Episode 5: Not Your Father's (or Your Mother's) Marijuana

Mar 30

For generations, cannabis use was hidden behind closed doors. It was either stigmatized or laughed off by the general public. This means there's never truly been an honest, open conversation about the impacts of marijuana use—whether those are positive or negative. But, with spikes in marijuana potency and widespread legalization, the conversation needs to happen. David, Meagen and Alexis discuss on Episode 5 of Inside The Mayo Lab.

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David Magee: I am David Magee and this is The Mayo Lab Podcast. So I have a confession to make. The confession is that when I first began talking to students in schools or student organizations like fraternities, when I would be invited in to talk to them about substance misuse and what I faced and what our family faced, I often avoided discussing marijuana. Here's why. Because the debate, as we move toward many states and the federal government potentially one day decriminalizing as they've done marijuana and making it not a federal offense, and as many states look at making it legal, in that movement, I felt a little pressure that if I said something that might sound negative marijuana, that people might hate on me, so to speak.
I've seen some of that frankly in social media where they say it's no different than alcohol and I do not disagree, but I think there's a lot of education points about alcohol that we can and should have, just like trans fats and so many other things that are healthy or not healthy if used in excess. Finally, one day, I realized that I needed to stand up and speak the truth, and here's where that truth came from. We long have had the National Center for Natural Product Research at the University of Mississippi and Dr. Meagan Rosenthal, you made a connection for me because you work with many colleagues over there and you said, "Hey, they may have some things to share with you." I reach out to them in what they share because they've long been one of the only sites in the country sanctioned by the federal government to grow and study cannabis and THC, the ingredients that makes you high.
What they report is that since 1995, the potency of street marijuana in America has gone up drastically, nearly 400%. When I heard that, it really helped me to start connecting dots of rising addiction, marijuana use disorder among young people, other issues faced, and I decided enough is enough. I got to get over myself. I can have a conversation about this logically without being against legal marijuana. What I always say is I don't know whether I'm for it or against it. The research will bear that out. Ultimately, whatever is healthiest for American families and individuals, if legal is it, I'm all for it, but right now, we still don't know that, I don't think. What we do know is that street marijuana potency has increased dramatically.
Dr. Meagen Rosenthal: That's right. You always talk about this David, and the name of this, it's not your mother or your father's marijuana. I think about even when I was in high school, the potency had obviously increased because I was in high school after '96, but it wasn't even, at that point, what it is today. You didn't hear until the last five years the idea of marijuana use disorder. The running convention at that point was, well, marijuana's not addictive, and it's natural. It's totally fine.
There are no negative consequences for that, but we're seeing that change dramatically and the number of issues that young people and people in general are having as a consequence of that, and we've seen some of that. Again, I'm not for or against it, but you look to places that have legalized it across the country and around the world, you are seeing the fallout from maybe not having those careful conversations and not engaging in that education and not really at this point, because it's relatively new, understanding all of the ins and outs of the impact that that has on our bodies. We're in the midst of a real life experiment as we speak.
Magee: We think. We are, Alexis Lee, in the midst of a real life experiment where, again, it's one of these issues that we talk about on this podcast so much. There's decent information there. There is good information, for example, that says high and repeated use of marijuana, chronic marijuana use to a young mind is very dangerous and damaging. There's not even any gray area in there, but somehow, in this country that was built on the back of education, we haven't done a very good job of getting that information to students so they can make their own decisions. I think that's what we have to do, figure out going forward is figure out how do we have that conversation with them, A, without turning them off. B, with really being able to open their mind so they understand what's happening.
Alexis Lee: True. Exactly what you just said, and I'm a perfect lab rat in that way of I... I've said this on the podcast before. I had no idea really about marijuana till I started this job in this field and have learned so much over the past couple months. I don't blame anyone for that. It was like this forbidden fruit before. No one wanted to talk about it, hidden, but there's so much that we need to talk about to educate students and we aren't going to tell them not to do it, just like we're not going to tell them not to do alcohol or drugs, but we need to give them the tools to make decision themselves, to equip them to understand what's happening and what's in it. It's natural, but what does that mean? How does that work in your body to understand so that when they take it, they're not completely just down a rabbit hole.
Magee: So, what's interesting is there's so much we don't understand and we saw an increase in the drinking age many years ago in this country and we've seen a correlation. Whether that's related or not, I don't know, but what I'm saying is we've seen a correlation at the same time of a rise in the use of marijuana of young people that has gone up pretty substantially, and in that rise has been an extension of how they use it. Typically, it used to just be smoked. Now it's often vaped. Now it's used in many ways that not only is the THC potency so much stronger, but it's used in ways that take more maximum potency from that THC, and therefore, a youth today that is chronically using street marijuana is likely getting four or five, maybe six times or more I'm told, of the potency and concentration of THC in their body on a daily basis than, say, the same teen would've gotten 20 years ago.
Now that's a drastic difference. That is a drastic difference. We are now beginning to see the evidence, as you say Meagan. Now, it's a common discussion where research is saying this is addictive, but we haven't quite gotten the information to the... When I go tell that to students and parents, they act surprised. I'm telling you, I will talk to a room full of college-educated parents and I tell them marijuana's addictive. They're like, "What? Are you sure?" They're checking on their phones. "Let me check this out." But the concept of drinking age, marijuana, again, I don't know if they're related, but I think that things are changing so fast and so drastically, at some point, we're going to have to try to unravel what is happening here.
Dr. Rosenthal: I don't have the answer to that either. That's the tricky thing about correlation, is they might be related, but they might not be, but it makes me start thinking about is... Because we haven't engaged with marijuana use culturally on a big scale that we maybe don't understand... We haven't had a big national conversation about what it looks like. We've had big national conversations about alcohol use. We have a long history in the United States of those kinds of conversations that led to prohibition, that led to all of these different kind of things in between increasing, decreasing legal drinking age, all of that. Because marijuana, like you said, Alexis has been behind closed doors and a certain kind of person used the marijuana historically-
Magee: Right. There's a stigma for sure. That's right.
Dr. Rosenthal: We've not done that with this yet on that kind of scale, and so it doesn't surprise me at all that parents don't know because I certainly didn't know until very recently that it was addictive. I wonder, and again, we'd have to look at this more closely, but if this, "We don't know," is connected to the increase in use for our young people because well, we don't know. It's natural. It's a plant and we think plants are good. We are always after everybody like eat your greens and more vegetables and blah, blah, blah.
It can't be bad for you. We also see again that parallel increase that we've talked about before on this on the mental health issues of our young people and they're looking for solutions, because until very recently, we haven't been talking about that either. We've left our young people in limbo so to speak. We haven't had this big national conversation about marijuana use and its implications. We haven't also had that same parallel conversation about mental health use. Our young people are in the midst of, "I'm feeling all these things and I don't have a solution and I'm not in a place where I can have that kind of conversation about either of those topics with my family or my parents or whomever. I don't feel like I can. Maybe this is a solution."
Magee: It's readily available.
Dr. Rosenthal: It's easy to get.
Magee: It changes how they feel.
Dr. Rosenthal: Exactly.
Magee: They're anxious, they're depressed, and so they're looking for some remedy and it's right there, it's affordable, it's available, it's accessible. Here they go. So we're seeing a dramatic increase, but in that dramatic increase, some studies show that some 20% of students, of teens these days, are using marijuana. Studies also show these days that 3 out of 10 of those students... Not a small number. 3 out of 10 of those students are likely suffering from marijuana use disorder.
Magee: That's a very substantial number, which tells the tale of why when I'm in schools and I start speaking of this, they first go start rolling their eyes, but then when I dig in and say, "I just need you to hear me. I'm not telling you don't do this. You're in charge of you. Go do whatever you want to do. I just want you to have the information, and what you need to understand is you are putting something in your body on a daily basis that is much stronger than what you have been told culturally is happening, and it may not be as easy to walk away from as you think."
Lee: I think, David, you can speak to this better because you've talked about it a little bit, that when you talk to people and they think marijuana's just not this strong drug and not this strong thing and there's no way I should have to go to rehab for marijuana, but that's not always the case, but that's what people have started to believe in a way.
Magee: Well, they do, but what's happened is we'll use an alcohol analogy. If in 1995, everybody was drinking light beers, teenagers have now moved to the effective pure grain alcohol, which we were all afraid of. That's the analogy and that's not mistaken. For the young mind, the issue is... What I tell young people, "It's your choice of what you want to do, but what I want for you is I want you to have your joy." What we are seeing increasingly is young people, for all the reasons you said, Meagan, that they are falling in that trap and then often, they're down a road of it hasn't solved anxiety.
For many, it's probably caused more. Because even in a legal state, they're not old enough to buy it, so it is created with them a relationship with what I can only call a drug dealer because they're illegal. They're being sold. It is something that is altering their mind, probably impeding their maturation of the brain and emotionally and just really interrupting their life more than you know, yet they can show up at family dinners and they can show up at school and nobody really knows for sure, like for example, if this were done by alcohol.
Dr. Rosenthal: Right. I think the conversation that we're having here reminded me of something or reminds me of something really important to think about. As it relates to what we know or don't know in the research literature right now is that it's worth pointing out the research literature often lags substantially behind the reality of what people are facing in the world. I think it's important to call that out, and one of the things that I love about the work we do with The Mayo Lab is that through your work, David, and the conversations you're having with our external communities and the conversations you have with students in high schools, we get a front row seat to what these young people are facing right now.
How do we start thinking about communicating not only with them but with their families and with our larger communities in a way to say, "Good, bad or otherwise, here's what we know right now," and how do we get you that information in a way that you can consume it and push the pause button for just a second to say, "Okay, is this a good idea for me and is this going to give me the thing I ultimately want with my life or not?" And then make the decision accordingly, but we are falling down in that regard at the research level. We're not engaging in those discussions, we're not listening carefully or even having conversations with people in the external world in the same way that we should be, I think. We are inflicting a real life natural experiment on people, but not really thinking carefully about what the implications and consequences that are going to be for them. It breaks my heart a little bit because-
Magee: Well, it does because when you think about it, let's say 9% of US adults are chronically using marijuana, 20% of teens for example. Those 20% of teens, that's risen. That's a new number. They are undeniably having impact on their lives, and then that 20% of teens, as they become adults, it does move us into a different state as a state of wellbeing as a country because it leaves us in a situation of perpetual self-medication for a large number of people, and that I think is a larger question also where it's not... What I tell students... When I walk in, a student told me once to a school, he's like, "I was afraid you were going to come in here and tell us don't do this, but I was glad you didn't." I was like, "I don't think I will ever say don't do this," but what I do think we need to increasingly help them understand, and parents who...
I had a parent call me last evening for example, and she said, "My child is really struggling and he's drowning in marijuana misuse. At first, I thought, well, he's a teen. I don't know what I can do about it, but it's gotten so severe that we've got to reach out and get some help and do something about it," and the message for them, I think for parents, she's saying, "What could I have done? What can I do?" I think for starters, it's not about spending so much time trying to scare them about it or tell them, but I think it's just having honest conversations may be beginning in middle school of, "Look, this is out there. It's a part of culture. You will undoubtedly face it. Here is what it does to the mind. Here's why I hope you will delay use."
The answer to parents that I always say is, "If you can, try every tactic reasonably to work with them to delay, delay, delay, because the longer they can just avoid that use and let their brain mature, the better odds that it will not impact them later." That's why the work I think we can do working with schools is so vital, because if we can just convey that education, young people are smart, but they just need to know the facts. Then they can make their own decisions.
Dr. Rosenthal: I think in combination with that too is this idea, and we talk a lot about this in our... Not on airtime, but the stigma of this. We think that still, culturally, and this is so not true, it's a certain kind of person becomes an addict. You have this certain vision of like, well, that could... Somebody potentially on a street corner or looking disheveled or doing... You guys can conjure all of this in your minds, so certainly, it wouldn't be my kid. It couldn't possibly. We have all of the things and we have a good life and I do good things, but that's not how any of this works.
That's the sinister part of substance misuse, is that it's not somebody else. It could absolutely be you and people in your family and your extended friend network and all of those different kinds of things. For parents to start thinking through and making the recognition that, yeah, it could be my kid, and then having that conversation with them, like you said, David, about what this does and what this looks like and how to avoid it and not feel peer pressured to start using it and doing all of these different kinds of things, it starts with us to have that frank conversation from a place of not trying to scare the pants off them to not do it, but that's really hard. Really hard.
Magee: You make a great point about the stigma because I'll be honest, I get this from parents more times than I'm comfortable with. The truth is it's easy for some people to look at different neighborhoods, lower economic strata and think, well, that's their problem. They're the ones who are just sitting around smoking weed all the time, and I actually see what I'll call some suburban judgment of when I have a parent, and it happens often, whose child is suffering from marijuana use disorder. They just don't want to admit that and face that and they will come up with any reason for their child to go get treatment except for marijuana use disorder because they think that is beneath them. I have to tell you. What we need, I think, is we really need to take the stigma out of marijuana in general so that therefore, we can begin to have an honest conversation about pros and cons.
Magee: Okay, sure. There's some medical benefits over here and here's what it does to a young developing mind. The stigma is a big issue, and I encounter that more than I like, and I try to push back against it. I say, "Look, this can impact everybody and does. Your family is no different. Your student or teen is no different, but that doesn't make them feel better." They'll go, "Oh, okay, I know, but let's not label it that." I'll have one change the language and go, "Maybe we will go for nicotine addiction, or maybe we'll say they've been drinking too much." I'm like, "Yeah, well, they're barely drinking at all." I think that it's important for them to deal with and face where they have some chronic misuse and the stigma is so critical.
So perhaps that's the one upside as we move toward a larger national conversation, but it's just not black and white. In the pushing for legality, it's not as simple as this is fine. It's that maybe, there's good arguments for it to be legal. It's just not so black and white because the data is clear. It's not just fine, the same as too much sugar or too much refined flour or too much alcohol or tobacco or anything else, and we can't be afraid to have that conversation with parents, with students, to begin to delve into how is this impacting me and if I use it daily, what is it going to do to me?
Dr. Rosenthal: That's right. I think that in addition to what you're saying there is this... This is a larger idea that we come back to in our conversations in the office and as part of this series in the podcast, is that it's not black and white and that sucks.
Magee: Be a lot easier.
Dr. Rosenthal: How much easier would it be-
Magee: It'd be a lot easier.
Dr. Rosenthal: ... if it was just right or wrong, but it's not, and so how do we... One of the things I really hope we can do with The Mayo Lab and do with our larger work at the institute is think through how do we get people comfortable with the fact that it's not black and white and what does that look like and how do we have those discussions with our young people and our families and our larger communities? I was right there with you, David, as you started talking about the fact that maybe the side benefit of legalization conversation is that the stigma attached to it goes away. That's a benefit-
Magee: That is a benefit, for sure.
Dr. Rosenthal: ... but it will come hand in hand with possibly a substantial increase in the negative consequences of using it, but if it gets us more people into treatment, then all the better, who need it, but how do we get comfortable with this idea that nothing is one or the other. It's always something in between. What that something in between is varies day to day, week to week, person to person, time to time, but we as human beings don't want to have those feelings all the time. How do we work at getting comfortable with that? I don't have the answer to that. Something I certainly struggle with every day in my life, but I think that's worthy conversation for us to delve more deeply into.
Magee: I think the only answer I have is that we know education works and young people just need the information. We just have done a very good job at teaching them how to read and write and math, and I think a lot of people would argue we need to do better. We need to do better, but by and large, our country has expanded and flourished for many decades due to education, but yet, I don't go in any school in the country really, that tackles this.
Frankly, even in this movement, as we talk about the stigma, schools are really scared of that conversation because even as it becomes more mainstream, just as I came on the beginning of this episode and said, "I'll be honest, I used to avoid this conversation," because I didn't want people saying, "Oh, well, clearly, you're anti-marijuana legal, this, that," and there is some of that that I've gotten, but I say, "But you're wrong. I might be the opposite once I have all the information, but all I'm about is about young people having the information." It comes back to social media, it comes back to counterfeit pills, it comes back to how do they manage their emotions. That has to become a part of curriculum in some way or another if we're really to move forward in this country as a healthy generation.
Lee: I think what's so great about this podcast is our goal is to start a different conversation. That's exactly what we need to do in this space, and it's with the students for sure. It's also with families, like we were talking about earlier. Vulnerability breeds vulnerability. When parents are able to take that out of their minds, stigma, and open up a space for their students to have these conversations, students, I feel, will have feel more of a safe space.
Like Meagan was saying earlier, "I'm having these mental health issues and I don't want to talk about marijuana with my parents." They're just in this no man's land of just creating and fostering a safe space for families to have these conversations through educating both the parents and the students to do that, and just, I think, also from observation, the students, if they are struggling, feel... They're already ashamed, but they know their parents are also ashamed of them or for them. It's almost like a double up that it makes it that much harder for them to speak out and speak up when they feel that.
Magee: There's no doubt about it. That's why indeed we are starting a new conversation, a different conversation. We appreciate you joining us on The Mayo Lab Podcast. I'm David Magee for Alexis Lee and Dr. Meagan Rosenthal. Come back and see us next time and tell others about it.
Lee: The Mayo Lab Podcast is produced by Dr. Natasha Jeter, Dr. Meagen Rosenthal, David Magee, Alexis Lee, and Slade Lewis. This podcast was recorded at Broadcast Studio in Oxford, Mississippi. The show was mixed and mastered by Clay Jones, and our original music was composed by Slade Lewis. The Mayo Lab Podcast is brought to you by the William Magee Institute for Student Wellbeing. For more information on The Mayo Lab, head over to themayolab.com and follow us on social media @themayolab.
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