Transcription
Welcome to GW Integrative Medicine, the podcast about disease prevention and health promotion from the office of integrative medicine and health at the George Washington University School of Medicine and Health Sciences. I'm Dr. Misha Kogan, an associate professor of medicine here at GW, chief medical officer of the GW Center for Integrative Medicine and co-author of the medical marijuana, Dr. Kogan's evidence-based guide for the health benefits of cannabis and CBD. And I'm Janet Rodriguez, the office's administrative director.
Today we talked to Dr. Peter Grimspoon about the US Congress reccriminalizing most hemp derived products. The measure is set to take effect one year from enactment and that'll be in and around November 12th, 2026.
Dr. Greenspoon is a primary care physician and can be specialist at Mass General Hospital in Boston, Massachusetts and an instructor in the medicine at Harvard Medical School. He's a certified health and wellness coach. He has provided medical cannabis care for patients for over two decades.
A widely recognized expert on cannabis science and drug policy. He is a board member of the advocacy group Doctors for Cannabis Regulation. He's also the author of Seeing Through the Smoke: A Cannabis Specialist Untangles the Truth About Marijuana. And guess what, y'all? He has another book coming out next year.
And I'm sure we're going to talk about that. But, uh, Peter, welcome back. So great to have you back. Um, we did a Was it a year ago when your book came out? But thanks for having me back. I always love being here and chatting with you.
Yeah. So, this book is on my shelf, right? And if if you're listening, you haven't read it, you're losing out. So, please do grab the book. It's a great book. It's very thorough. But today, we're here for a different reason. I hope Peter, you will tell us a little bit about your upcoming book. But I think this new law that was just passed as part of the I guess renegotiating government opening has been on the I've probably had I don't know at least couple of dozen emails from my patients who are using different hemp products from different online mostly distributors and they're asking what's going to happen you know this works for me then and am I going to lose the access to this? So, you're kind of the our number one to go expert on this topic. So, we figured let's get together and chat about this.
Yeah. It's just you can't make this stuff up. I mean, it's just really weird.
They legalized all these things and now they're criminalized again.
Yeah. So, you know, basically this new law um kind of reverses the prior uh farm bill where hemp was placed. Uh, it's called the Mary Miller amendment. Um, so you know, tell us just in general what does this signifies and more especially uh, you know, what what how do you see this? Is this are we going backwards? Are there going to be some potential pluses out of this law? Like just just summarize it for for our listeners.
Well, hemp is the same thing as cannabis or marijuana, except it has less than.3% THC, which is the psychoactive compound in cannabis that makes you high that people use for recreational purposes. Hemp used to be legal for hundreds of years earlier in this country's history for fiber, for rope. Um, then they criminalized it as part of the war on drugs. Uh, they criminalized cannabis, but they also criminalized hemp at the same time. uh, which you know, really interfered with like many many industries that were hemp-based. Um, then uh more awareness has come. Hemp is richer in CBD, which is the second most common ingredient of cannabis, which you know, a lot of people are familiar with and a lot of people use. It helps with with childhood epilepsy syndromes but also with anxiety, with sleep, and with chronic pain. And you know, CBD started to come out of the shadows of the war on cannabis. And nobody's really against CBD. It it's non intoxicating. So in 2018, you know, it's interesting. Mitch McConnell, um, conservative s senator from Kentucky, they the tobacco industry isn't doing as well. And he thought, hey, we can grow hemp. And he was one of the leaders in the United States Senate. So he helped lobby for and in 2018 they legalized hemp, which again, legalizing the marijuana plant if it has less than.3% THC, um, the intoxicating uh compound in cannabis. So with hemp legal, that changed everything. Hemp is used uh, it could be used for rope, it could be used for paper, it could be used for fiber, it could be used for clothing, as it has been, you know, for many thousand years in human history. Um, now that hemp was legalized, uh, you know, it was a great industry for a lot of people, but there was something in the 2018 Farm Bill that sort of led to the law of unintended consequences. It was called a THC loophole. And essentially, anything that could be produced from CBD, uh, again, the supplement that so many of us use, one in three Americans have tried CBD. Something like one in seven Americans are using a CBD product currently. Nobody. Nobody is against CBD, but with the THC loophole in the 2018 Farm Bill, uh, people were able to produce a whole host of psychoactive compounds. Um, in regular cannabis, you have something called delta 9 THC. You could produce delta 8 THC or delta 10 THC, which are very close to delta 9 THC, and they weren't illegal um, according to the 2018 Farm Bill, again, because of this THC loophole. And also they started producing some of these synthetic canabonoids, HHC, THCP, very psychoactive that are new and untested. Um, and so we have all these new intoxicating canabonoids. Um, and this is sort of independent of the 24 states that have legalized recreational marijuana and the 38 states that have legalized medical marijuana. It was like an independent system and uh, just briefly, there are some very good arguments against these products. There are very arguments for and against recriminalizing the stuff, which is as you mentioned, what the Mary Miller amendment did. That was to the recent budget amendment though it doesn't go into effect for a year. The favor, the arguments in favor of criminalizing these things again are that there are all these unregulated psychoactive products. The synthetic ones like HHC and THCP have never been tested in humans. We don't know, dangerous, helpful, not dangerous. You know, they might have medical utility like a lot of the other canabonoids like THC, but nobody's really tested them before. And number two, they're very poorly regulated. Uh, no one's regulating the FDA, the CDC. Nobody is regulating these. So, you know, they've done some, you know, they've randomly ordered and tested some of these products like Delta 8 THC that a lot of people use for medical reasons, but it is contaminated. It can be contaminated with industrial byproducts. So, the regulation of these, the manufacturing of these substances is completely unregulated. And the third thing is at a medical cannabis dispensary, they're very, very careful and strict about checking ID and not selling it to minors under age 18 or age 21, whatever the law happens to be in that state. But these hemp products, which are again, very intoxicating, are sold at gas stations and at smoke shops and over the internet. And obviously in these uh environments, they they can't and don't check ID or age nearly as carefully. So um, you know, teen, there was a lot of concern that teens were getting access to these like untested and unregulated products.
Now, at the same time, a lot of people use these products. There there are many many ethical um producers of these products. It's not like every producer is unethical. There are many many very good products. Millions of medical patients rely on them. Um, particularly, and this has been studied, they are used more in the states where there isn't legal access to medical marijuana. So to recriminalize them is to really rip them out of the hands of really probably tens of millions of medical patients who are using them with benefit. Uh, and also, you know, the war on cannabis has been such a disaster over the last 70 years with you know, more than 20 million people with mostly black and brown skin being arrested for nonviolent cannabis possession. This really recriminalizing this product feels like a step backwards in the fight against this awful awful war on drugs that we've had. So, just briefly in a nutshell, there are good arguments for and against recriminalizing these products. I I tend to feel as a clinician that you it's very harmful to take these products out of medical patients that really rely on them when they work better than traditional pharmaceuticals for for miserable conditions like chemotherapy induced nausea and vomiting, chronic pain, which tens of millions of Americans suffer from, insomnia, anxiety, spasticity for multiple sclerosis, colitis. So, I tend to be more against recriminalizing them, but I do agree that you don't really want this toxic soup of unregulated uh and untested products available to teenagers. So, I think what the best solution would just be to federally legalize cannabis so that everybody has access to the regular old medical marijuana that human civilization has been using for 5,000 years. But a second best plan would be to keep these products legal, but to actually study and regulate them in a sensible manner so their use would be safer.
Yeah. I mean, it sounds like this whole decision was very rushed. They did not give any time for comments for anybody. My understanding is that some of the hemp industry partners that are pretty sizable like large corporate, they had no idea that this was thrown in there. And suddenly like we find ourselves in in the back seat realizing that lots of our patients going to lose access within few months. And you know, it's it it feels that if they were to truly benefit the public, there should have been a process that should have been publicly set up and organized and there should have been time to to sort of contribute some input into it and the decision shouldn't have been this rushed. have been a writer. It shouldn't have been an amendment to a budget bill that was desperately needed government. I mean, there's a lot of moral panic. If you look at the original criminalization of cannabis, it wasn't about science. It wasn't about benefiting the public. It was about, oh, look at these crazy Mexicans smoking marijuana. Oh, look at these black musicians playing. It was all all about racism >> and competing commercial interest. And and here there was just this huge moral panic. You hear about the person who takes a gummy with one of these new synthetic canabonoids and overdoses and ends up no one dies from cannabis products but ends up like you know, sick and miserable in the emergency department. You hear about these cases, but you don't hear about the tens of millions of people that are using them with really good medical benefit because that's just not interesting. It's not newsworthy. So it just was based I agree much more on even though there are good arguments on both sides. this was based so much more on moral panic. And when they're doing something based on moral panic, the last thing is what they want is what you're talking about is like a measured uh, you know, scientific discussion.
You know, I I find it very ironic because just like I think six or eight weeks before this law was passed, Trump was on record saying he would like CBD to be covered by Medicare and uh and six weeks later it got outlawed. So like now what are they going to do? Right? In fact, I just published but you're assuming that he sort of knows what's going on and you're assuming that he sort of knows about these issues even what CBD is. He just sort of goes with whatever a latest adviser tells him. So, I don't think he really has any idea about any of this.
He may not even still know that this was passed. He probably doesn't.
Guys, what does uh project 2025 say about this? Is this one of those things that that we're this came from that? Do we know?
Well, you know, that's really interesting question because one of the I didn't go over all the arguments for and against criminalizing because I didn't want to give a two-hour saliloqually on your corporate podcast, [laughter] but one of the arguments against it is from like the KO Institute and the libertarians. They're saying, "Why would the government impose this ban on people? This should be a states rights issue. This should be just like medical and recreational cannabis. It should be decided state by state." and project 2025, which in my opinion is like the most >> came out of the Heritage Foundation and they're they're not libertarian, >> right? Well, they they want to just destroy everything that's good about our government so that you could take all the money and give it to the top 1% and make them richer. That's basically what project 2025, not to be political, is about, but you'd think that they would be against government regulation because they're against government doing anything helpful or unhelpful. So, I don't know if they have a specific position on this, but I would it' just be very ironic if they supported the recriminalization because they're just really dismantling the government piece by piece.
Yeah. And also, you know, there's also a couple other huge points. I mean, you know, you mentioned really critical aspect. What about patients, medical patients who have been taking this and they're in the states where cannabis is not legal for medical or recreational? What are they going to do? Like, how are they going You're out of luck. If you're if you're in Idaho, you're just out of luck. Your mom's in Idaho.
She has metastatic cancer. She's getting chemotherapy. And cannabis by far, as you wrote extensively in your book, Amisha, cannabis by far is the most effective treatment for chemotherapy induced nausea and vomiting. Not to mention the weight loss, the appetite loss, the pain, the insomnia, the anxiety that goes along with cancer. And someone in Idaho is just going to be either out of luck. this medicine's stripped away from them or criminalizing drugs tends to make them people still use them but they tend to go more into the illicit market. So the quality of these products is going to be even more suspect questionable and people are going to face you know criminal charges for using them. So it's just going to get so much worse for like someone's mom in Idaho with cancer. It's awful for the patients,
you know, and and frankly, it it's only going to probably give power to the black market. I mean, it's just going to flourish. The they're not going to be able to enforce every little producer who's going to sell this however they want with even less quality control than it currently is. And and in essence potentially we're going to see a more intoxication in the sense that you know, we know that all this illegal well all this alternative delta whatever you know delta 8 delta 10 they come a lot of times with the toxins in there they themselves may not be toxic but you got heavy metals in there pesticides residues and it's only going to get worse in the sense is the black market obviously is going to care even less about their quality since no one's going to you know measure. So I think we're also potentially in some way making it from perspective of just safety making it even worse
because people who found it effective they're going to find they're going to find a way to get it one way or another.
People need canabonoids and they're going to use canabonoids and criminalizing drugs doesn't >> generally make people use fewer drugs. It just makes the drugs more dangerous. I mean, I I argue I've argued in a piece in Time magazine that we should decriminalize opiates. If people with chronic pain and addiction had a legal route, maybe a government access to opiates, nobody would be buying illegal fentanyl on the streets and nobody would be overdosing. And here it is, we're losing 100,000 people a year to these overdoses. And I agree with you completely. Criminalizing these products is going to just make them more dangerous.
an argument in favor of criminalizing them just to you know, to give both sides is that this whole derived industry competes with the legal medical marijuana industry and in those 38 states, one might argue that it's better to go through um the legal marijuana system, which is more regulated, you know, no industrial contaminants um, the labels are accurate and they check for ID so teens aren't getting it again for the 12 states where there's no medical marijuana, that's really awful for patients. But maybe if they don't have this, this would increase pressure to legalize cannabis in those 12 states. Now, keep in mind that like most major politicians are in favor of legal access to medical marijuana. And in in some polls, between 87 and 93% of Americans are in favor of legal access to medical marijuana. So I mean, I think ideally it would be best if we had access to medical marijuana in all the states, but again, I agree with you, you know, and to the extent that this hemp derived industry competes with the medical marijuana system, it might undermine it to a certain extent, but I agree with you, like criminalizing it and like ripping it away from patients is not a healthy uh adequate or beneficial response.
So, Peter, what do you think will Let's Let's presume for a second this all goes in effect, right, as they planned because it's I I think there's also a chance that there's going to be some loopholes and they're going to do something about it since you still have, you know, 11 months left or whatever. But let's say this all goes as planned. What What's the impact you think is going to happen on the actual cannabis industry, right? I mean, we're talking about not just medical, but also recreational.
Well, I you know, I'm not an economist, but ironically, this is going to be, you know, devastating. It's going to wipe out the hemp derived, you know, product industry, which is a huge industry. And as you said, they're going to fight this and try to uh unrecriminalize it. But the actual cannabis industry will probably do better because if people don't have a legal alternative to the cannabis products, they're going to buy again, the people in the 12 states, they're out of luck where they don't have any medical or recreational cannabis. But in the other states, it's probably going to help the cannabis industry to not have a huge amount of the need for canabonoids siphoned off by this parallel industry. So I think for the mainstream cannabis industry, it's actually going to be I'm guessing is going to be beneficial.
Misha just keeping question. Yeah, I was just thinking
you guys you guys keep uh >> answering my questions, so I have nothing. [laughter]
All right. Well, let's let's pivot. And I I get Misha, I get the sense that you're just from the way you're talking about this that you obviously are aware of and understand both sides, but you sound like you're pretty heavily in the camp of like why on earth would we recriminalize these products from the point
exactly, you know, and I I have one of my biggest dilemmas is, you know, as a guriatrician, I see a lot of really old and frail people and you know that the the medical cannabis rules are extremely patch-like. like like like one state has one thing another like Virginia just completely revamped their system now we have to go on a special portal patients have to go on a special portal imagine 90 yearear-old person who is not using computer how are they going to take care of this right how how are they going to get a card and so you know I often find that some of these hemp industry partners they sort of just were bypassing all this plus their prices were about half on average compared to
it's much more it's much more Right? It's much lower threshold for medical cannabis products. You don't have to go through a state bureaucracy. You don't have to buy a medical marijuana card. You don't have to pay a doctor for a medical marijuana card. You don't have to go through whatever bureaucracy each state puts up with. You're absolutely right. It's like balconized how the different states have different regulations. Yeah.
And those regulations for for somebody who is, you know, they're simply not tech savvy, they're often impassible. They have to find someone potentially pay someone extra money to help them to set up the card which you know, it's we talk about how you know, we tend to ostracize older population in this country because we pres presume that they should be able to do everything that 25 year olds can do and that's just very unfortunate and
presume that they have children and grandchildren that can do it for them.
That's right. But that's not always the case.
Can I take a brief digression because you mentioned older Americans two seconds. That's what my new book is about. That's coming out in May 5th, 2026. It's causing it's called Aging Well with Cannabis and CBD. And it's about why seniors are using cannabis, how they can use it safely, who shouldn't use it, and how they can get started. So, in a nutshell, aging well with cannabis and CBD. But you're >> right. But you're absolutely right.
You beat me to the punch. You beat me to the punch. I was supposed to write this book, but then my book they didn't want me to write this just on older adults. So, we definitely going to have to have you back when the book is out.
No one's written it actually. But, you know, the other I mean, to your point, it's not just older adults. Like, I work in as a primary care doctor and I do cannabis too at an inner city clinic. Uh, a lot of immigrants. Onethird of my patients speak English, right? I mean, these are patients that could just go into the smoke shop and get some Delta 8 THC and get some relief. They're not going to be able to get a medical card and finesse that and, you know, come up with an ID and a driver's license and a and you
cost extra cost. There's a lot of extra cost in most states. You have to pay for the card. You have to pay off into a card.
Yeah. hundreds of dollars every year for the doctor for the card. And as you mentioned, the hemp drive products are less expensive. Insurance doesn't pay for any of these products. Um,
so, oh, I'm just getting a question. Who wrote the forward? I'm very proud to say Dr. Stacy Gruber, uh, the director of the mind institute at Harvard Medical School, uh, wrote the forward and I just read it and it's a really great forward. So, looking forward to that. So,
well, this is such a great topic. So again, we'll make sure I I presume there is the link already up so we can put the
Yeah, it's on Amazon. You could just do Peter Ginsman aging. So we'll just make sure that we'll we'll put the link and of course I'm going to pre-order it right after we're done.
So that's great. I think that's actually a critically needed topic. In fact, of course, I'm sure you covered that in the book, but the older adults is the fastest growing users in this country. And in the last 10 years, I think it's like more than double amount of older adults who
Oh, yeah. It's gone from 2% to 4%. Now it's 10 to 15%. You know, and they don't how to use it. They hear from their friends how to use it and then they go in the bud tender might be like, "Sure, try 20 milligrams of this and they take too much and they freak out." And you know, older people don't metabolize cannabis as well. Liver is older, the kidneys older. Their brains a little more vulnerable to the intoxicating effects of THC. They tend to be on many, many medications that can interact with the cannabis. And it's all completely safe if you do it the right way. As you mentioned over and over in your book, you want to start low and go slow. But with older people, you start even lower and go even slower. But if you gently get them up to the right dose, you can get them feeling a lot of relief. For example, from their chronic pain. Many people use fewer opiates. They use fewer non-steroidals which can kill your kidneys and cause a heart attack. Um, you know, they for sleep, they use fewer sedatives which can cause memory loss and which can cause falls. You know, cannabis is not by any means without harm completely. But this is all about harm reduction. And if you could use a safer substance over a less safe substance, you've made a lot of progress. Um, and and that's going to be the case with seniors. And you know, sometimes people get these products from their kids, but the kids don't real often patients of mine get products from their kids, but the kids don't realize like mom's 85, she's on 12 medications. She doesn't need the same dose that I need who's been using cannabis for 25 years if she's never tried it before. They take way too much. So, I just want to make the whole thing sort of demystify it and make the whole thing safer.
Yeah. So, such a critical topic. I'm so glad you did this. And again, as I said, we're definitely going to post the links. We're definitely going to have you back because as you know, that's what I do for a living. So, I definitely would want to go way into detail on actual clinical aspect here. So, you know, but I think today my other key question is, you know, the government kept telling us that, you know, we need to do more research on cannabis. Now this law definitely will even worsen because there's been a lot of you know, I wouldn't say top quality research, but there's been a lot of data gathering and a lot of publications coming from hemp industry because again, millions of patients are using some of the better um partners out there wanted to publish what they're observing, they wanted to set up some studies, so that's all also going to go away. So it also competes against the direct imperative of how are we going to optimize this field if we don't have enough research. If we're going backwards on research too, you know, it's only going to make it's only going to slow down understanding for general public how are we going to be implementing all of the protocols for various conditions,
right? No, absolutely. I mean, it's been very difficult to research cannabis because it's stuck in schedule one of the controlled substance act, which means no medical utility, which is nonsense, and high abuse liability, which is nonsense. But it makes it very, very onerous and expensive to research. And you know, these other products, delta 8, delta 10 THC, the semi synthetics are very close to the natural delta 9 THC. Who's to know they might not be more effective medically and even safer if we don't study them? We're never going to know. And then we've got these new canabonoids, uh, HHC, THCP, you know, again, those are complicated because they are untested. And you know, you could argue, should they really be available to an unsuspecting public if nothing's known about them? You can make that argument, but you could also make that argument of like, they're going to remain untested as long as we lock them away and throw away the key, we're never going to learn. They might have phenomenal medical benefit. And how would we know, just to your point, if we if we lock them away? So, uh, you know, there are arguments in both sides, but like research is like the lynch pin to all of this.
Yeah. Yeah. That's that's how it feels. I mean, even in my own backyard, I mean, we've I've been working with at least one producer. I'm going to keep the name away just for, you know, and we've put the study together. I mean, we're just observing what's happening. So, they're going to have to stop all this. And this is an important topic. We know that in progressive dementia, when people get sick enough, they all start having neurobbehavioral disturbances, the sleep disturbances, agitation, anger, you know, frustration, paranoia. And the drugs for those things are all in beer's list criteria, so drugs are all not recommended. It's very difficult to treat condition and actually cannabis is often almost universally effective and often you need very little THC. You just give these patients a bit more CBD and just few milligrams of THC. And so I've been working with several hemp partners and some of the products seem to be working great at much lower cost without all this complexities of medical cannabis dispensaries again. And so the study will have to be stopped. We may not never get enough to publish.
No, exactly. And you know, an analogous situation is we need more. There's amazing sort of anecdotal evidence that these very low THC preparations help kids with autism, both with the noncore symptoms, you know, the behavioral disturbances, self-injurious behaviors, and potentially with the core symptoms, the lack of connection. And a lot of these parents, it also helps with caregiver fatigue and burnout and a lot of just as with dementia patients, it helps with caregiver fatigue and burnout. Uh, that's been shown and a lot of these parents and kids with autism are going to really suffer. Um, number one, they're going to suffer from the lack of the readily available products. It's going to be much more restricted if you have to go through the medical cannabis system.
Well, in many states, it's not even allowed. In many states, kids are not even really listed there.
Right. So, what do you do if you're a parent with a kid who has autism and you think it's really really helping your kid like so many of these parents? Do you stop using it and let your kid suffer? Do you drive from Idaho to Colorado and buy it and then carry it back illegally? It presents and and have to get a medical all of that is going to happen.
Yeah, it's >> that's not in anybody's interest. Whose interest is that in? I can't think it's the law enforcement lobby. You know, as usual with the war on drugs, they are the big winners whenever you criminalize anything. But aside from that, I can't think of anybody whose interest it's in.
Again, it's it's again kind of interesting, right? Because the RFK supposed to be fighting war on autism. And that sounds like a total setback, >> you know, [laughter] by by claiming that vaccines cause autism, which is not true. Today they voted to ban giving newborns hep B vaccines and they're going to cause thousands of needleless deaths. So he's fighting a war on autism by by pretending that vaccines cause autism and he's not fighting the war on autism by helping us provide these canabonoids to these poor kids fighting autism. So it's exactly backwards in every possible way.
Yeah. So you know I guess we can theoretically hope that there's still a time and then this is a pretty sizable industry. they'll somehow gather their act together and try to repeal. Again, I agree with you wholeheartedly. There is some some small amount of silver lining in there that that we do have to regulate this new canabonoid somehow. And you know, I maybe some what will come out is that they push for the regulation of those things somehow while keeping the hemp. I don't know. That's what at least I'm hopeful for. But of course, [laughter] who can regulate all this though?
That's right. Well, that's that really comes down to like FDA is completely overwhelmed like they're not going to be able to handle any of this, you know, and so how you do this in essence that you of course you and I and and you know, any sensible person here would agree that totally decriminalizing cannabis and then setting up specific regulations how people obtain it would be way way easier because then you won't need to worry about anything DA based and it's not going to happened but there was a provision of trying to move THC into into the schedule three at least that failed. Um, so there's been attempts the good attempts I would say way better than this one to to to do something sensible here and the key question is in in this current administration are they going to have a will to actually address this appropriately I think time to be to to show it to us but um, you know, but this all smells very backwardly to me.
No, I agree. This current administration seems to have a wide spectrum of believers on this issue. There are definitely some people in the administration that are in favor of descheduling cannabis or rescheduling at least to schedule three. And then they have a lot of like these old school drug warriors. So, they just have a lot of mixed opinions and it's hard to imagine a lot getting done with so many strong opinions on both sides.
Yeah. meantime, you know, the newest data showing somewhere between 150 to 250,000 annual deaths. And if you carefully analyze Trump, somebody told the Trump that if we implement access to CBD for the entire country that we can say 50 to 80,000 deaths per year. I would not be surprised if that's not far off the truth because in reality,
I work for the addiction clinic at my hospital and This definitely saves lives. I I dealt with a gentleman um actually this is privately not at the addiction clinic. I do private consulting who had just and this is not an uncommon story at all using CBD and some THC transitioned off 6 to 12 drinks of alcohol for 30 years. His liver was shot. Now he's thriving. His marriage is back on track. His job is back on track again. This is harm reduction because cannabis is not completely free of harms which you discuss in your book and I discuss in my book. No drug or medicine is completely free of harms. It just doesn't exist. I give you penicellin, you could have a anaphylactic reaction. It's still the right thing to give you penicellin if you need it. But um, you know, a lot of people transition or help transition off opiate addiction with cannabis. It helps with the withdrawal symptoms. It helps with the anxiety, the insomnia, and chronic pain. A lot of the things that drive the addiction in the first place. And um, we're we could save so many lives uh with with with cannabis. And not just saving lives. We could Whoops, I just disappeared. We could save quality of life, right? I mean, you know, people use cannabis instead instead of ambient to sleep or these other h sedative hypnotics >> or alcohol as you said or people going to go back and have their night caps and then we're going to have more alcohol related mortality. I mean, it's it's been clearly shown that states that have legalized cannabis have seen drop in alcohol use. And it's not a trivial drop. It's quite substantial. It's often in double digits percentage-wise.
So, >> well, absolutely. That's why alcohol industry contributed lavishly uh to try to stop each of the cannabis legalization referendum state by state. But now that they're losing, they're sort of taking a the alcohol industry is taking a if you can't beat them, join them. And they're sort of trying to merge with the cannabis industry. A study just came out three days ago that was pretty strong evidence for the quote unquote substitution effect that people um substitute uh alcohol which which contributed to 178,000 deaths last year to cannabis which contributed to uh exactly zero deaths. You know, they took college kids and gave them highdose, medium dose and placebo cannabis and then they put them at a bar which offered their favorite drink. And in the highdose and the medium dose cannabis, there was a significant reduction in the alcohol consumed. I mean, I mean again, there's as you mentioned, you know,
and much better liver function also. So like an actual objective they measured objective data of intoxication and it was it was better.
Absolutely. I mean, we've been sold a bill of goods about cannabis and we've been sold a bill of goods about alcohol. Just good drug versus bad drug. You know, ironically, alcohol is the good drug and cannabis has been the bad drug. But alcohol causes cancer, heart disease, liver disease, dementia. Cannabis causes none of these things. And you know, there are safer and less way safe ways to use cannabis, right? Um, but at the overall, it's like considerably safer than alcohol. And it's just so ironic that alcohol is descheduled under the Controlled Substance Act. I'm not saying it should be scheduled, but it's ironic that cannabis is locked away in schedule one. And it just shows our society was so distorted by the war on drugs and all the nonsense and all the propaganda and we're just coming out of it. And as we mentioned at the beginning, this recriminalization of the hemp derived products really does in some ways feel a step backwards in terms of dismantling this awful racist counterproductive war on drugs. And you know, you really make a good argument that like you can't really criminalize control these molecules. You could just make them safer or less safe. And to criminalize them just makes them, as we discussed, less safe.
All right. We have a rule on this podcast. We don't we don't end on on really negative territory. I think we dumped ourselves into dark space. So, let's try to get out of it. Um, what are you looking forward for? I mean, the book is coming out. Do you have any other updates for us? You have you involved in anything else that's really interesting and and let's say positive. [laughter]
Well, I've been working at the addiction clinic and and it's very positive working at the addiction clinic in my hospital. They very low barrier to treatment. Anybody can walk in, no health insurance, uh different hospital system, no primary care doctor. And we, it's just phenomenal how effective we are treating these people for various addictions. You know, we're better at treating opiate addiction because we have Suboxone and methadone. And we're better at treating alcohol addiction because we have nrexone and so forth. But we're getting there. We're learning how to treat methamphetamine addiction and cocaine addiction. And it's really just been an incredibly eye-opening uh and positive experience. And you know, a lot of people used to think addiction, hopeless, no treatment. We're really getting a lot better at treating it. And to me that's been an extremely positive experience.
So it sounds like cannabis has a really strong role to play there. Now I don't do this work. So I don't clinically know but it sounds like what you're saying is that a lot of your patients are using some canabonoids, right?
Oh yeah, absolutely. And there's evidence that cannabis can help people transition off alcohol, can transition off opiates. So, it's interesting the a lot of the addiction psychiatrists are sort of stuck in the past about cannabis and they're still have sort of a 1970s era um view of it. So, I don't think it cannabis is being nearly as widely implemented as it could be in terms of helping people with addiction. However, the younger doctors are obviously much more open to it than the older doctors. that I think is is slowly changing in the right direction just as generally speaking uh physicians are becoming your average physician is becoming much more interested in using medical cannabis than they used to be say 10 or 15 years ago.
All right friends, that's all we have for today.
Thank you guys so much. This is great discussion >> as always. I I knew that I was going to learn and I always learn from you guys. So, this is the GW Integrative Medicine podcast from the GW Office of Integrative Medicine and Health.
I'm Dr. Misha Kogan.
I'm Janet Rodriguez. Thanks for listening.