link |
00:22:38.580
Then the heat liberates some of the psychoactive components
link |
00:22:42.720
that when inhaled into the lungs,
link |
00:22:44.560
because the lungs include a lot of vasculature,
link |
00:22:46.820
a lot of basically blood vessels and capillaries,
link |
00:22:50.400
that the psychoactive components are actually
link |
00:22:54.020
directly absorbed from the lungs into the bloodstream,
link |
00:22:56.460
and they can cross into the bloodstream
link |
00:22:58.060
and permeate throughout the body
link |
00:23:00.260
and cross the so-called blood-brain barrier.
link |
00:23:02.240
So in other words, burning the plant liberates the smoke
link |
00:23:06.820
that contains the psychoactive compounds,
link |
00:23:09.660
and those are inhaled into the lungs
link |
00:23:11.540
and then get into the brain and body
link |
00:23:13.140
and act on the brain and body.
link |
00:23:14.620
And the major effect of sativa varieties
link |
00:23:17.220
are to create a high, if you will,
link |
00:23:19.940
and I'm putting this in air quotes
link |
00:23:20.980
for those of you that are listening,
link |
00:23:22.440
but to also act as a stimulant.
link |
00:23:24.460
The sativa varieties tend to make people
link |
00:23:26.260
feel kind of invigorated, somewhat alert.
link |
00:23:29.040
It doesn't tend to be as much of a sedative
link |
00:23:31.060
as some of the other varieties.
link |
00:23:32.720
Some people report heightened sense of focus
link |
00:23:35.140
or heightened sense of creativity.
link |
00:23:36.680
We will talk a little bit later on
link |
00:23:37.880
as to whether or not they actually are achieving
link |
00:23:39.820
heightened levels of focus and creativity,
link |
00:23:41.780
or whether or not they just perceive themselves
link |
00:23:43.460
to have heightened levels of focus and creativity.
link |
00:23:45.480
The sativa varieties tend to make people
link |
00:23:47.880
feel a little bit less susceptible
link |
00:23:50.520
to pain and noxious stimuli,
link |
00:23:52.780
which are basically stimuli that you don't like.
link |
00:23:55.900
So the sativa varieties are often prescribed
link |
00:23:59.260
or are used in the recreational context
link |
00:24:02.840
for pain management and relief.
link |
00:24:05.200
Basically, the sativa variety is known
link |
00:24:07.580
to include a sort of head-biased effect.
link |
00:24:10.460
So here we're talking about subjective effects,
link |
00:24:12.920
and of course, these will vary
link |
00:24:14.200
from one individual to the next.
link |
00:24:15.980
Some people will smoke cannabis sativa
link |
00:24:18.020
or ingest cannabis sativa orally,
link |
00:24:21.160
and will feel an entirely different array of effects,
link |
00:24:24.400
but most people, the majority of people,
link |
00:24:26.420
experience a sort of head-centered high alertness focus
link |
00:24:30.500
and a sense that they're more creative.
link |
00:24:33.020
Contrast that with the indica varieties of cannabis,
link |
00:24:36.300
and when people smoke or eat or ingest indica varieties,
link |
00:24:40.940
the psychoactive components of indica,
link |
00:24:43.100
and again, this is pure indica,
link |
00:24:44.620
so not hybridized with sativa at all,
link |
00:24:46.460
but just pure indica,
link |
00:24:47.820
tend to lead to more full-bodied effects.
link |
00:24:51.040
People report feeling more complete full-body relaxation,
link |
00:24:55.340
more of a sedative effect.
link |
00:24:57.540
Indica cannabis is often prescribed
link |
00:25:00.420
and or used recreationally
link |
00:25:02.140
in order to achieve a state of sleep
link |
00:25:04.860
or to help relieve anxiety,
link |
00:25:06.780
so less of a stimulant effect,
link |
00:25:09.260
and we will talk about why,
link |
00:25:10.980
literally the underlying neural circuits,
link |
00:25:12.960
that lead to the sativa variety
link |
00:25:15.740
causing more of a elevated mood and a head high, if you will,
link |
00:25:19.900
and the indica varieties being more full-body relaxation.
link |
00:25:23.000
One of the ways to remember the distinction
link |
00:25:24.420
between the effects of cannabis sativa and cannabis indica
link |
00:25:27.540
was relayed to me by a friend
link |
00:25:29.180
who actually was a chronic, meaning every day, all day,
link |
00:25:33.580
consumer of marijuana.
link |
00:25:34.800
He basically smoked marijuana for 20 years
link |
00:25:36.700
before quitting about four or five years ago,
link |
00:25:39.020
and he said that indica is often referred to as indicouch,
link |
00:25:43.340
meaning laid back in the couch,
link |
00:25:45.860
and that can help you remember
link |
00:25:47.580
that the indica varieties of cannabis
link |
00:25:50.020
do tend to be more sedative in their effects.
link |
00:25:52.860
Okay, so there's sativa and there's indica,
link |
00:25:54.500
and then now there are hybrid strains.
link |
00:25:56.780
So marijuana growers and people who specialize
link |
00:26:00.180
in creating novel varieties of the cannabis plant,
link |
00:26:03.860
again, I'm using the words cannabis and marijuana
link |
00:26:05.780
more or less interchangeably here,
link |
00:26:08.000
they are very good at creating new strains of plant
link |
00:26:12.200
that might be 25% sativa and 75% indica or vice versa,
link |
00:26:17.300
or 50-50 or 90-10.
link |
00:26:20.080
Essentially what's happening nowadays
link |
00:26:21.620
is that through plant biology, plant genetics, I should say,
link |
00:26:26.340
growers are getting quite efficient
link |
00:26:28.960
at creating a variety of different strains
link |
00:26:31.560
of the marijuana plant that give rise to very nuanced
link |
00:26:35.840
and distinct effects on brain and body.
link |
00:26:39.040
In fact, so much so that there's now a new nomenclature,
link |
00:26:42.680
a new language emerging around cannabis
link |
00:26:46.540
and the development of novel strains of cannabis
link |
00:26:48.780
for medicinal and or recreational purposes.
link |
00:26:51.780
And while this might sound a little bit medical
link |
00:26:54.940
or a little bit clinical to some people,
link |
00:26:57.440
believe it or not, this is the nomenclature
link |
00:26:59.140
that it's now typically used.
link |
00:27:00.500
People still refer to the sativa, indica,
link |
00:27:03.260
and hybrid strains, but there's now also a description
link |
00:27:06.480
of so-called type one, type two, and type three strains
link |
00:27:11.240
for any given sativa, indica, or hybrid strain.
link |
00:27:14.800
Okay, so just to put this clearly in your mind,
link |
00:27:17.200
you've got sativa varieties, that is pure sativa varieties.
link |
00:27:20.440
You have indica varieties, again, pure indica,
link |
00:27:24.400
and then you have hybrid varieties.
link |
00:27:27.040
And beneath each of those, you have type one, type two,
link |
00:27:30.280
and type three strains of indica, sativa,
link |
00:27:36.440
or hybrid varieties.
link |
00:27:38.140
What are type one, type two, and type three?
link |
00:27:41.340
Well, type one, type two, and type three strains
link |
00:27:45.420
are strains that have varying amounts
link |
00:27:47.740
or ratios of THC to CBD.
link |
00:27:52.160
So for instance, type one strain.
link |
00:27:54.760
So for instance, you could have a pure sativa type one
link |
00:27:58.160
or a type one pure sativa, or a type one indica.
link |
00:28:02.200
Those are going to have the greatest amount
link |
00:28:04.240
of THC relative to CBD.
link |
00:28:06.540
And I really want to emphasize this,
link |
00:28:08.240
understanding the ratio of THC to CBD
link |
00:28:11.520
can help explain a lot or even predict a lot
link |
00:28:14.380
about how a given strain of cannabis will impact somebody.
link |
00:28:18.740
For instance, because THC is largely responsible
link |
00:28:22.880
for the typical psychoactive components of cannabis,
link |
00:28:27.880
so what I mean here is if somebody is ingesting sativa
link |
00:28:31.320
and it routinely makes them feel more energized,
link |
00:28:34.640
elevates their mood,
link |
00:28:36.840
gives them a heightened sense of creativity.
link |
00:28:38.280
If that's what they experience
link |
00:28:40.200
and they're taking a type one version of that,
link |
00:28:42.680
that means that it's quite rich in THC and very little CBD.
link |
00:28:47.520
However, if they were to take a type one version of sativa
link |
00:28:51.280
and it feels far too strong, like too much energy,
link |
00:28:53.560
or they felt like they were too much in their head,
link |
00:28:55.480
nowadays, there are strains of sativa
link |
00:28:59.080
that have been genetically engineered.
link |
00:29:01.520
And I don't mean by an engineer tinkering away
link |
00:29:03.680
with gene engineering in a kind of CRISPR creating mutants,
link |
00:29:08.600
but literally by hybridizing,
link |
00:29:10.020
crossing different plants to one another, okay?
link |
00:29:13.140
Creating in a natural context,
link |
00:29:15.120
the same way plants in the outside world
link |
00:29:17.320
would sometimes hybridize to one another.
link |
00:29:20.720
Creating a variety that's perhaps type two,
link |
00:29:23.580
which is going to have less THC and more CBD,
link |
00:29:28.640
or a type three, which is going to be very high CBD
link |
00:29:31.520
and very little THC.
link |
00:29:33.400
And the same is also true for the indica varieties.
link |
00:29:36.480
So I want to make sure that everyone understands this
link |
00:29:38.200
because it becomes very important
link |
00:29:39.200
for understanding the biology of cannabis
link |
00:29:41.520
and predicting positive versus negative effects of cannabis.
link |
00:29:46.680
Sativa has this kind of stimulant-like effect
link |
00:29:49.440
and tends to be more of a head high, if you will.
link |
00:29:51.600
Indica tends to be more full body than lead to more
link |
00:29:54.080
in the couch, as I referred to it before, pun intended.
link |
00:29:59.120
Deep relaxation, reduced insomnia, et cetera.
link |
00:30:02.040
Now within each of those, sativa and indica,
link |
00:30:03.680
you have type one, type two, and type three.
link |
00:30:05.200
And that has everything to do with how much THC,
link |
00:30:09.220
which is the dominant psychoactive compound versus CBD,
link |
00:30:13.660
which has other effects mainly on the body,
link |
00:30:15.960
but not so much on the brain and modes of thinking
link |
00:30:19.100
and mood, et cetera.
link |
00:30:20.080
How much THC versus CBD is present.
link |
00:30:22.200
And again, type one is THC dominant,
link |
00:30:25.080
type two kind of equal ratios, if you will,
link |
00:30:27.380
of THC and CBD, and type three tend to be high CBD.
link |
00:30:30.800
Okay, so already we've got some categorization here
link |
00:30:32.720
that hopefully isn't overwhelming to you,
link |
00:30:34.640
but this turns out to be extremely important
link |
00:30:37.100
if you want to understand how cannabis works
link |
00:30:39.440
and predict the effects of cannabis.
link |
00:30:41.360
I'd like to take a quick break
link |
00:30:42.880
and acknowledge one of our sponsors, Athletic Greens.
link |
00:30:45.800
Athletic Greens, now called AG1,
link |
00:30:48.260
is a vitamin mineral probiotic drink
link |
00:30:50.620
that covers all of your foundational nutritional needs.
link |
00:30:53.520
I've been taking Athletic Greens since 2012,
link |
00:30:56.200
so I'm delighted that they're sponsoring the podcast.
link |
00:30:58.440
The reason I started taking Athletic Greens
link |
00:31:00.020
and the reason I still take Athletic Greens once
link |
00:31:02.480
or usually twice a day is that it gets me the probiotics
link |
00:31:06.000
that I need for gut health.
link |
00:31:07.680
Our gut is very important.
link |
00:31:08.800
It's populated by gut microbiota
link |
00:31:11.340
that communicate with the brain, the immune system,
link |
00:31:13.080
and basically all the biological systems of our body
link |
00:31:15.500
to strongly impact our immediate and long-term health.
link |
00:31:19.140
And those probiotics in Athletic Greens are optimal
link |
00:31:22.160
and vital for microbiota health.
link |
00:31:24.840
In addition, Athletic Greens contains a number
link |
00:31:26.680
of adaptogens, vitamins, and minerals that make sure
link |
00:31:28.820
that all of my foundational nutritional needs are met
link |
00:31:31.760
and it tastes great.
link |
00:31:33.640
If you'd like to try Athletic Greens,
link |
00:31:35.080
you can go to athleticgreens.com slash Huberman
link |
00:31:38.480
and they'll give you five free travel packs
link |
00:31:40.440
that make it really easy to mix up Athletic Greens
link |
00:31:42.760
while you're on the road, in the car,
link |
00:31:44.060
on the plane, et cetera.
link |
00:31:45.360
And they'll give you a year's supply of vitamin D3K2.
link |
00:31:48.760
Again, that's athleticgreens.com slash Huberman
link |
00:31:51.440
to get the five free travel packs
link |
00:31:52.820
and the year's supply of vitamin D3K2.
link |
00:31:55.760
Okay, so somewhat surprisingly,
link |
00:31:57.280
we're going to set aside cannabis.
link |
00:31:58.680
We're going to take what we know about sativa, indica,
link |
00:32:01.200
type one, type two, type three, CBD, et cetera.
link |
00:32:03.600
We're just going to set that aside for a moment.
link |
00:32:05.640
Why would we do that?
link |
00:32:06.480
Well, we have to ask ourselves,
link |
00:32:08.600
why would any of these plants,
link |
00:32:10.480
why would any of these compounds, THC, CBD, sativa,
link |
00:32:14.280
indica, et cetera,
link |
00:32:15.600
why would any of that have any effect on us at all?
link |
00:32:19.680
And this discussion that we're about to have
link |
00:32:21.720
very much resembles the discussion
link |
00:32:23.800
that we had on a previous episode about nicotine.
link |
00:32:26.480
Because as many of you know,
link |
00:32:28.000
nicotine is a commonly used substance.
link |
00:32:30.420
In fact, if we were to look at
link |
00:32:31.500
the three most commonly used drugs,
link |
00:32:34.060
alcohol will be the top of the list.
link |
00:32:35.600
Many billions of people regularly use alcohol
link |
00:32:38.520
or occasionally use alcohol.
link |
00:32:40.740
Many billions of people also use nicotine.
link |
00:32:44.200
It's the second most consumed drug.
link |
00:32:46.720
So more than 1 billion
link |
00:32:48.480
and probably closer to 2 billion people consume nicotine.
link |
00:32:51.080
And then the third most consumed drug is cannabis
link |
00:32:55.480
in one form or another.
link |
00:32:57.160
And many of you are probably shouting,
link |
00:32:58.280
what about caffeine?
link |
00:32:59.120
What about caffeine?
link |
00:32:59.940
Well, in the context of drugs
link |
00:33:02.160
and in particular addictive drugs,
link |
00:33:03.580
caffeine doesn't quite rise to the list.
link |
00:33:06.160
But if we were to look at caffeine
link |
00:33:09.140
and include in that list,
link |
00:33:10.800
caffeine would be above all of those, okay?
link |
00:33:12.560
But the most commonly used drugs are alcohol.
link |
00:33:14.400
Second after that is nicotine and then cannabis.
link |
00:33:19.520
Nicotine, as some of you may know,
link |
00:33:21.860
if you listen to the episode on nicotine,
link |
00:33:23.320
but even if you didn't,
link |
00:33:25.280
nicotine comes from the tobacco plant.
link |
00:33:27.660
And there are a few other plants that include nicotine.
link |
00:33:29.600
And typically it's brought into the brain and body
link |
00:33:32.400
by smoking tobacco, dipping tobacco,
link |
00:33:34.240
snuffing tobacco or vaping nicotine.
link |
00:33:39.360
Nicotine exists in the outside world in these plants,
link |
00:33:41.640
the tobacco plants.
link |
00:33:42.800
But the reason it has an effect on the body
link |
00:33:44.640
is that there are so-called nicotinic receptors
link |
00:33:47.080
in the body.
link |
00:33:47.920
Now those nicotinic receptors
link |
00:33:48.880
were named after nicotine, the compound,
link |
00:33:51.260
but they existed in the brain and body,
link |
00:33:53.420
not because of the existence of a tobacco plant,
link |
00:33:55.980
but because there are other chemicals in the body
link |
00:33:59.080
that naturally occur, namely acetylcholine
link |
00:34:01.960
that bind the nicotine receptor.
link |
00:34:05.040
Those chemicals such as acetylcholine
link |
00:34:07.320
that bind the nicotinic receptor in your brain and body
link |
00:34:10.080
create an enhanced sense of focus, et cetera, et cetera.
link |
00:34:13.220
But nicotine from tobacco binds that same receptor,
link |
00:34:19.000
but with much greater affinity
link |
00:34:20.680
and therefore also creates a state of focus,
link |
00:34:23.560
but a much greater one than we can achieve without nicotine.
link |
00:34:27.080
Okay, so you can see the nicotine episode
link |
00:34:28.480
if you want to learn more about that.
link |
00:34:31.400
In a very similar way,
link |
00:34:34.240
all of our brains and bodies
link |
00:34:35.540
from the time that we are conceived,
link |
00:34:38.120
believe it or not, very shortly after conception,
link |
00:34:40.360
if we want to be accurate,
link |
00:34:41.740
very early conception when you were in the womb,
link |
00:34:45.200
and still now, if you're listening to this,
link |
00:34:47.040
you have what are called cannabinoid receptors
link |
00:34:51.800
because you also have endogenous cannabinoids.
link |
00:34:55.880
What do we mean by that?
link |
00:34:56.720
You have receptors which are like little parking spots
link |
00:34:59.460
that are present on cells in your brain and body,
link |
00:35:03.340
and what we call a ligand,
link |
00:35:05.680
which is basically just a chemical that's released,
link |
00:35:07.560
parks in that receptor,
link |
00:35:09.760
and causes a number of different biological effects.
link |
00:35:14.540
Cannabis contains compounds
link |
00:35:17.340
that also bind to those receptors,
link |
00:35:19.480
but here I want to make a really clear distinction.
link |
00:35:21.440
We have what are called endogenous ligands,
link |
00:35:23.660
those that just mean chemicals from within us
link |
00:35:26.240
that we make naturally,
link |
00:35:27.360
even if we never go near the cannabis plant
link |
00:35:29.360
or any other source of cannabis,
link |
00:35:31.160
we have chemicals that are created in us
link |
00:35:34.200
that park in those receptors and cause biological effects
link |
00:35:38.320
on mood, on perception, on the immune system,
link |
00:35:40.340
on hunger, et cetera.
link |
00:35:41.640
Again, without ever going anywhere near cannabis,
link |
00:35:44.400
we have these endogenous cannabinoids.
link |
00:35:47.080
So endogenous cannabinoids are floating around in us,
link |
00:35:49.680
or I should say they are released in us in particular ways,
link |
00:35:52.080
bind to these receptors
link |
00:35:53.040
and cause changes in mood, appetite, et cetera.
link |
00:35:55.760
They have many different effects on the brain and body.
link |
00:35:57.720
We will talk about those.
link |
00:35:59.680
But just like with nicotine,
link |
00:36:01.220
there are substances in the outside world,
link |
00:36:03.280
in this case, cannabis contains these substances,
link |
00:36:06.800
so things like THC and like CBD,
link |
00:36:11.280
that when ingested by smoking or vaping
link |
00:36:14.040
or by ingesting edibles,
link |
00:36:16.760
also will park in those same receptors,
link |
00:36:20.160
the cannabinoid receptors, and lead to biological effects.
link |
00:36:24.360
Now it's a little bit misleading
link |
00:36:25.560
because we call them cannabinoid receptors
link |
00:36:27.480
as if they were there to bind cannabis,
link |
00:36:31.440
or just like we call the nicotine receptors
link |
00:36:33.440
nicotinic receptors,
link |
00:36:35.240
it makes it seem as if they were there
link |
00:36:36.880
in order to bind nicotine from tobacco.
link |
00:36:40.320
But that's not the way our brains and bodies evolved.
link |
00:36:42.560
Our brains and bodies evolved for these receptors
link |
00:36:45.600
to make use of chemicals that exist within us
link |
00:36:48.560
called, again, endogenous chemicals.
link |
00:36:51.480
And those endogenous chemicals lead to certain effects,
link |
00:36:54.200
as I mentioned before.
link |
00:36:55.440
The key thing here,
link |
00:36:56.580
if you haven't understood anything I've said up until now,
link |
00:36:59.360
please understand this.
link |
00:37:00.360
The key thing is that THC and CBD
link |
00:37:04.560
and the other components of cannabis
link |
00:37:06.760
bind to those receptors,
link |
00:37:08.420
those endogenous cannabinoid receptors,
link |
00:37:10.660
the ones that we naturally make,
link |
00:37:12.520
with much greater affinity
link |
00:37:14.840
and exert a vastly greater potency
link |
00:37:17.720
and effect on mood and perception, et cetera,
link |
00:37:20.820
than do our endogenous cannabinoids.
link |
00:37:25.440
Another analogy that one could take
link |
00:37:26.760
in order to understand this
link |
00:37:28.280
would be hormones like testosterone and estrogen.
link |
00:37:31.800
Many people, I would say all people,
link |
00:37:35.040
make testosterone and estrogen to varying degrees.
link |
00:37:37.600
It's going to depend on whether or not you're male, female,
link |
00:37:39.280
your age, whether or not you've gone through puberty,
link |
00:37:40.800
et cetera, et cetera.
link |
00:37:42.200
But let's just say testosterone, for example.
link |
00:37:45.360
There's testosterone circulating in your body.
link |
00:37:48.960
That's true if you're male or female.
link |
00:37:50.800
And there are receptors called androgen receptors.
link |
00:37:53.060
We could even call them testosterone receptors.
link |
00:37:56.080
And the testosterone binds to those receptors
link |
00:37:58.180
and has effects on cells.
link |
00:37:59.320
It causes hair growth, changes the voice.
link |
00:38:01.660
It can affect libido.
link |
00:38:02.920
It affects all sorts of things in the brain and body,
link |
00:38:04.640
depending on which organ and tissue you're talking about.
link |
00:38:07.740
But of course, there are people
link |
00:38:09.280
that take synthetic testosterone
link |
00:38:11.080
or derivatives of testosterone.
link |
00:38:14.000
And some of those derivatives, for instance,
link |
00:38:15.600
in the bodybuilding community and the sports community,
link |
00:38:17.600
they will take things like Diana Ball.
link |
00:38:19.260
These are modified versions of testosterone
link |
00:38:23.160
that can bind to the testosterone receptor
link |
00:38:26.120
with much greater affinity, or I should say,
link |
00:38:28.580
the androgen receptor with much greater affinity
link |
00:38:31.040
and have supra physiological effects,
link |
00:38:34.060
effects that would essentially never be seen
link |
00:38:36.880
from testosterone that was endogenously,
link |
00:38:41.720
excuse me, endogenously released within the body.
link |
00:38:45.600
We could say the same thing for estrogen.
link |
00:38:47.280
There are estrogen receptors.
link |
00:38:49.560
They bind estrogen, okay?
link |
00:38:51.800
But if someone were to take synthetic estrogen
link |
00:38:54.240
or to ingest a plant compound
link |
00:38:55.840
that contains various estrogenic compounds,
link |
00:38:58.080
and those plants certainly exist out there,
link |
00:39:00.680
they can have supra physiological effects
link |
00:39:03.240
on those receptors.
link |
00:39:04.800
Why am I telling you this?
link |
00:39:06.080
Well, many people believe that because cannabis,
link |
00:39:10.040
marijuana is a plant and plants grow out of the ground
link |
00:39:14.100
and they're naturally occurring,
link |
00:39:16.040
and because we have receptors in our body
link |
00:39:19.360
that are there without the need to engineer them
link |
00:39:23.040
from some external source, right?
link |
00:39:25.120
They're in our genome, they program for it,
link |
00:39:26.720
and we're born with these things,
link |
00:39:27.720
and we keep these our entire life.
link |
00:39:30.080
Many people mistakenly think, ah, you know,
link |
00:39:33.160
these plant compounds are safer for us or better for us
link |
00:39:36.560
or are somehow appropriate for us to ingest,
link |
00:39:39.880
but that's simply not true.
link |
00:39:41.440
And here, I'm not saying that cannabis
link |
00:39:43.180
is always a bad idea for people.
link |
00:39:44.720
There are certain populations and certain people
link |
00:39:46.440
for which it can be relatively safe recreationally.
link |
00:39:49.520
That's the truth.
link |
00:39:50.360
And there are other populations
link |
00:39:51.440
for which it can be downright dangerous,
link |
00:39:53.460
recreationally or medicinally.
link |
00:39:55.880
And of course, there are medicinal purposes
link |
00:39:57.400
that are being explored, and we'll talk more about that.
link |
00:39:59.600
But this is vital to understand
link |
00:40:01.120
because I think that when we hear,
link |
00:40:02.580
oh, it's from a plant, it's natural,
link |
00:40:04.680
and then you also have a receptor for these,
link |
00:40:06.400
endogenous cannabinoid receptors,
link |
00:40:08.080
and therefore the marriage of those two, right?
link |
00:40:11.500
The coming together of the chemical, THC or CBD or both,
link |
00:40:15.360
with these receptors is somehow supposed to happen
link |
00:40:18.240
as if this was a purpose of having these receptors,
link |
00:40:21.440
but it's simply not the case.
link |
00:40:22.720
In the same way that the nicotinic receptors
link |
00:40:24.820
are not there because nicotine is good for us.
link |
00:40:27.340
They're there because there are compounds
link |
00:40:28.640
that exist within us that are good
link |
00:40:30.940
to bind to those receptors from time to time.
link |
00:40:34.160
Now, here's the key thing about,
link |
00:40:36.240
I guess today I'm saying there are a lot of key things,
link |
00:40:37.760
but here's another key thing about understanding cannabis
link |
00:40:41.020
and the way that it works,
link |
00:40:42.360
which is that THC and CBD,
link |
00:40:45.740
when they're brought into the brain and body
link |
00:40:47.600
by smoking or edible, et cetera,
link |
00:40:50.440
they bind to those receptors,
link |
00:40:53.940
those endogenous cannabinoid receptors,
link |
00:40:56.340
and they tap into the same systems
link |
00:40:58.460
that your endogenous cannabinoids would tap into,
link |
00:41:01.820
the ones that affect mood and energy and creativity
link |
00:41:04.180
and relaxation, et cetera,
link |
00:41:05.880
but they do so with thousand fold greater potency.
link |
00:41:11.100
And as a consequence of that,
link |
00:41:13.260
your endogenous cannabinoids are out competed.
link |
00:41:16.820
They really get no opportunity
link |
00:41:18.620
to interact with those receptors.
link |
00:41:20.780
And understanding that can lead
link |
00:41:23.040
to a very clear understanding of why, for instance,
link |
00:41:25.580
when people use cannabis to relieve anxiety
link |
00:41:28.740
or they use cannabis to enter a certain brain state
link |
00:41:31.140
for creativity or to enter sleep,
link |
00:41:33.620
why a dependence on cannabis starts to emerge,
link |
00:41:37.060
because if they don't ingest cannabis,
link |
00:41:39.540
and again, ingest could mean smoke,
link |
00:41:41.620
to bring THC in or CBD in or ingest orally
link |
00:41:45.260
or even transdermal or tincture
link |
00:41:46.700
or one of the other varieties,
link |
00:41:48.380
if they don't do that,
link |
00:41:50.100
then what happens is not only are the receptors
link |
00:41:53.300
not stimulated to the same degree
link |
00:41:55.460
or with the same potency that they normally are,
link |
00:41:59.060
but the endogenous cannabinoids
link |
00:42:01.160
can no longer have their effect.
link |
00:42:02.620
So people experience heightened levels of anxiety,
link |
00:42:05.160
disrupted mood, disrupted brain state, and so on.
link |
00:42:09.860
Now, again, I want to be very clear
link |
00:42:11.900
that I'm not trying to paint a picture of cannabis
link |
00:42:13.980
as all bad or even partially bad.
link |
00:42:16.120
What I want to do today is give you as much information
link |
00:42:18.260
I can as to how cannabis works,
link |
00:42:21.460
how its different component parts work,
link |
00:42:23.020
how the different types of cannabis work,
link |
00:42:25.060
and point to some of the valid medicinal uses
link |
00:42:28.700
and some of the recreational uses,
link |
00:42:30.220
and then lay out the landscape for you
link |
00:42:33.040
as to who is really most at risk
link |
00:42:35.300
in terms of psychoactive components,
link |
00:42:38.380
immune components, and so on and so forth
link |
00:42:40.640
so that you can make the most informed choice for you.
link |
00:42:42.540
I am not here to tell you what to do or what not to do.
link |
00:42:45.980
As I like to say, do as you wish, right?
link |
00:42:49.700
I mean, don't do as you wish
link |
00:42:51.240
if it harms other people or yourself,
link |
00:42:52.440
but do as you wish, but know what you're doing.
link |
00:42:55.020
So that's really my goal here.
link |
00:42:56.500
So as we begin to dive further into the biology,
link |
00:42:58.580
I think you'll start to get a clearer picture
link |
00:43:00.540
of why cannabis is so effective in some contexts,
link |
00:43:03.740
but also why it can create such massive suffering
link |
00:43:07.700
in other contexts because of the way that it out-competes
link |
00:43:11.300
your own natural endogenous cannabinoid systems.
link |
00:43:14.580
So let's talk about those endogenous cannabinoid systems,
link |
00:43:16.740
what they are and how they work,
link |
00:43:18.660
because that will give us a lens
link |
00:43:20.380
into what the higher potency,
link |
00:43:22.820
sort of maximum impact of the various cannabis plant
link |
00:43:26.220
varieties and strains and THC and CBD and so forth,
link |
00:43:28.980
how and why those work.
link |
00:43:30.980
So what are the endogenous cannabinoids,
link |
00:43:32.980
these chemical substances that everybody makes?
link |
00:43:36.860
You make them, I make them.
link |
00:43:38.380
You've been making them
link |
00:43:39.380
basically from the time that you were conceived
link |
00:43:41.180
and you are going to make them until the time that you die.
link |
00:43:43.880
Whether or not they have the impact
link |
00:43:45.520
and the biological functions that I'm about to describe
link |
00:43:47.620
will depend a lot on whether or not
link |
00:43:49.560
you are using your own endogenous cannabinoids
link |
00:43:53.240
to park in those receptors that you also have
link |
00:43:55.820
from birth until death,
link |
00:43:57.980
or whether or not you are tickling those receptors
link |
00:44:01.780
or strongly activating those receptors
link |
00:44:04.380
using some external source like cannabis, THC, et cetera.
link |
00:44:09.380
The two main endogenous cannabinoids
link |
00:44:14.020
that we want to consider are anandamide,
link |
00:44:16.660
which we will refer to as EAE.
link |
00:44:18.980
So anandamide and another one,
link |
00:44:21.500
which is arachidinoyl glycerol, arachidinoyl glycerol,
link |
00:44:26.020
which we will abbreviate 2AG.
link |
00:44:28.140
So let's just take EAE and 2AG,
link |
00:44:31.620
lump them together and talk about the endogenous cannabinoids
link |
00:44:34.780
just to make it simple.
link |
00:44:35.860
But if you want to do the deep dive on anandamide
link |
00:44:38.240
versus 2AG, please be my guest.
link |
00:44:42.700
The endogenous cannabinoids are released from neurons.
link |
00:44:45.980
What are neurons?
link |
00:44:46.820
Neurons are nerve cells,
link |
00:44:48.580
and nerve cells should be conceptualized like this.
link |
00:44:52.360
You have presynaptic neurons and postsynaptic neurons.
link |
00:44:54.940
Presynaptic neurons basically contain little vesicles,
link |
00:44:57.740
little bubbles full of neurotransmitter,
link |
00:45:00.800
which are chemicals.
link |
00:45:02.020
And when neurons are stimulated electrically,
link |
00:45:05.140
and that could be from a thought,
link |
00:45:06.540
it could be from the desire to move,
link |
00:45:08.800
it could be because of a drug,
link |
00:45:10.700
it could be because you're hungry,
link |
00:45:13.340
the relevant neurons will vomit out or will fuse,
link |
00:45:17.740
as we say, those little packets,
link |
00:45:19.620
those little bubbles of neurotransmitter
link |
00:45:21.500
into the gap between the pre and postsynaptic neuron.
link |
00:45:23.940
We call that a synaptic cleft or the synapse.
link |
00:45:26.540
It's a little gap, a little space.
link |
00:45:27.900
And the neurotransmitter flows across that synapse,
link |
00:45:30.760
and some of it will park in little parking spots
link |
00:45:33.480
that we call receptors on the postsynaptic neuron side.
link |
00:45:36.460
Depending on which neurotransmitter it is,
link |
00:45:38.400
and a bunch of other things,
link |
00:45:39.860
not worth going into right now,
link |
00:45:42.220
the parking of that chemical
link |
00:45:43.400
in those neurotransmitter receptors
link |
00:45:44.800
will either cause that neuron on the postsynaptic side
link |
00:45:48.900
to itself release neurotransmitter elsewhere,
link |
00:45:52.700
or it will quiet it down,
link |
00:45:54.640
so-called excitation and inhibition.
link |
00:45:56.400
That's kind of neurotransmission in a nutshell.
link |
00:45:58.540
If you don't understand it, no big deal.
link |
00:46:00.220
It's not going to prevent you
link |
00:46:01.100
from understanding today's discussion.
link |
00:46:02.380
If you understand even a small fraction
link |
00:46:04.380
of what I've just said,
link |
00:46:05.780
then it's going to allow you to understand
link |
00:46:08.680
not just today's discussion, but a lot of neuroscience
link |
00:46:10.940
with a lot more nuance and depth of understanding.
link |
00:46:15.180
The key thing to know about the endogenous cannabinoids
link |
00:46:18.920
is that unlike most neurotransmitters,
link |
00:46:22.500
they are released from the postsynaptic side.
link |
00:46:25.700
So what happens is neurotransmitter
link |
00:46:27.920
goes from presynaptic neuron to postsynaptic neuron,
link |
00:46:31.100
but under certain conditions,
link |
00:46:33.000
the postsynaptic neuron itself releases a chemical,
link |
00:46:36.580
and that chemical goes backward,
link |
00:46:38.340
what we call retrogradely, to the presynaptic neuron,
link |
00:46:41.340
binds the receptors there,
link |
00:46:42.980
and changes the probability that the presynaptic neuron
link |
00:46:46.580
will release neurotransmitter.
link |
00:46:49.680
Put simply, endogenous cannabinoids
link |
00:46:52.460
tend to decrease the probability
link |
00:46:55.140
that a neuron will release neurotransmitter.
link |
00:46:59.000
They are sort of a brake on the system.
link |
00:47:00.740
They are a way of shutting down
link |
00:47:03.100
the communication between neurons, regulating it,
link |
00:47:06.120
not to make it completely quiet,
link |
00:47:07.500
but to adjust the levels with a lot of nuance.
link |
00:47:10.660
Now, the other thing that the endogenous cannabinoids do
link |
00:47:13.620
is sort of a mind-bender
link |
00:47:15.420
because we're talking about cannabis,
link |
00:47:17.300
and a commonly known feature of cannabis
link |
00:47:20.380
and marijuana consumption
link |
00:47:21.980
is disruptions in short-term memory,
link |
00:47:24.020
and there is essentially zero debate
link |
00:47:26.220
as to whether or not that occurs,
link |
00:47:27.500
and we'll talk about the mechanisms a little bit later,
link |
00:47:29.780
and yet endogenous cannabinoids,
link |
00:47:33.660
the chemicals that you naturally release
link |
00:47:35.300
from these postsynaptic neurons
link |
00:47:36.700
that travel retrogradely back to the presynaptic neuron,
link |
00:47:40.220
actually can lead to strengthening of connections
link |
00:47:43.820
between the presynaptic neuron and the postsynaptic neuron
link |
00:47:47.260
through a process called long-term potentiation, or LTP.
link |
00:47:51.600
They can also cause what's called depression
link |
00:47:55.140
of communication between a presynaptic neuron
link |
00:47:57.680
and a postsynaptic neuron.
link |
00:48:00.260
Long-term depression has nothing to do
link |
00:48:03.580
with depression as a psychological state or as a illness.
link |
00:48:09.020
Long-term potentiation and long-term depression
link |
00:48:11.060
simply refer to the probability
link |
00:48:12.940
that one neuron will be able to stimulate
link |
00:48:15.380
and activate another neuron,
link |
00:48:17.240
and as I just told you, the endogenous cannabinoids
link |
00:48:21.440
can either turn up the dial or turn down the dial.
link |
00:48:24.420
They can either increase the probability
link |
00:48:26.340
or decrease the probability
link |
00:48:28.060
that a given connection between neurons
link |
00:48:30.580
will function more or will function less.
link |
00:48:33.340
So if you think about the communication between neurons
link |
00:48:35.060
as a crosstalk, as a conversation,
link |
00:48:37.860
well, the endogenous cannabinoids
link |
00:48:40.900
can dictate whether or not that conversation
link |
00:48:42.740
is likely to occur or not to occur.
link |
00:48:44.640
Think of them as either putting someone
link |
00:48:47.380
at the top of your text chain in your phone,
link |
00:48:50.320
which would be long-term potentiation,
link |
00:48:52.460
or essentially blocking their number,
link |
00:48:55.100
which would essentially be long-term depression.
link |
00:48:58.680
So if you're getting the impression
link |
00:49:00.860
that the endogenous cannabinoids
link |
00:49:02.260
are working in a number of different ways
link |
00:49:04.160
and it's not very straightforward, you're right.
link |
00:49:06.220
In fact, that's the message that I'd like you to take away.
link |
00:49:08.420
The endogenous cannabinoids
link |
00:49:10.260
are sometimes increasing neuronal communication.
link |
00:49:12.420
This can lead to increases in mood
link |
00:49:14.420
or increases in the likelihood
link |
00:49:16.860
that someone will talk a certain way
link |
00:49:18.380
or behave a certain way or feel a certain way.
link |
00:49:20.760
They can also lead to decreases in synaptic transmission,
link |
00:49:24.220
that is communication between neurons,
link |
00:49:25.760
in ways that will make somebody's mood lower
link |
00:49:29.180
or will make them less hungry or more hungry.
link |
00:49:32.380
And here's the really key thing.
link |
00:49:34.980
There are two kinds of endogenous cannabinoid receptors
link |
00:49:38.260
referred to as CB1 and CB2.
link |
00:49:40.940
And we can say with confidence
link |
00:49:42.960
that CB1 is highly enriched in the nervous system
link |
00:49:46.620
and especially within the brain.
link |
00:49:48.180
It's found not everywhere,
link |
00:49:49.480
but almost everywhere in the brain
link |
00:49:51.060
and elsewhere in the nervous system,
link |
00:49:52.180
so spinal cord and other aspects of the nervous system.
link |
00:49:55.900
CB2, the cannabinoid receptor.
link |
00:49:59.540
CB2 is largely located in the tissues of the body,
link |
00:50:02.500
including the immune system, the liver,
link |
00:50:04.660
even the genitals, et cetera.
link |
00:50:07.060
So what this means is that the endogenous cannabinoids
link |
00:50:09.680
are having these sorts of effects on neurons
link |
00:50:11.880
that I talked about,
link |
00:50:12.720
but they are also having effects on immune cells,
link |
00:50:15.660
on reproductive organs, on liver, on digestion,
link |
00:50:18.420
on hunger, et cetera,
link |
00:50:19.660
through mechanisms that are divorced from the function
link |
00:50:22.640
of the nervous system of neurons.
link |
00:50:24.900
Now, in reality, no system of the brain and body
link |
00:50:26.860
is divorced from the nervous system
link |
00:50:28.060
because the nervous system is controlling everything.
link |
00:50:30.340
There is really the master controller
link |
00:50:31.620
and everything's feeding back to the nervous system,
link |
00:50:33.440
so it's a two-way street.
link |
00:50:34.880
But the simple way to think about it is CB1 receptors
link |
00:50:38.180
are mainly in the nervous system
link |
00:50:40.140
and CB2 receptors are mainly in the body
link |
00:50:42.300
and endogenous cannabinoids.
link |
00:50:45.020
Again, EAE, anatomide, and 2AG, arachidinol glycerol,
link |
00:50:50.540
are impacting CB1 and CB2 receptors.
link |
00:50:53.460
Today, we're mainly going to talk about CB1 receptors
link |
00:50:55.740
because they are the ones that are responsible
link |
00:50:57.220
for most of the familiar effects of cannabis.
link |
00:50:59.780
But the key takeaway at this point
link |
00:51:02.500
is to really understand that the major effects
link |
00:51:05.920
of your endogenous cannabinoids on these receptors
link |
00:51:08.740
in this particular CB1 are very nuanced.
link |
00:51:12.220
It depends on context, it depends on which neurons.
link |
00:51:14.260
It's sometimes increasing communication between neurons,
link |
00:51:17.020
sometimes decreasing it.
link |
00:51:18.940
And then along comes cannabis.
link |
00:51:21.260
And that cannabis, again, can arrive by smoking,
link |
00:51:24.280
by vaping, by edible.
link |
00:51:26.780
And cannabis contains THC and CBD
link |
00:51:30.060
that potently bind the CB1 receptor.
link |
00:51:34.700
And now the effects of the CB1 receptor
link |
00:51:37.900
being occupied by THC or being occupied by CBD
link |
00:51:42.380
are not very nuanced.
link |
00:51:44.860
In fact, they are very predictable.
link |
00:51:47.500
And especially important is to understand
link |
00:51:50.120
that they are so strong and they park in that receptor
link |
00:51:53.220
with such affinity, with such force and precision
link |
00:51:56.500
and stubbornness and refusal to leave that receptor
link |
00:52:00.100
that they completely out-compete
link |
00:52:02.020
the endogenous cannabinoid system.
link |
00:52:04.100
In fact, they leave the endogenous cannabinoid system
link |
00:52:06.440
essentially dysfunctional,
link |
00:52:08.440
which in some cases may be a good thing,
link |
00:52:10.920
but in most cases is going to lead to problems
link |
00:52:14.280
of various kinds.
link |
00:52:15.120
And we'll talk about what sorts of problems.
link |
00:52:16.520
And again, I feel obligated to say,
link |
00:52:19.140
this is not me saying don't ingest cannabis or THC or CBD.
link |
00:52:23.220
That's not what I'm saying.
link |
00:52:24.400
What I'm saying is if you evaluate the potency,
link |
00:52:28.020
that is in technical terms,
link |
00:52:29.460
it would be the affinity with which these compounds,
link |
00:52:32.500
THC and CBD and CBN bind to these endogenous receptors.
link |
00:52:37.220
That would be like a howitzer gun,
link |
00:52:38.820
like a cannon going off as compared to endogenous cannabinoid
link |
00:52:43.980
whether or not it's EAE or 2AG,
link |
00:52:46.580
which is more like a cap gun level of activation,
link |
00:52:49.700
at least in this analogy.
link |
00:52:50.980
So now you have what at least I would like to think
link |
00:52:53.700
is a fairly complete understanding
link |
00:52:55.620
of the different varieties of cannabis,
link |
00:52:57.780
at least at a broad sweep
link |
00:53:00.380
and the different biological effects that they can have,
link |
00:53:03.100
at least in terms of the major receptors
link |
00:53:04.860
and in retrograde signaling, et cetera, et cetera.
link |
00:53:07.940
Now let's take a step back into the real world
link |
00:53:10.500
and evaluate or think about
link |
00:53:12.500
what happens when somebody smokes cannabis
link |
00:53:16.140
or ingest cannabis by way of edible
link |
00:53:18.660
or tincture or something of that sort.
link |
00:53:22.260
Cannabis is very fast to enter the bloodstream.
link |
00:53:26.940
In fact, within 30 seconds,
link |
00:53:28.940
it's going to enter the brain
link |
00:53:30.060
and permeate throughout the brain and body.
link |
00:53:32.320
That's very, very fast.
link |
00:53:33.720
I mean, we contrast that with something like alcohol
link |
00:53:36.260
or even nicotine, depending on how the nicotine
link |
00:53:38.200
is delivered, that is a very fast delivery
link |
00:53:41.420
of the psychoactive and biologically active compound,
link |
00:53:44.340
which in this case is THC and CBD
link |
00:53:46.480
and probably some other things as well.
link |
00:53:48.780
So within 30 seconds,
link |
00:53:49.900
it reaches the brain and bodily tissues.
link |
00:53:52.920
And within 30 to 60 minutes,
link |
00:53:56.140
it's going to reach its peak concentrations
link |
00:53:58.620
and have its peak biological effects.
link |
00:54:00.900
Those aren't always the same thing,
link |
00:54:01.940
but in the case of cannabis,
link |
00:54:03.660
and again, here I'm using cannabis
link |
00:54:04.780
as a kind of an umbrella term for THC and CBD,
link |
00:54:07.520
the effects are going to peak at about 30 to 60 minutes
link |
00:54:10.700
after bringing those compounds into the body
link |
00:54:13.380
in some way or another.
link |
00:54:15.020
And the effects tend to last
link |
00:54:16.360
anywhere from three to four hours,
link |
00:54:17.980
although there's some variation on that
link |
00:54:19.720
depending on individual metabolism,
link |
00:54:21.860
whether or not somebody is familiar with the compound,
link |
00:54:26.340
believe it or not, psychologically familiar,
link |
00:54:27.780
but also biologically familiar,
link |
00:54:29.480
or whether or not it's a first time use
link |
00:54:30.780
or occasional use and so on.
link |
00:54:32.180
THC and CBD and other components of cannabis
link |
00:54:37.640
are highly what we call lipophilic.
link |
00:54:39.560
That is they have an affinity toward
link |
00:54:42.360
and they can actually pass through fatty tissues.
link |
00:54:44.480
Now, every cell in your body,
link |
00:54:45.560
but especially neurons have a double layer of fat
link |
00:54:48.860
on their outside.
link |
00:54:49.960
And of course, when people hear fat,
link |
00:54:51.800
they always think, ooh, fat's bad, fat's whatever.
link |
00:54:54.100
Most of the world seems to want to lose fat or bodily fat.
link |
00:54:57.000
Here we're talking about the fatty membrane,
link |
00:54:59.840
the barrier around each tissue.
link |
00:55:01.600
In this case, we're talking particularly about neurons.
link |
00:55:04.400
And THC and CBD and the other components of cannabis
link |
00:55:08.740
are highly lipophilic.
link |
00:55:10.040
So they can get into essentially all cells
link |
00:55:11.920
just simply by flowing into them.
link |
00:55:13.720
They will also remain in those cells for a long time.
link |
00:55:17.000
So I know that a number of people,
link |
00:55:19.320
depending on whether or not they get tested for work
link |
00:55:21.920
or for sport or otherwise for cannabis or CBD and THC,
link |
00:55:27.200
don't take this as a strict number,
link |
00:55:28.980
but typically if one ingests CBD or THC,
link |
00:55:34.000
smokes cannabis, ingests orally, et cetera,
link |
00:55:36.900
it doesn't matter.
link |
00:55:37.740
It's going to stay in that fatty tissue
link |
00:55:39.560
and can be detected for at least as long as 80 days
link |
00:55:42.960
after ingestion.
link |
00:55:43.780
And there's a whole industry as to, you know,
link |
00:55:45.780
how to accelerate the clearance.
link |
00:55:47.880
And I should just tell you that just losing bodily fat
link |
00:55:51.280
isn't going to eliminate it from your system,
link |
00:55:54.360
maybe partially in those fat cells,
link |
00:55:56.440
but certainly intravisceral fat and other fatty tissue
link |
00:56:00.440
that's in and around the brain and body
link |
00:56:02.380
is going to harbor that THC molecule and the CBD molecule
link |
00:56:06.700
for quite a long while, at least 80 days.
link |
00:56:09.060
Okay, so if someone smokes cannabis
link |
00:56:12.160
or they ingest cannabis,
link |
00:56:13.760
very rapidly gets into the bloodstream
link |
00:56:16.400
and the components that are psychoactive
link |
00:56:18.160
get into the bloodstream
link |
00:56:19.200
and are immediately able to access neurons and other cells
link |
00:56:23.560
and start having these effects of parking
link |
00:56:25.020
with those endogenous cannabinoid receptors
link |
00:56:27.200
and impacting the signaling between neurons,
link |
00:56:29.480
which leads to the subjective effects of cannabis,
link |
00:56:34.000
including THC and CBD.
link |
00:56:35.300
So let's talk about what those different
link |
00:56:37.040
subjective effects are.
link |
00:56:38.520
Again, this is going to vary depending on whether or not
link |
00:56:40.480
people are ingesting sativa varieties of cannabis.
link |
00:56:44.700
Just to remind you, those tend to be elevated.
link |
00:56:47.160
Mood, alertness, talkativeness,
link |
00:56:48.980
people who take sativa varieties tend to talk a lot more
link |
00:56:51.740
than they would otherwise.
link |
00:56:53.380
Again, there are exceptions to this.
link |
00:56:54.800
Of course, there are exceptions.
link |
00:56:56.020
I'm sure there are people out there shouting,
link |
00:56:57.360
although I guess if you're the quiet people
link |
00:56:58.600
who don't talk too much, you're probably not shouting,
link |
00:57:00.440
or if you're not, you're not doing sativa.
link |
00:57:02.900
Joke intended.
link |
00:57:03.740
But in any event, there are exceptions,
link |
00:57:05.920
but there are also general rules.
link |
00:57:07.720
And the sativas tend to meet people
link |
00:57:09.160
sort of mood elevated, energetic,
link |
00:57:10.880
again, the sort of head high.
link |
00:57:13.040
And indica varieties tend to do the opposite,
link |
00:57:16.500
more of a sedative, relaxant, et cetera.
link |
00:57:19.900
Why and how would they do that?
link |
00:57:21.720
Okay, without going into an extensive deep dive
link |
00:57:24.280
into the different neurotransmitter systems
link |
00:57:25.840
of the brain and body,
link |
00:57:27.740
what we know for sure is that CB1 receptors
link |
00:57:30.680
are present on an enormous number of different neurons
link |
00:57:33.040
in brain structures and neural circuits,
link |
00:57:35.340
so that the sativa varieties that act as sort of a stimulant
link |
00:57:39.760
making people feel happy,
link |
00:57:42.800
because in general, they do tend to elevate mood,
link |
00:57:45.400
at least at certain dosages.
link |
00:57:47.480
Talkative tend to make people feel
link |
00:57:50.840
like they have ideas that are interesting,
link |
00:57:52.760
that they might want to share,
link |
00:57:54.480
tend to narrow their context,
link |
00:57:55.800
so we tend to increase focus.
link |
00:57:57.240
This is something that's not often discussed about cannabis,
link |
00:57:59.440
but it can, especially the sativa varieties
link |
00:58:01.280
can increase people's level of focus to particular things,
link |
00:58:04.360
something they're watching or something they're doing,
link |
00:58:06.280
or music allows them to narrow their sense of focus.
link |
00:58:10.220
That's going to occur by activation of CB1 receptors
link |
00:58:13.400
in the so-called prefrontal cortex,
link |
00:58:14.880
which is just behind the forehead.
link |
00:58:16.540
And the prefrontal cortex acts as a strong modulator
link |
00:58:19.840
of so-called limbic circuitry and other circuitry
link |
00:58:22.580
that is more stress-oriented.
link |
00:58:24.560
The way to think about the stress and limbic circuitry,
link |
00:58:27.960
such as the amygdala, which many people have heard about,
link |
00:58:30.360
is that they aren't really circuits for fear and stress.
link |
00:58:33.200
They are circuits that are constantly evaluating
link |
00:58:35.360
one's own internal state, heart rate, et cetera,
link |
00:58:38.240
and what's happening externally.
link |
00:58:40.200
And sorry to say, but the default of those systems
link |
00:58:43.360
is to detect danger, the sort of threat detection systems.
link |
00:58:46.340
And then the prefrontal cortex largely acts
link |
00:58:48.500
as a brake on those systems,
link |
00:58:50.300
sort of like the reins pulling back on a steed of horses
link |
00:58:53.140
that would otherwise just kind of take off.
link |
00:58:55.440
And so the sativa varieties tend to increase CB1 activation
link |
00:58:59.280
in the prefrontal cortex and in other circuitry
link |
00:59:02.080
that then leads to a kind of overall reduction in stress
link |
00:59:05.220
because of the way that prefrontal circuitry
link |
00:59:06.660
can reduce activation of the amygdala.
link |
00:59:09.240
Now that, of course, does not explain
link |
00:59:11.540
why some people become very stressed and very paranoid
link |
00:59:14.520
when they smoke sativa varieties
link |
00:59:16.160
or other varieties of cannabis
link |
00:59:17.920
or ingest other varieties of cannabis.
link |
00:59:19.600
We will talk about the paranoid effect and why that occurs
link |
00:59:22.520
and who might predict that would occur to them in it
link |
00:59:25.480
in a little bit.
link |
00:59:26.720
But I just want to give you a sense of how this is working
link |
00:59:28.920
because as I mentioned before,
link |
00:59:31.320
THC and or CBD are going to bind that CB1 receptor,
link |
00:59:34.880
let's say in prefrontal cortex
link |
00:59:36.040
and neurons of prefrontal cortex is going to bind there.
link |
00:59:38.360
And then there'll be a retrograde signaling
link |
00:59:40.320
back to the presynaptic neuron.
link |
00:59:41.640
And in the case of prefrontal cortex,
link |
00:59:43.420
what's happening is it's increasing transmission,
link |
00:59:46.440
increasing the release of neurotransmitter
link |
00:59:48.120
in prefrontal cortex.
link |
00:59:49.700
However, at the same time,
link |
00:59:53.040
the very same THC and CBD that was brought into the system
link |
00:59:56.480
is binding the very same type of receptors,
link |
00:59:59.080
CB1 receptors in other brain structures,
link |
01:00:01.260
such as the amygdala
link |
01:00:03.260
and causing retrograde signaling
link |
01:00:05.760
back to the presynaptic neurons in the amygdala,
link |
01:00:09.160
but it's quieting the activation of those neurons.
link |
01:00:13.240
So this is interesting, right?
link |
01:00:14.440
We have the same compounds, THC and or CBD
link |
01:00:18.220
brought into the body and brain binding the same receptors,
link |
01:00:22.880
in this case, the CB1 receptors,
link |
01:00:25.180
but depending on where those receptors are located
link |
01:00:28.440
and which brain areas we're referring to,
link |
01:00:31.080
they are either causing heightened levels of alertness
link |
01:00:36.200
and activation of systems that are designed
link |
01:00:38.540
to make you talkative and alertness and mood, et cetera,
link |
01:00:41.000
focus, or they are causing suppression of those circuitries.
link |
01:00:45.680
So we have kind of a seesaw effect here
link |
01:00:47.680
where the same compound is increasing mood and alertness
link |
01:00:49.880
and focus in the prefrontal cortex
link |
01:00:51.200
and is decreasing stress and threat detection
link |
01:00:54.480
in the amygdala.
link |
01:00:56.000
And that's one of the reasons why,
link |
01:00:57.400
especially the sativa varieties of cannabis,
link |
01:01:00.340
allow people to enter these states of focus,
link |
01:01:02.760
some might even say flow,
link |
01:01:03.920
although I don't want to go into what flow states
link |
01:01:06.800
really are, that's for a different discussion,
link |
01:01:09.180
and it's very poorly defined as it is.
link |
01:01:12.600
And I certainly don't want to give people the impression
link |
01:01:14.360
that cannabis increases flow states,
link |
01:01:16.040
because that's not always the case,
link |
01:01:18.620
and certainly most often is not going to be the case.
link |
01:01:21.020
But the idea here is that this molecule
link |
01:01:23.120
comes into our brain and is shifting everything
link |
01:01:26.060
towards a state of focus, elevated mood,
link |
01:01:29.240
of heightened sense of importance
link |
01:01:30.920
about whatever it is that we happen to be doing.
link |
01:01:32.840
And now of course, whatever we could happen to be doing
link |
01:01:35.400
could be writing a song, writing poetry,
link |
01:01:39.180
communicating with somebody,
link |
01:01:40.520
but it could also be something as trivial
link |
01:01:42.240
as watching cartoons or watching a movie,
link |
01:01:45.840
which is not trivial in its own right,
link |
01:01:48.080
but in terms of thinking about the creative aspects
link |
01:01:50.860
or the creativity stimulating aspects of cannabis,
link |
01:01:54.200
not sort of productivity oriented.
link |
01:01:57.000
So narrowed focus, elevated mood,
link |
01:01:59.020
more relaxed and yet energetic.
link |
01:02:01.200
That's the major effects of the sativa varieties,
link |
01:02:04.120
except, and this is a really big, bold face,
link |
01:02:07.000
triple underlined except, except in some individuals,
link |
01:02:11.240
depending on dosage,
link |
01:02:12.320
but also depending on preexisting neural circuitry
link |
01:02:16.360
and propensity for anxiety,
link |
01:02:18.240
some people ingest or smoke sativa varieties,
link |
01:02:22.000
and regardless of whether or not it's a type one,
link |
01:02:23.920
type two or type three variety, okay,
link |
01:02:25.940
regardless of the ratio between THC and CBD,
link |
01:02:29.120
people will experience intense anxiety and paranoia.
link |
01:02:33.920
Now, how do you predict
link |
01:02:35.600
who will experience intense anxiety and paranoia
link |
01:02:38.160
and who will experience intense relaxation,
link |
01:02:40.800
focus and sense of creativity from ingesting or smoking
link |
01:02:45.200
a type one, type two or type three sativa?
link |
01:02:47.920
Well, there is no way to predict that.
link |
01:02:50.520
And there's a lot of kind of what I would call street lore
link |
01:02:52.960
or dorm room lore or kind of peer, not peer reviewed,
link |
01:02:57.860
but sort of peer discussed,
link |
01:03:00.440
I mean, among friends and people in acquaintances,
link |
01:03:03.040
lore out there that what one needs to do
link |
01:03:05.840
is simply smoke more, right?
link |
01:03:07.680
Or just ingest more, you hear that.
link |
01:03:09.480
Oh, well, listen, if it makes you paranoid,
link |
01:03:11.040
you simply need to use more.
link |
01:03:12.320
That is absolutely categorically false.
link |
01:03:14.800
Everything we know about the way that THC and CBD work
link |
01:03:18.160
is that they tend to potentiate,
link |
01:03:20.020
that is increase the effects of these different systems
link |
01:03:25.500
at given synapses and in different areas
link |
01:03:27.240
of the brain and body.
link |
01:03:28.080
That is if someone experiences paranoia or anxiety
link |
01:03:32.880
from a given strain of the marijuana plant
link |
01:03:37.100
or from ingesting an edible in a particular way
link |
01:03:39.240
or a particular kind of edible,
link |
01:03:41.680
that person is very likely to experience the same effect
link |
01:03:44.800
every time they ingest that strain or variety.
link |
01:03:48.600
This is part of what's led to this enormous industry.
link |
01:03:52.000
I mean, there are a number of different reasons,
link |
01:03:53.080
but this is part of what's led to this enormous industry
link |
01:03:55.200
of highly customized cannabis,
link |
01:03:58.520
where people will spend some time
link |
01:04:00.240
really seeking out the different strains of cannabis
link |
01:04:02.680
and hybrids of cannabis that work best for them
link |
01:04:07.000
and work best for them in particular context.
link |
01:04:09.640
I wish I could tell you that if you are a person
link |
01:04:12.800
who is between five foot seven and six feet tall
link |
01:04:16.280
and you have blue eyes or brown eyes,
link |
01:04:19.400
that the sativa varieties are going to be right for you
link |
01:04:21.780
or that the sativa varieties
link |
01:04:23.080
are going to give you panic attacks.
link |
01:04:24.400
I can't do that.
link |
01:04:25.440
The only way to determine it would be
link |
01:04:27.120
to actually experience ingesting those or smoking those,
link |
01:04:30.160
which is certainly also not what I'm suggesting, right?
link |
01:04:32.440
That's up to you.
link |
01:04:33.280
I'm not telling you what to do or what not to do,
link |
01:04:35.200
but there are no good predictors.
link |
01:04:36.960
In fact, if you look in the literature,
link |
01:04:39.920
it is not at all clear that people
link |
01:04:41.520
who have a heightened level of anxiety
link |
01:04:44.440
when they do not smoke cannabis
link |
01:04:47.000
will experience cannabis as less paranoia inducing
link |
01:04:52.360
or more relaxing.
link |
01:04:53.200
That's simply not the case.
link |
01:04:55.180
Now, what we can say for sure
link |
01:04:57.920
is that general categories of effects,
link |
01:05:00.760
such as increased focus and reduced anxiety
link |
01:05:03.600
are largely due to activation of areas
link |
01:05:05.420
like the prefrontal cortex.
link |
01:05:06.860
Now, unlike other compounds like nicotine or alcohol
link |
01:05:10.180
or neurotransmitter systems like dopamine,
link |
01:05:12.160
when we talk about the cannabinoid system
link |
01:05:14.400
and I say effects, biological effects, psychoactive effects,
link |
01:05:18.960
I want you to keep in mind always, please, please, please,
link |
01:05:21.640
keep in mind that those effects can be varied
link |
01:05:25.480
and often opposite in direction.
link |
01:05:28.680
So let's just give an example of that.
link |
01:05:30.860
I just mentioned that when people smoke or eat sativa,
link |
01:05:34.780
that it tends to lead to one specific set of,
link |
01:05:37.640
or generally leads to one specific set of effects,
link |
01:05:40.560
heightened focus, mood, et cetera.
link |
01:05:41.920
Whereas when they ingest or smoke indica
link |
01:05:45.640
and its components, right?
link |
01:05:47.320
Again, we're still talking about THC and CBD
link |
01:05:49.860
in varying ratios, but now indica cannabis
link |
01:05:53.600
and say, well, why would it improve
link |
01:05:56.240
the transition time to sleep?
link |
01:05:58.160
Or at least give people the impression
link |
01:05:59.480
that it improved the transition time to sleep.
link |
01:06:01.020
We'll talk about what indica actually does for sleep
link |
01:06:03.200
in a little bit.
link |
01:06:04.440
But indica also tends to suppress activation
link |
01:06:07.360
of the amygdala and threat detection centers in the brain.
link |
01:06:09.600
Again, binding the same CB1 receptors
link |
01:06:11.560
and those retrograde signaling mechanisms
link |
01:06:13.640
that talked about before.
link |
01:06:15.120
But it also tends to shut down the hippocampus,
link |
01:06:18.320
an area of the brain associated with memory,
link |
01:06:21.720
which is why indica varieties lead to pronounced,
link |
01:06:26.040
or I should say profound defects in short-term memory
link |
01:06:29.400
and sometimes in long-term memory as well
link |
01:06:31.040
if it's consumed over long periods of time.
link |
01:06:33.880
We'll talk about short, medium and long-term consumption,
link |
01:06:36.200
occasional consumption going forward.
link |
01:06:38.000
So what I'd like you to take away
link |
01:06:39.080
from this component of the discussion is,
link |
01:06:40.860
first of all, the mechanism of action
link |
01:06:43.900
by which cannabis impacts the brain and body,
link |
01:06:48.280
but in particular, the brain is going to be
link |
01:06:49.680
through CB1 receptors and those CB1 receptors
link |
01:06:52.420
can lead to either an acceleration or a break
link |
01:06:55.000
on particular biological mechanisms.
link |
01:06:56.680
And there are going to be a constellation
link |
01:06:59.600
of different accelerations and breaking
link |
01:07:01.960
of different neural systems in the brain and body,
link |
01:07:05.160
depending on whether or not people ingest sativa
link |
01:07:07.920
or indica or some hybrid strain.
link |
01:07:10.360
And perhaps most importantly,
link |
01:07:11.860
even if you didn't understand anything that I've said
link |
01:07:13.600
about the biology of these different strains
link |
01:07:15.360
and the receptors, please do understand
link |
01:07:17.520
that there is no way to predict what the effect
link |
01:07:21.720
of a given strain will be on an individual.
link |
01:07:24.340
There has been extensive exploration
link |
01:07:26.720
as to whether or not people who are so-called mellower
link |
01:07:29.340
or more anxious or any number
link |
01:07:32.280
of different personality dimensions will respond
link |
01:07:35.240
in one way or the other.
link |
01:07:36.120
But in fact, there is no way to tell.
link |
01:07:38.580
Layer on top of that, the fact that dosing THC and CBD
link |
01:07:43.240
can be fairly straightforward in the form of edibles, right?
link |
01:07:46.320
Because there can be, at least if it's a controlled source,
link |
01:07:50.240
a defined number of milligrams of THC,
link |
01:07:53.560
a defined number of milligrams of CBD,
link |
01:07:55.960
that's true for ingestibles.
link |
01:07:57.920
It's much harder to gauge that
link |
01:08:00.120
from the smokable forms of cannabis,
link |
01:08:02.540
especially if those smokable forms of cannabis are obtained
link |
01:08:04.980
through sources where there isn't a lot of clear information
link |
01:08:08.160
about the total amount of THC in that product.
link |
01:08:11.240
Now, this is all changing quite a lot nowadays
link |
01:08:13.280
because of the commercialization of THC and CBD products
link |
01:08:17.520
and cannabis in a number of different areas,
link |
01:08:19.520
including in the United States.
link |
01:08:21.220
But still many people are ingesting cannabis, THC, CBD
link |
01:08:24.960
through sources where they don't really know
link |
01:08:26.200
how much they're bringing into their system.
link |
01:08:28.040
And so whether or not someone gets
link |
01:08:31.520
incredible anxiety relief, enhanced sense of mood
link |
01:08:34.040
and focus and wellbeing, pain relief, et cetera,
link |
01:08:37.060
or whether or not they have full-blown panic attacks,
link |
01:08:39.640
et cetera, is very hard to predict
link |
01:08:42.920
based on dosage information alone.
link |
01:08:45.200
Now, of course, we can create broad categories
link |
01:08:47.700
and we were going to talk about studies
link |
01:08:48.900
that create broad categories of low dose,
link |
01:08:50.900
moderate dose and high dose, frequent use and infrequent use
link |
01:08:54.920
but unlike alcohol, unlike nicotine,
link |
01:08:57.740
we can't really point to specificity
link |
01:09:00.620
of X amount of alcohol, grams of alcohol per week,
link |
01:09:04.720
which is safe or X amount of alcohol, which is not safe.
link |
01:09:07.720
And so I know a lot of people out there are wondering,
link |
01:09:10.220
how often can they smoke cannabis
link |
01:09:13.260
or how often can they eat cannabis or THC or CBD
link |
01:09:16.860
in any number of its different forms and products safely?
link |
01:09:21.220
Well, we have to really define what safely means
link |
01:09:23.740
and we have to really acknowledge
link |
01:09:25.240
that there's a pretty loose set of controls
link |
01:09:29.420
over what one is bringing into their brain and body
link |
01:09:32.500
as they ingest THC and CBD.
link |
01:09:35.180
But even under conditions in which it's very controlled,
link |
01:09:38.440
it's very hard to predict what those effects will be.
link |
01:09:41.040
So before moving into specifics of taking cannabis
link |
01:09:44.960
or not taking cannabis, who should, who shouldn't,
link |
01:09:46.760
what the medicinal purposes are
link |
01:09:49.180
and what some of the newer exciting data point to,
link |
01:09:52.580
I just briefly want to make a list
link |
01:09:53.900
and I promise very briefly, I know I'm not often concise
link |
01:09:56.620
but I do try to be thorough for your sake.
link |
01:09:59.380
I want to make a very brief list of the different brain areas
link |
01:10:03.320
that are impacted by THC and CBD
link |
01:10:06.580
and why THC and CBD have the various effects they do.
link |
01:10:10.160
When somebody smokes or ingests cannabis,
link |
01:10:17.320
doesn't matter what the THC or CBD ratio is,
link |
01:10:22.400
if they experience deficits in memory
link |
01:10:26.720
and that's almost always present,
link |
01:10:29.780
that's going to be because of reductions
link |
01:10:31.720
in electrical activity within this brain region
link |
01:10:33.760
we call the hippocampus, okay?
link |
01:10:35.400
Hippocampus means seahorse, it's shaped like a seahorse,
link |
01:10:37.560
anatomists like to name things after what things look like
link |
01:10:40.400
but hippocampus memory, memory is reduced
link |
01:10:43.420
in particular short-term memory.
link |
01:10:45.000
That's true regardless of whether or not
link |
01:10:46.820
one is using sativa, indica or some hybrid.
link |
01:10:52.540
In general, the prefrontal cortex is going to be activated
link |
01:10:57.280
by the sativa varieties, which is going to increase thinking
link |
01:11:00.060
and narrowly constrain focus to some activity
link |
01:11:04.240
and that's more commonly associated
link |
01:11:05.680
with the sativa varieties.
link |
01:11:07.040
The indica varieties, as I mentioned before,
link |
01:11:09.160
tend to lead to a suppression of activity
link |
01:11:11.200
in prefrontal cortex, believe it or not,
link |
01:11:13.440
and turn off thinking and planning.
link |
01:11:15.640
This is why indica varieties are often used for relaxation
link |
01:11:20.360
and for promoting sleep.
link |
01:11:23.560
Regardless of whether or not sativa or indica variety,
link |
01:11:27.360
and again, regardless of the ratio of THC to CBD,
link |
01:11:30.760
there is a general suppression of neural circuits
link |
01:11:33.760
within the so-called basal ganglia and cerebellum.
link |
01:11:35.960
Basal ganglia and cerebellum are areas of the brain
link |
01:11:38.520
that are involved in action planning and withholding action,
link |
01:11:41.120
so that would be the basal ganglia,
link |
01:11:42.280
so-called go-no-go circuitry,
link |
01:11:44.800
and the cerebellum, which is involved in balance
link |
01:11:47.400
but also motor planning and motor sequencing.
link |
01:11:51.200
This is why people who smoke marijuana,
link |
01:11:55.580
regardless of the strain,
link |
01:11:57.040
will tend to be less physically mobile.
link |
01:12:00.020
Other common effects are reddening of the eyes,
link |
01:12:02.520
dryness of the mouth,
link |
01:12:03.440
that's actually caused by the same general mechanism,
link |
01:12:06.280
which is a reduction in the secretion of saliva
link |
01:12:09.320
and of sort of tears and lubrication of the eyes
link |
01:12:12.420
from the lacrimal glands of the eyes
link |
01:12:14.180
because of the presence of largely CB2,
link |
01:12:17.760
but also CB1 receptors in the mouth and on the eyes.
link |
01:12:21.380
And there tends to be,
link |
01:12:23.340
especially with certain strains of cannabis,
link |
01:12:26.040
increase in appetite, so-called munchies,
link |
01:12:28.840
and that has everything to do with very, very high density
link |
01:12:33.420
of CB1 receptors in the hypothalamus,
link |
01:12:35.600
and in particular areas of the hypothalamus,
link |
01:12:37.360
like the arcuate nucleus of the hypothalamus,
link |
01:12:39.860
other areas as well, of course,
link |
01:12:41.640
that have tons of CB1 receptors, bind THC and CBD,
link |
01:12:46.440
and activate the neurons that strongly stimulate appetite
link |
01:12:49.760
through two mechanisms.
link |
01:12:51.260
One is a cognitive mechanism of creating a preoccupation
link |
01:12:55.140
with food and anticipation of taste,
link |
01:12:58.000
as well as the experience of taste,
link |
01:12:59.840
so the narrowing of focus to what you want to go eat, right?
link |
01:13:04.200
You really crave, I don't know, pizza,
link |
01:13:06.880
it seems to be high fat, high carbohydrate foods,
link |
01:13:08.680
but really crave pizza and narrowing of focus
link |
01:13:13.680
so that you're not thinking about anything else,
link |
01:13:15.160
but also signaling from the hypothalamus to the gut
link |
01:13:18.920
to neurons within the stomach itself
link |
01:13:21.320
that regulate blood sugar.
link |
01:13:23.040
So there are strong effects on blood sugar of THC and CBD
link |
01:13:27.840
that generally lead to increases in appetite.
link |
01:13:29.960
So two parallel mechanisms, one within the brain,
link |
01:13:32.680
one within the body, increasing appetite.
link |
01:13:34.880
So there's an array of different effects.
link |
01:13:36.320
And as I mentioned before,
link |
01:13:37.600
CB1 receptors are present all over the nervous system
link |
01:13:41.100
in the brain, the spinal cord.
link |
01:13:42.200
In fact, the presence of CB1 receptors in the spinal cord
link |
01:13:44.920
largely explains the fact that THC and CBD,
link |
01:13:48.300
to some extent, although it's not very well studied,
link |
01:13:50.360
can provide some pain relief.
link |
01:13:52.440
I say some because a lot of people perceive
link |
01:13:55.760
or believe that they experience more pain relief
link |
01:13:58.480
from cannabis than they actually do.
link |
01:14:00.680
It actually has a lot to do with a perceptual shift
link |
01:14:03.260
to basically focusing on other things,
link |
01:14:04.920
but there does seem to be some anti-nociceptive,
link |
01:14:08.360
meaning anti-pain effects of cannabis, THC in particular,
link |
01:14:13.000
and that is exerted largely through effects
link |
01:14:15.400
on CB1 receptors in neurons of the spinal cord.
link |
01:14:19.700
So a broad array of effects are taking place
link |
01:14:21.960
regardless of what strain you take
link |
01:14:23.320
and whether or not you eat the cannabis
link |
01:14:25.500
or you smoke the cannabis.
link |
01:14:26.960
And the broad array of effects can be explained by the fact
link |
01:14:30.000
that that retrograde signaling can lead to activation
link |
01:14:32.240
or suppression of activity in various neurons.
link |
01:14:34.920
So now I'd like to take a step back
link |
01:14:36.520
from the biology of cannabis and THC and CBD
link |
01:14:39.040
and all the signaling and receptors, et cetera,
link |
01:14:41.000
and really just focus on cannabis use.
link |
01:14:44.120
And wherever possible,
link |
01:14:45.280
I will point to the specific strains that have been studied
link |
01:14:48.680
and the ratios of THC to CBD.
link |
01:14:51.200
But I have to say that unfortunately,
link |
01:14:54.260
most studies of marijuana of cannabis,
link |
01:14:57.460
while they have been very careful
link |
01:14:59.800
to detail the amount of THC,
link |
01:15:02.440
low dose, medium dose, or high dose,
link |
01:15:03.960
and actually getting very specific,
link |
01:15:05.060
right down to the number of milligrams
link |
01:15:06.320
or even how much circulating THC is present
link |
01:15:08.280
after somebody smokes a joint or ingests cannabis,
link |
01:15:13.360
most studies have not distinguished
link |
01:15:15.960
between sativa and indica strains.
link |
01:15:19.880
And that's unfortunate because in the real world,
link |
01:15:22.160
people are distinguishing between sativa and indica strains
link |
01:15:25.440
in their patterns of use and what they prefer
link |
01:15:27.240
and what they don't prefer,
link |
01:15:28.120
even what they prefer to smoke during the day
link |
01:15:30.280
or ingest during the day versus night.
link |
01:15:31.640
Believe it or not, there are people
link |
01:15:32.480
who are using certain strains during the day
link |
01:15:34.840
and other strains at night.
link |
01:15:37.260
But the science is yet to catch up to that.
link |
01:15:39.640
Or I should say more accurately,
link |
01:15:42.760
the general public and the themes that are emerging
link |
01:15:45.380
and the practices that are emerging around cannabis,
link |
01:15:47.960
especially in states where it's decriminalized or legalized,
link |
01:15:51.240
are occurring at such a rapid rate
link |
01:15:52.600
that there's absolutely no way
link |
01:15:53.800
that the science could keep up.
link |
01:15:55.120
This is a naturally occurring experiment.
link |
01:15:57.200
Not to say that it's natural, like people should do it,
link |
01:15:59.080
but it's an experiment that's happening in real time
link |
01:16:01.160
in the real world,
link |
01:16:02.100
much faster than controlled studies
link |
01:16:05.080
within university laboratories
link |
01:16:06.360
and other laboratories can keep up.
link |
01:16:07.920
So at this point, I think it's appropriate to ask ourselves,
link |
01:16:10.680
why do people even use cannabis?
link |
01:16:12.760
I mean, what are they trying to achieve?
link |
01:16:14.060
Is it always about not feeling pain?
link |
01:16:16.380
Is it always about reducing anxiety?
link |
01:16:18.360
Well, sometimes it is,
link |
01:16:19.260
but oftentimes people are using cannabis
link |
01:16:21.520
in order to achieve a particular state.
link |
01:16:23.840
And we could use a broad brush and say,
link |
01:16:25.960
well, they just like being high,
link |
01:16:27.920
but while that may be true in a lot of circumstances,
link |
01:16:31.520
and I have to believe it actually is true
link |
01:16:33.260
in a lot of circumstances,
link |
01:16:35.400
there are a lot of people who use cannabis
link |
01:16:37.900
in a very directed way,
link |
01:16:39.480
or they get quote unquote high in order to achieve states
link |
01:16:43.000
that to them are particularly attractive.
link |
01:16:45.440
And one such state is a state of creativity.
link |
01:16:49.080
And this brings us to a broader theme,
link |
01:16:51.080
which is does cannabis increase creativity?
link |
01:16:54.360
And if so, is it the THC, the CBD?
link |
01:16:56.720
What's the appropriate ratio
link |
01:16:58.080
or the best ratio for accessing creativity?
link |
01:17:00.880
This is an interesting and important discussion, I believe,
link |
01:17:02.840
because creativity is one of the more sought after
link |
01:17:05.880
and more elusive states that humans can experience.
link |
01:17:08.800
And yet, if you look at human evolution,
link |
01:17:11.200
you look at our progression
link |
01:17:12.960
in terms of technology development and culture
link |
01:17:16.000
and music and poetry, et cetera,
link |
01:17:19.400
we really can look to creativity as the state
link |
01:17:21.680
that fostered so much of that evolution.
link |
01:17:24.580
So whether or not you're into technology
link |
01:17:26.460
or you're into art or music,
link |
01:17:28.200
whether or not you're just somebody
link |
01:17:29.440
who wants to expand their understanding
link |
01:17:31.800
or their experience of life in some way,
link |
01:17:33.700
creativity is a fundamentally important state
link |
01:17:37.140
to try and access and to try and access regularly
link |
01:17:39.440
and to try and tap into
link |
01:17:40.720
in order to eventually produce something,
link |
01:17:43.320
in order to create something of meaning that exists,
link |
01:17:45.560
not just in that creative state,
link |
01:17:47.040
but to yourself after that creative state has gone away.
link |
01:17:50.960
So the painting that you paint in the creative state
link |
01:17:52.880
hopefully is a painting that still inspires
link |
01:17:55.040
and has impact after you exit that creative state
link |
01:17:58.340
and that will inspire others.
link |
01:17:59.800
And this could be true for any number of different things,
link |
01:18:01.840
not just painting.
link |
01:18:03.220
So does cannabis increase creativity?
link |
01:18:06.080
The short answer is it depends.
link |
01:18:08.420
First of all, we need to define creativity.
link |
01:18:10.620
Here we are as thinking as scientists,
link |
01:18:12.780
if not already scientists.
link |
01:18:14.560
And there are basically two modes of thinking
link |
01:18:17.320
that are associated with creativity
link |
01:18:18.720
and they don't completely explain creativity.
link |
01:18:21.420
But if you look in the research, the psychology research
link |
01:18:23.760
and the neuroscience research,
link |
01:18:25.300
you'll hear about convergent thinking
link |
01:18:28.400
and divergent thinking.
link |
01:18:30.860
Convergent thinking is taking loose ideas
link |
01:18:34.380
and kind of braiding them together,
link |
01:18:36.680
finding a common thread,
link |
01:18:38.840
synthesizing and organizing those different ideas
link |
01:18:41.920
into some common or specific framework
link |
01:18:45.200
in order to get or create some specific outcome.
link |
01:18:49.140
So convergent thinking is basically the person in the room
link |
01:18:53.340
who's listening to all the ideas and taking them all in.
link |
01:18:56.860
Maybe it's a panel of how should we get a certain product
link |
01:19:02.120
out to market or what are the different motifs
link |
01:19:06.060
that we should include in a piece of music?
link |
01:19:07.840
Or what should we do in terms of re-architecting
link |
01:19:12.360
a given physical space,
link |
01:19:14.080
taking in those different opinions,
link |
01:19:15.580
those different ideas from different people,
link |
01:19:17.520
and then synthesizing them and coming up with one
link |
01:19:21.240
or a small subset of coherent ideas that incorporate
link |
01:19:24.240
some or all of the ones that they heard.
link |
01:19:26.080
Okay, so that's convergent thinking.
link |
01:19:27.360
It doesn't have to involve a panel of people talking to you.
link |
01:19:31.240
I use that as an example of what goes on
link |
01:19:33.640
inside your own head
link |
01:19:34.480
when you are engaging in convergent thinking.
link |
01:19:36.200
You're thinking, well, so-and-so said this,
link |
01:19:38.720
and I think that, and you're kind of braiding them through
link |
01:19:40.680
and trying to get some common theme,
link |
01:19:43.200
some common vector to emerge from that.
link |
01:19:45.960
Divergent thinking on the other hand
link |
01:19:48.320
is best described as brainstorming.
link |
01:19:50.440
It's exploring ideas and continuing to move
link |
01:19:53.120
into the variation and the vastness of ideas
link |
01:19:56.840
in hopes of eventually being able to converge
link |
01:19:59.000
on some novel idea or framework, okay?
link |
01:20:01.640
So these are similar and related,
link |
01:20:03.080
but typically the creativity process
link |
01:20:04.960
involves first brainstorming and divergent thinking,
link |
01:20:08.960
and then in order to arrive at something
link |
01:20:11.240
to actually create something, right?
link |
01:20:12.960
The verb create, not just thinking about
link |
01:20:15.680
what you might create, which occurs during divergent thinking
link |
01:20:18.400
but actually creating something, a specific painting,
link |
01:20:21.200
a specific song, a specific body of literature,
link |
01:20:25.480
a specific scientific project or experiment, and so on.
link |
01:20:29.720
That usually involves convergent thinking.
link |
01:20:32.920
Now, these can be explored in the laboratory
link |
01:20:35.600
and they can be explored in the laboratories
link |
01:20:37.240
through sets of different types of questionnaires
link |
01:20:39.240
or even tasks that you can give human subjects,
link |
01:20:41.200
and this has been done extensively.
link |
01:20:43.280
And across the entire body of data,
link |
01:20:47.000
and by that, I mean literally hundreds of studies
link |
01:20:49.740
that have explored the relationship
link |
01:20:50.900
between particular neural circuits and neurochemicals,
link |
01:20:53.120
convergent and divergent thinking,
link |
01:20:55.720
we can arrive at a principle.
link |
01:20:57.680
And the principle involves a molecule
link |
01:21:01.140
that many of you have heard about before,
link |
01:21:02.460
which is dopamine.
link |
01:21:03.300
Dopamine is a neuromodulator, it's involved in motivation,
link |
01:21:06.160
and it tends to direct our attention to things outside of us
link |
01:21:08.980
but it's also closely related to convergent thinking
link |
01:21:12.140
and divergent thinking and to the creative process.
link |
01:21:15.080
And therefore, it should come as no surprise
link |
01:21:17.620
that diseases of the nervous system, excuse me,
link |
01:21:21.040
such as bipolar disorder,
link |
01:21:23.000
which we've done an episode all about bipolar disorder,
link |
01:21:25.800
or schizophrenia, or mood disorders
link |
01:21:29.720
that impact the levels of dopamine,
link |
01:21:31.760
either make it way, way too high or way, way too low,
link |
01:21:35.840
strongly impact whether or not people will be creative.
link |
01:21:38.520
And I think the short takeaway
link |
01:21:40.120
that makes the most sense in terms of framing this,
link |
01:21:42.600
and we cover this on the episode on bipolar disorder,
link |
01:21:45.360
sometimes called bipolar depression,
link |
01:21:47.160
is that in professions
link |
01:21:48.720
where there's a lot of creativity required
link |
01:21:50.840
in order to succeed, so again,
link |
01:21:52.280
musicians, composers, artists, et cetera,
link |
01:21:55.220
you tend to find more manic depression
link |
01:21:57.880
and manic depression, at least in the manic states,
link |
01:22:00.880
the hyperactive states are correlated
link |
01:22:03.560
with elevated levels of dopamine.
link |
01:22:06.480
Likewise, it has been seen over and over throughout history
link |
01:22:10.680
that individuals that have mild forms of schizophrenia
link |
01:22:13.480
or even full-blown schizophrenia,
link |
01:22:15.640
many famous painters, for instance, or musicians,
link |
01:22:18.920
they are known to have elevated levels of dopamine
link |
01:22:21.580
and they are quite creative.
link |
01:22:22.740
Now, that doesn't mean everybody who's creative
link |
01:22:24.500
has elevated levels of dopamine,
link |
01:22:26.280
although it's likely that their levels of dopamine
link |
01:22:28.500
are at least not diminished.
link |
01:22:29.620
And it doesn't mean that non-creative people
link |
01:22:31.440
have low levels of dopamine,
link |
01:22:32.560
so don't get carried away with the interpretation here.
link |
01:22:34.780
But the point is this.
link |
01:22:36.960
Dopamine levels strongly relate to the probability
link |
01:22:41.080
that you can engage in convergent and divergent thinking,
link |
01:22:43.960
and they do so in the following way.
link |
01:22:45.840
When dopamine levels are high,
link |
01:22:49.000
divergent thinking is more likely.
link |
01:22:51.140
That is, when people have a lot of dopamine circulating
link |
01:22:53.760
in their system,
link |
01:22:54.880
they tend to be very expansive with their ideas.
link |
01:22:57.460
They tend to brainstorm a lot.
link |
01:22:58.680
They tend to be comfortable and even want to,
link |
01:23:02.520
or reflexively, throw out a lot of ideas
link |
01:23:05.260
that sometimes even seem a little disconnected.
link |
01:23:07.860
Some people might think of this
link |
01:23:09.120
as kind of attention deficit, but it's not.
link |
01:23:11.520
It's really the idea of throwing out disparate ideas, right?
link |
01:23:16.040
You know, you hear sometimes, you know,
link |
01:23:17.440
you throw things against the wall and see what sticks.
link |
01:23:19.360
Well, these people, that's obviously an analogy,
link |
01:23:21.960
but people are throwing lots of things against the wall
link |
01:23:25.120
and seeing what stick,
link |
01:23:26.240
and then seeing how the things that stick fit together.
link |
01:23:28.480
That's divergent thinking,
link |
01:23:29.720
and elevations in dopamine
link |
01:23:31.600
tend to increase divergent thinking.
link |
01:23:34.040
However, they tend to do this
link |
01:23:36.160
in kind of an inverted U-shape way.
link |
01:23:38.680
For those of you that are watching on YouTube,
link |
01:23:39.860
I'm just drawing kind of a hump, obviously,
link |
01:23:42.320
and for those of you listening, just imagine a U,
link |
01:23:45.320
the shape of a letter U, and then just flip it upside down
link |
01:23:48.080
so it looks like a bump.
link |
01:23:49.680
Turns out that when dopamine levels are very low,
link |
01:23:51.660
there's a low probability of divergent thinking.
link |
01:23:53.820
When dopamine levels are high, as I mentioned before,
link |
01:23:56.080
there's a high level or probability of divergent thinking.
link |
01:23:59.140
But when dopamine levels go very, very high,
link |
01:24:02.480
then there's, again, a reduction in divergent thinking.
link |
01:24:05.480
In other words, there's a kind of a sweet spot
link |
01:24:07.840
of elevated dopamine for divergent thinking.
link |
01:24:10.320
And again, divergent thinking
link |
01:24:12.040
is critical for the creativity process
link |
01:24:14.480
because creativity, by definition,
link |
01:24:16.600
is taking a novel set of ideas
link |
01:24:19.200
and arranging them in a particular way,
link |
01:24:21.200
or taking existing ideas and arranging them in a novel way
link |
01:24:25.180
that then you eventually converge on some new product,
link |
01:24:28.120
new idea, new song, et cetera.
link |
01:24:30.720
Now, convergent thinking follows a very different pattern.
link |
01:24:34.920
When dopamine levels are high,
link |
01:24:36.480
convergent thinking is not very likely.
link |
01:24:39.560
And when dopamine levels are low,
link |
01:24:41.320
convergent thinking is very likely.
link |
01:24:43.040
So here, using arguably a very reductionist view,
link |
01:24:47.040
we're looking at all of this thing of,
link |
01:24:48.560
we're calling creativity
link |
01:24:49.400
through a very neurosciency reductionist lens,
link |
01:24:51.680
we can say this.
link |
01:24:52.620
The creative process involves going into a state
link |
01:24:55.500
where you're willing to consider a lot of options,
link |
01:24:58.160
many of which seem distantly
link |
01:24:59.940
or not even connected to one another.
link |
01:25:01.660
And dopamine facilitates that divergent thinking state
link |
01:25:04.960
in which you are perfectly happy
link |
01:25:06.440
and in fact experience a kind of a joy or elation,
link |
01:25:10.960
a comfort and a pleasure
link |
01:25:13.560
in organizing all these different ideas
link |
01:25:15.420
that to anyone else might seem not that related.
link |
01:25:19.140
But when your dopamine levels are elevated,
link |
01:25:21.200
these all seem like great ideas
link |
01:25:22.440
and that maybe there are connections there, right?
link |
01:25:24.360
You're not accepting all of them as true and valid
link |
01:25:26.400
and interesting and combining them,
link |
01:25:28.300
but there's this idea that it's worth entertaining
link |
01:25:31.920
the possibility, at least for moments.
link |
01:25:34.400
And then as dopamine levels drop,
link |
01:25:38.020
there is the process of convergent thinking,
link |
01:25:39.800
which is taking options down off the wall,
link |
01:25:42.800
saying, no, no, that doesn't fit with that,
link |
01:25:45.300
doesn't fit with that,
link |
01:25:46.140
but ah, that fits with that and that can work.
link |
01:25:48.340
That feels right or sounds right or looks right.
link |
01:25:52.240
That's the creativity process.
link |
01:25:54.040
And so I think this is not just important
link |
01:25:56.820
for understanding cannabis,
link |
01:25:58.280
which we'll get back to in a moment,
link |
01:25:59.720
but it's important for understanding creativity
link |
01:26:02.080
and brain states in general.
link |
01:26:03.840
Brain states are not, as we would say,
link |
01:26:05.700
a square wave function.
link |
01:26:06.600
You don't just drop into a trench of creativity.
link |
01:26:08.640
Creativity is not an event, it's a process.
link |
01:26:11.680
And what I'm telling you is that it's a process
link |
01:26:14.120
that involves divergent thinking and consideration,
link |
01:26:16.080
a lot of different ideas.
link |
01:26:17.080
That's correlated with high, but not too high dopamine.
link |
01:26:20.920
And then one has to transition into a state
link |
01:26:24.640
of convergent thinking,
link |
01:26:25.800
which is really homing in on the ideas
link |
01:26:28.320
that seem to have validity or that could have validity
link |
01:26:31.020
and getting rid of everything else.
link |
01:26:32.400
And that's associated with low dopamine.
link |
01:26:34.480
It's more about logical implementation and consideration
link |
01:26:37.680
as opposed to thinking about and considering everything.
link |
01:26:40.880
So let's now return to the question of whether or not
link |
01:26:42.960
cannabis and its different components increase creativity.
link |
01:26:48.160
And when you look at the literature on this,
link |
01:26:50.240
you find studies that very clearly point to a yes,
link |
01:26:53.840
it increases creativity.
link |
01:26:55.640
And it's not surprising therefore
link |
01:26:57.500
that cannabis can increase dopamine transmission,
link |
01:27:00.960
that is dopamine levels, in certain brain areas,
link |
01:27:03.360
in particular brain areas involved in thinking and planning.
link |
01:27:06.720
Okay, so cannabis increases dopamine in these areas,
link |
01:27:09.400
elevated dopamine increases divergent thinking,
link |
01:27:11.960
and divergent thinking is associated with creativity.
link |
01:27:14.320
And there are studies that support the idea
link |
01:27:16.360
that cannabis can increase creativity.
link |
01:27:20.220
However, there are at least as many studies
link |
01:27:23.700
that say that cannabis does not increase creativity,
link |
01:27:26.720
that cannabis increases consideration of multiple ideas,
link |
01:27:30.060
perhaps through elevation of dopamine and related systems,
link |
01:27:33.820
but that ultimately the ideas that converge from that
link |
01:27:36.840
are not truly creative ideas.
link |
01:27:38.360
At least they don't make the criteria
link |
01:27:39.680
for creative brainstorming and extraction of ideas
link |
01:27:42.880
that are truly novel.
link |
01:27:44.080
So it doesn't increase creativity.
link |
01:27:46.480
So which one is it?
link |
01:27:48.040
Well, fortunately, there's an entirely distinct set
link |
01:27:50.920
of literature that has taken all the other literature
link |
01:27:53.420
into consideration, and here's where we arrive.
link |
01:27:56.320
So there's a really nice study
link |
01:27:57.560
that explored creativity in cannabis users,
link |
01:28:00.560
and we will provide a link to the study.
link |
01:28:02.760
First author is Emily LaFrance,
link |
01:28:04.540
and the title of the paper is somewhat amusing
link |
01:28:08.160
in its own right, which is, it starts with a question.
link |
01:28:10.760
Inspired by Mary Jane, of course,
link |
01:28:12.560
Mary Jane being one of the kind of old school versions
link |
01:28:15.400
or ways of talking about cannabis or marijuana.
link |
01:28:18.360
Nowadays, people refer to it mainly as pot,
link |
01:28:20.620
has other names too, of course.
link |
01:28:22.400
And the title of the paper is Inspired by Mary Jane,
link |
01:28:24.880
Mechanisms Underlying Enhanced Creativity in Cannabis Users.
link |
01:28:28.200
And I really like this study for a couple of reasons.
link |
01:28:30.820
First of all, they looked at people who did not use cannabis
link |
01:28:36.240
as well as people who use cannabis.
link |
01:28:38.660
So they had two different groups,
link |
01:28:39.920
but they did not evaluate creativity of the cannabis users
link |
01:28:44.760
while they were under the influence of cannabis.
link |
01:28:47.200
They looked at the level of creativity
link |
01:28:50.520
in these cannabis users
link |
01:28:52.560
when they were not under the influence of cannabis
link |
01:28:55.380
and asked whether or not their ability to be creative
link |
01:28:58.280
was enhanced by cannabis.
link |
01:28:59.680
Now we're going to compare this to studies
link |
01:29:01.840
in which people come into the laboratory
link |
01:29:03.880
and actually use cannabis,
link |
01:29:05.040
and then they evaluate creativity under that context.
link |
01:29:08.560
But this study has some unique takeaways
link |
01:29:10.640
that I think are really interesting.
link |
01:29:11.880
First of all, they did, yes,
link |
01:29:14.400
see evidence for enhanced creativity.
link |
01:29:16.880
And when I say enhanced creativity,
link |
01:29:18.360
I mean within the context of this divergent thinking thing
link |
01:29:21.720
that I talked about a moment ago.
link |
01:29:24.480
And when I say enhanced,
link |
01:29:25.580
I mean significantly greater than in non-users,
link |
01:29:28.020
so people that don't use cannabis.
link |
01:29:29.940
So right now I can imagine that all the cannabis users
link |
01:29:32.120
are cheering, yes, cannabis increases creativity,
link |
01:29:35.160
makes people more creative than they would be otherwise.
link |
01:29:37.760
Well, this is interesting.
link |
01:29:39.420
We have to ask ourselves how that was accomplished.
link |
01:29:42.960
And it turns out that one of the major ways
link |
01:29:44.640
in which it was accomplished is that cannabis users,
link |
01:29:47.600
even if they are not under the influence of cannabis,
link |
01:29:51.040
are far more open to novel ideas,
link |
01:29:54.680
and they have a more explorative and sort of reduced anxiety
link |
01:29:58.960
or I should say lower anxiety mode of thinking
link |
01:30:01.440
when they explore novel ideas,
link |
01:30:02.840
which is essential for divergent thinking.
link |
01:30:04.800
So they observe both enhanced divergent and convergent
link |
01:30:08.880
creative type thinking in cannabis users.
link |
01:30:12.920
And the source of that, they conclude,
link |
01:30:16.440
is, and here I'll just quote,
link |
01:30:18.500
"'Cannabis users' higher levels of openness to experience
link |
01:30:21.280
are responsible for their enhanced self-reported creativity
link |
01:30:23.740
and convergent thinking test performance.'"
link |
01:30:26.040
So it's not necessarily that cannabis is increasing
link |
01:30:29.800
the capacity of the brain areas
link |
01:30:32.100
that are associated with creativity,
link |
01:30:33.920
but rather cannabis appears to be increasing in openness
link |
01:30:39.000
and probably doing that in part through lowering anxiety
link |
01:30:42.480
in particular people.
link |
01:30:44.420
And that openness is leading to inclusion of more ideas
link |
01:30:48.600
during the divergent thinking process, right?
link |
01:30:51.160
They're willing to consider throwing up more things
link |
01:30:53.300
on the wall to see if they stick, so to speak.
link |
01:30:55.920
So in their conclusions, they have a really nice statement.
link |
01:30:58.320
Again, I'll just read from the paper
link |
01:31:00.160
because they said it better than I ever could.
link |
01:31:02.320
Quote, "'While mainstream media has propagated the idea
link |
01:31:05.000
that cannabis expands the mind and enhances creativity,
link |
01:31:08.440
our results show the link between cannabis and creativity
link |
01:31:10.960
is largely a spurious correlation.'"
link |
01:31:13.640
Meaning that it's not the case
link |
01:31:16.040
that cannabis increases creativity,
link |
01:31:20.380
but, and I inserted the but in this quote,
link |
01:31:25.400
"'But driven by differences in personality
link |
01:31:28.560
that are related to cannabis use.
link |
01:31:30.600
For example, openness to experience
link |
01:31:32.520
that are related to both cannabis use
link |
01:31:34.240
and augmented creativity.'"
link |
01:31:36.780
This is a real chicken egg argument.
link |
01:31:38.680
What do I mean by that?
link |
01:31:39.840
What I mean is this paper finds
link |
01:31:42.560
that people who are more open to experience
link |
01:31:46.040
are more likely to use cannabis
link |
01:31:48.320
and people who use cannabis
link |
01:31:49.920
are going to be more open to new experiences.
link |
01:31:53.440
And that combination of features, openness to experience
link |
01:31:56.840
and what that openness to new experiences brings
link |
01:32:00.440
enhances the convergent and divergent thinking
link |
01:32:03.680
that is characteristic of the creative process.
link |
01:32:06.760
So in short, cannabis increases creativity,
link |
01:32:10.040
but through changes in personality
link |
01:32:12.420
that tap into the creative process
link |
01:32:14.720
rather than directly impacting the neural circuits
link |
01:32:18.300
that for instance, turn on creativity.
link |
01:32:21.080
And I have to say this study is really important
link |
01:32:24.080
because by exploring cannabis users
link |
01:32:28.360
not while under the influence of cannabis,
link |
01:32:30.880
they were able to tap into this very important,
link |
01:32:33.960
what I believe to be fact.
link |
01:32:36.060
Because if you think about a study
link |
01:32:37.520
in which you would have one group using cannabis
link |
01:32:40.440
and another group not using cannabis
link |
01:32:42.080
and then you give them some tasks that taps into creativity,
link |
01:32:44.880
you will see effects and very likely you'll see effects
link |
01:32:47.360
where cannabis might even increase divergent,
link |
01:32:49.280
convergent thinking and creativity.
link |
01:32:51.040
Those results have actually been published
link |
01:32:52.320
many times before.
link |
01:32:53.800
But given the varied effects of cannabis and THC
link |
01:32:56.640
that we talked about earlier
link |
01:32:57.520
through all that complex signaling stuff,
link |
01:32:59.620
you can imagine that there will also be other studies
link |
01:33:01.920
and in fact, there are
link |
01:33:03.280
where divergent and convergent thinking
link |
01:33:06.040
and creativity is not assisted by cannabis
link |
01:33:09.200
and might even be reduced by ingesting cannabis.
link |
01:33:11.940
However, if one considers that divergent thinking
link |
01:33:14.800
is absolutely crucial to the creativity process
link |
01:33:18.640
and the range of things that one will explore
link |
01:33:21.660
will be enhanced by openness
link |
01:33:24.280
and by reduced levels of anxiety.
link |
01:33:26.820
So a willingness to explore different options,
link |
01:33:28.760
some of which might seem completely crazy
link |
01:33:31.160
and cannabis increases the personality types
link |
01:33:34.260
and reduces the anxiety that create that sense of openness.
link |
01:33:38.080
Well, then it makes perfect sense
link |
01:33:39.340
why cannabis would increase creativity
link |
01:33:42.600
in certain individuals, but not directly.
link |
01:33:45.280
And this study, the one I just referred to,
link |
01:33:47.940
which I should say was published
link |
01:33:49.180
in the journal, Consciousness and Cognition,
link |
01:33:50.920
and again, we'll provide a link to it,
link |
01:33:53.040
did a wonderful job of teasing out this impact of cannabis
link |
01:33:57.800
on personality, which then impacts creativity.
link |
01:34:01.280
So if somebody asks you, or if you're wondering,
link |
01:34:03.420
or if you feel like cannabis increases creativity,
link |
01:34:06.560
in some sense, the answer is yes,
link |
01:34:08.080
but the answer is yes,
link |
01:34:09.080
because of the ways that it shapes openness to new ideas
link |
01:34:13.120
and can, I should say can, because not in everybody,
link |
01:34:15.980
but can in some individuals reduce anxiety.
link |
01:34:19.180
What this means is that if you are somebody
link |
01:34:21.960
who experiences anxiety or increased levels of focus
link |
01:34:27.560
from cannabis, regardless of the strain,
link |
01:34:30.880
and here I have to imagine people
link |
01:34:31.960
are exploring different strains
link |
01:34:33.320
if they're exploring them at all,
link |
01:34:35.500
exploring different modes of delivery,
link |
01:34:36.840
smoking or ingestible, et cetera,
link |
01:34:38.700
if you're somebody who experiences anxiety,
link |
01:34:41.640
it's very likely that you won't have the increased openness
link |
01:34:47.220
to experience and divergent ideas
link |
01:34:49.420
that will facilitate creativity.
link |
01:34:50.840
However, if you are somebody
link |
01:34:52.040
who achieves heightened levels of relaxation
link |
01:34:54.700
and reduced levels of anxiety from cannabis,
link |
01:34:57.580
regardless of which strain we happen to be talking about,
link |
01:35:00.400
well then, yes, it will position you
link |
01:35:03.060
to be in a heightened state of creativity,
link |
01:35:05.720
at least as defined by convergent and divergent thinking.
link |
01:35:08.520
One of the more characteristic,
link |
01:35:10.160
or I should say stereotype qualities
link |
01:35:13.320
of people that smoke a lot of marijuana
link |
01:35:15.380
or ingest cannabis through other means
link |
01:35:18.100
is their changed patterns of speech.
link |
01:35:20.320
In fact, there's a kind of a lore in the clinical realm
link |
01:35:25.500
that you can predict or get some strong indication
link |
01:35:29.400
as to whether or not somebody is a cannabis user
link |
01:35:31.720
or a pot smoker based on their voice
link |
01:35:34.960
and their particular tone of voice
link |
01:35:37.200
and their lack of inflection.
link |
01:35:39.240
There's a lot of speculation here,
link |
01:35:40.680
but fortunately it's been studied.
link |
01:35:42.360
So I'd like to discuss now
link |
01:35:43.640
whether or not cannabis can impact patterns of speech,
link |
01:35:46.720
both acutely, meaning while under the influence of cannabis
link |
01:35:50.080
and over time in chronic cannabis users.
link |
01:35:53.640
And when I say chronic cannabis use,
link |
01:35:55.160
I want to be very specific what I mean.
link |
01:35:56.800
Chronic cannabis use does not necessarily mean
link |
01:35:59.000
that people are smoking cannabis
link |
01:36:00.240
or ingesting cannabis every day.
link |
01:36:02.080
Although certainly if they are,
link |
01:36:03.040
that qualifies as chronic use.
link |
01:36:05.360
Chronic use is regular use over time
link |
01:36:07.760
of anywhere from twice a week or more.
link |
01:36:10.200
So using cannabis once a month
link |
01:36:11.820
would not be considered chronic use,
link |
01:36:13.320
even if it's for many, many years.
link |
01:36:15.520
Using cannabis or ingesting cannabis in some way or form
link |
01:36:18.640
twice a week would be considered chronic use.
link |
01:36:21.400
And then of course,
link |
01:36:22.240
some of you out there are going to ask me to split hairs
link |
01:36:24.040
and say, well, what if somebody uses it twice a month?
link |
01:36:26.560
Well, listen, the clinical literature
link |
01:36:28.860
and the scientific literature don't get that specific.
link |
01:36:31.460
And of course there are an infinite number of ways
link |
01:36:33.320
to arrange one's cannabis use,
link |
01:36:35.600
everything from zero, none at all,
link |
01:36:37.440
to constantly every day, all day and everywhere in between.
link |
01:36:41.160
But think of chronic use as twice a week or more.
link |
01:36:44.960
Think of occasional use as less than that
link |
01:36:47.600
and realize that within the realm of chronic use, excuse me,
link |
01:36:51.320
that or more can be anywhere from twice a week
link |
01:36:54.360
to every day to just in the evenings, et cetera.
link |
01:36:58.860
The effects of chronic use of cannabis,
link |
01:37:02.600
as I just defined it, on speech have been studied
link |
01:37:07.920
because of this characteristic drawing out
link |
01:37:11.560
of certain syllables, a slowing of speech,
link |
01:37:14.660
and in many cases, a total change or alteration
link |
01:37:19.100
in the way that people speak and use language,
link |
01:37:23.120
both when under the influence of cannabis
link |
01:37:25.620
and when not under the influence of cannabis,
link |
01:37:28.020
if they are chronic users.
link |
01:37:29.840
And here, we really want to distinguish between THC and CBD
link |
01:37:33.900
and just make it really simple and say that CBD
link |
01:37:37.600
is not responsible for most of the psychoactive effects
link |
01:37:41.260
of cannabis, whereas THC is.
link |
01:37:43.760
And again, the ratio of CBD to THC
link |
01:37:45.480
is going to be relevant there,
link |
01:37:47.160
but let's just think about cannabis and THC
link |
01:37:50.000
as one in the same for this portion of the discussion,
link |
01:37:52.840
realizing that, of course,
link |
01:37:53.680
they are not exactly the same thing.
link |
01:37:55.640
There's an excellent study entitled,
link |
01:37:57.220
adults with history of recreational cannabis use
link |
01:37:59.680
have altered speech production.
link |
01:38:01.840
And we will provide a link to that.
link |
01:38:02.840
First author, Adam Vogel, really liked this paper.
link |
01:38:06.040
It was published in the journal,
link |
01:38:07.660
Drug and Alcohol Dependence.
link |
01:38:09.540
We will provide a link to it for you
link |
01:38:11.860
if you'd like to peruse it in more detail.
link |
01:38:14.320
The title itself, adults with a history
link |
01:38:16.600
of recreational cannabis use have altered speech production
link |
01:38:20.040
tells you pretty much everything you need to know,
link |
01:38:22.240
except there's some important nuance in here
link |
01:38:24.720
because as I mentioned earlier,
link |
01:38:26.840
people who smoke sativa varieties of cannabis
link |
01:38:30.160
oftentimes will become more talkative, much more talkative.
link |
01:38:34.400
However, whether or not people tend to rely
link |
01:38:37.320
on sativa cannabis use or indica cannabis use,
link |
01:38:42.820
there is a very consistent finding
link |
01:38:44.920
that people who are chronic users,
link |
01:38:46.280
again, twice a week or more,
link |
01:38:48.040
recreational use or medicinal use,
link |
01:38:50.700
undergo pretty profound changes in the way that they speak,
link |
01:38:54.320
but in a very specific set of ways.
link |
01:38:57.880
Now, first of all,
link |
01:38:59.720
the changes in speech shouldn't surprise us at all
link |
01:39:02.600
because both sativa varieties of cannabis
link |
01:39:05.720
and indica varieties of cannabis
link |
01:39:08.100
impact those brain centers involved in movement,
link |
01:39:10.800
the basal ganglia, remember the go-no-go circuitry,
link |
01:39:13.660
the circuitry that makes you want to do things
link |
01:39:15.480
and the circuitry that makes you want to withhold action,
link |
01:39:18.080
and it tends to shift the body and brain
link |
01:39:21.040
toward more inaction.
link |
01:39:23.940
And cannabis impacts CB1 receptors in the cerebellum,
link |
01:39:27.180
which is involved in motor planning, execution, and balance.
link |
01:39:31.120
So regardless of whether or not people are using cannabis
link |
01:39:35.000
of the sativa or the indica variety,
link |
01:39:37.520
there are disruptions in motor circuitry.
link |
01:39:39.480
And as you may have heard,
link |
01:39:40.900
if you listen to our episode with Rockefeller professor,
link |
01:39:44.480
Dr. Eric Jarvis, who works on speech and movement,
link |
01:39:48.040
speech is movement, right?
link |
01:39:50.640
The movements of the mouth, the movements of the hands,
link |
01:39:53.160
those are intimately related in terms of our speech.
link |
01:39:55.840
In fact, the centers of the brain involved in hand movements
link |
01:39:58.920
are part of the speech areas and vice versa.
link |
01:40:02.320
Eric actually pointed out
link |
01:40:03.200
that if you put your hands behind your back,
link |
01:40:05.040
provided you normally do have use of your hands,
link |
01:40:07.280
it actually will reduce your fluidity of speech.
link |
01:40:10.280
And so I'm going to put them back in front of me now.
link |
01:40:13.740
The point is smoking marijuana or consuming marijuana
link |
01:40:18.280
by edible changes one's speech
link |
01:40:21.520
and does it in a very specific way.
link |
01:40:23.040
And in this study by Adam Vogel and colleagues,
link |
01:40:26.640
they explored a huge different variety of aspects of speech.
link |
01:40:30.460
And this can be done using spectral processing,
link |
01:40:32.640
which is fancy nerd speak
link |
01:40:34.200
for looking at how much inflection there is
link |
01:40:36.440
or looking at how long people hold vowels
link |
01:40:38.720
or consonants, et cetera.
link |
01:40:39.860
And again, these are people
link |
01:40:40.840
not under the influence of cannabis,
link |
01:40:42.800
but rather people who tend to be
link |
01:40:45.000
under the influence of cannabis
link |
01:40:46.200
when not participating in the study.
link |
01:40:48.200
In other words, chronic recreational cannabis users.
link |
01:40:51.360
So what are the two major shifts that cannabis causes
link |
01:40:54.680
on our patterns of speech?
link |
01:40:56.080
Well, the first one is a change
link |
01:40:57.920
in what's called spectral tilt.
link |
01:40:59.900
And that's fancy nerd speak for vocal effort and intensity.
link |
01:41:03.740
So I'm not a pot smoker, I confess,
link |
01:41:08.440
but if I were to say the sentence,
link |
01:41:11.820
vocal effort and intensity
link |
01:41:13.400
are important components of speech.
link |
01:41:16.180
That's the way I would say that sentence
link |
01:41:17.940
if I was striving to enunciate very carefully
link |
01:41:20.500
and to accent certain words and syllables.
link |
01:41:24.180
A pot smoker or somebody who uses
link |
01:41:27.280
recreational cannabis fairly often
link |
01:41:29.960
would have reduced spectral tilt,
link |
01:41:32.480
AKA vocal effort and intensity,
link |
01:41:34.920
and might say spectral tilt is vocal effort and intensity,
link |
01:41:39.220
and it differed between groups
link |
01:41:40.440
and appeared to change in line
link |
01:41:41.660
with the duration of abstinence from cannabis use.
link |
01:41:44.840
That I think is not a far cry
link |
01:41:47.080
from the change in spectral tilt that they observed here.
link |
01:41:49.520
In addition, there are changes in verbal timing.
link |
01:41:54.080
That is pronunciation of words and accenting
link |
01:41:57.660
particular syllables of words
link |
01:42:00.200
in people that consume cannabis or smoke cannabis.
link |
01:42:04.680
So rather than emphasize particular words within a sentence,
link |
01:42:09.280
so again, I'll just use a sentence from the paper
link |
01:42:11.260
so that you can gain more knowledge from the paper.
link |
01:42:13.500
Cannabis, and I'll say it the way that I would say it,
link |
01:42:16.000
since I'm not a cannabis user.
link |
01:42:18.960
Cannabis, marijuana, is the most commonly used
link |
01:42:21.440
illicit drug in the world
link |
01:42:22.560
with approximately 4% of adults
link |
01:42:24.720
aged 15 to 64 years reporting recent use.
link |
01:42:27.640
And the citation is from the United Nations
link |
01:42:29.720
Office on Drugs and Crime, 2019.
link |
01:42:33.000
So that would be the way
link |
01:42:34.020
that I would typically read that sentence.
link |
01:42:35.900
And having gone into the data on this paper
link |
01:42:38.440
and of course evaluated references therein
link |
01:42:41.120
and listened to some of the spectral analysis
link |
01:42:44.180
that they include as data,
link |
01:42:46.160
you can literally go into these papers online
link |
01:42:47.940
and hear recordings of people who are cannabis users
link |
01:42:51.240
or non-cannabis users.
link |
01:42:52.760
And I'll try and give you a clear sense
link |
01:42:55.280
without picking an extreme example
link |
01:42:57.720
of how somebody who's a fairly consistent
link |
01:43:00.720
or even occasional cannabis user
link |
01:43:02.520
might read that very same sentence.
link |
01:43:06.480
Cannabis, marijuana, is the most commonly used
link |
01:43:08.960
illicit drug in the world
link |
01:43:10.360
with approximately 4% of adults
link |
01:43:12.600
aged 15 to 64 years reporting recent use.
link |
01:43:15.840
And the citation comes from the United Nation
link |
01:43:17.960
Office on Drugs and Crime, 2019.
link |
01:43:20.960
Now you'll notice that wasn't a dramatic difference.
link |
01:43:23.440
And of course I could have taken the liberty
link |
01:43:25.440
to pick an extreme example of the sort
link |
01:43:27.180
that they did occasionally observe
link |
01:43:29.480
in evaluating subjects for this paper.
link |
01:43:31.720
I could have said something like cannabis,
link |
01:43:34.060
marijuana is the most commonly used illicit drug,
link |
01:43:36.400
but frankly that would have been
link |
01:43:37.640
selecting an outlier example.
link |
01:43:39.320
And I don't want to do that.
link |
01:43:40.200
I don't want to skew the data as they say.
link |
01:43:42.680
Rather, if you heard the first time I read the sentence
link |
01:43:47.040
and the second time I read the sentence,
link |
01:43:48.280
what's mainly different is the difference
link |
01:43:51.880
in the amount of enunciation
link |
01:43:54.200
and accenting of particular words
link |
01:43:56.080
and symbols within a sentence.
link |
01:43:57.480
So the total content that's delivered is exactly the same.
link |
01:44:00.360
And while I wasn't measuring my pace,
link |
01:44:02.560
the overall rate of communication is essentially the same,
link |
01:44:07.360
but there's less sort of lilting
link |
01:44:09.400
and falling of the voice and less accenting.
link |
01:44:11.240
That's the major consistent effect of cannabis use.
link |
01:44:14.320
Now, of course, there are examples of people
link |
01:44:16.320
who are using a lot of cannabis
link |
01:44:18.640
and it impacts brain centers involved in movement and speech
link |
01:44:21.720
so much so that they really do have
link |
01:44:23.840
the really drawn out kind of nah.
link |
01:44:26.560
And oftentimes this will be detected in the laugh.
link |
01:44:29.080
You know, there's this sort of stereotypical stoner laugh
link |
01:44:31.840
as it's sometimes called rather than say ha ha ha,
link |
01:44:34.340
or that's a fake laugh, obviously.
link |
01:44:36.720
It's hard to make myself laugh
link |
01:44:37.860
if something's not actually funny.
link |
01:44:38.920
I'll have to think of something funny
link |
01:44:40.360
when people will say ha,
link |
01:44:41.480
like that's a bit more of the way I might laugh,
link |
01:44:43.360
like ha, sort of the inspiratory laugh
link |
01:44:45.840
or the ha, which is expiratory laugh.
link |
01:44:48.460
People who use cannabis chronically
link |
01:44:50.200
will often do the ah, right,
link |
01:44:52.180
which is sort of the back of the throat, ah.
link |
01:44:54.560
It's sort of the, it's neither inspiratory
link |
01:44:57.240
nor expiratory laugh.
link |
01:44:58.400
And believe it or not, there's an entire literature
link |
01:45:00.020
on inspiratory inhaling versus expiratory laughs.
link |
01:45:03.000
And there's also a literature on cannabis
link |
01:45:06.700
altering the pattern of inspiratory and expiratory laughs.
link |
01:45:09.400
It almost sounds like a sarcastic laugh
link |
01:45:11.780
when in fact they may not be feeling sarcastic at all.
link |
01:45:14.320
And I have a very close friend and colleague
link |
01:45:16.880
who's a phenomenal neurosurgeon and neuroscientist
link |
01:45:19.260
by the name of Dr. Eddie Chang.
link |
01:45:20.480
He's the chair of neurosurgery at UCSF and his lab
link |
01:45:23.800
and him are expert in the study
link |
01:45:25.820
of neuroscience controlling language and speech.
link |
01:45:29.560
And he often tells me that he can predict
link |
01:45:34.100
with almost certainty whether or not somebody
link |
01:45:36.240
is a regular cannabis user
link |
01:45:38.220
based not just on the patterns of speech that they use,
link |
01:45:42.280
but even just by recording specific neurons in their brain
link |
01:45:45.300
that underlie the laugh reflex
link |
01:45:47.860
and certain patterns of speech.
link |
01:45:49.440
So this idea that cannabis use changes your ability
link |
01:45:52.540
to speak and enunciate clearly does appear to be true.
link |
01:45:55.820
And the stereotype that cannabis use
link |
01:45:58.560
tends to create more of a drawl
link |
01:46:00.640
or kind of a, if you will, a laziness in the laugh
link |
01:46:04.800
and some of the reflexive enunciations that people use
link |
01:46:08.000
does also appear to be true.
link |
01:46:09.260
And I say all that of course with the caveat
link |
01:46:11.940
that many people out there will know individuals
link |
01:46:15.020
or perhaps you yourselves are individuals
link |
01:46:17.960
that may use cannabis, but that have incredible articulation
link |
01:46:22.180
probably better than mine
link |
01:46:23.300
and better than other people out there
link |
01:46:24.660
who speak for a living.
link |
01:46:25.940
So I'm not saying that 100% of people
link |
01:46:28.020
that use cannabis regularly can't speak well or clearly.
link |
01:46:31.300
That's simply not what I'm saying.
link |
01:46:32.980
And I don't want to communicate that idea at all.
link |
01:46:35.520
But it is the case that people who are regular cannabis users
link |
01:46:38.740
are impacting the neural circuits involved
link |
01:46:40.740
in movement, movement also controls speech
link |
01:46:43.100
and therefore cannabis is impacting speech.
link |
01:46:46.380
Now I'd like to turn our attention to whether or not
link |
01:46:48.340
cannabis can increase sexual activity,
link |
01:46:51.100
sexual desire and or sexual function.
link |
01:46:54.460
So we're going to be talking about libido,
link |
01:46:56.420
about sexual desire and about effects of cannabis
link |
01:46:59.300
on hormones.
link |
01:47:00.600
And while this might sound like a discussion
link |
01:47:02.660
that's purely oriented towards recreational use of cannabis,
link |
01:47:06.080
that is people using cannabis to heighten
link |
01:47:08.380
or increase their sense of arousal for sexual activity.
link |
01:47:12.020
It actually ventures into the clinical realm too,
link |
01:47:14.540
meaning there have been excellent peer-reviewed studies
link |
01:47:17.600
that I'll describe to you in a moment
link |
01:47:19.100
exploring the use of cannabis or THC more specifically
link |
01:47:23.060
for something called hypoactive sexual desire disorder,
link |
01:47:26.980
which refers to a persistent or recurrent deficiency
link |
01:47:30.420
or absence of sexual fantasies and thoughts
link |
01:47:32.740
and or desire for or receptivity to sexual activity.
link |
01:47:37.300
This is a disorder that is fairly common,
link |
01:47:39.620
anywhere from six to 9% of people, both males and females.
link |
01:47:43.580
It used to be considered higher prevalence in females
link |
01:47:47.580
than in males, but now those numbers seem to be evening out.
link |
01:47:50.760
So basically there are anywhere from six to 9%
link |
01:47:54.440
of people out there who have very diminished sexual desire.
link |
01:47:58.700
And so a number of those people are interested
link |
01:48:01.260
in figuring out ways to increase their amount
link |
01:48:02.980
of sexual desire.
link |
01:48:04.260
And of course there are people in the general population
link |
01:48:07.180
who may not have hypoactive sexual desire disorder
link |
01:48:10.660
who are interested in using cannabis recreationally
link |
01:48:13.340
in order to increase their desire for
link |
01:48:15.580
or their experience of sexual activity.
link |
01:48:18.540
Now, first we have to acknowledge that sexual desire
link |
01:48:21.140
and activity is a complex set of processes,
link |
01:48:24.100
meaning it's not just one event, sex, the verb,
link |
01:48:27.660
it involves arousal, it involves sex, the verb,
link |
01:48:31.740
and it involves a whole set of mindsets and emotional states
link |
01:48:35.340
that vary tremendously between individuals.
link |
01:48:37.780
But once again, we can distill out a few basic principles
link |
01:48:41.980
and I should emphasize these are by no means
link |
01:48:44.380
the only chemicals in neural circuits involved
link |
01:48:46.500
in the sexual arc, as we'll call it,
link |
01:48:48.940
desire, the act of sex, et cetera,
link |
01:48:51.720
but they are central to it, they are vital to it.
link |
01:48:54.260
They would be considered what I would call necessary
link |
01:48:56.980
but not sufficient, okay?
link |
01:48:58.380
So there'll be other chemicals involved too,
link |
01:49:00.260
but the main chemicals in neural circuits
link |
01:49:01.760
are those involved in dopamine.
link |
01:49:03.540
So the so-called mesolimbic reward pathway,
link |
01:49:05.820
in particular a brain structure called nucleus accumbens,
link |
01:49:08.740
which we'll talk about more in a moment,
link |
01:49:10.360
is vital to all motivated behaviors
link |
01:49:13.220
and to the seeking out of all particular types
link |
01:49:16.340
of pleasurable experiences and sex is no exception.
link |
01:49:18.960
So when we hear that the nucleus accumbens is activated,
link |
01:49:21.980
that almost always means that dopamine has been released
link |
01:49:24.820
in that area and other areas of the brain and body,
link |
01:49:27.540
and we can consider dopamine central
link |
01:49:29.500
to the desire for pursuit of end act of sex.
link |
01:49:34.860
In addition to that, there are molecules like oxytocin,
link |
01:49:38.500
which are involved in pair bonding,
link |
01:49:40.020
and they're going to be neural circuits
link |
01:49:41.140
specific to the oxytocin circuitry,
link |
01:49:43.580
but in terms of sexual arousal and sexual behavior,
link |
01:49:47.380
it's really the dopamine pathway in this nucleus accumbens,
link |
01:49:50.100
which are especially vital.
link |
01:49:52.720
That allows us to address the question,
link |
01:49:54.560
does cannabis increase, decrease,
link |
01:49:58.840
or have no effect on sexual desire
link |
01:50:01.660
and or the ability to have sex?
link |
01:50:04.660
And therein, we will find some very interesting answers
link |
01:50:08.700
because once again, it will point to the fact
link |
01:50:12.180
that the effects of cannabis on different individuals
link |
01:50:15.940
can be highly divergent, meaning in one set of individuals,
link |
01:50:20.260
cannabis will make them far less anxious,
link |
01:50:22.780
and in another set of individuals,
link |
01:50:24.380
the same strain of cannabis at the same dosage
link |
01:50:26.740
will make them extremely anxious,
link |
01:50:28.320
the same can be said also of sexual activity.
link |
01:50:31.940
And this was beautifully illustrated
link |
01:50:33.980
in the context of sexual desire
link |
01:50:35.860
in the journal Psychopharmacology
link |
01:50:37.820
in a paper published in 2017.
link |
01:50:39.420
The title of this paper is Individual Prolactin Reactivity
link |
01:50:43.300
Modulates Response of Nucleus Accumbens to Erotic Stimuli
link |
01:50:46.940
During Acute Cannabis Intoxication, an FMRI pilot study.
link |
01:50:51.420
So I'll give a little bit of definition
link |
01:50:53.580
to some of the terms in the title
link |
01:50:54.700
that will make it easier for you to understand the paper,
link |
01:50:57.620
but then I'll just march through the results
link |
01:50:59.100
because they are very straightforward and easy to understand
link |
01:51:01.820
and very interesting.
link |
01:51:03.380
FMRI is just functional magnetic resonance imaging.
link |
01:51:06.540
So basically, subjects in this experiment
link |
01:51:09.260
came into the laboratory.
link |
01:51:12.020
They were either people who had not used cannabis before
link |
01:51:16.180
or who had used cannabis before.
link |
01:51:19.180
They were placed into a brain scanner,
link |
01:51:20.940
one of these FMRI devices.
link |
01:51:22.660
It looks like a tube that people are backed up into
link |
01:51:26.080
and then they can view images in there
link |
01:51:27.460
and their brain can be imaged
link |
01:51:28.820
without having to remove any skull or drill into the skull,
link |
01:51:31.180
no neurosurgery.
link |
01:51:33.700
The participants in this study were grouped
link |
01:51:35.820
according to whether or not they'd experienced
link |
01:51:37.660
any aphrodisiac effects
link |
01:51:39.580
during the intoxication with cannabis.
link |
01:51:41.740
So that would be the first group, group A.
link |
01:51:43.740
They literally called it group A for aphrodisiac.
link |
01:51:45.940
And then the second group,
link |
01:51:47.060
and this is the only thing I don't like about this study,
link |
01:51:48.820
is rather than call it group B,
link |
01:51:50.300
they called them group non-A,
link |
01:51:52.660
which just gets a little confusing.
link |
01:51:54.700
So I'll try and simplify all this.
link |
01:51:56.420
There are two groups
link |
01:51:57.820
and one group experiences sexual arousal
link |
01:52:02.180
when under the influence of cannabis, THC specifically.
link |
01:52:06.260
The other group does not.
link |
01:52:07.620
And it turns out this is a very commonly observed
link |
01:52:10.620
divergence of effects of cannabis.
link |
01:52:14.260
Some people experience a lot of sexual arousal
link |
01:52:16.820
from cannabis and THC in particular,
link |
01:52:19.180
and some people do not.
link |
01:52:20.560
In fact, they experience suppression of sexual desire.
link |
01:52:24.100
And it's always been a little bit mysterious
link |
01:52:25.940
as to why that is.
link |
01:52:27.940
Well, in this study,
link |
01:52:29.320
they showed people in both groups erotic images,
link |
01:52:33.720
and they measured sexual arousal
link |
01:52:35.880
through a number of different measures.
link |
01:52:36.940
We won't go into all that.
link |
01:52:37.840
It was largely subjective.
link |
01:52:39.300
There've been other studies
link |
01:52:40.220
where they've actually measured things like erections
link |
01:52:43.260
in males and vaginal lubrication in females,
link |
01:52:45.780
the so-called autonomic responses
link |
01:52:47.840
that people can't lie about, so to speak,
link |
01:52:51.220
and that tap into other aspects
link |
01:52:54.340
of the so-called sexual arousal process.
link |
01:52:57.640
In this study, they also took blood samples
link |
01:52:59.780
to look at the concentration of things like cannabinoids.
link |
01:53:03.160
So this is a really nice study
link |
01:53:04.440
in that they actually measured how much THC
link |
01:53:07.360
was in the bloodstream in different individuals
link |
01:53:09.660
who reacted to these erotic stimuli in different ways.
link |
01:53:12.400
And they measured hormones, namely cortisol,
link |
01:53:15.220
which is a stress hormone,
link |
01:53:16.280
which tends to negatively correlate
link |
01:53:17.820
with sexual arousal and prolactin.
link |
01:53:20.540
And the interesting takeaway from the study
link |
01:53:22.640
was that for people,
link |
01:53:24.980
and it didn't matter if it was males or females,
link |
01:53:27.440
because they looked at both,
link |
01:53:30.260
for people that experienced elevated prolactin levels
link |
01:53:35.400
under cannabis intoxication, that's how they referred to it.
link |
01:53:39.260
People take cannabis, they measured prolactin.
link |
01:53:40.980
Some people had elevated prolactin, some people did not.
link |
01:53:45.260
For the people that had elevated levels of prolactin,
link |
01:53:49.200
they did not observe activation of brain areas
link |
01:53:52.420
associated with sexual arousal,
link |
01:53:54.340
in this case, the right nucleus accumbens.
link |
01:53:56.440
So you have two nucleus accumbi, I guess they'd be called,
link |
01:53:59.640
one on each side of the brain.
link |
01:54:00.800
And the activation of that brain area
link |
01:54:02.520
is strongly associated with dopamine and with arousal
link |
01:54:05.520
and sexual arousal in particular in this study.
link |
01:54:07.880
And if people had elevated prolactin,
link |
01:54:10.000
they did not experience activation of nucleus accumbens
link |
01:54:12.880
and they did not report feeling sexually aroused
link |
01:54:15.400
to those pictures,
link |
01:54:16.240
at least not to the same degree as the other group.
link |
01:54:18.500
So some people's prolactin levels go up
link |
01:54:20.620
when they ingest cannabis
link |
01:54:22.680
and those people do not achieve elevated levels
link |
01:54:25.880
of sexual arousal when under the influence of cannabis,
link |
01:54:29.360
even if they're looking at erotic stimuli.
link |
01:54:32.200
That makes sense because prolactin
link |
01:54:35.740
is mutually inhibitory, as we would say.
link |
01:54:39.120
It's kind of in a push-pull with dopamine.
link |
01:54:41.040
When dopamine levels are high,
link |
01:54:42.280
prolactin levels tend to be low.
link |
01:54:44.560
And when prolactin levels are high,
link |
01:54:46.160
dopamine levels tend to be low.
link |
01:54:48.000
The other group, so-called group A,
link |
01:54:50.540
that experienced elevated levels of sexual arousal
link |
01:54:53.480
when under the influence of cannabis
link |
01:54:55.240
and viewing erotic stimuli,
link |
01:54:57.740
that group did not show elevated levels of prolactin
link |
01:55:01.600
in response to cannabis.
link |
01:55:03.800
So this, I believe,
link |
01:55:04.840
resolves a longstanding controversy in the field,
link |
01:55:08.040
which is does cannabis increase sexual arousal?
link |
01:55:11.300
Well, it depends.
link |
01:55:12.280
If you fall into the category of person
link |
01:55:14.220
who has elevated levels of prolactin in response to cannabis,
link |
01:55:18.000
then no, actually cannabis will suppress
link |
01:55:20.960
your sexual response and desire.
link |
01:55:23.240
If, however, you are in the category of person
link |
01:55:26.400
that does not have elevated levels of prolactin
link |
01:55:29.840
in response to cannabis,
link |
01:55:31.700
well then erotic stimuli can potentially,
link |
01:55:35.080
and in fact do, increase sexual arousal
link |
01:55:37.760
in the majority of individuals.
link |
01:55:39.320
Now, many of you are probably hearing this
link |
01:55:40.820
and wondering whether or not you fall into
link |
01:55:43.400
one category of individual or another.
link |
01:55:45.860
And the key thing here to understand
link |
01:55:48.960
is that levels of prolactin heading into the study
link |
01:55:53.100
did not predict, did not predict,
link |
01:55:56.100
whether or not people would respond to cannabis
link |
01:55:59.140
with elevated or non-elevated
link |
01:56:02.300
or even reduced levels of sexual arousal.
link |
01:56:04.960
It was whether or not people's prolactin levels went up
link |
01:56:08.680
or did not go up that predicted
link |
01:56:11.280
whether or not their levels of arousal would go up or not.
link |
01:56:14.680
So if you are somebody who, yes,
link |
01:56:17.100
does experience elevated levels of sexual arousal
link |
01:56:20.440
and function when under the influence of cannabis,
link |
01:56:23.600
well, that's very likely that cannabis
link |
01:56:25.160
does not increase your prolactin levels,
link |
01:56:26.880
at least not to a significant degree
link |
01:56:29.080
while you're taking it.
link |
01:56:30.440
And if you are somebody who does not experience
link |
01:56:32.520
increases in sexual arousal or function
link |
01:56:35.000
or even diminished sexual arousal and function
link |
01:56:36.940
when under the influence of cannabis,
link |
01:56:38.340
it's very likely the cannabis
link |
01:56:39.740
is increasing your levels of prolactin.
link |
01:56:41.720
Unfortunately, there's no way to know or predict
link |
01:56:44.320
based on some other measure.
link |
01:56:46.360
I think the outcome measure that is increased
link |
01:56:49.080
or not increased or even reduced sexual arousal
link |
01:56:51.560
is really the litmus test by which one can figure that out.
link |
01:56:54.940
While we are on the topic of the effects of cannabis
link |
01:56:57.200
on sexual function and hormones like prolactin,
link |
01:57:00.320
it's probably worth mentioning
link |
01:57:01.640
that cannabis has been studied extensively
link |
01:57:04.080
for its impact on other hormones.
link |
01:57:06.260
And we can summarize those literature in the following way.
link |
01:57:09.960
And here I'm referring to studies only on adults.
link |
01:57:12.060
We will talk about the developing brain and body
link |
01:57:14.400
in a little bit, but it is very clear
link |
01:57:17.400
that smoking cannabis increases prolactin levels.
link |
01:57:23.580
Very, very clear.
link |
01:57:24.440
Now you might say, didn't you just describe a study
link |
01:57:27.840
about a set of individuals whose prolactin didn't increase
link |
01:57:31.480
and as a consequence, their level of sexual desire went up?
link |
01:57:35.760
Yes, there are a subset of individuals
link |
01:57:37.520
for which that's true.
link |
01:57:38.860
But people who smoke cannabis do experience increases
link |
01:57:44.720
in prolactin and that's especially pronounced
link |
01:57:46.780
in people that smoke cannabis more than twice a week.
link |
01:57:49.760
So this is important.
link |
01:57:51.480
Prolactin, as I referred to earlier,
link |
01:57:54.420
is reciprocal or mutually inhibitory with dopamine.
link |
01:57:59.760
One way to think about this is in the context
link |
01:58:01.480
of the normal sexual arousal arc
link |
01:58:03.600
whereby dopamine is increased
link |
01:58:05.380
when people are sexually aroused,
link |
01:58:07.200
but then after orgasm, both in males and females,
link |
01:58:10.640
prolactin levels skyrocket.
link |
01:58:12.800
This is actually what creates the so-called refractory period
link |
01:58:15.880
for males during which they cannot achieve erection again
link |
01:58:18.380
for some period of time.
link |
01:58:19.580
That relates directly to how long
link |
01:58:22.360
the prolactin increase lasts, okay?
link |
01:58:26.440
Prolactin is also increased in new parents of all species,
link |
01:58:30.220
including humans, which at least partially explain
link |
01:58:35.220
some of the reported or typical reductions
link |
01:58:38.480
in sexual desire and activity in new parents.
link |
01:58:41.040
Now there are other reasons for that too, sleep deprivation,
link |
01:58:43.140
but nature is smart and has arranged a set of hormones
link |
01:58:46.960
and circuits in the brain and body
link |
01:58:48.300
such that when tending to a newborn
link |
01:58:50.280
is the most important thing, it relegates,
link |
01:58:53.100
it reduces the importance of producing more children
link |
01:58:57.780
and sexual activity in those moments
link |
01:59:00.060
and days and weeks, sometimes longer.
link |
01:59:01.940
So when prolactin levels are up, dopamine levels are down.
link |
01:59:04.520
Smoking marijuana more than twice a week
link |
01:59:06.500
significantly increases prolactin.
link |
01:59:09.020
There are fewer studies exploring whether or not
link |
01:59:12.060
edible marijuana has the same effect,
link |
01:59:14.260
although the preliminary evidence suggests that it does not.
link |
01:59:18.160
I get into this in a lot more detail in a future episode,
link |
01:59:21.180
all about hormones with Dr. Kyle Gillette,
link |
01:59:24.100
who's been on this podcast before,
link |
01:59:25.900
but he verified that and my read of the literature
link |
01:59:28.340
is that the edible forms of marijuana,
link |
01:59:33.020
cannabis, probably, again,
link |
01:59:35.260
let's put an asterisk next to this,
link |
01:59:37.060
but it appears do not have as much
link |
01:59:39.400
of a prolactin elevating effect
link |
01:59:41.060
and therefore not as much of a dopamine suppressive effect
link |
01:59:45.000
and therefore not as much
link |
01:59:46.140
of a testosterone suppressing effect.
link |
01:59:48.340
And that gets to the issue of testosterone.
link |
01:59:50.000
Does cannabis marijuana suppress testosterone?
link |
01:59:52.740
And this is a very controversial literature and here's why.
link |
01:59:56.660
Some studies say, yes, it suppresses testosterone
link |
02:00:00.660
in males and females.
link |
02:00:02.020
And keep in mind that testosterone in females
link |
02:00:03.700
is vital for libido and cognitive function,
link |
02:00:06.380
cellular repair, et cetera.
link |
02:00:08.380
So it's not just important in males, of course.
link |
02:00:11.340
However, other studies say that cannabis
link |
02:00:14.340
does not decrease testosterone.
link |
02:00:16.500
And it seems to depend on whether or not
link |
02:00:19.640
the cannabis is brought into the system
link |
02:00:21.460
by way of smoking or edible.
link |
02:00:23.620
And it seems to depend on whether or not the cannabis
link |
02:00:27.160
is used chronically by an individual or acutely.
link |
02:00:29.980
And here, I just want to zoom out and say that studies
link |
02:00:32.800
on cannabis or drugs of any kind in humans
link |
02:00:35.160
are really complicated.
link |
02:00:36.200
If you think about it,
link |
02:00:37.060
someone has to come into the laboratory.
link |
02:00:38.740
And let's say you want to study chronic cannabis use.
link |
02:00:41.420
Well, you can't keep them in the laboratory all the time.
link |
02:00:43.940
So you have to rely on their self-report
link |
02:00:45.680
of how often they use cannabis and in what form.
link |
02:00:47.900
And you can't really control from one individual
link |
02:00:50.020
to the next of how much cannabis and THC
link |
02:00:51.940
they're bringing into their system.
link |
02:00:52.900
One person might smoke cannabis out of a bong
link |
02:00:55.620
and take big, deep lungs full bong inhalations or such.
link |
02:01:02.260
Other people might smoke joints.
link |
02:01:04.540
Other people might use edibles.
link |
02:01:06.100
It becomes very complicated to know what people have done
link |
02:01:08.420
and that they're reporting it accurately.
link |
02:01:10.320
And no joke here, especially if marijuana
link |
02:01:12.980
is impacting the short-term memory systems.
link |
02:01:14.940
They might not actually remember.
link |
02:01:16.140
They might not be tracking it that well.
link |
02:01:18.620
Contrast that with studies of the acute use of cannabis
link |
02:01:21.460
and THC, where people who are not regular users
link |
02:01:24.040
come into the laboratory.
link |
02:01:25.140
And now suddenly with institutional guidelines
link |
02:01:28.260
and safety protocols are under the influence
link |
02:01:30.580
of THC and cannabis.
link |
02:01:31.740
Well, now you're dealing with a person
link |
02:01:32.940
who may not have experience with the elevated heart rate
link |
02:01:37.120
and blood pressure that's characteristic of cannabis
link |
02:01:39.100
because it is a stimulant,
link |
02:01:40.100
at least when initially brought into the system,
link |
02:01:42.060
even if it might eventually lead to relaxation.
link |
02:01:44.380
So now you've got someone who's anxious
link |
02:01:45.780
or somebody who's not anxious, who's deeply relaxed,
link |
02:01:48.780
and you're trying to study these effects.
link |
02:01:49.980
So it's a moving target of sorts.
link |
02:01:52.420
It's very complicated to study marijuana and cannabis
link |
02:01:56.060
and its various derivatives in this way.
link |
02:01:57.780
Now you can probably appreciate better
link |
02:01:59.860
as to why there's so little nuanced data
link |
02:02:02.540
about sativa versus indica
link |
02:02:04.780
versus different ratios of CBD and THC.
link |
02:02:07.980
It's really difficult to do these studies
link |
02:02:09.740
in the first place.
link |
02:02:10.620
That said, the general rules are smoking marijuana
link |
02:02:13.360
increases prolactin in men and women,
link |
02:02:14.900
which will reduce dopamine and testosterone.
link |
02:02:17.260
Smoking marijuana chronically,
link |
02:02:19.920
meaning more than twice a week,
link |
02:02:22.380
does appear to reduce testosterone significantly
link |
02:02:25.300
and elevate so-called aromatase enzymes,
link |
02:02:28.580
which are the enzymes that convert testosterone
link |
02:02:30.480
into estrogen.
link |
02:02:31.520
This might partially explain the effect
link |
02:02:33.740
that occurs in about 35% of males,
link |
02:02:36.540
which is gynecomastia,
link |
02:02:38.340
which is a development of breast tissue in males,
link |
02:02:41.060
in particular young males
link |
02:02:42.660
who have elevated levels of testosterone
link |
02:02:44.500
or who are taking exogenous testosterone
link |
02:02:47.320
for testosterone replacement therapy,
link |
02:02:49.300
or if they're taking high doses, anabolic steroids,
link |
02:02:51.740
or in females, the increase in breast size,
link |
02:02:55.340
which is due to additional estrogen
link |
02:02:58.200
from testosterone converted to estrogen.
link |
02:02:59.900
So it does appear that marijuana and cannabis
link |
02:03:01.780
increase estrogen, reduce testosterone,
link |
02:03:03.700
increase prolactin, especially in chronic users.
link |
02:03:07.420
Now I'm sure that some people out there will say,
link |
02:03:08.900
well, their testosterone levels are exceedingly high
link |
02:03:12.320
or they are fine,
link |
02:03:13.740
meaning the constellation of symptoms
link |
02:03:15.420
associated with low testosterone and elevated estrogen
link |
02:03:18.620
are not present in them.
link |
02:03:20.140
That probably means one of two things or both.
link |
02:03:25.080
They either had elevated levels of testosterone
link |
02:03:27.040
to begin with, so their ceiling was higher,
link |
02:03:28.700
so bringing it down didn't have that much of effect,
link |
02:03:30.640
or that they have very low levels
link |
02:03:33.460
of aromatase in their system.
link |
02:03:35.620
There are some anecdotal evidence
link |
02:03:38.180
that smoking particular parts of the marijuana plant,
link |
02:03:41.180
in particular the seeds,
link |
02:03:42.740
can increase aromatase
link |
02:03:45.380
in the conversion of testosterone to estrogen.
link |
02:03:47.380
I think in the old days,
link |
02:03:48.500
the lower was the seeds make you sterile,
link |
02:03:50.540
and I think that was related to what I just told you,
link |
02:03:52.660
this increase in conversion of testosterone to estrogen.
link |
02:03:55.780
There's a vast literature
link |
02:03:57.540
on the effects of cannabis on fertility.
link |
02:04:00.740
It does seem, yes, it does seem to alter sperm motility
link |
02:04:05.200
and sperm health and function
link |
02:04:06.620
when taken chronically more than twice per week,
link |
02:04:08.800
in particular high doses of high potency THC.
link |
02:04:12.100
This is something we will cover in far more detail
link |
02:04:14.300
on a future episode all about fertility.
link |
02:04:16.380
And in females, there's an increase in estrogen
link |
02:04:19.540
as a consequence of smoking marijuana
link |
02:04:22.460
and increasing prolactin and estrogen in parallel.
link |
02:04:26.420
Whether or not that's detrimental isn't clear,
link |
02:04:29.060
although I point out that elevated estrogen and prolactin
link |
02:04:33.760
can be associated, again, can be associated,
link |
02:04:36.180
not necessarily, and certainly not causative,
link |
02:04:38.620
but can be associated with elevated levels
link |
02:04:41.540
or frequency of breast cancer detection.
link |
02:04:43.580
So cannabis and its effects on hormones
link |
02:04:46.020
are not without consequence.
link |
02:04:48.840
There are effects of cannabis on cortisol.
link |
02:04:52.100
In some individuals, it greatly increases cortisol
link |
02:04:54.660
due to the anxiety and paranoia it can create,
link |
02:04:57.980
and in other individuals, it reduces cortisol.
link |
02:05:00.300
Again, we have these divergent effects,
link |
02:05:02.220
but I want to be very clear.
link |
02:05:03.700
The effects on prolactin, meaning elevated prolactin,
link |
02:05:05.940
the effects on testosterone, meaning,
link |
02:05:07.980
at least most studies point to reduced levels of testosterone
link |
02:05:10.780
and increased estrogen,
link |
02:05:12.460
that seems to be true for most all individuals
link |
02:05:15.380
that chronically use cannabis.
link |
02:05:17.720
Whereas the effects on cortisol tend to be divergent,
link |
02:05:21.380
cannabis increases cortisol in some individuals
link |
02:05:23.620
and decreases cortisol in others.
link |
02:05:25.220
In general, increases in cortisol that are ongoing
link |
02:05:28.640
are not healthy for us and so on.
link |
02:05:31.940
And then of course, there are other effects on hormones,
link |
02:05:34.500
and I'll just briefly summarize those,
link |
02:05:35.900
that THC in particular, not CBD, but THC in particular,
link |
02:05:39.820
is known to be strongly inhibitory
link |
02:05:41.640
for something called gonadotropin-releasing hormone.
link |
02:05:43.940
This is a hormone that's released from the brain,
link |
02:05:45.980
from the hypothalamus, that then feeds onto,
link |
02:05:49.460
or I should say, signals to the pituitary gland,
link |
02:05:51.640
which is also near the roof of your mouth.
link |
02:05:52.980
A lot of stuff happening near the roof of your mouth,
link |
02:05:54.460
it turns out, biologically.
link |
02:05:56.060
And reduced levels of gonadotropin-releasing hormone
link |
02:05:59.220
caused by cannabis use,
link |
02:06:00.460
reduced levels of LH, luteinizing hormone, and FSH,
link |
02:06:03.620
which reduce levels of testosterone
link |
02:06:05.880
and sperm production in males,
link |
02:06:08.080
and egg health and ovulation
link |
02:06:12.240
and menstrual function in females.
link |
02:06:14.940
Now, I'm sure there are a number of women out there
link |
02:06:17.860
who will say they have perfectly normal menstrual cycles
link |
02:06:19.900
despite using cannabis.
link |
02:06:22.100
I'm certainly not going to dispute that.
link |
02:06:24.500
But if you are somebody who's trying to maximize fertility
link |
02:06:28.140
or regulate or balance hormones,
link |
02:06:30.840
marijuana and cannabis reduces GnRH,
link |
02:06:35.140
that is the gonadotropin released from the hypothalamus,
link |
02:06:38.620
and thereby reduces luteinizing hormone
link |
02:06:40.700
and follicle-stimulating hormone,
link |
02:06:42.180
which are released from the pituitary
link |
02:06:43.820
and travel in the bloodstream
link |
02:06:45.460
to support normal ovarian function and health
link |
02:06:48.540
and normal testicular function and health
link |
02:06:51.080
in females and males, respectively.
link |
02:06:53.220
Up until now, I've been discussing the biological
link |
02:06:55.300
and psychological effects of cannabis.
link |
02:06:57.920
Now, I'd like to shift our attention
link |
02:06:59.380
to some of the negative health effects of cannabis
link |
02:07:02.500
and shine light on some of the individuals
link |
02:07:05.440
or groups out there that need to be especially wary of
link |
02:07:08.860
and probably avoid cannabis use entirely,
link |
02:07:11.700
including ingestion of cannabis by way of edible.
link |
02:07:16.180
And I frame things that way
link |
02:07:17.300
because I think there is an increasingly large number
link |
02:07:20.060
of people out there that appreciate
link |
02:07:22.620
that smoking tobacco or smoking cannabis,
link |
02:07:27.320
vaping tobacco, yes, vaping tobacco or vaping cannabis,
link |
02:07:32.840
each and all have negative health consequences
link |
02:07:35.900
on the lungs and on the so-called endothelial cells
link |
02:07:38.860
of the body, the cells that make up the vasculature,
link |
02:07:41.200
the capillaries and blood vessels.
link |
02:07:43.360
If you don't already know this,
link |
02:07:46.000
I'll make it very clear and I'll make it very brief.
link |
02:07:48.600
Whether or not you smoke or vape tobacco or cannabis,
link |
02:07:53.440
you are severely impairing the function
link |
02:07:56.240
of endothelial cells that make up the capillaries
link |
02:07:58.860
and blood vessels of your brain and body.
link |
02:08:01.140
And that is known to decrease cognitive capacity over time,
link |
02:08:05.800
increase probability of strokes,
link |
02:08:07.600
severely impact lung function,
link |
02:08:10.980
and also lead to things like peripheral neuropathies.
link |
02:08:14.360
It leads to sexual dysfunction
link |
02:08:16.280
because of lack of blood flow to the genitals,
link |
02:08:19.660
can lead to other aspects of reproductive damage,
link |
02:08:22.480
including to the ovaries and testes.
link |
02:08:25.080
Essentially, there is no other way to state it
link |
02:08:27.200
except that smoking and vaping
link |
02:08:30.020
have negative health consequences
link |
02:08:32.460
that are independent of the substances
link |
02:08:36.540
that people are trying to get into their bloodstream
link |
02:08:38.980
by smoking or vaping.
link |
02:08:40.280
So people smoke and vape tobacco
link |
02:08:41.960
and people smoke and vape cannabis.
link |
02:08:44.160
And in both cases,
link |
02:08:45.640
if we just set aside the direct effects of tobacco
link |
02:08:49.000
and the direct effects of cannabis,
link |
02:08:52.420
we can confidently say that the process of smoking,
link |
02:08:56.060
of inhaling smoke into the lungs,
link |
02:08:57.760
and yes, also vaping,
link |
02:08:59.680
bringing the chemicals that transport nicotine,
link |
02:09:04.760
or in this case, cannabis into the lungs by way of vaping,
link |
02:09:08.120
are both severely detrimental to endothelial cells.
link |
02:09:11.500
I think a few years ago when vaping wasn't as prominent,
link |
02:09:14.360
there was this question and this idea
link |
02:09:16.360
that maybe vaping was going to be far healthier
link |
02:09:18.840
or at least not as bad as smoking,
link |
02:09:22.640
but now we can see a huge number
link |
02:09:24.880
of negative health effects of vaping,
link |
02:09:26.460
some of which are distinct from the effects of smoking.
link |
02:09:29.200
So if you'd like more information on smoking versus vaping,
link |
02:09:32.320
please see the episode that I did on nicotine.
link |
02:09:34.280
We will also do an entire episode
link |
02:09:36.080
all about vaping in the future,
link |
02:09:38.600
but there's really no way to slice it and dice it
link |
02:09:41.360
or candy code it.
link |
02:09:42.600
The fact of the matter is that smoking has clear
link |
02:09:45.560
and severe negative health consequences,
link |
02:09:48.080
regardless of whether or not you're smoking tobacco
link |
02:09:50.480
or cannabis, THC,
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02:09:53.680
and vaping has negative health consequences,
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02:09:57.780
whether or not you're using the vape
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02:09:59.400
to bring in nicotine or THC
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02:10:01.720
or some combination of THC and CBD.
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02:10:04.240
That's simply the way it is.
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02:10:05.560
With that said, now I'd like to focus our attention
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02:10:07.680
on the direct effects that cannabis has,
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02:10:10.480
either by way of THC action or by way of CBD action
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02:10:15.160
in terms of positive or negative health effects
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02:10:18.240
on the brain and body.
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02:10:19.200
And we're going to explore that first as a function of age.
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02:10:22.920
And the reason we're going to do that is related to a fact
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02:10:26.080
that I mentioned at the beginning of the episode,
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02:10:27.960
which is that the CB1 and the CB2 receptors,
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02:10:31.520
the two receptors for cannabis
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02:10:33.960
to which THC and CBD and CBN
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02:10:36.640
and all other psychoactive compounds in cannabis bind to
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02:10:40.760
to have their actions are present throughout development.
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02:10:45.320
Believe it or not,
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02:10:46.160
they are present very soon after conception
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02:10:49.340
and the CB1 and CB2 receptors actually play a critical role
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02:10:53.560
in the development of the fetus.
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02:10:55.760
Now you might wonder why that is
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02:10:58.400
because of course the developing fetus
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02:11:00.400
doesn't necessarily expect to see cannabis
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02:11:02.560
or to be exposed to cannabis and THC and CBD.
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02:11:05.840
But as you recall, endogenous cannabinoids are present
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02:11:10.600
in the adult brain and body
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02:11:12.160
and endogenous cannabinoids it turns out
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02:11:14.880
are also present in the developing fetus.
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02:11:16.920
In fact, endogenous cannabinoids are present
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02:11:19.560
at much greater levels than the developing fetus
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02:11:22.180
than they are after a child is born.
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02:11:25.840
And levels of endogenous cannabinoids
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02:11:27.800
actually go down across development.
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02:11:30.240
I find this really interesting.
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02:11:31.520
What this means is that endogenous cannabinoids
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02:11:34.060
and activation of the CB1 and CB2 receptors
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02:11:37.040
are an integral part of neural development.
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02:11:40.320
And this is going to become especially relevant
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02:11:42.200
in considering whether or not pregnant mothers
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02:11:44.080
should or should not use cannabis or CBD.
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02:11:48.180
And it also points to some very interesting biology
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02:11:52.540
in terms of how the brain develops
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02:11:54.280
and how the body develops.
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02:11:55.640
Now the development of the brain and nervous system and body
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02:11:58.920
is a fascinating and vast literature,
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02:12:01.140
certainly far too vast to cover in today's episode,
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02:12:04.120
especially at this late hour, as it were.
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02:12:06.880
But we will have a future episode
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02:12:08.780
all about brain development.
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02:12:10.840
In terms of the effects of cannabis,
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02:12:13.720
it's sufficient to say that cannabinoid receptors
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02:12:17.360
are present and active in the developing fetus.
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02:12:21.160
They are present and active in the newborn.
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02:12:23.480
They are present and active in adolescents.
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02:12:26.000
And across that time from conception until adolescence,
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02:12:30.080
endogenous cannabinoids are mainly responsible
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02:12:32.820
for the actions of those cannabinoid receptors.
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02:12:35.940
During that time, the cannabinoid receptors
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02:12:37.900
are having very specific effects
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02:12:39.780
that are distinct from their effects later in life.
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02:12:42.320
And those effects can largely be explained
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02:12:44.160
in terms of neural development.
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02:12:45.500
Again, we don't have time for an entire lecture on this now,
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02:12:49.160
but during development,
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02:12:51.600
your body was a collection of a bunch of cells.
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02:12:54.280
It's actually called a blastula,
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02:12:55.920
which means a ball of cells.
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02:12:57.260
And then those cells actually have to grow out connections
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02:12:59.700
and duplicate themselves.
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02:13:01.360
And this is a very interesting process
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02:13:03.240
by which neurons initially are situated far apart,
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02:13:06.120
and then they grow out connections
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02:13:07.680
and make contacts with one another.
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02:13:09.000
They remove certain connections,
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02:13:10.280
depending on what kind of life events you're exposed to.
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02:13:13.260
If you have a wonderful event early in life
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02:13:15.520
or a traumatic early life,
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02:13:17.480
those connections change, et cetera.
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02:13:20.300
The important point for today's discussion
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02:13:21.840
is that the CB1 receptor in particular
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02:13:25.080
is expressed on every neuron in the developing brain
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02:13:28.680
and has been shown to be important
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02:13:30.020
for every aspect of neural development,
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02:13:33.060
from the proliferation of cells,
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02:13:35.160
meaning getting enough cells to create a brain,
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02:13:37.500
to the outgrowth of the so-called axons,
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02:13:40.000
the little wires that connect up neurons with one another,
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02:13:43.220
to the steering, the direction
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02:13:45.560
at which those axons go in development, which is essential.
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02:13:50.600
And even so far as to explain the connections
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02:13:54.200
that form between neurons, the so-called synapses,
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02:13:56.760
and then how those synapses work.
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02:13:58.660
So the basic statement here is that endogenous cannabinoids
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02:14:02.920
and CB1 receptor activation are critical
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02:14:05.080
for every aspect of brain wiring and development.
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02:14:08.900
With that in mind, the statement I'm about to make
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02:14:11.380
is absolutely terrifying, at least to me,
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02:14:14.160
and frankly, it should be terrifying to you as well.
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02:14:17.000
And the statement is the current statistics
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02:14:21.720
on cannabis use in pregnant mothers
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02:14:25.440
is absolutely shocking.
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02:14:27.560
The most recent survey of pregnant mothers
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02:14:30.080
in the United States show that 15%, one five,
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02:14:33.720
15% of pregnant mothers report using cannabis
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02:14:37.620
in some form or another, either smoking it
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02:14:40.460
or more likely ingestion of an edible,
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02:14:43.840
because they are aware of the negative effects of smoking
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02:14:46.160
on the developing fetus, ingestion of an edible
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02:14:49.040
to increase THC and or CBD during pregnancy,
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02:14:53.540
which to me, I have to say as a developmental neurobiologist
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02:14:56.920
is frankly, it's scary.
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02:15:00.480
It's absolutely scary because that CB1 receptor
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02:15:03.560
is not just a minor player in neural development,
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02:15:06.320
it is absolutely central to every critical aspect
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02:15:09.440
of brain wiring and development.
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02:15:11.520
Now, the long-term implications
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02:15:12.940
or even the short-term implications of this 15%
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02:15:15.740
of mothers self-reporting the use of cannabis
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02:15:18.880
at some point during pregnancy are not yet known.
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02:15:22.160
This is, as we would say, it's an experiment that's ongoing,
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02:15:25.720
but I'd be remiss if I didn't point out these data
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02:15:28.560
and just implore you, please, please, please,
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02:15:31.400
if you are pregnant or considering getting pregnant,
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02:15:33.300
you're a cannabis user, whether or not you're using edibles,
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02:15:35.440
if you're a CBD user, please do whatever is necessary
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02:15:41.280
to not ingest cannabis or smoke cannabis
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02:15:45.100
or ingest CBD during pregnancy.
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02:15:47.760
Now, there may be certain clinical indications
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02:15:50.080
by which your physician and your OBGYN
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02:15:53.280
and the pediatrician that will eventually
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02:15:55.520
be the pediatrician for your child will prescribe CBD,
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02:16:00.700
although it's hard to imagine what those are.
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02:16:02.400
I contacted a number of different pediatricians and OBGYNs
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02:16:07.360
and not a single one said they would ever suggest
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02:16:10.460
and in fact would strongly discourage their patients
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02:16:12.960
from using cannabis during pregnancy.
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02:16:15.980
But I think that the advent of edible forms of cannabis
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02:16:20.880
and the combination of THC and CBD in certain products
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02:16:25.800
and the fact that most people view CBD as safer
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02:16:28.760
because it does not include as, or does not have,
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02:16:32.120
I should say, the psychoactive effects that THC does
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02:16:35.200
has led to a situation where you have 15%
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02:16:39.560
of pregnant mothers using cannabis
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02:16:41.340
at some point during pregnancy
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02:16:43.080
and maybe even frequently throughout pregnancy
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02:16:45.400
and the effects on the developing fetus
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02:16:47.280
are completely unknown,
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02:16:49.040
but recall that cannabis and THC and CBD out-compete,
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02:16:54.800
meaning they park in the receptor
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02:16:56.860
for endogenous cannabinoids
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02:16:58.600
and prevent endogenous cannabinoids
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02:17:01.160
from having their normal level and pattern of action.
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02:17:04.480
So this is absolutely critical.
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02:17:06.060
I cannot encourage you enough, or rather I should say,
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02:17:08.560
I cannot discourage enough the use of cannabis
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02:17:12.720
and any related compounds in cannabis,
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