What are common things people say about the effects of marijuana?
What are the facts about those common claims?
What implication does this have in therapy?
Conversations about the effects of marijuana give rise to really interesting information being shared. Much of it isn’t based on science or fact. It can be really hard to know what the real truth is, even if you know where to look. This week we’ll be discussing the common claims about marijuana.
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You’re listening to the All Things Substance podcast, the place for therapists to hear about substance abuse from a mental health perspective. I’m your host, Betsy Byler and I’m a licensed therapist, clinical supervisor, and a substance abuse counselor. It is my mission to help my fellow therapists gain the skills and competence needed to add substance use to their scope of practice. So join me each week as we talk about All Things Substance.
Welcome back. This is episode 21 of the All Things Substance podcast. We’re in a series where we’re talking about different substances of abuse. This is episode 2 about marijuana.
Last week, we covered the basic facts about marijuana: what it is, how it’s used, short-term and long-term effects and implications for therapy. This week we’re going to talk about the common claims about the effects of marijuana.
Over my career, I’ve talked to a ton of people about marijuana. I’ve heard just about everything that you could think of in terms of why marijuana is good and why it’s bad and everything in between. I’ve been to countless trainings too, about chemical dependency and talks about marijuana. And I’ve noticed that even amongst therapists and even amongst people who are speaking about marijuana, lots of information gets misstated, conclusions get drawn and that generally there’s a lot of misinformation online and being spread just around. It’s hard to know what’s real and what’s true.
When I bring you information, I always tell you that I’m going to put links in the show notes to where I got information. I take time to research things, to make sure that I’m stating them as accurately as well. The information I give you is current as of the time of recording.
When I see conversations online about marijuana, typically I don’t even read them because they just get ridiculous. It depends on the site you’re on. There was a long time where I used to read Reddit and those conversations, especially, Oh my gosh, they just get so ridiculous. To read on there, you would think that weed was like the answer to life, God and everything.
I’ve been seeing some conversations about the effects of marijuana in some therapist forums that I’m on, on Facebook. The conversation there is an example of a really black and white view about marijuana, either from one side or the other. I saw a post where a therapist asked about her client who was in recovery from one drug. But was smoking marijuana and she wondered what stage of change they were in. Some of the answers were “harm reduction folks”. Or if this was a medication, would you still be asking that? I had a lot of things to say about that, because this is so much more complex than those comments represent.
I even saw someone in an EMDR group ask if it mattered if somebody was high while they were doing processing. The answer is yes, it matters and no don’t do that. I don’t have any judgment on the person for asking that question. What it confirms for me is that we didn’t get the training that we needed and that substance use is all around us and that we really needed this training in order to do our jobs as effectively as possible.
Now, if you’ve been listening to my podcast for any period of time, you know that I’m a little sarcastic. When I talk about this, that’s going to come through really strongly. It’s not about judgment. It’s that I have had 17, 18 years of listening to people tell me how amazing marijuana is.
It’s kind of funny when you hear these things over and over and over, just like all of the reasons I’ve heard why people fail drug tests. Those are funny too.
One of the reasons that I want to cover these common claims is that in our work, talking with people who are smoking weed can be really difficult. And if you haven’t had a chance to think about these things and people say them to you, you’re not really going to know what to say. I feel really strongly that if we’re going to say things with a voice of authority, that we need to actually have some information that’s accurate and be able to know what we’re talking about.
In the field of addiction, people who smoke weed are notoriously difficult to deal with. Because the drug is in that middle ground where we’re not worried about immediate death. We have to argue against all of this propaganda saying that it’s amazing. It’s no problem.
When you hear me make comments or say something’s funny, that’s where it’s coming from. My heart for these people is that if marijuana is causing them trouble, that they find a way to move past it and get to a place of healing and freedom.
Life without weed is less stressful. In the beginning, it feels like it’s super stressful because you’re used to having it. But not having to worry about whether you have it, whether you have enough, where you can smoke it, do you have money for it, do you smell like it all sorts of things. Those things just fall away and they aren’t part of your day anymore. It’s a really cool thing. And when your head clears. It’s really awesome to just feel that and not have to compensate for it or try to hide it.
Effects of Marijuana on medical illnesses
So one of the main common claims that I’ve heard over the years about weed is that it’s from the earth. The insinuation here is that because it’s from the earth, it’s safe. Just because it’s from the earth, doesn’t really mean anything. Lots of things are from the earth.
Heroin comes from a plant. Cocaine comes from a plant. Arsenic, strychnine, all sorts of things that are deadly and damaging come from the earth. The idea that things that are natural or from the earth are safe is kind of odd to me. The earth has lots of things that can kill you and always has. I’m not really sure where that started, but it definitely is something that comes up when you’re talking about weed.
Another thing people say is it’s good for you. The insinuation here is that it cures or helps various medical ailments from diabetes to cancer to seizures. The answer on this is kind of mixed. There’s no evidence to suggest that marijuana cures cancer fixes diabetes or cures all seizures. There are some research studies going on and we have some evidence that it can help certain things. So I’m going to go through those.
When it comes to cancer, there is a study going on that’s being used with rodents where. They’re testing whether CBD or CBD plus THC helps slow the growth of cancer cells. The research is looking positive, but it’s still in really early stages and on a really small scale. I absolutely support them to keep doing this kind of research because anything that can slow the rate of cancer, I’m absolutely behind and I think we should look at. The bottom line is we don’t have evidence that it can cure cancer.
When it comes to diabetes, it’s actually pretty 50/50. There’s been research that says that it messes with your blood sugars in a bad way. There’s been research to support that it helps regulate blood sugars in a good way. So I’m not really sure what to conclude about that, except that we don’t know and research is still ongoing.
I’ve heard people tell me that marijuana stops seizures or helps seizures. Marijuana can lower your seizure threshold in adults causing there to be more seizures. It’s not that marijuana causes seizures, just that it could lower your seizure threshold. We do have evidence and there are medications being used for two particularly bad forms of childhood epilepsy.
The FDA approved a medication called Epidiolex, which is a CBD based medication. This is not THC. That is the psychoactive component of marijuana. CBD is cannabidiol with the THC taken out. It doesn’t get you high, but it is an extract of the cannabis plant. This medication that was made from CBD has been found to help these two particularly rough forms of epilepsy and is available for use for children 2 and over.
I should point out that medical marijuana is not the same thing as CBD and that commercial CBD products are not the same as using Epidiolex to treat epilepsy. One of the well-known uses for marijuana is to stimulate appetite for people who are suffering from nausea and side effects from chemotherapy and wasting syndrome.
Marijuana has been used for several years to help these conditions and with good effect. Remember that we’re not talking about wax, THC oil and those kinds of things. Those are really high potency and can have a paradoxical effect, if they’re taken in high doses, and make nausea and vomiting.
You’ve probably heard people talk about CBD in relation to arthritis or chronic pain. There is some evidence to suggest that CBD could be a promising treatment. That’s about as good as we have. We have more anecdotal data from different people, but there are at least a hundred different types of arthritis. It’s difficult to know what’s going to work with which one.
Chronic pain is a really difficult thing to deal with and manage on a daily basis and if CBD can help that I’m all about it. I don’t have an issue with CBD at all. CBD does not have a psychoactive component. There are some CBD products that have trace amounts of THC in them, kind of like decaf coffee has trace amounts of caffeine in them. You can get CBD products that don’t have any THC in them at all.
We do have evidence suggesting that a combination of CBD and THC can be used to help muscle control problems for MS. In the UK there’s a mouth spray containing CBD and THC that is available by prescription to help these muscle control problems. It’s not available in the U S yet.
The last thing I’ll talk about in terms of health is the link between use of marijuana and developing psychosis. The links between use of marijuana and psychosis is well established. They have found a specific gene that seems to mediate the response to cannabis use. Scientists have located the gene called AKT1 that affects the likelihood of marijuana users developing psychotic disorders.
This gene has also been found to mediate the acute response to cannabis in healthy individuals. This means that the gene, AKT1 can be used to predict how susceptible somebody is to the mind altering effects of the drug.
The risks for developing a psychotic disorder due to marijuana use goes up with frequency of use. The number of people who develop a psychotic disorder from use of marijuana is pretty small. Estimates put it around 1 to 2%. The question then is raised, will it clear once somebody stops using marijuana and the answer is not always. Psychosis is a tricky thing.
The literature talks about a psychotic disorder rather than specifying schizophrenia because schizophrenia is a psychotic disorder, but not the only one. We have seen in our practices that psychosis can come in different forms and with different diagnoses. I’ve seen people experience psychosis with PTSD, major depression, bipolar disorder.
Typically when they experience psychosis with those diagnoses, it’s not an ever present thing. It can fade depending on where they are in a cycle, say in bipolar disorder or when their major depressive episode abates or when their PTSD is being treated and resolving.
Psychosis with schizophrenia is going to stay permanently. What they have found is that there’s some interplay between that gene and other genes that they believe to be related to schizophrenia and developing schizophrenia. People who have a risk for schizophrenia and are smoking marijuana are increasing their chances of developing schizophrenia.
It is not that marijuana causes schizophrenia. Marijuana does not cause psychotic disorders per se. Cannabis psychosis as they call it does exist and is extremely rare.
What we need to be concerned about is that when we have young people who are smoking marijuana and they have a risk for schizophrenia that we’re aware of, or we start seeing psychosis pop out, we need to be paying extra attention. Because once that psychosis switch gets flipped in those instances, it does not revert.
It is one of the saddest things I see when somebody develops permanent psychosis and they get clean and it doesn’t go away, it is heartbreaking. Now, certainly I see far more of that with meth use than I do with marijuana use. I have worked with people over my career who developed permanent psychosis, regardless of whether they were using anymore or not.
Remember that last episode, I talked about the fact that the structure of THC is similar to the one of our brain chemicals and so it allows it to act in the brain to interrupt certain functions. This and because it crosses the blood-brain barrier it has access to the brain in ways that other things might not.
Effects of Marijuana in terms of danger
Another common claim that I hear is it’s not as dangerous as alcohol. The insinuation here is that alcohol is legal and therefore marijuana should be legal. My opinion in this is that no, it’s not as dangerous as alcohol. Now, I was at a training this summer where I was listening to a woman and she said that marijuana is as dangerous as alcohol.
It was an online training with a large group of people and so I didn’t get a chance to question her. I don’t know, in what realm those two things could be considered equal. Alcohol can kill you from alcohol poisoning. It can kill you from long-term use from cirrhosis of the liver, pancreatitis and encephalopathy and the withdrawal can kill you.
So like using it in excess once, on one occasion using it in excess on many occasions or trying to not use it can kill you. I just don’t know how we could equate that to like, really. The issue here is that question of, is it legal? Therefore does that mean it’s safe?
So when somebody says that it’s safer than alcohol, it’s important to understand what they’re trying to say, because we’re talking in one sense about whether it does harm and the other one we’re talking about whether or not it’s legal. Those are really different things.
There are lots of drugs that aren’t as lethal as alcohol, but that doesn’t make them a great idea to you. Take LSD or shrooms, for instance. Not really a great idea and probably not going to kill you. Now, I know that there are studies being done, especially in the trauma world, in using psychedelics.
We’ll talk about that in a different podcast, because I think it bears noting. I was at a training with Bessel van der Kolk a few years ago where he talked about this and in a controlled setting and a dosage that’s regulated, if it can help with trauma, then I say, okay, let’s go for it.
But when people talk about that it’s like they’re putting a stamp on psychedelics, like whatever, it’ll help with trauma. Well, opiates help with pain, but that doesn’t mean that we should just take them without any thought. So we will cover that eventually . We’ll cover hallucinogens and another podcast too.
I think the takeaway for this one is that the law doesn’t determine what is safe. The law determines what is legal and the parameters around that thing.
Guns are legal and they have to be carried in a certain way. You have to be a certain age. You have to have passed certain background checks depending on the state. It regulates their availability and possession of them. That doesn’t put a stamp on them saying, no problem. When things are made, remembering that in the States there is a lot of money in lobbying that goes into whether or not laws change become more restrictive or when they relax.
This is not just something that is the will of the people. Lobbyists are incredibly powerful and are working all the time behind the scenes to push certain things through. Not saying that it’s all bad, just saying that it’s there. Just because a law exists doesn’t actually mean anything in terms of personal safety and choice.
Effects of Marijuana in terms of addictive potential
One of the favorite common claims is that weed isn’t addictive. I’m always a little perplexed by this. I think it’s sort of one of these statements that people make and they don’t think about. So when they say things like, well, it’s psychologically addicting, but not physically addicting. That’s sorta like saying muscle weighs more than fat.
Uh, no, it doesn’t. One pound of fat equals one pound a muscle. Because they’re both a pound, they just take up less space. So I think people just make that statement and it’s like they haven’t thought about it and it’s become like a catchphrase a little bit. Marijuana is addicting, all day, has always been, will be. Anything that you can get physically dependent on and go through withdrawal is addictive.
The difference here is that the withdrawal just isn’t that bad. You’re going to get cranky and annoyed for four or five days. After about a month, the cognitive fog, so to speak clears. That doesn’t make it not addictive. I think the insinuation here is that they can quit whenever they want.
That is an interesting argument. When people say that to me, that’s a red flag because they’ve thought about it and decided that “no, I’m fine” rather than thinking “hmm. How much am I smoking? Am I smoking too much?” I’ve had conversations a lot with people over the years, because I do talk about this when they’re smoking marijuana or drinking or whatever it is.
I’ll ask them “All right so how much is too much?” They usually have trouble answering that right away and I’ll say, “okay, so what’s normal drinking?” Is normal drinking, drinking every day? Is normal drinking, drinking once a week? So we’ll find this middle ground where they decide “yeah, I think that’s about normal drinking and if I drank more than that, it would be too much.” Okay. So we have a line, right.
I think it’s important to have a line because as you get closer to the line, the line mysteriously starts to move and we need to know where that is. So I remember working with a kid years ago who was in love with marijuana. Like it was his entire life.
I was talking to him about, okay, so when should we be concerned? What does he think is normal use of weed. We came up with a line. He decided that if he started coming to school high, and if he started going to family functions high, that that would be too much.
Later on when he got to those limits and was doing those things, I talked to him about it. I didn’t coach him or encourage him. That was his value about six months before. We were able to have a conversation about, “all right, so now we’re at this line what do you think”. At that time he was able to admit that, yeah, weed is addictive.
Your body requires it. You build a tolerance. There’s withdrawal. You have to figure out how to get it each day. It’s addictive. So when you have this conversation with somebody, it’s not something that you want to come out and be like, yes, it is.
You just need to talk with them about what they mean by addictive. A lot of times what they mean is they’re not going to turn into a junkie and that’s a really stark difference between saying addictive and junkie. There’s a gap there and I like to clarify what they exactly mean by that.
Effects of Marijuana on driving
Another thing I hear people tell me is “I’m a better driver when I’m high”. Not just, I’m a better driver when I’m high versus drunk, but like in general that they believe that they’re a better driver when they’re high.
So the reason people say this is that you have kind of a hyper-focus when you’re high. You are a little paranoid and so you’re watching things a little more carefully. You’re a little more aware of stuff. The problem though, is that you don’t know what you’re missing. It alters your perception of time and space.
I remember driving high all the time and I remember forgetting I was driving while I was driving. And that didn’t happen just once. I was using marijuana multiple times a day for years. I had tolerance. I was used to it. I knew how to function, but driving requires reaction time and immediate decision-making. Marijuana is a depressant, therefore slows down reaction time. It interferes with control. It interferes with decision-making.
It’s going to interfere with impulses, getting from your brain to your extremities. It might be a fraction of a second, but we know that a fraction of a second when driving a one and a half ton vehicle can make all the difference. .
Another thing I’ve heard is “I’m more productive”. The insinuation here is that marijuana can help you get stuff done. So this kind of goes contrary to the stereotype of a stoner. So if you watch stoner movies like Pineapple Express, Dazed and Confused, Friday, Harold and Kumar Go To White Castle there’s a stereotype, right?
That they get really focused. They’re kind of ditzy. That they aren’t really tracking things very well, and they’re not really getting stuff done. There are people who feel like they get hyper-focused and are able to get things done when they’re high. There is a hyper-focus that can happen with marijuana and it seems like it’s with different strains. Couldn’t tell you what those strains are.
Just that different strains of marijuana produce a different high. It also depends on your tolerance. How used to it you are,. As I talked about in the last podcast, in the beginning when you’re smoking marijuana, you can’t function the way other people do. Someone who’s new to smoking marijuana is going to want to sit and stare at stuff. Someone who’s smoking all the time they can function and do things , it doesn’t really seem like they’re high
Because marijuana alters your perception of time and space. I don’t know whether it could make you more productive. It’s possible. I suppose that for some people that happens. I just don’t know that we can trust that their perception of time and productivity is quite as accurate as they might think it is. I also don’t argue about this because it’s a personal experience , and arguing about a personal experience isn’t isn’t wise.
Effects of Marijuana and finding the truth on the internet
I’ve also heard people tell me, well, there’s all this stuff on the internet… The insinuation here is that there’s all this stuff on the internet saying that marijuana is good for you.
When you Google marijuana and the word benefits an incredible amount of information comes up. There are so many things I’ve seen people say about marijuana that sometimes I don’t know where they get it.
Then there’s information that sounds like it’s going to be balanced, but it’s actually pretty inflammatory. There’s a website called drug policy.org. While I understand where they’re coming from and trying to end the war on drugs and find a different way to manage drugs.
Some of the articles I’ve read have been really inflammatory and quite biased. They did a pro and con list for legalization, and it’s not actually a pro and con list. It talks about the cons that people list in terms of legalization, but it more explains why they’re not actually real or they’re not cons. I don’t find that accurate.
I find that there are two main sources of information when it comes to marijuana in terms of sheer volume. One is from big marijuana in terms of the industry that is billions of dollars large; has tons of money to be made. These are not pot smokers that are just wanting to bring weed to the world. These are business people who want to make money and figure out a way to capitalize on something that’s addictive because they know they can get better results in money terms.
The other people who are putting on a bunch of information are people who are using marijuana on a regular basis and they want to put information out there about why they think it’s beneficial. Both parties have a biased reason for promoting it.
As therapists, our responsibility, in my opinion, is to go with science. I don’t think our job is to take a side. I think our job is to look at: what do we know about science? How does this impact cognition and mood? How does that interplay with the person’s life experiences, trauma, genetics, and what impact does that have on their mental health? I think that’s our role. .
Just like with anything, when it comes to research and information we have to know who is providing it. I don’t know how many of you were in the field when drug reps were able to come and bring lunches and do presentations for us. It’s been a while for me since that was allowed, but prior to about 2010, where I live, it was a thing. We had people bringing really fancy catered lunches in, we had lots of swag and they would come do these presentations on medications .
The information they’re providing, sometimes I found useful, but at the same time it was a whole bunch of like rah, rah, this medication is awesome. I had to wonder who paid for that research? Well, the research is done by the drug company in a lot of cases.
They put millions of dollars in developing a medication and the trouble is they’re doing lots of research in developing medications, but not every medication in fact, probably most of them don’t make it to market. So they need their other medications to make money to make that up.
I don’t feel like I can trust the word of someone who is paid to tell me that this drug is going to solve the problems for my clients who have bipolar disorder or depression or whatever. We need a critical eye to look at who is telling me this information.
So like I said, you look up drug policy.org. It’s a really good name and you can’t take what they’re saying at face value. You have to look at where it’s coming from. I am not saying that drug policy.org doesn’t have good stuff on their site. I’m just telling you what I noticed when I was looking for specific information. There is a slant. That’s a normal thing. It’s just something that I think we should be aware of and be really upfront about
Effects of Marijuana and potential lethality
One of the final things that I hear people say about marijuana is: it can’t kill you. This is a difficult one. I have seen online, multiple places that say no one has ever died from marijuana. People die all the time everywhere. My experience dealing with coroners and medical examiners is they don’t do the kind of forensics that we see on TV. They can’t tell you the exact time of death. They can’t tell you the exact cause of death.
They could tell you about someone who died from a smoking related illness that these lungs are consistent with somebody who could have been experiencing COPD. They don’t have these in-depth ways of telling exactly what killed a person. I don’t think there’s any way to know. Statistically speaking, think about the odds that nobody ever had a bad reaction to marijuana and that nobody ever had it to the point that they ended up dying from some complication.
The odds on that would be astronomical. As we talked about last week, THC potency is really, really different. It is not the weed of the sixties, seventies, even the eighties, nineties, and early two thousands. This is not the same drug.
The basic plant has gone up at least 10% in potency, remembering that anything over 10% is considered high potency . We’re not even talking about a 15.5% plant. We’re talking about a 99% THC concentrated product that causes THC poisoning. Which happens all over the country in ERs every single day.
I can’t speak for other countries because I don’t know what they’re experiencing, but it’s probably similar. THC poisoning is extremely unpleasant. It has a paradoxical effect. As I said earlier, causing extreme nausea , causing extreme vomiting, rapid heartbeat, panic, psychosis, where people end up in the hospital.
The idea that that’s never killed anybody, like I just don’t get that. Our bodies are remarkable and strong and at the same time, fragile. Every one of us has known somebody who was seemingly extremely healthy and dropped dead. So this idea that it can’t kill you. It’s difficult to know what to say to that because a) we don’t know that b) that’s not the point. The point isn’t whether or not weeds going to kill you. Meth doesn’t typically kill you either. It just destroys your life and then you end up dead. But meth itself doesn’t typically cause immediate death.
Yeah. There are things like heroin, inhalants, ecstasy cocaine, alcohol, there are things that can kill you outright. Is alcohol going to kill you if you do it once? No, probably not. Is lethality the only thing that we evaluate when we’re deciding whether something’s good or bad? That’s kind of odd.
So people you say this quite a bit, and I don’t really get into an argument about it. I more ask them to tell me what that means. What does that say to them? If they think it can’t kill you, does that mean like it’s safe all the time in any quantity? I just start a conversation and it’s kind of like that with any of these.
They’re statements that people make when they want to defend something. I’m not interested in countering them. I’m interested in finding out what they mean and what their values are about their body, their health, and what they believe about it. There’s debate all over about what addiction is, how it’s caused, whose fault it is when it gets bad. All sorts of different aspects of it.
I am not sure why marijuana has stayed on the schedule one list all this time. I’m guessing that there wasn’t money behind it to force people to pull it off. They tried prohibition, it didn’t fly. It did decrease drinking for a time, but it created a number of other social problems. Ultimately there was too much money to be made.
I’m guessing that there wasn’t money in marijuana and that public opinion was that it was still some dangerous drug that was going to lead kids into doing other drugs that was going to lead people down the happy trail to hell or something like that. I’m guessing that’s why it’s just been recently that it’s been coming around. There has to be money to push the lawmakers, to change it, that needs lobbyists, and that needs people to put information out there. All that has to be funded somehow.
So we’ve talked about what marijuana is, what it does. We’ve talked about the things that people typically claim about marijuana. And now we come down to legalization. That’s going to be the topic of our next podcast. Legalization is complicated. It is not cut and dried. There’s a lot of terminology that gets thrown around as though it’s interchangeable like legalization versus decriminalization, which are two different things.
We’re going to talk about that next week. Hope to see you then.
Thank you for listening to the All Things Substance podcast. For show notes, links and downloads, please visit betsybyler.com/podcast. If you loved what you heard today, it’d be great if you would share those with your therapist friends and colleagues. If there are topics that you think would be useful and you’d like to hear me cover them, please let me know. Just send a message to firstname.lastname@example.org. I’ll see you on next week’s podcast. And until then have a great week.
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