Is There a Relationship Between Schizophrenia and Drug Use?

One of the things that happened to me as a result of like traveling all over the world is that I met this schizophrenia researcher. His name is Paul Fletcher. He's at Cambridge. And he wanted to experience like schizophrenia. He's treating these people and he wanted to really know because of this critique that you just laid out. And he's the only person who I know in that area who's done this. You know, so he he did like ketamine to try and reproduce the experience because he heard that that was like reproducing the would reproduce the experience. Of course it doesn't. But this is what people have said. Our animal models use ketamine for that reason, but it doesn't. But he was curious enough to try to figure out what schizophrenic people who are diagnosed with schizophrenia. He tried to figure out what they were experiencing. I don't know if he figured that out from this sort of experiential perspective. But what I do know is that if I ever had a relative who had schizophrenia, I would send him to Paul Fletcher. Because his perspective on it, it really respects the person who has this diagnosis and it offers them the greatest amount of hope that I have seen in that area. And it would be good if other scientists in these areas, drugs, whatever it is, would also seek to try to figure out the experience that their patients are going through. Yeah, it'd be almost like learning martial arts without ever sparring. Yeah, yeah. Or coaching basketball without really playing. Yeah, under pressure. Is there anything that mimics schizophrenia? Is there a commonly thought of substance that mimics schizophrenia? They have suggested large doses of amphetamine over periods of time with sleep deprivation, can mimic paranoid schizophrenia, but I don't know if it really does. I mean, all of this stuff I am now questioning. So I don't know. I mean, at one time, if you would ask me that question maybe five years ago, I would have said amphetamines, but I don't know now. Schizophrenia is an odd one, too, right? Because doesn't it affect somewhere in the neighborhood of 1% of the population? Yeah. That's a lot of people. But I have a lot more hope about schizophrenia after having met Paul Fletcher, just in terms of I don't want to bastardize his sort of model of thinking about it. And so I may not have all the details right, but I would just say simply try to explain that. Like you and I, we go through the world, everybody, we have these theories about how the world works. Like you smile, I have a theory about what that means, right? And so, oh, Joe likes me or he's happy today, whatever. And then I'm right because you tell me that whatever. Somebody who's diagnosed with schizophrenia, they also have these models that they're testing out. And so their model might be like when you smile, they think that you're angry or whatever. Or you're plotting against them. Yes. And their model is just wrong. I mean, it's just like they're just getting, they just have, they're bumping up against these wrong answers. And then when they get more wrong answers, it's even, it causes even more stress. And that's very anxiety provoking. And then all of that is playing into this. It's like, first of all, your models are off and now you're just getting this increased anxiety. And so I think that's how his model sees it. So that means that it's okay. As long as we let people understand that don't worry if your model is getting it wrong. It doesn't mean that that something's wrong with you. It could be maybe we are, we have it wrong in our society and you have, you might have a better way of thinking about this. So it's like, as opposed to it being one way, there might be multiple ways of thinking about these, these solving these problems that humans solve throughout their day. And that's how, I think that's how he thinks of it. And it's a model of hope for me because you lessen the anxiety among the patients. And many of the, much of the problems deals with this anxiety of people telling them that they're incompetent. And you know how that is, how that feels as an adult, somebody telling you that you're incompetent. It's like, how can you tell me I'm incompetent? So it exacerbates whatever problems they might initially have. It makes them far worse. Exactly. Yeah, there's also a thing that seems to have, I've only known a few people that are schizophrenic, but it's a disturbing thing when they think that everybody's against them and they feel like they're on their own. By virtue of everyone being against them, they feel isolated. And then whatever paranoia they have, it's like throwing dry sticks on it, just rages into a fire. And it gets even worse because they think that people are plotting against them and everyone's against them. And they don't have anybody comforting them. And we need that. We all need that. Absolutely. And I just think particularly people with a slippery version of reality probably need that more than most. Yeah, when you say reality, it might be multiple realities. And that's the thing that we need people to understand or that it's like, it's okay. It might be, your reality just might be different from theirs. But not to the point where you have a different reality and then you're allowed to abuse people. So I want to be clear because I know there are some people out here saying something about alternative facts. I don't mean it like where you manipulate people. I mean it for people who are struggling, like these people with schizophrenia, just to help lessen their anxiety. Yeah, so in terms of marijuana, particularly like high doses of marijuana, particularly edible marijuana, could really seriously exacerbate someone who's kind of hanging on barely anyway and then boom, you eat an edible. Absolutely. And you're fucked. So someone like Alex would say that person's schizophrenia was brought on by marijuana. Whereas I think you and I would probably agree they were more likely inclined towards schizophrenia anyway. And the high dose of marijuana pushed them over the end. Well, all the evidence says what you just said. I mean, so when you look at the evidence where people have done all of these studies, folks who didn't have these predispositions, marijuana doesn't cause people to be schizophrenic or have a psychotic disorder. Right. But it certainly can precipitate or exacerbate psychosis in people who are predisposed. So what I was going to get to was, do you think that maybe for people that have this predisposition towards schizophrenia, they should probably avoid psychoactive substances, or avoid something that radically perturbs their version of reality? They probably should avoid cannabis, right? I don't want to say avoid everything because— Is there anything that they could maybe use that maybe would help them? Yeah, so I spend a little time working in a heroin clinic in Geneva, and so they give out heroin to these patients twice a day, every day. How do they give it to them? Intervenience or oral, however the patient wants it, but a lot of intravenous heroin users. And it's all sanitized setting, hospital setting, or clinic setting twice a day. Many of these people have psychotic disorders, like diagnosed with schizophrenia, and heroin helps. Calms them. Yeah, with many of these symptoms, and they feel better, even more so in some cases than antipsychotic. Really? Yeah, I talk about this in the new book, in fact. But yeah, this is—so I don't want to have this blanket statement that they should avoid psychoactive substances because some might actually be helpful. And some other people have tried other drugs. One psychiatrist in the Netherlands gave his patients amphetamines, and he swears that it works. But that has to be researched out, but we'll see. But I know cannabis for sure. I wouldn't do that one. You wouldn't do cannabis and perhaps maybe not high levels of amphetamines as well, either, right? I don't know. I would have to slowly titrate and see whether or not it worked, whether or not people felt better.