Joe Rogan - Is Weed a Gateway Drug | JRE Pot Debate

It's not simply a perspective enhancer. It changes how your body and your brain deal with opiates. I think Tim Ferriss has actually talked about that before as well. But I mean, I've seen it in my practice and there are medical studies, so I don't think that we should throw out the fact that cannabis can help the opioid crisis. And then also too, you want to look at it from a clinical perspective, right? So we know that opioids can kill people, right? Because it acts on the brain stem, whereas cannabis doesn't. So you might be saying you're just substituting one for the other. And sometimes that is true. But if you're using a less harmful substance, to me that's like a huge win. So if someone has to drink 12 beers a night versus smoking one joint, man, that's awesome. And I mean, you look at all these clinics, like you look at like methadone clinics, I mean, what are they doing? They're trying to get people off one substance to a substance that is a little bit less harmful. And I think that when you use cannabis, it can be effective for opioids. It can also be effective for benzodiazepines and for other medicines as well. So it would be awesome if everyone would just feel happy and great all the time by just exercise and nutrition. And that's what I advocate and that's what I try to do personally. And that's what I try to say to my patients all the time. But I understand though that sometimes life is hard. Sometimes things hit you. You have crisis in your life. You have personal crisis that can throw off your mental health and then you get into a car accident and you could be in really severe pain. And in those times, you know, sometimes diet, exercise, meditation, doing all the right things just isn't quite enough. And you know, I think that it's great that we have cannabis for those situations because it does seem to be, you know, very effective and has less side effects compared to some of the other medicines that we have traditionally used. And you know, even though, you know, I'm talking about opiates and deaths, you know, we can also talk about NSAIDs, right? Like nonsteroidal anti-inflammatory drugs. So you know, these drugs can also, you know, wreak havoc on your GI system. I saw one study, actually I tweeted out, Rhonda Patrick tweeted out, said that if you use NSAIDs, it was really short. I got to look it up again, but it was like two weeks. It can decrease your, your gonadotropins, which can stimulate your testosterone level by like 25%. And on that note too, we should talk about, I can't believe I forgot to talk about this, but opiates can drastically inhibit your, your testosterone production, right? Which is a huge thing for depression because I've had guys come in to me before that have been, you know, really, really depressed. You just give them a small amount of testosterone and then they're off their antidepressants and they're off to the races. They're doing great. So you know, are we creating a lot of people who are, who are depressed because they're using opiates and their testosterone levels are low? And you know, for men, I mean, having low testosterone is horrible. You know, your libido goes, you know, you're going to have low motivation. You know, you're not going to feel as well. You're not going to want to do things. So you know, if you're giving someone a medicine that, that, that nails their, their testosterone levels down, that's going to really, you know, wreck, wreck, wreck havoc on their mental health. And I just want to make a note too, because Ben Greenfield, who again, I really, really respect. I like that guy a lot. You know, he was talking a little bit with you about testosterone and, and, and cannabis and how it can drop it. So I think there was three studies I saw done on, on humans. And two of them noted no statistical difference and drop in testosterone levels. And one study, the other study noted a small statistical difference. So you know, I think that, you know, it may drop your testosterone levels a little bit, but it's not going to substantially drop them. So just so people, people know, know that, because I know that comes up all the time, you know. Oh yes. As the, as the, as the dumb anti-drug advocates like to say, doobies cause boobies. Oh yeah. Yeah. That is, that is not, that is not right. There's no going to, there's no getting that so associated with that. I'm joking. Risperdahl causes boobies. That's a different issue. Risperdahl's an antipsychotic. Risperdahl, yeah. So, so look, I think, I think the issue of whether cannabis is a gateway drug, there, it's a hundred percent clear that cannabis is a gateway drug. The argument is why. Did you say it was a hundred percent clear? A hundred percent clear. The argument is why. Okay. So, so it's quite clear that cannabis use oftentimes precedes other drug use, whether it's opioids, cocaine, other drugs. Now one argument, and this is actually a pro legalization argument, is one reason it's a gateway is that if it's illegal, you got to buy it from your friendly neighborhood dealer. He might have access to heroin or cocaine, other drugs. And so eventually maybe you decide to try one of those other drugs. So actually that's really why the Dutch legalized. They wanted to create an avenue for people to use cannabis that wasn't connected to other drugs. Okay. So the third possibility is that using an addictive intoxicating substance, you might like it and you might want to try other addictive intoxicating substances and it might prime your brain. And then the third possibility really is that there are just some people risk takers out there, right? They use, they're going to use cannabis, they're going to gamble, they're going to, and cannabis is a little bit easier to access than other drugs. So they're probably going to try cannabis first. So it's not really that, that cannabis drives the use. It's just that cannabis is first. They're just curious people. What's your thoughts on? Well, what I will say, I mean, I'm just going to go back to the NAM report, right? I mean, I mean you quoted these people in your book. You know, so this committee couldn't find sufficient data demonstrating an association between cannabis use and initiating opioid use. They found no compelling evidence to support the gateway drug theory. So again, those are the people that you quoted in your book. So there's been more research done since then, but things have radically changed. I would say things have changed some. Here's what I would rather say. I think that probably it's a combination of those things, right? There's certainly an environmental factor where again, if you're buying from somebody who's got access to other illegal drugs, maybe you try those drugs. At the same time, getting high feels good and maybe you want to try other drugs. And at the same time, you're just a risk taker. Okay. What nobody seriously ever said until about the last five years is that cannabis could be an off ramp for opioids. Okay. And there's a lot of reasons to believe that's a really bad idea. First of all, cannabis, if you actually need opioids for pain relief, cannabis is not a good enough pain reliever. It's like alcohol. It's a mild pain reliever. It's not strong enough. You're dying from cancer. Cannabis probably is not the pain reliever that you need. You need opioids. Okay. And again, the state level data is not as good. If you want to really figure out what's happening to an individual, the best way to do that is to follow that individual. And there's a really good paper that came out in 2017 after the NAMM report, so they didn't have it, that shows that people who used cannabis in 2001, this is based on a large national study in the US, were three times as likely to be using opioids three years later. Okay. And that just intuitively makes sense to me. And the other thing that people on the legalization side don't ever talk about is who are the two countries that have the most cannabis use in the West, the US and Canada? Who are the two countries that have by far the worst opioid epidemic, the US and Canada? Okay, but there's a real issue with that because the United States is also the only country other than New Zealand that allows pharmaceutical companies to advertise. Advertise, sure. I mean, there's a- Yes, but Canada doesn't. The amount of opioids that are prescribed in the United States is fucking preposterous. I agree. Particularly, I don't know if you ever saw the documentary, the OxyContin Express, but the way Florida used to be structured, where they didn't have a database. Yep. And you could just literally go from pharmacy to pharmacy. Yeah. Yeah. No, we have a problem with the way we prescribe drugs in this country. Opioids, ADD drugs, benzos, SSRIs, all of them. And we're connected to cannabis, so it makes sense that it would filter over there. Yes. But what I would say is the people who think that cannabis is not part of that overprescribing problem are diluting themselves. And what do you think to that? Sorry, can you repeat the question again? So I agree with Joe. The way the access to opioids in the US, I mean, certainly it's come down a little bit in the last couple of years, but Purdue Pharma, there's a special place in hell for those guys. But it's not just opioids. We prescribe too many benzos. We prescribe too many ADD drugs. We probably prescribe too many SSRIs. We prescribe too much in this country. I think we all agree on that. I agree with that. And I think that cannabis is another example of us looking for a drug to solve our problems. But what I'm... Okay, again, just from a clinical perspective, I can't just rely on diet and exercise. I can't just rely on exercise for all my patients. I have to use other tools. And again, everyone here in this room, we're all pretty healthy. I don't have a bad back or I don't have a mental health diagnosis or anything going on. So I have to look at patients that are coming to me. So the way I see it is that we just mentioned a bunch of other drugs, antidepressants, amphetamines, all these types of things. Cannabis, and again, I'm going to separate the THC and CBD. It's an incredible medicine and it doesn't kill people. So as a clinician, that's so comforting for me to know that every single night I go to bed, I killed zero people. I know that. So that's really, really comforting for me to know. Also I feel we're just talking about amphetamines and we're just talking about SSRIs. I feel that cannabis, particularly the CBD component, can actually be more effective. That's what I've seen a lot in my practice and other people have seen that as well. So I think that we need to take that into consideration when we're using all these drugs. And Alex, some of the things that you're saying, they're quite admirable and a lot of things like researchers say are quite admirable as well and they feel that they can tell clinicians, give them really good advice, but they're not the ones in the trenches. They're not the ones in front of the people. They're not the ones that have to chat with patients. I have an obligation to do something for my patients to make them better. I really feel, we just listed a bunch of drugs that cannabis is a really, really effective tool and it doesn't kill anybody. So because of that, I'm going to keep using it. But like I said, I'm always looking for other drugs. I'm always looking for other alternatives to also help my patients. But I think that using cannabis is a really effective tool for a lot of clinicians and it's helped a lot of patients. But what do you think about his argument about it being a gateway drug other than what these people said in the study that there's no evidence that supports it, it's a gateway drug. What are your personal feelings about that argument? So I don't feel that cannabis is a gateway drug. I do feel that one of the things that you mentioned earlier is that some people kind of have this personality where they're like an experimenter and they just want to try something. So the fact is that alcohol and cannabis just get introduced first most of the time. Most people don't do coke or LSD and then say, hey man, let's try some cannabis. So it's just that that's the very first one there. So you could say anything that was easier access. If there was some new drug that did something similar to alcohol or similar to cannabis that was introduced in our society, you'd be calling that the gateway drug. And I do believe that that... Laffhalls clearly been demonstrated as being the gateway drug to almost all heart drugs because of the loosening of inhibitions. Whereas the opposite could be said about cannabis. That it makes you paranoid, you might actually be less likely to try cocaine afterwards. And I know that the name, they don't feel that cannabis is a gateway drug either. I mean, again, they said, they found no compelling evidence to support the gateway theory. And again, I mean, these are the people that you are calling in your book. Let me just go a little bit further. They said in a retrospective cohort study, Mayatt from ETAL and the 2016 examined the transition from cannabis use to the use of other illicit drugs. They found that the probability of initiating other illicit drugs after cannabis did not differ significantly from the probability of starting with other illicit drugs. So it's just that cannabis is there first. It's definitely not a gateway drug in any stretch of the imagination. Again, I totally disagree. And again, there's 50 years of data on this. I know the studies that he's quoting, but there are many others. And I think the argument is as to why. And again, I think the argument that to some extent having access to this drug via illegally tends to open you up to other illegal stuff, which to me is an argument for legalization. But I do want to throw one thing out there. I don't know how many of your viewers have teenage kids or it's probably more likely to be teenage kids than to have teenage kids. The book has... The one thing that really worries me, if we're talking about gateway drugs, is that Juul and vaping are really a gateway to THC vaping. So you can... Why did you say that? Because, well, first of all, it gets people, it gets kids, teenagers used to inhaling this illicit substance and you can actually retrofit a Juul pod with THC. They don't sell them, but you can easily go online and look at how to do it. And I think it really worries me, and I've heard from a lot of parents in the last month, that there is an epidemic of nicotine vaping and THC vaping going on right now. And that, I think... And we're talking about 15, 16, 17-year-olds inhaling pure THC, the most dangerous form of this drug. And I think, unfortunately, it's not going to take long before the mental health consequences of that become apparent. And I really do hope that the book gives parents some tools to talk to their kids about that, if nothing else.