Dr. Nicole Ashpole: The Truth About Marijuana

Apr 4

Episode Guest:

Dr. Nicole Ashpole

Humans have consumed marijuana for hundreds of years. But, as researchers look more deeply into the drug many may view as harmless, they now are seeing it cause addiction disorders, especially among adolescents—and especially in a new age of availability and variations in how marijuana is consumed. Three out of 10 people who use marijuana regularly experience a higher chance of marijuana disorder or addiction, according to the CDC.

Dr. Nicole Ashpole, an associate professor of Pharmacology at the University of Mississippi, and David Magee discuss common misinformation about cannabis and the disconnect between the science and the public.

“It’s amazing that we’ve been consuming this plant for thousands of years, and we still don’t know a lot about it … Right now, when it’s becoming mainstream, we need to have more and more studies to try to understand what the short-term and long-term effects are going to be.”

- Dr. Nicole Ashpole

Dr. Nicole Ashpole, an Associate Professor of Pharmacology, is trained in neuroscience, geroscience, and molecular and cellular biology. She completed her Ph.D in Medical Neuroscience where she focused on molecular changes that lead to cell death within the nervous system. For her post-doctoral studies, Dr. Ashpole examined how hormone changes early in life lead to changes across the entire lifespan.

Dr. Ashpole began her independent research career by joining the University of Mississippi School of Pharmacy, where her laboratory works to explore the pharmacological activity of cannabinoids and other natural products as modulators of inflammation and neurological function. She utilizes a series of pharmacological and genetic tools to observe changes in behavior, physical phenotypes, and cellular responses in the brain. Dr. Ashpole’s collaborative teams have received over $3 million in funding from the National Institutes of Health for research studies. She has published more than 45 peer-reviewed scientific papers and has mentored numerous award-winning graduate and undergraduate students. In 2022, Dr. Ashpole as named the Faculty Mentor of the Year from the Southern Region Educational Board, which spans 13 states in the southern United States.

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David Magee: I am David Magee, and this is The Mayo Lab Podcast.
When I'm traveling different parts of the country and speaking to students, and often parents, there is one persistent topic that comes up over and over again, peppered by so many questions, and it's about marijuana and how it is used, and what is its impact, and everything that parents and students don't understand about it. So what we've decided to do on this podcast is double up on the content a little bit and continue the conversation about the effect of THC on young minds, and even older minds, not just young mines, and everything that we know and some of what we don't know. Alexis Lee, always good to see you on the podcast.
Alexis Lee: Hello.
Magee: So young people are more prone to marijuana use than older adults. We're seeing increasingly that there's probably 20% of the young population that uses marijuana, whereas there are fewer adults in America, though I think the number is increasing, but that doesn't... Sometimes it can feel like we live in this marijuana nation at a moment where there's this movement going on, but that 20% is 20% of young people and less than adults. It certainly doesn't mean everybody is doing it.
Lee: But it can feel like everyone is doing it and everyone around you is doing it. And I think the best correlation to draw to this is when I arrived on the Ole Miss campus, I thought everyone was in Greek life. It just felt like everyone was in Greek life, but we have less than half percent that are in Greek life. And so it feels like it and it's a hot topic right now, so it can definitely feel like you're a minority if you're not doing it.
Magee: And a lot of times when I'm talking to young males in particular, it does feel like more than 20% are using it, maybe more than like 50%. But we'll dig into that. We'll dig into that. We've got a great guest today to help us go there.
Lee: We do. Dr. Nicole Ashpole, an associate professor of pharmacology, trained in neuroscience, geroscience, and molecular and cellular biology. And she has such great insights. She works with a lot of different partnerships on campus, and so I know there's going to be some good conversations.
Magee: Okay. My first conversation is, can you please tell me what geroscience is? I do not know.
Dr. Nicole Ashpole: Yes, so geroscience is the study of aging. So, you think about geriatric medicine. Well, we needed to have a scientific an ology or a science, and so we went with geroscience in the field.
Magee: Okay. All right. Well, see, I learned something already. Nicole, when we talk about young people in particular and marijuana use, what I tell young people when I'm in schools, I say, "You think I'm probably out of the gate, but let me just say I'm not, meaning I don't have any stance anymore than I do about alcohol or honey buns." It's not my place to say, "You shouldn't do this." They have to figure that out for themselves. So what I've tried to do is, what we've tried to do is create a form where we can have a conversation about the substance and what it is so they can make their own decisions. When we talk about marijuana in THC for example, the studies are clear. It's like a lot of drugs in the country. It's not all bad. There could be some.. I think there are some proven scientific benefits, for example.
Dr. Ashpole: Yeah, there are some scientific benefits. We do have some FDA-approved medicines that have constituents of cannabis in it. So whether that's like... CBD isn't Epidiolex, which is used to treat childhood forms of seizures and epilepsy, and then there's also like some THC derived medicines that can be used to help with nausea and vomiting with chemotherapy and with aids. And so we know that even the FDA has found some warrant in some cannabis-based medicines. And then with all of the states trying to legalize medical marijuana, just like we did here in Mississippi recently, we've seen benefits against things like pain and some forms of anxiety, PTSD type effects. There's also risks, like you said, right? And so we have to just go with what the science tells us, and the science tells us that there are some things that might work well on, and there are some things that are going to have clear risks.
Magee: So it's interesting. I think the story has been told culturally. When I talk to young people, for example, they anecdotally share that they believe it reduces or eliminates anxiety kind of carte blanche across the table. And I usually say, I think the research shows that for some people and for some circumstances, and in certain amounts, it can reduce, right?
Dr. Ashpole: Right. For sure. Higher amounts of THC actually can induce anxiety. And so you see that some people will do what they call dabbing, which is going to take this oil or this butter and try to inhale that. That's been shown to definitely have increased levels of anxiety. There are some people who just respond differently. I know that I have responded very poorly with high anxiety when I have consumed cannabis in the past, but others will use it to try to help reduce that anxiety. And so I don't know... We have our own endogenous cannabinoid system, the endocannabinoid system that we know regulates emotion and pain. And so it probably contributes to why some people might respond one way or the other, depending on what your own normal balance is within your system.
Magee: Yeah. And I think that's a great point. We have tried culturally to apply kind of a one size fits all. Here is this drug. And people growing up kind of get this same message, and it's like the truth is brains are different, as you just noted, for everybody, little points of difference. There are studies around cannabis that show males and females respond differently even to it. So we know that it's clearly not one size fits all. So when a parent says to me, "I don't like it that my child is using marijuana, I don't like it at all, but hey, they're anxious. If it reduces their anxiety..." And I'll often say, "But I'm not sure that. I'm not sure that that does just that." What do we know that happens with marijuana in the brain? What's going on in that relationship?
Dr. Ashpole: Well, we know that when we're taking something that has THC in it, THC is acting on one of our receptors called the CB1 receptor. And that is what gives you that high, that psychoactive response. And so when CB1 is activated, you see reduction in movement, you start kind of slowing down. That's typically where you start to see the relaxation. You can get a drop in your body temperature. And that's just because where the receptors are for CB1, and what it's regulating is this normal natural response. And so we can see that agonists will do that. But when people are taking cannabis, when they're smoking pot or consuming an edible, they're not typically just getting THC. They're getting THC and all of the other compounds that are similar to it within the plant as well. So you have to keep in mind that the plant doesn't just produce THC or CBD.
There's over 130 cannabinoids that are found within the plant. Plus, then you have all the things that give it its flavor and its smell, the terpenes and the flavonoids, and we know that some of those are active too. So there's a reason why people might respond differently to one strain or type of cannabis than another.
Magee: Got it.
Dr. Ashpole: So if we think about... In science, we try to really target and try to understand what is CB1 doing? What is CB2, the other cannabinoid receptor doing? But what we've learned is that you're going to be taking in... A lot of people are taking in these dried leaves that have all sorts of compounds in them, and they're not just hitting one receptor or the other. They can hit some of the other components of our cannabinoid system. They might hit things totally unrelated to the cannabinoid system. And so putting all of those constituents together into our body might have a different effect than just taking THC.
Lee: If you do edibles, oils, is that different. Also, when it hits your system?
Dr. Ashpole: Yeah. The way that you isolate out the material from the plant will give you different chemical compounds. So if you're going to boil it in water, so in a bong, you're going to get out different chemicals that could go out into the water and could respond to that heat and water to come out, compared to if you're putting it in butter in the pan and you're trying to make an edible, we get out different compounds. And that's just because the chemicals themselves, some of them are really oily, and so they come out in oil-like substances, and some of them aren't. But when you put in heat and you kind of cause a conversion with water present, you're going to get other compounds out. So people can respond differently because you're getting different chemicals out, whether you're boiling it, smoking it, or putting it in water.
Magee: And another common myth, I think about marijuana throughout the country, particularly in young people, is that they don't consider it addictive. But the CDC has a study out in recent years that suggests that some three out of 10 people who are using cannabis on a regular basis likely suffer from marijuana use disorder.
Dr. Ashpole: Right.
Magee: What is the role of, say, academics, and what is the role of studies as this becomes more pervasive? I have a common line. People that listen to this podcast have certainly heard me say it before. I tell young people all the time, I'm like, "Look, just because alcohol is legal doesn't mean that if you were drinking a fifth of vodka every day, that you would be functional and that would be a good quality of life." And so somehow in this march to mainstream, we've got to also balance it out with education. So how do you see the role of in, say academics and in the government like the NIH in different study? Where do we go from here to, as this becomes increasingly mainstream, to really ramp up the education and the conversation?
Dr. Ashpole: I think it's amazing that we've been consuming this plant for thousands of years now, and we still don't know a lot about it. We might know a lot about the plant, but we still don't know about the long-term effects, the risks at different stages of our lives, the benefits at different stages of our lives. And there's some politics behind that, right? There are many other things that kind of influenced maybe that lack of knowledge that we have. But right now, when it's becoming mainstream, we need to have more and more studies that are done to try to understand what the short-term and long-term effects are going to be. And when we know that people are trying to find different strains that they think this strain is going to be best because I have cancer pain, or this strain is going to be best over here, we don't have really clear science behind really any of that.
Now, I know that there's been a push from the Biden administration. They released a statement that they're going to open up research access, because one of the things that's been hard is it's been hard to access cannabis for research. We're very lucky here at the University of Mississippi.
Magee: And we've been one of the only ones back in the day. Our marijuana studies here sanctioned by the government were one of the rare few ones for a long time, right?
Dr. Ashpole: Right. Yes. So we've been studying for over 50 years. Our campus has been the only federally approved growth site for cannabis for over 50 years now.
Magee: Wow.
Dr. Ashpole: They're opening that up so that other places might be able to grow, but we're still the main producer right now for any medical cannabis, anything that's happening in research that's sanctioned by the DEA and that's supported by the National Institute of Drug Abuse.
Magee: Wow.
Dr. Ashpole: So, yeah. But I think that now that we can see this drive in public demand, we need to make sure that we're getting that research that is matching, and we are demanding more research to try to understand the effects of all of these constituents in humans.
Magee: Well, it's vitally important in a lot of ways, because as you noted earlier, there is potential long-term health implications that we may not know. There's certainly likely some. And it's not the norm that if large amounts of substances are consumed at a young age over a long period of time, there's usually some impact, you would think. But then also the difference in this and say alcohol, for example. Students will tell me, "Well, hey..." And I think the workplace is no different. They'll say, "I can get away with coming to school high, whereas if I walked in there and they smelled alcohol in my breath, I'd be out of there in one minute." And it stays in your system long. So as it becomes this mainstream movement... Again, I'm not passing judgment on it. What I tell everybody is, look, if that's the best way forward, I'm all for it. I don't spend any time on legal, not legal. I just am concerned about humans having the education and the facts.
Dr. Ashpole: Right.
Magee: That's what we know, right? That can drive us forward.
Dr. Ashpole: Well, I think the way you've said that with... You started out by saying there were 20 to 25% of young adults or teenagers that are consuming cannabis, and we know it's about five to 6% that consume daily based on the FDA study. But when you look at cannabis use disorder, one of the clear things that's come out are the marijuana use disorder is that earlier in life, it appears to be more prevalent in individuals who are adolescents who are consuming more frequently. And so a use disorder, whether it's alcohol use disorder or cannabis use disorder, those are defined not just by having that addictive potential, but they're defined by us having cravings or feeling like, "You know what? I can't get out of bed. I can't go to school if I don't smoke pot before I go," but also that you're willing to make riskier decisions to try to get to that.
And so even if you think, "Well, I don't need cannabis, I'm not addicted to it like my friend who's addicted to alcohol," if you're showing some of those signs and symptoms that are just, you think you need this to relax, or you just really would like to have it right then, or you're willing to go and break the law to do something, You're showing those signs. But the adolescents are the ones that we're seeing increased risk of cannabis use disorder if they're using earlier in life.
Magee: Yeah. I'm increasingly seeing that, and I think some of the information is not clear, but I increasingly see young men suffering more. I'm not to say that... And that's anecdotal, but I think that there are plenty of studies that say men, in general, are more likely to suffer from misuse of illicit drugs, I think. So it's not necessarily off base what I see anecdotally, but they say to me over and over again, young men do, they will say, "Wow, I thought this wasn't addictive." I think because they think addiction is, just as you said, I'm having these shakes. I'm not sure that they're piecing together this psychological dependence and are putting themselves at risk at it, but they will say, "I'm anxious so I don't feel comfortable going to school without it." That's what they will say, not really being able to make that association that on a habitual level, they are altering how they feel.
Dr. Ashpole: Right. Yeah, for sure.
Magee: Alexis, when you grew up as a young person, was marijuana prevalent? Most of us have marijuana stories, but I'm not sure everybody does.
Lee: And I'm one of those that does not. We joked, and I joked with someone over the weekend, and I was like, I don't think I knew how to spell marijuana before getting into this field, really. It wasn't something I was around a lot. When I came to college, it was a little more prevalent, but I still didn't really, really understand or have the education behind it, what it was, what did to your brain. Honestly, I'll be honest, in college, I was like, where do you even get it? I kind of was one of those, I was just like... And I felt very left out, in a way of, I just didn't know, but I also kind of was kind of scared of it.
Magee: Right.
Lee: So it was a healthy balance of, I don't know a lot about it. I don't really know if I want to know a lot about it.
Magee: Right.
Lee: But I had friends around me that were doing it, and I just really was kind of stayed away from it.
Magee: My wife tells the same story, that when she was in college, she wasn't made a part of it, but she almost felt strangely left out, not that she... You know what I mean? So it was interesting. But for me, who has battled substance use disorder, marijuana didn't take to me the same way that it did to my two sons, who when I read in my late son's, William's journal about starting using marijuana early in high school, he would argue back to me in debate that it wasn't addictive. But by the time he got into treatment, he wrote in his journals about being completely addicted. And my other son experienced the same thing, where in my same family, where substance use disorder was prevalent, for me, alcohol would've been something that hit my brain, and my brain said, oh, go back to that. Where frankly, marijuana, my brain said, you could live without that. It kind of makes you feel a little creepy. Maybe avoid that.
So I think that it is such a learning process that, what you said, how it's just not one size fits all, but that is the message that's pervasive out there, I think.
Dr. Ashpole: Yeah, I agree. I think that is, especially as it's been growing in popularity, and as you're starting to see more and more CBD products and you're starting to see more delta-8 coming around, that people think that everyone's going to respond the same and that it's all going to have either a really good effect or a really bad effect. And I think that's been really polarizing, and it's limited that push for research. And I'm hoping that that'll change more over time. I guess I was more like Alexis during high school. I didn't really know the difference between marijuana or meth. I knew they were both bad.
Magee: Stay away from them.
Dr. Ashpole: Talked about them. Yeah.
Lee: Yeah.
Dr. Ashpole: And so it was a learning process for me. And I was pretty naive in college when I bought a special brownie that I thought was just on sale. I just didn't really put it together.
Magee: But seriously. And how did that go?
Dr. Ashpole: So it's actually even worse than you'd think because I split it with my professor.
Magee: Stop it.
Dr. Ashpole: So I was doing a study abroad.
Magee: And what university was this? No, I'm teasing.
Dr. Ashpole: Yeah, I was doing a study abroad with biology, and I got a brownie at... We were waiting for our airplane or something, a form of transportation. And there was a cart, and so I was like, oh, I'm going to get this brownie, and it so special. Right? Especial. And I was like, oh, perfect. But it was pretty big. And I was like, oh, it's kind of weird flavor, and it kind of smells weird.
Magee: Wow.
Dr. Ashpole: And I kept eating it. And then I offered some to my professor, and he's the one who told me.
Magee: Oh, then he's like, "By the way, that specialty wasn't built in whipped cream."
Dr. Ashpole: Yeah. No, he immediately, his eyes went big, and he was like, "Where did you get this? What is this?"
Magee: Wow.
Dr. Ashpole: I was like, "Oh, okay."
Magee: Yeah.
Lee: We've talked about it a lot in this podcast, education. There's a huge gap in education in all wellbeing space, but I think especially in this space, and it's interesting of, where do you educate kids? How do you have this conversation? Because I don't think schools really are necessarily are like, "Yes, let's talk about it."
Magee: Actually, I will interrupt you on that, Alexis, and say... Because you just hit on something.
Lee: Yeah.
Magee: I'm going to give you a real life experience. I was in a state recently speaking at a school where marijuana, not medical marijuana, but marijuana has just become fully legal. Okay? And again, I'm not passing judgment. I'm just saying that, schools.. I think the workplace is the same way there. It's happening fast, and so they're figuring out, what are we going to do? So I'm at this school and it's just become legal. Now, it's legal 21 and up and not for 16 year olds, but edibles are suddenly flourishing in the community. They're everywhere, right? And so some student came to school with a lot of edibles, and they're passing around, and they're noticing. It's kind of like you with that brownie on the plane and your professor and whatever's happening. We won't go there, but it's having an impact, right? It's having an impact. And so this was happening in the school, and the school was kind of caught off guard because they have seen the legislation pass and they knew that it was about to happen. But what they don't know, and I think the workplace is the very same thing, is how...
Okay. Edibles, for example, they're not smoking it, they're not, but they are bringing it in, and suddenly they could be under the influence in our school or in the workplace. And what are we to do?
Dr. Ashpole: I think that education... If you go on to the NIH's webpages, they have a lot of resources on educating about a lot of potential drugs of abuse, but they have some really good marijuana research pages-
Magee: Okay.
Dr. Ashpole: ... that even have printouts that people can take and use in schools. I think that the NIH has realized that there is this education gap. I thought it was particularly interesting. Mississippi just passed medical cannabis, right? And it's active now. And so I was on our Mississippi State Health Department's webpage, and there's the links to the cannabis to sign up up and how you get your card, but there wasn't any links to anything on education of marijuana and cannabis. And I thought even here, we have a gap. This is a state-
Magee: The law changes, but then catching up.
Dr. Ashpole: Yeah.
Magee: So you bring up a great points in that. Okay? And you've kind of gotten my wheels turning, because that's one of the things that we try to achieve with this podcast. So let's take your example of the NIH website that has very good marijuana education information. Now, that gets me excited because this research is being done, and the government entity is doing its job and it's out there. What our challenge is in, that's kind of what The William Magee Institute for Student Wellbeing functions as, is trying to figure out, how do we get that information and make it more accessible? Because let's be honest, well, you don't count, Alexis, because you work within The William Magee Institute, but I'm betting even so, you haven't probably spent your life dialing up the NIH website.
Lee: I haven't. I can't I have.
Magee: NIH.gov.
Lee: No. Yeah.
Magee: So how do we take that information and parlay it into meeting the audience and accessibility? And I think Dr. Ashpole, you have really just put your finger on something that I think that some of the work you do and some of the work we do, and that's why you're here. But I think the real magic of this is, how do we take it much deeper beyond, because information is only as useful as it is fully accessible.
Lee: Yes.
Magee: Yes.
Dr. Ashpole: Because if you look it up [inaudible 00:26:41] cannabis, you're going to get all the paid sponsor labs and all of the cannabis companies, and you have to kind of sit there and look through. So if you just Google cannabis NIH, you're more likely to get that.
Magee: Yes.
Dr. Ashpole: But the NIH actually has really good webpages for a lot of diseases and a lot of just general health information. But yeah, you're right, most people aren't looking at nih.gov.
Magee: Yeah, they're not. They're not. I actually do. And it's funny because... So in August, I have this book coming out, which is more a guide book. It's not like my memoir, but it's called, Things Have Changed: What Every Parent and Educator should Know About the Student Mental Health and Substance Misuse Crisis. And what's interesting is Alexis was talking to me one day and she said, "This is fascinating. So you're not a researcher, per se." Maybe, I say a lay version of one, but I've got research throughout the book. And what my response was, because say there's... I find when... Because I'm a journalist, so I can get 17 pages in a Google search and start to find stuff. There is a lot of good information out there. There really is. But it is almost... But I walk into a school and have a parent meeting and I tell them that marijuana use disorder is a thing.
And these are people, the majority of which had college degrees, and I promise you I'll maybe get one out of 20 who even believe me. Not only do they go, "Oh, I've learned something," they actually don't even really believe me.
Dr. Ashpole: Obviously, you're doing the hard work of out into the schools, and making new webpages is kind of adding to this void of... We could make another webpage to try to make it more apparent, but there are web pages, and it's like, how do you get them up there? So how would you foresee trying to get that info out more?
Magee: Yeah. So that's a great question, and that's why I love this forum. This is a lab. This is why this podcast lives within the Thomas Hayes Mayo Lab within The William Magee Institute because it is a lab, and that's a lot of what this conversation is. Frankly, I think it is taking that research information, which frankly I have read it, and it does speak pretty clear language. A lot of it is who it's coming from and where it lives, as you noted, because there's not a lot of people going to those websites. I think it is continually getting at really studying... Okay, I have my answer. I'll phrase it for you.
We've done a good job in this country, I think better than people realize, in research around mental health and substance misuse. We also are pretty good in this country at storytelling, I think. I think where we've done a poor job is melding the research between storytelling and the actual science of what's happening with the brain. And I think that if we hear or we can inspire others to become excellent researchers and storytellers in that gap, that we really need to study not just what's happening, but how do we make sure that information is being received. And we need to study the young minds about what substance do to them, substances do to them in misuse, and we need to study young minds as in how they best get that information.
Dr. Ashpole: Yeah, I agree. I do imagine that when you go and look up research, it's very different than when Alexis looks at research, and the venue that people your age might be more interested in watching-
Lee: Right.
Magee: Yeah. Right.
Dr. Ashpole: ... or taking part in.
Lee: Right. Right. And it's hitting those my age, and then it's hitting the teens, and hitting all the students in between of how we have these conversations and the parents and the educators because they spend more time with those students, or the educators spend more time with those students than the parents sometimes.
Dr. Ashpole: Yeah.
Magee: Well, actually, I've had two young people tell me... And they were from different areas. They weren't like University Mississippi students. One of them was, one of them was from somewhere else. But I've had two students recently say, "Oh, my news source is TikTok."
Dr. Ashpole: Yeah. Yeah.
Lee: For sure.
Magee: I'm talking in the last week. I was like, your news source is TikTok? A, that thing's probably going to be banned soon, so you need to find another one, and B, your new source is TikTok? Really? But they're dead serious. They mean that. And so yeah, they're not Googling the NIH site. And look, a lot of what I find on there... Again, we agree because that's why I got so excited about writing this guidebook, because I thought, well, that's what I thought my job was, because there was so much information that I would just see that was out there. And I thought, gosh, we have done an incredible job in this country of research around the mind and substances. And gosh, we have done an absolute terrible job. Why is a doctor I know telling clients and patients that marijuana is not addictive? And why do parents not know that it's 400% stronger today? And why do they think that everything their children are vaping is nicotine? And I'm like, hello? I don't think so. You might want to ask them.
Dr. Ashpole: I think even in the pandemic, we realized that scientists, we created our own language, the scientific language. If people go and pull our scientific papers, any normal person is going to have a hard time trying to get through even the first three sentences, right? And so we've done a terrible job of communicating ourselves because we have built this language that is just not digestible. And then fortunately with cannabis, we've had this divide or these restrictions in the field where this lack of information has kind of gone into this void of not being able to research it very clearly. So now we have to not only catch up on the research, especially that clinical side of putting these things in human patients and watching how they respond, but we also need to catch up on scientists communicating effectively with the general public in a way that the general public will believe and understand, right?
Magee: Yes. And part of what we have to do as a general public is trust and engage. Because we talk about stigma, sometimes scientists face their own stigma when you have a movement going on. One scientist told me once, "I'm a little afraid to say negative things about marijuana. They're going to come on my Twitter account and throw bricks at me." And he said, "It's not that I'm even opposed to it." I said, and I always say, "Sure. It's like..." I use the honey bun. I actually like a honey bun, I grew up with them, but that doesn't mean I should eat 15 a day. And nobody's shy about telling me that they're health issues with it. We don't ban honey buns. They're all over markets today, and good for them. But I think we've been not shy about saying over consumption of processed foods, over... That information's out there. I think widely, the general public knows this, and that's okay. So I think we just have to take the same tactic with marijuana as we have in other things, as we've tried to assess obesity in so many other areas.
Dr. Ashpole: I do think scientists tend to either hedge their bets because they know that the science hasn't tested all the variables. And we understand that not everyone is going to respond the same, so maybe we haven't been as concrete in our responses to some of those questions. But at the same time, I think sometimes we just don't really know. And so we're scared to speak something into the truth when it might not be the truth.
Magee: So one area, speaking of not knowing, is in this marijuana world, there's also these products that are unregulated that show up in gas stations. I think this is a bigger issue. My son, William, my late son, William, actually was the first one who taught me about this. And I was like, "You got that at a gas station?" The government's working overtime to make sure that beer over here has its exact alcohol content. And it's great, because if somebody gets that, we know what they're getting. We don't know though, in a lot of these products that are on shelves.
Dr. Ashpole: There are a lot of products out there that are not regulated because they fall in this void of not being food, and they not a drug, and so they're not FDA regulated or approved, right? And so they have to be marketed in a particular way so that they don't say, "Use this to treat X," because that's considered mislabeling from the FDA side of a product. But you go to gas stations, and you're right, you're going to see all of these little packets of things for sale, and we don't know fully what's in them. One of the studies last year... Even just look at CBD products, right? There's CBD products everywhere. There's CBD stores everywhere. And CBD is legal, right? Hemp is legal. You just have to make sure the product contains no more than 0.3% THC. And so if you take these products from the stores and you test them... The FDA did a study that came out last year that showed only, I think it was 45% had what was listed for the amount of CBD was accurate.
Magee: Wow.
Dr. Ashpole: There were many that had less, and then there were lots that had more, right? And so have more than just CBDs, right? So they had about 50% tested positive for THC above the level of what you'd expect.
Magee: Wow.
Dr. Ashpole: And so that can be dangerous when people are taking what they think is a CBD product, and then they're testing positive for THC.
Magee: Yeah.
Dr. Ashpole: If you were having a psychoactive response to a CBD product, you're not-
Magee: That's probably what's going on.
Dr. Ashpole: Yeah. I read these online forums on Reddit or see things on TikTok, and I'm just like-
Magee: I've seen that too. I don't think it's the special brownie, right?
Dr. Ashpole: Yeah. But it's amazing to see what is regulating what isn't. Because even all of those vitamins and supplements you can get at the pharmacy or in the grocery store, they fall under this special category of not being medicine and not being food, and their regulation is just very different. And so we just have to be really careful. One of the rising products that people talk about is delta-8.
Magee: Yes.
Dr. Ashpole: If you don't know it, your kids know it.
Magee: They absolutely do. Even if they're not using it, they've heard of it.
Dr. Ashpole: Yeah. And so that is... It's really similar to delta-9 THC, which we would just normally call THC. It's just like one small chemical different. And it's taken usually from hemp. So people think, well, hemp is legal, so therefore this product taken from it must be legal. Delta-8 technically right now still falls under being not regulated, but it is showing clear signs of psychoactivity.
Magee: Wow.
Dr. Ashpole: And so many states have been kind of battling what are they going to do about this. And the fact is that the gas stations, it's filled with it.
Magee: Right.
Dr. Ashpole: And it's one of the-
Magee: And any age can walk in and buy.
Dr. Ashpole: And it's one of those ones you're finding a lot in vapes now-
Magee: Yes.
Dr. Ashpole: ... is Delta-8.
Magee: Yes. And that's what I tell parents. That's not always nicotine. They'll say, "Oh, my child is vaping." And I'll say, okay, I get it, but you also do know that that's not always nicotine, that they're vaping." In fact, I can find very few teens, they may start with nicotine, but they often move to that because it's available to the gas station, they can get it, and that's typically where they're vaping. When we talk about young minds, what does... The study seem very clear that repeated cannabis use, cannabis misuse among young people, that their brain is at risk. And what happens with... Do we understand what happens? Is it delaying development? Is it leading to other issues? What is the risk for a young person in habitual cannabis use?
Right. I think those kind of two questions you ask there. And the first is, what do we know about what it actually leads to? So if we know that during pregnancy, that use and exposure when you're first developing, that's going to lead to an increased risk of anxiety, attention disorders. The biggest risk that they see right away is low birth weight. But as that child develops, they see increased risk of a lot of these behavioral problems the kind of pop up in their adolescent or their younger years. So that one has been pretty well defined, and you can see that pretty clearly. The adolescents that are consuming, it really gets to kind of a chicken in the egg, or maybe we just don't know enough about it still about those who are taking it long-term use, and whether that is contributing to the onset of a psychiatric illness or whether that is maybe they're using it to try to self-medicate a psychiatric illness that it hasn't quite popped out yet.
And I think that's pretty similar to what you see if you talk about schizophrenia and smoking, right? There's this really strong correlation between people who have schizophrenia or live with schizophrenia and how much they smoke. And they've seen that some people have been using that to try to help self-medicate or reduce some of the symptoms, but also smoking it increases some of the other symptoms, right?
Magee: Oh, absolutely.
Dr. Ashpole: So it's both sides. And I think that maybe that's what we're going to see a bit more with cannabis, because the ones that it's been tied to, which is schizophrenia and higher levels of anxiety. If people are taking cannabis to try to reduce their anxiety already-
Magee: Right. Right.
Dr. Ashpole: And then we can't make this false assumption that it led to it if that's what they were taking it for. Maybe they couldn't articulate it when they were younger. And so I think that science still has to kind of show us that. Those longitudinal studies are needed to really see, because there've been multiple reports. Some come out and say that it's negative, it leads to schizophrenia, it leads to all sorts of anxiety disorders, and then the next report comes out and says they don't see it.
Magee: Yes. Right.
Dr. Ashpole: And so whether they're just smaller studies that have been done, and once you get them all together, we'll see clear path-
Magee: And also, I go back to what you said earlier, that different personalities are impacted different way. I've seen studies where... We talk about anxiety, but for some personalities, depending on what strain they're using, it may greatly increase anxiety. So one of the issues we have here is that it impacts differently. And even though alcohol, I think is certainly more consistent in how it impacts people, I think we all know people that are impacted differently, that maybe seem to metabolize it more quickly, and something happens or they get to a depressed state while somebody is over here. Sure, they're the funniest person ever. And so I think cannabis is the same, where we don't understand that fully. And I think science continuing in to play that role and help us understand it, but I think in young people in particularly, which will ultimately work its way into the workforce and into families, I think that helping them just... What I find when I get in schools and I give them information about marijuana and other things, but marijuana in particular, they're pretty hungry for it because they've not heard it.
So I think that it can continue to deliver it in what I'll call non-judgmental format. This is non-judgmental not just against those that might use it, but non-judgmental against the product itself, which sounds... Because if they think you're coming from that stance, sometimes there's often this like, "Oh, you're that person," and they'll cut you off. We just have to get down to the fact of, we care about your mind, we care about your wellbeing. And this is not... The studies are very clear that young people that are habitually using marijuana are facing a lot of risks, and they're doing damage to their wellbeing. And I think that's the message we have to continue to get there, but it has to come with open arms and very information fact based.
Dr. Ashpole: I think earlier, you talked on the fact that you see maybe men or males have more likely of these use disorders that manifest. And I think one of the things that we've seen with psychiatric medicine is that men have what we might refer to as externalizing disorders in that if they're experiencing anxiety or if they're experiencing or living with ADHD, that they're more likely to do things like-
Magee: Yes.
Dr. Ashpole: ... go to substances, whereas women more often will experience and manifest these with anxiety, eating disorders, other internalizing type of disorders.
Magee: Yep.
Dr. Ashpole: And so I think if we keep that in mind as well in our approach of, if you're concerned about your adolescent having a substance use disorder, going to cannabis, marijuana, vaping with maybe delta-8 or something else, then you might need to address why were they doing this?
Magee: Right.
Dr. Ashpole: Is there something else that we can do? Are they doing this because they were trying to relax and have fun at a party every once in a while?
Magee: Right.
Dr. Ashpole: Or is this because they need this because they need to talk to a therapist, they need to see a doctor, and maybe talk about mental health on a bigger picture?
Magee: That is the point of the day, because frankly, almost not a single young person I've ever talked to tells me that they're using marijuana to have fun at a party. They might use it to reduce their anxiety to get into a party, but more often than not, those that I talk to who are engaged in daily use, it's more often alone at home to get to school, using it to get through school, to get through homework, to get the sleep at night. That's what I hear. And that really leads us to understand why are they using that to change how they feel, and where can therapy or counseling get ahead of that and really help them process and understand, why are they doing that? Right? That's such great information. Dr. Nicole Ashpole, thank you so much for joining us on The Mayo Lab Podcast.
Dr. Ashpole: Thank you so much for having me. Pleasure to be here.
Magee: All right.
Lee: Thank you for joining us on this episode of The Mayo Lab Podcast. 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 @MayoLab. If you enjoyed listening to The Mayo Lab Podcast with David Magee, we need your help. Tell others about it, and we'd love for you to subscribe, rate, and give us a review on iTunes, Spotify, or wherever you are listening to this podcast. This podcast represents the opinions of David Magee and guests of the show. This podcast is not intended to be a substitute for the medical advice of a licensed counselor or physician. The listeners should consult with their mental health professional in any matters relating to his or her health, or the health of a child.