Joe Rogan - Is Marijuana Medicine? | JRE Pot Debate

Two, one, and we're live, ladies and gentlemen. Uh, or gentlemen, you too. Ladies and gentlemen listening, but you too. Uh, unless you have some non-binary handle that you enjoy. It's a new world. Uh, please, please introduce yourself. Sure. So, uh, I'm Dr. Mike Hart, originally from St. John's, Newfoundland. Uh, now I'm residing in London, Ontario and I'm a family doctor and I've been practicing cannabis medicine for just over five years. And you sir? Uh, my name's Alex Berenson. I used to be a New York Times reporter. Uh, then I became a spy novelist and most recently I wrote the book, Tell Your Children, The Truth About Marijuana, Mental Illness, and Violence, which came out last month and, uh, has not endeared me to the cannabis advocacy community, I'd say. Have they, uh, attacked you mercilessly for this book? Yes, they have. Yes. And that's, and that's okay. Uh, I've also heard from a lot of parents, uh, you know, some users, but parents who've told me, uh, that the book really encapsulates their, their family's problems in the last couple of years. Um, I suspect my, my real thoughts here before we even get started is that we're going to find that the truth is somewhere in the middle here. Um, I don't think marijuana is a hundred percent safe, honestly, for everybody. I really don't. I know too many people that have had experiences where they took too much, particularly edibles. And uh, I don't, I want to say I know anybody who had psychotic breaks, but I know some people that freaked out for weeks. You know, in fact, uh, we just had a, uh, a comedian here from Brazil, um, a couple days ago, Rafi Bastos, who said he took a couple of hits of a vape pen. He was high for 14 days, went to a psychiatrist and, and he's a big guy. He's like six foot five, six, six, you know, and you know, they told him to keep taking it because you know, he's like, you're so big, just keep smoking. And so he doesn't smoke. So he just kept hitting his vape pen. He said, I was high for fucking two weeks. Yeah. You need to do it properly, right? It needs to be held to the same standard as any other medicines. So you need to identify that there's risks and there's benefits to it. Right. And some people are definitely, you know, going to be more susceptible to those risks. Yeah. And so you're going to, you know, tease out those people and make sure that those people, you know, don't put themselves at risk. Yeah, I think so as well. And this is one of the reasons why I want to state this because I'm a well-known marijuana advocate, but I, I do believe, I believe absolutely there are great benefits to it. I think there's great benefits in terms of, uh, relieving pressure, ocular pressure for people that have glaucoma, people with AIDS who are on medication, people with cancer that are going through chemotherapy, find great benefit in terms of helping them. And then there's also some people with autism. I know people that their children have autism and they give them small amounts of edible marijuana and stop seizures. It's incredibly beneficial in the form of CBD for a lot of different ailments. But I think with all things, and this is a stance that I've kind of like really come to accept over the last few years with all things that affect the mind, they affect everyone slightly differently. Absolutely. Alex, you want to say something? No, no, well, first of all, I, I suspect, you know, there are people who said, don't go on with Joe. He's just going to, you know, he's going to try to eat you alive and, and especially the, it'll be two on one. I told them the truth. First of all, I, I'll go on with anybody and I'm glad you had me on or you're having me on because, uh, you know, Bill Moore, he won't have me on. He's afraid to talk to me about this. Why? What he said. Well, he, you know, he told the, or his people told the Simon and Schuster PR people, uh, we just don't want to have him on. And uh, and NPR had a national NPR show, had an interview scheduled with me, an hour long segment and they canceled it. They said, they said, we don't believe in the conclusions of the book. Okay. You don't believe in the conclusions of the book? Have me on, ask me anything. And that's why I'm so happy that you're not afraid to have me on, that we can have a conversation, that we can have a conversation. Come at me with any question you want about the science. I mean, I'll say right off the top, I don't think marijuana is medicine. It has a few, uh, medical uses, uh, that have been, you know, CBD has been shown to reduce seizures in kids. That's great. Uh, THC has been, uh, shown to reduce the nausea associated with chemotherapy. That's nice. Uh, but for the most part, people use THC and cannabis as recreational intoxicants. They use them to get high the same way they use alcohol, the same way they use other drugs. And the sooner we, we accept that reality, the better off we'll all be. That this is a drug and it has risks and benefits and the risks and benefits are different than alcohol. They're different than other drugs. But I don't think if you look sort of on a population level basis, they're less than alcohol. I don't think you can even say that. I don't, I really strongly disagree with that. And I mean, you just have to look at the death rate, right? Uh, you know, more people die from alcohol than, you know, almost all drugs combined. But when we're looking at cannabis, there's zero deaths attributed to the use of cannabis itself. Sure. You could say, you know, someone could use cannabis and jump off a cliff or something like that, but we're talking about the lethal dose. You cannot die from cannabis and just based upon that alone, it makes it much, much safer than alcohol. How could you say that if that is the case? So, okay. So that's a really good question. Uh, the normal number that's used for us deaths from alcohol is about 90,000. Now about 30 to 40,000 of those deaths are deaths from the physical effects of alcohol, right? Essentially liver damage, either chronic liver damage, you get cirrhosis, you die. In some cases you can drink so much that you kill yourself in a night. Uh, so that's about 30 to 40,000 deaths. The other deaths are generally associated with alcohol, meaning somebody drinks. Violence. Exactly. Violence, suicide, car accidents. All those numbers are basically based on studies from the nineties and before where, you know, people looked at traffic accidents and there were a certain number of those accidents where people had a blood alcohol content of higher than 0.1. They said, okay, that's an alcohol associated death. That's a fine way to count as far as I'm concerned. Nobody has ever done that count for cannabis. And I can tell you based on the, on the talk screens that I've seen from Colorado, where people had cannabis in their blood and committed suicide, people had cannabis in their, or I should say THC in their blood and, uh, and got into fatal confrontations with police officers. If, if, if, and when we do this number for cannabis, which we need to do as soon as possible, the number's going to be a lot higher than zero. I suspect it will be in the 10 to 20,000 range. We won't know till we actually do it. Okay. But let's, let's eliminate, let's go even over the alcohol. Let's eliminate all things like violence and let's eliminate suicide. And let's assume those people would have committed violence and committed suicide without it. You're still looking at a giant number of people who drink themselves to death, thousands and thousands and thousands of people every year versus zero with marijuana. And you're aware, I'm sure that correlation does not equal causation. And that especially in a place like Colorado, where you're dealing with cannabis, something that stays in the system for many, many weeks. If you're testing people and they test positive for marijuana and they wind up committing suicide or they wind up committing violence, they don't even necessarily have to have been under the influence of it. Well, as you know, there's, when you test the blood, you can test the, both the active metabolite and the inactive metabolite of THC. So the tests, when you do a blood test on somebody who's, you know, who's committed suicide, it's sophisticated enough to tease that out. So there's a lot of people who have the active metabolite in their blood. I agree. And alcohol is a physically toxic substance. Cannabis is a neurotoxin for a lot of people. But in addition to, you know, the death, there's also just the morbidity that's associated with alcohol. I mean, it ruins people's lives. It ruins marriages. It leads to weight gain. It leads to a lot of metabolic disturbances. I think you could say that for some people with marijuana too. I think you could say some people, especially weight gain, that some people smoke a lot of pot and they get lazy and they start eating Cheetos all day. And you could also say that with some people, you know, the wake and bakers that, you know, seem to be wasting their lives away. And that's like the stereotypical negative con, you know, when you're talking about a negative description of a marijuana user, it's the wake and bake, or the person who's high all the time. You could absolutely say that could ruin relationships. You could absolutely say that would ruin your job. You could, but again too, you know, we're using the term marijuana and really we should be using THC or high THC when we're saying that. Because you know, people who use high CBD every day, as we know, or most people listen this probably because CBD is non-psychoactive. It does not get you high. Super beneficial. You know, that can be extremely beneficial for a variety of different disorders that people have. So, you know, we really need to be careful about using cannabis versus using, you know, THC because it's really the THC that can do that. And to your point, you know, but you know, you say like THC can cause the munchies and of course it's, you know, not good for someone who doesn't want to gain weight. And just, you know, so people know the way that it does do that is when THC attaches to the CB1 receptor, you get an increase in a hormone called ghrelin and ghrelin can actually induce hunger and that's why people get the munchies. But you know, that is not necessarily a bad thing if you're someone who has cancer or if you're someone, you know, who's wasting away from a terrible illness. You know, so sometimes, you know, having, having the munchies is, is definitely a good thing. And I know, you know, a lot of people have said to me, you know, it's not available. So you should probably, you know, not talk about as much, but there is another cannabinoid called THCV. So, you know, there's, there's over a hundred cannabinoids in cannabis, THC and CBD are only two of them. You know, those are the main ones that people know about. So THCV has been shown to actually reduce appetite. So if we can get that out there in the market, you know, like we have with, with CBD, then we can almost, you know, eliminate or potentially, you know, substantially reduce the problem that people have with, with, with THC by using it with THCV. Dr. Hart, I have a question for you. When people come into your practice, do they, do they want high CBD products or did they want to get intoxicated? No, absolutely. Well, in Canada, it's fully legal. Sure, of course. Yeah. So it's like, if they don't need to go to him to get intoxicated. Right. So you're seeing a population that is genuinely interested in the health benefits. Absolutely. Because I mean, if, and I mean, I'm glad that, that, that's legalized in Canada because it does make my job a little bit easier because like basically everyone who's coming to me now, I know that they want to use it medically because if they want to use it recreationally, I mean, they just go to the store, right? Right. Because it's kind of a pain to, you know, get in to see me come in and have the discussion and all that type of stuff. So, you know, the people who see me now, you know, they're all using it medically. And then, you know, to answer your question though, Alex, almost all my patients, as soon as they come in, they say, I don't want to get high. I don't want to get high. Like that's almost what everyone says. So you know, I think the word is out there that, you know, CBD is non-psychoactive and it doesn't get you high. And I think that a lot of people are really interested in that compound. And you know, if, if the people didn't have the success that they've had over the past few years, you know, it wouldn't be as popular as it is. So you know, I think that, you know, we do need to look at the scientific evidence, but we do need to listen to others. And the anecdotal evidence is, you know, something that, that we should consider because it is so strong. Alex, let me ask you this. Why don't you consider it medicine when it has proven medical benefits? Well, it obviously can be medicine for these narrow things that the FDA has approved it for. But as you know, I'm sure, when people talk about it as medicine, when the, the, the, the ballot initiatives that have gotten it approved as medicine have really essentially deceived voters about the process, right? So you go to a, you, you go to a pot doctor, you get an authorization. That authorization essentially enables you to buy as much cannabis as you want for the next year. Most of the time in reality, these doctors are not giving you a real medical examination. They're saying to you, Hey, do you have pain? Do you have anxiety? Here's your authorization. I don't think you should speak for every single doctor. No, no, no, no, not every, no. We don't do that at my clinic. And I know that, you know, a lot of the clinics in Canada anyway, we definitely do not do that. And you know, we provide a lot of education at my clinic and there's other clinics in Canada that also provide a lot of education. Sure. And, and I, and I imagine there's a spectrum, but in the US, this was a, and I spoke to advocates from my book, I spoke to Rob Campia who, you know, who ran the marijuana policy project for a long time for the book. And he, and he acknowledged, you know, the advocates knew that this was a backdoor route to legalization in the US. Yeah. I used to joke around about it. Yeah. My doctor said, why did he pot? I said, I get headaches. He said, when you get headaches, I said, whenever I think about the fact that pots illegal, so he wrote me a prescription. I mean, let's be honest about it. I'm not, look, I say in the book at the end, I don't think this should be, this substance should be legal. I have favored decriminalization. We're sort of jumping ahead here, but if it's going to be legal, I'd rather have it be legal for recreational use. I'd rather that we don't pretend that THC high cannabis is a medicine and I'd rather separate out doctors like Dr. Hulme. But THC is a medicine though. Yeah, but why are you saying don't pretend? Because there's many medicines that have horrific side effects. Sure. The medicine THC in regards to children's autism is pretty significant and well documented. Epilepsy, autism, those are two huge things that happen with children that they've been shown to severely mitigate with edible marijuana. So I have to push back on you a little bit. CBD has been shown to reduce seizures in children with epilepsy. It's FDA approved for that. Okay, this is proof, maybe anecdotal, but I have a good friend who has a child who he uses it on and he shows, I mean, it's been a game changer. Yeah, I mean, let me just, let me interrupt for sex slick. I had a patient four or five years ago and she was 20 years old. She couldn't drive a car because she had seizures, right? So you can imagine being 20 years old, not being able to drive a car, all your friends are driving around. So she uses a little bit of CBD, not even every day. She's never had a seizure since. Okay, but I think he's- And now she's able to drive her car. But this is, we're talking about CBD, he's talking about THC. So you're talking about, you're talking about a case, okay? And I'm not saying that your friend's situation didn't happen. I'm not saying it's not real. What I'm saying is that the reason we have clinical trials is because science, the way you know whether a medicine works or not, whether a chemical compound works, whatever that compound is, the best way to know is you give it to two groups, you give the real medicine to one group of people and you give a placebo to the other group. And you see the changes in those two groups over time and you find out whether or not your theory about whether this works on a population level basis is real or not. That is at the core of medical science and we've basically thrown that rule out for THC. Well, that's not entirely correct. You do know that there were studies that were run during the Nixon administration that showed the efficacy of marijuana and the safety of it and those were all squashed. And you also, I'm sure you know, when we're talking about marijuana, you're talking about something that's federally illegal. It's not something that's easy to run these FDA studies on. Yes, and I do think, and I say at the end of the book, I think we should drop that. I think anybody who's got a legitimate interest in researching either THC or cannabis or any of the compounds for a medical condition, let them run phase one, phase two, phase three trials. Let's see if this plant is good for these things. I think that's a great idea, but still, why are you saying that you don't think it is medicine when all these people find benefit in it? So, so... Do you think they're getting it from just the CBD, the minimal amount of CBD in marijuana? No, I think that, again, there's been a lot of research done on THC and cannabis to see whether or not those, whether THC is a compound and whether smoke cannabis can treat these conditions and for the most part, the studies have been negative. The again, there's... Negative in what way? Meaning they haven't shown any actual like... Can you cite these studies? I mentioned them in my book. Okay, well what were the conclusions of these studies when you're saying that they're not positive? Again, that they didn't work, that the drug didn't work on what? On cancer, on Alzheimer's disease, on irritable bowel syndrome, on all kinds of... So Alex, I mean, you're throwing a few different things out there and I appreciate the fact that we can't be going around saying things like cannabis cures cancer, right? But I've done videos in this even recently stating that, but if you look at the research, I mean, specifically, if you look at specific cancers, there are studies that have shown that THC and CBD can help. Like, say if we're talking about breast cancer, and I did a video on this recently, you know, if you are HGR2 positive and you use C and CBD, it can in fact reduce tumor size and it can reduce tumor growth. Now if you have... What is that? I'm sorry, can I interrupt you? Sure. What does that mean? It's a subset of breast cancer. Right. So there's different types of breast cancer and that's just one subset of breast cancer. So there are other breast cancers which do not express cannabinoid receptors. And I've seen one study at least, again, it's only one study that show that when they gave THC in that animal model, it actually caused a proliferation of tumor. So it worsened them. So I do agree with you, Alex, and the fact that we have to be careful about using terms like that, but that just doesn't mean that we can't say that cannabis is no good for cancer at all. And I mean, even in the National Academy of Science and Engineering report, you know, they said that cancer was great for chemotherapy, induced nausea and vomiting, right? So you know, it's definitely a really good medicine for a lot of different things. And when we're talking about THC, you know, I said earlier, of course, we need to be careful about THC, but it definitely is still a medicine. And to your point with regards to not being a medicine, say for something like PTSD, you know, I come from it from a clinician's point of view. So I'm not a researcher. So I need to make sure that my patients are getting better. It's very frustrating for me just to say to someone, oh, there's nothing I can do for you. There's nothing I can do for you. You know, so, and I understand that, you know, doing something sometimes is not going to be beneficial just because you're doing something. You have to do something that actually works. But you know, we do have epidemiological studies and we have other studies that have shown that, you know, when patients are given cannabis, it can reduce their symptoms of PTSD. There's also another study, you know, I don't use this drug too often called, called, Nabilone. So Nabilone is just pure THC. Nabilone was shown to reduce nightmares and people who have PTSD. So you know, it's just saying just, so just because THC is psychoactive doesn't mean that it's not a medicine. And just to keep on the topic of PTSD. In addition to that, we've identified mechanisms of action. I know there's one study, I think Matt Hill was on the, was one of the authors of that study. And he noted that in people who have PTSD, there's an over 50% decrease in levels of enantiamide. So enantiamide. Which is the naturally occurring cannabinoid. Which is the naturally occurring enantioid, correct. So you can get that through, through exercise, which is one excellent way to do it. And you know, and that's part of the, the high that you get when, after you exercise. But the other way that you can get it is by using cannabis. So when, when THC attaches to those CB1 receptors, you can get a release of enantiamide. And a cannabis dial can actually increase enantiamide by another mechanism of action as well. So, you know, there's different ways where we can, you know, raise a level of, of deficiency. So you know, to me as, as a clinician, you know, if I have someone who is not doing very well, you know, they've been on a bunch of different medications, I've identified that, you know, they have PTSD, we have a mechanism of action, we have studies. And then again too, you know, don't discount my clinical experience, right? I've been working for over five years, you know, just with, just with cannabis. I mean, I do other medicines, I use prescribed other medicines as well, but I've been doing cannabis medicine for over five years. And you know, there's a lot that, that I've learned, right? So as much as I've learned, you know, through reading studies and through going to conferences and things like that, you know, for sure the, the best resource as a clinician is, is to learn from your patients and, and to hear what your patients tell me. And you know, the, the things that my patients tell me is that THC is really effective for the sleep at night. And a lot of my patients, especially my veteran patients have done really, really well with that. Just one further point too, you know, there was a, I know it was, it was in 2015, I believe it was, there was a meta-analysis done, I can pull it up if we need to, that indicated that you know, a lot of the medicines that are being used now for PTSD are just simply ineffective. And the other thing too is that there's never been a medicine made specifically for PTSD. So all the medicines that people are using are for anxiety or they're for depression or they're for insomnia or they're for something else, you know, but when we look at like, like a study that says people with PTSD have a lower level of ananamide. And then if you can increase that, a level of ananamide, you know, that's a good way to treat someone. It doesn't matter whether it's a vitamin, whether it's a hormone, if long as you are correcting a deficiency, you're generally going to get excellent clinical results.