The High Cost of High-Potency Marijuana For Adolescents, with Dr. Libby Stuyt
Host: Brenda Zane, brenda@brendazane.com
Guest: Dr. Libby Stuyt, Board-Certified Addiction Psychiatrist
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about this episode:
When voters in Colorado legalized marijuana in 2000, they did so with good intentions: as compassionate health care for people with serious conditions. After all, the FDA approved THC-based medicines like Marinol at doses of 20mg. Then concentrates hit the recreational market. Today in CO, an 18-year-old with a medical marijuana card can legally purchase more than 50 times the daily dose of THC originally prescribed as medicine. And Dr. Stuyt sees the consequences. This is a must-listen episode for parents, especially if you’re thinking, “Well, at least it’s just pot.”
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I know today's episode is going to be so informative and also somewhat frightening for you. If your young person is using a lot of thc, which I know a lot of them are, marijuana is one of the most commonly used substances that we see in our communities, in the woods and the stream, and there's so much about it that we don't understand, or I should say we didn't [00:01:30] understand until after you listened to this episode.
You may have listened to episode 46 called the Marijuana Episode, the Real Deal About Teens Weed and Addiction with Dr. Nzinga Harrison, which is phenomenal, and I would definitely go back, rewind, and take a listen if you haven't already, but I realized that that was recorded in January of 2021. So it's been a little bit, and I wanted to get the most current information to you because this industry moves quickly.
I was fortunate to have Dr. Libby Stuyt join me for this critical conversation about what is happening today with our young people and their brains, as more of them are using very, very high potency marijuana. Dr. Stuyt is a board certified addiction psychiatrist and has worked in the addiction and behavioral health field since 1990.
She was the medical director for the Circle program, which was a 90 day inpatient treatment program funded by the state of Colorado for people with co-occurring mental illness and substance abuse who failed at other levels of treatment for over a decade. From 1999 to 2020, she has been actively incorporating complimentary treatments into treatment programs, one of which is the five point Ear Acupuncture Protocol called nada.
And B S T Brain synchronization therapy to help patients [00:03:00] recover from addiction as well as trauma, which often underlies addiction and chronic pain issues. Dr. Stat retired from clinical practice in 2021 and she continues to do consulting work for treatment programs. She does trainings on ear acupuncture and B S T and does presentations to educate as many people as possible on the unintended consequences of the commercialization of marijuana, focusing primarily on the deleterious effects of high potency THC on the developing brain.
Now, I will warn you the information I learned during this conversation about the impact of hypo potency of marijuana, which by the way, is the only product available in most places was somewhat terrifying. We cover topics like psychosis and chs, which is cannabinoid hyperemesis syndrome. The connection between THC and suicide in young people.
And we also talk about how ultimately money is driving the continued sale and deceptive marketing of high potency T hc. But it is one you must hear, so I'll get right to it. Please listen. And on this one I'm going to beg you to share it with as many people as you can. This is my conversation with Dr.
Libby Stuyt.
Welcome Dr. Stuyt to Hope Stream. This is a conversation that is so, so important. I think I, [00:04:30] I couldn't do enough episodes, um, on marijuana and the impact that it's having, and you truly are an industry expert in this area. So I'm thrilled to have you here for real information, not just anecdotal information.
So thank you so much for making the time.
Dr. Stuyt: I'm happy to be here.
Brenda Zane: I think there's always new information that we're getting that is important for parents to understand. And as parents, you know, I forget, I've been doing this for three years and so as parents kind of age into the podcast, sadly they do. They might not have heard episode, you know, five or whatever it was where I talked about this.
So maybe you can just give us a, a quick kind of state of the industry, if you will, of what you're seeing as far as usage, especially with adolescents. Cause I know that's an area that you have an a ton of knowledge in, and that's what I am concerned about is the really, the impact on the adolescent brain.
But maybe just give us from a 50,000 foot view, what is going on in, in, in the marijuana
Dr. Stuyt: industry. Yeah. Well, I, I think it's very sad what's going on because. I've, I've been working in this field for the last 33 years, so I'm an addiction psychiatrist and I ran a treatment program at the state hospital in Colorado the last 20 years.
And it was really excellent program. It's now defunct because of money [00:06:00] issues or something, but sadly, I, I was treating people who have failed everything else, so people who had been through multiple treatment programs and it was a dual diagnosis program, one with people had mental health issues and substance abuse issues.
And I started seeing more and more problems of marijuana in Colorado. We legalized medical back in 2000 and I thought it was stupid to vote for a, a medicine and I didn't vote for it, but I wasn't that worried about it because back in 2000, um, marijuana was, It was starting to get stronger, but it wasn't a problem.
We, we weren't seeing a serious problem with it. And the highest potency back in 2000 was 5%, uh, in the plant, and there were no concentrates. And so I, I really think people voted for it because they thought this is compassionate care for those poor people that were having very serious medical problems.
And then, and then the industry, what, what happened was basically really started in 2009 when, um, the Obama administration put out the Ogden memorandum, which basically said they would not prosecute anybody in a state. Medical marijuana if they were following the law. And so in, in [00:07:30] our state in Colorado in 2009, we had 5,000 people on the medical marijuana registry.
By 2011, there were 119,000. So people either got really, really ill all of a sudden, or they were flocking to get their medical cards so that they could, you know, have legal marijuana. And around 2010 is when the concentrates hit the market. So we started getting stronger and stronger potency things to the point now.
And so then we, we legalized recreational in 2012. The stores opened in 2014. And then we had incredible numbers of people that were getting marijuana. And the potency. Now the average in the plant is around 20%. We have plants with much higher potency. And then the really concerning thing are the concentrates, because we have concentrates that go all the way up to 99.9% pure th h c, and, and these are still being advertised in marketed as medicine, and they are available in the medical market, which is crazy because there's no research on them at all supporting their use in any kind of medical condition.
And if you look at the research supporting marijuana for any medical condition, it's done with all less than 10% thc. And the problems are showing up with [00:09:00] T H C higher than 10%. So 10% and higher is where we start seeing problems lower than 10%. We don't see that many problems. And so that what has happened in Colorado is the kids, I think because their parents are using, their parents think it's safe.
They think it's safe, they think it's medicine, so they're vaping oil. They're, um, dabbing, wax, shatter, these things that are very high potency and very, very dangerous for the developing brain. And, and, and, you know, that goes all the way up to 25.
Brenda Zane: Yeah. The dabbing, the concentrates in the shatter and all of that, that is where you're talking the concentrates that were introduced in 2010, that can be up to 99% pure thc.
Right, right. That is so frighten.
Dr. Stuyt: And so we actually were seeing so many problems with adolescence in Colorado that we were able to pass a bill, uh, in 21. It was called House Bill 21 13 17, which, um, we didn't get everything we wanted for sure, but we were able to get some things to happen, like, um, warnings.
Like there's a handout that if somebody goes to a dispensary to purchase a concentrate, they have to get this handout that says all the problems that are related to using these products like addiction, psychosis, [00:10:30] cannabis, hyperemesis syndrome. Uh, and the one thing we couldn't get on there cuz the industry fought, it was.
However, there is so much research out there now demonstrating this high, high, high correlation between cannabis use and suicidal ideation and attempts. And in fact, in Colorado, it's the number one drug found in toxicology of teens who die by suicide. Hmm. And, and, and, you know, I, I prescribe a lot of psychiatric medications that have black box warnings about suicide.
I mean, pretty much everything that impacts the brain like that very strongly can have that effect. But so the other thing that we were able to get was a significantly decreased amount that could be purchased, because prior to this bill, 18 to 20 year olds could get medical marijuana cards without any parental consent or knowledge, and they could purchase 40 grams a day.
I mean, that's like insane and everybody could purchase 40 grams a day. You know, people, the recreational, adults, medical, and, and so in this bill we got it reduced to where 18 to 20 year olds can only purchase two grams a day, and adults can purchase eight grams a day. That's still a wapping amount of [00:12:00] marijuana.
You know, we do have medication that is FDA approved, that is basically based on thc. So there's a drug called Marinol, or Dronabinol, which, um, has been used for some time for people with severe cancer. You know, they're having debilitating illnesses that where they can't eat, and so it's to help with them increasing their appetite.
And the maximum dose recommended by the FDA is 20 milligrams a day. So 10 milligrams, b i d. Now an 18 year old with a medical marijuana card in Colorado can purchase two grams a day. So that's 2000 milligrams. If you look at that, like if it's an 80% thc, that's 1600 milligrams that they can purchase every day compared to the 20 milligrams that they recommended for medicine.
Right. And that's, that's, it's insane. The industry tried to introduce a bill last week to revoke what we got out of that because they wanted to go back to be able to purchase 40 grams. And luckily they didn't have enough votes to even bring it to the first committee. And it was killed. So that was good.
Brenda Zane: I mean, from a medical standpoint, how could you [00:13:30] ever justify that? It doesn't make, it just makes no sense.
Dr. Stuyt: Well, yeah. And that's the other thing that the bill was supposed to do. I mean, it, it really spelled out what the doctors who are recommending marijuana were supposed to do. So instead of the bud tender at the dispensary recommending what people should take, the doctor was supposed to say, okay, this is the product you should use the potency, you should use the amount, the frequency, the route, it's not happening because they didn't assign any entity to monitor that and monitor the doctors who are doing that.
And so I know of several people, cuz I've been collecting these data that, um, are getting medical marijuana cards and they've got bogus. Things. I mean, they don't have a medical problem that fits the criteria and the doctors haven't spent any time with them. They haven't looked, you know, you can do this online, you can get a medical marijuana card within like 60 seconds online.
Right, right. It's crazy. And, and just the fact that young people could do this, this is why we had such a big problem, because when they could get 40 a day, and I think it's still happening now because nobody I think actually uses two grams a day, but they, um, you know, would sell to their friends. And so it became the way it got into the black [00:15:00] market or the gray market.
So more and more kids were getting it from people that had a card. And, you know, I think that's happening in many states. I, I think this is a, an experiment that we are going to really regret, mainly because of how it affects the developing brain. Right.
Brenda Zane: Well, I think we're, at least from the parent's point of view, we are deeply regretting it.
And I think what you said about diversion is really important because a lot of parents who are kind of new to this discovery that their kids are using so much is, well, where would they get it? Well, where would they get it? Right? My kid's 14, my kid's 15. Where would they get it? And I think often there's a perception, you know, they think of a drug dealer and they think of some creepy guy, you know, in an alley somewhere, and it's like, oh no, this is the kid from the soccer team who, you know, has this card and got more, and then they're selling it.
So I think it's just a completely different landscape than parents are, are thinking in their brain of where their kids are getting this and the, the potency. So just to clear this up, because they're, you know, there's all this, well, marijuana can't be addictive because it's. A natural plant. I am gonna guess that you would say it is very addictive.
And what I heard you say was that it, in really you're, where you're seeing the problems is in [00:16:30] the over 10% potency, but maybe you can talk to us about potency, addiction, sort of where, where that connection is and is it more addictive for adolescents and adults. Yeah. All, all of that just cleared up for
Dr. Stuyt: us.
Yes. So, you know, when I first got into this business back in 1990, we didn't even think it was addicting. It was in the class of hallucinogens because we knew it caused hallucinations and hallucinogens don't have a withdrawal syndrome. So that's why it was in that class. And the research is showing that when it was less than 5%, people did get, have problems, but it might have been more psychologically addicting.
Um, it wasn't a big thing. So, They did this big study there, it's called a NECAR survey where thousands of people are surveyed and they get all this information. And so back in 2003, 4, 5, 8 0.9% of people who used marijuana would eventually then have a problem with addiction. And so that was considered the lowest addictive drug because it was less than 10%.
However, then they did that survey again in 2012, 13, something like that, and that was still not as potent as we have today. And they found that 30% would, that used it would become addicted. And [00:18:00] so this is all ages, but they found that, you know, if you started using as an adolescent, then you're much higher risk of addiction.
And I think that's only going to get worse because. In my experience, treating people in an inpatient setting, I have worked very hard to make programs tobacco free, because to have the best outcomes, it's best to quit everything at once. And if you're in an inpatient setting, that's the best place to do that.
So I try and get programs to go tobacco free because nicotine has always been the most addictive drug we have, and that's the one that people say is the hardest to quit. But now with these people doing this high potency stuff, I am finding the same thing that that is the hardest thing to quit. And so I think it's just, you know, in this study that they did, um, they said with tobacco, almost 62% of the people who ever use tobacco become addicted to it.
So that does have the highest addiction. But I think if we do this again with this high potency, now that it's gonna be similar. And so, you know, it's extremely addicting, which means it has a, a very severe withdrawal syndrome. And it depends on, you know, the potency people are using, how often they're using it, how bad the withdrawal syndrome is.
But it has a very short half. And [00:19:30] so what I was seeing in my program is that people were in withdrawal immediately, like within the first day or so, and people are showing that they're developing this addiction faster than any other addiction. Uh, and that's really kind of scary. They did this study looking at, this is in Michigan, where they had people who were getting a medical marijuana card.
So one group they said, okay, go ahead and use the card immediately. And then the other group had to wait 12 weeks, so they couldn't use their card. And then they followed them to see, you know, how much they were using and whether they developed cannabis use disorder or addiction to cannabis. And they found that the people who got the card immediately very rapidly developed cannabis use disorder.
Like within 12 weeks they developed cannabis use disorder, which is very scary. Uh, and so I think that people need to know that because this is why people develop things like cannabis, hyperemesis syndrome. Most people that just use cannabis occasionally are never gonna have that problem. It's a very rare problem for most people.
But what we're finding for the people that are using high potency and regularly, it's a very common problem. And, and so like young people I've worked with who. [00:21:00] Who after I finally convinced them that that's what their problem is, because that's the biggest problem. People cannot believe that cannabis is causing the symptoms.
But these people have severe abdominal pain, severe nausea, cyclical vomiting that they cannot control, and we don't have meds that help with that very well. Once I finally convinced them well, and they come back to me and say, well, yeah, I guess you're right. This is what's causing my problems. I'll say, well, then you need to quit.
And sh then they say, yes, I know I need to quit. And then they can't. And, and that's another concerning thing, because what I'm finding is the only way these people are being able to quit are being in an inpatient setting, in a controlled setting when they're away from it. Right. And most insurance doesn't pay for.
Cannabis use disorder. Yeah.
Brenda Zane: Wow. Okay. So I need to rewind. There's so much in there. First of all, you mentioned can, uh, cannabis hyperemesis syndrome and some of the symptoms that you mentioned, like the vomiting and all that. Could you, because I think what I'm hearing from the parents that I work with, I think they're seeing this, but they don't know what it is.
So could you just tap on that really quickly, like what it is, what they might be seeing in their kids or what their kids might be experiencing, and then what should they do? Yeah,
Dr. Stuyt: yeah. No, this is something that [00:22:30] parents really need to be aware of and, and sometimes they have to educate the doctors because there are so few doctors still that are really recognizing this, but it's, you know, somebody who just feels nausea.
A lot. Like they have periodic bouts of, they get really sick to their stomach and they start vomiting. And once they start vomiting, they can't seem to stop. And one of the things that has been found to help for some people is hot baths or hot showers. So if they're doing that and then they feel some relief, that's a really good clue that that's what's causing that.
And, uh, you know, there's this really great Facebook support group that I give to everybody. It's called Recovery From Cannabinoid, hyperemesis Syndrome. There's actually several groups on Facebook, but it, it is wonderful in terms of helping people who have this problem because they're supporting each other.
Okay. And I, I've worked with so many people that have been in and out of the emergency room with nobody noticing it because they're not asking the questions. Mm-hmm. And people aren't providing it. And this is something else that needs to change. In in medicine because most places, you know, you're mandated to ask, do you use alcohol, drugs, or tobacco?
And if you ask those questions, people will say no. If they're using cannabis, cuz they don't consider it a drug, [00:24:00]
Brenda Zane: even though they had to get a medical card to get it.
Dr. Stuyt: Yeah, you have to ask specifically about cannabis. Right,
Brenda Zane: right. Okay, good to know. So then, if they're seeing this in their young person, is it an ER visit?
Like, is that the best thing to do?
Dr. Stuyt: If you vomit enough to deplete all of your electrolytes, that puts you a very high risk of dying and you can kill your kidney doing that. And so if somebody, you know, their kidney totally dies or they have, you know, their heart is losing all the electrolytes, so people need to be in the emergency room and get hydrated so they get IV hydration.
And they're given medication to try and stop the nausea, vomiting. But the normal things that we use like Odansetron or Zofran, don't work. And, and so people are having to get intravenous Helo Paradol. I mean, that's a very potent antipsychotic, but it does help with nausea and vomiting.
Brenda Zane: Wow. Oh, that's, that's just so distressing to hear, and I'm glad that you mentioned that.
It may have to be a question to the doctor. Could this be chs? Because they might not know probably in a state like Colorado or Washington or some of these states where we've had legalization longer, they may be seeing it more, I would think, but if you're, especially if you are in a state [00:25:30] where it is not yet legal, And you're seeing this, it, there's, I would imagine there's a good chance that the doctors are not necessarily as
Dr. Stuyt: aware.
Right. And you're absolutely right about that. We're much more attuned to it in Colorado. But I had an 82 year old gentleman who no one knew he was using marijuana. And he had, had, he had had so many visits to the emergency room unrecognized and had 10 CAT scans of his abdomen. Oh my God. Until, until some very astute ER physician finally asked the right questions.
You
Brenda Zane: mentioned psychosis. Well, you mentioned that medication and that it was an antipsychotic. I know that is another thing that parents are seeing is they're freaking out because their kids are having these psychotic breaks. They don't understand that. They don't know what to do. And from what I understand that that truly is happening from these high potency.
Marijuana products. So maybe you could just talk about that and then what do we know about the psychosis from this? Is it temporary or is this something that's gonna be ongoing in their life?
Dr. Stuyt: Yeah. Okay. This psychosis issue is probably the worst. Well, also suicide. Those are the two worst outcomes of this.
And the landmark study that was out of the United Kingdom was back [00:27:00] in 2015. That was the first one to kind of really point out that it was the high potency causing the problem. What they did was they did this evaluation. Multiple, multiple people who were having their first episode of psychosis, and these were all ages actually, and they found that if they were using the stuff that was 15% or higher, they had a three times increased risk of psychosis.
If they were using it daily, there was a five times increased risk. And if they were using the stuff that was 5% or less, there was no associated risk of psychosis. And I think that's why we haven't seen that until now. Because as I said, you know, when we first did medical marijuana in Colorado, the potency was 5%.
And so I, I think that's why it wasn't really noticed. But now with the hypo potency, we're seeing significantly increased risk. And all, all drugs, addictive drugs have the potential of causing psychosis. I have even seen nicotine cause psychosis in a young person. But there was a study out of Denmark looking at all the drugs that can cause psychosis and looking at then did they convert to either schizophrenia or bipolar disorder?
Because you know, most people who have a drug-induced psychosis and they stop using the drug, the psychosis resolves, it goes away. But you have this risk of converting to [00:28:30] long-standing schizophrenia or bipolar disorder, and they found that the drug that had the highest conversion rate of all of them was cannabis.
Almost 50% of people who used cannabis and developed psychotic symptom. Converted to schizophrenia. Wow. And of course, the younger somebody's using, the higher the risk is for developing the psychotic symptoms. Uh, and there was another study just looking at people who use cannabis, um, and, and, and up in emergency rooms finding that one in 200 people have the risk of showing up in an emergency room with psychotic symptoms.
So it, it, it really is a problem. And then once they have it, like I've worked with several young people who it took more than one antipsychotic to stabilize. In fact, I was working with one young man who was 20, who it took three antipsychotics plus two months in an inpatient setting before his psychosis stabilized.
And, and then of course he gets out and he wants off the medication because the medication has awful side effects. And so I worked with him to do that and he was able to get off the meds and he was fine. And I warned him, do not go back to this. [00:30:00] Well, sure enough, a month later, his parents bring him back and he was back to being psychotic.
And I said, what are you doing? And he told me he was dabbing again, and I really think that caused him to become permanently impaired. Very sad.
Brenda Zane: If you're here listening to Hope Stream, I'm guessing you might be glad to know there are other resources that you can take advantage of as you work on getting your family to a better place. We've now combined all the information you need into one simple space called Hope Stream Community. It's where you can learn about our private online communities for moms and dads, our retreats, our educational offerings, and of course the podcast.
Hope Stream Community is a nonprofit organization that exists solely to help you navigate this challenging season in life and to be connected, educated, and taken care of so that you're better equipped to help your child make positive change in their lives. You are not helpless when your child misuses substances, and we're here to give you the tools and information you need after the episode.
Take a look@hopestreamcommunity.org to find what we offer. Now back to the show.
A lot of the times the reason [00:31:30] these kids are using the products in the first place is because they are sort of self-medicating a d d or maybe it is bipolar or, or one of these other conditions that's really difficult for them. So they find THC and it's like, oh, this works really well. So what I'm wondering is when you, if you have like a baseline mental health problem, which is very likely, and then you start adding on these hypo potency products, which could lead to then the psychosis or um, or something worse, how do you start to untangle, like what's the.
Original cause versus what's the, you know, impact of the medication? That, that just sounds like a, a medical mystery to me and especially for a parent observing this. Like how do you ever start to understand kind of what's driving the bus?
Dr. Stuyt: Yeah. To me the problem has come from people saying that this is medicine because yeah, people say they self-medicate, but what they find is it doesn't help.
I mean, it's a temporary thing. So a great example is post-traumatic stress disorder. There is no research that has been done that supports the use of it all of the U. All of the research has shown that it makes P T S D worse. But the reason people like it is because, yes, it [00:33:00] initially works like when people are using marijuana to sleep.
Yes, it initially works, but then it starts affecting your sleep architecture, where then it doesn't help you anymore. Posttraumatic stress disorder it, yeah. When you're under the influence of it, you don't have the intrusive thoughts, you don't have the flashbacks, you're numb. But the minute it wears off it, they're right back.
And so in order to keep the symptoms at bay, you have to use every day, all day long sometimes. So the same thing with people. Start using it for anxiety. Initially it seems to help, but then ultimately it makes the anxiety worse. And this is really true of all addictive drugs, if they're used addictively and if you use higher potency products, I mean, we know that about all the drugs.
And the other problem is if somebody has a psychiatric illness and they're on a medication, marijuana can actually make the medication not work because it interferes with the metabolism of the medication. And so that's what I was seeing a lot when I was working at an fq H C as a consultant.
Psychiatrist, because. They had primary care doctors who would make the diagnoses and prescribe medication. They had behavioral health people who were doing therapy, and they would refer them to me when nothing was [00:34:30] working. And so the facer would come see me and say, and I'd say, why am I seeing you? Well, you need to give me the right medication because this medication is not working.
And so then I'd get the history from 'em and find out they're vaping 60% hash oil or something. And I said, this is why your medication is not working and, and you really need to stop using the marijuana. Well, no, that's my medicine. I mean, it's just, wow. And so to me, the goal is we've got to get to people before they start using.
Because another thing, the way these drugs work in the brain, and this is true of all of them, but especially THC and, and even nicotine does this, that when you're using chronically, it can shrink your hippocampus. And the hippocampus is where you put all your new memory and learning. So it can make it very difficult to learn new things when you're actively using, and this is why I advocate for tobacco-free treatment, because you're in treatment and you're, if you're smoking the whole time, it's really hard to put any of that new information into your long-term memory bank because of the effect of the drug on your brain.
And so I just know that when I'm talking to somebody who's actively using, they can't really hear me. I mean, they hear what I'm saying, but it isn't getting processed in their brain. Because all they are [00:36:00] remembering is the good stuff. You know, the good stuff. This is why people don't learn from their consequences.
You, you would think if somebody has a psychotic episode, they would never ever do it again. Right? But cause they haven't done anything to change their thinking. That old stuff is just wired in there. It's hardwired in there and, and that's why somebody can sit in jail for months at a time, not using anything if they haven't done anything during that period of time to change their thinking and actually get some treatment.
This is why I think treatment should be available in jail. They leave and even if they've sat there saying to themselves, I'm never doing this again, never, ever, because I'm not coming back to. The minute they get out, the very first thing they do is buy cigarettes. And then, you know, then they see their dealer and they make a d a deal.
They make a buy. Um, because they haven't done anything to change the way they think. And that's what treatment is about. Treatment is about putting in new wiring in your brain because you have a hundred billion neurons, you know, you don't use all of 'em and you need to wire new neurons and, and that's what has to happen.
The
Brenda Zane: short term memory we, that you were talking about when somebody is using, I'm just wondering what some of those, specifically the adolescent brain. What some of those impacts [00:37:30] are that parents might be seeing as an indicator because kids are really good, obviously at hiding this, right? They can vape it and there's no smell.
Parents don't know what's going on. Um, and then I also wanna ask you about edibles, but what are some of the things that a parent might see? Maybe they suspect, yeah, I don't know, maybe my kid's doing a little bit of weed, but are there things that they could watch for that would indicate that maybe there is a problem?
When you, when you mentioned short term memory, that just stood out to me. Cause I imagine there's a pretty big impact on the schoolwork if you are talking about, you know, an adolescent who's still in school. But what are some of the things that, that they could look for?
Dr. Stuyt: A lot of it is not doing as well in school as they used to do.
And this is why kids need to sleep at night too. You have to go to sleep at night to incorporate all the stuff that you've gone through during the day. So it gets into your long-term memory bank. But when you're actively using substances, it can actually affect your sleep architecture. So in order to learn new information, you have to go through all the stages of sleep.
And that includes three, four sleep, which is slow wave sleep, um, before REM sleep. And you have to go through all these. However, these, all these substances of abuse can significantly diminish three, four sleep, which then makes it a difficult to get that new memory and learning incorporated into your brain.
And so [00:39:00] that's a big one, is just, you know, kids that, you know, used to be doing really well, getting A's and B's, and now all of a sudden they're getting C's, even though it seems like they're doing their work and they're trying to apply themselves. That that is a big one. Another one is impulse control problems, because it really does affect the frontal lobe.
You know, this place where, you know, you're supposed to be making all your, uh, judgments, it's not fully online yet as an adolescent, so it's not working very well, but when you put a substance in there like marijuana, it really isn't working at all. And so kids have, you know, poor judgment, um, impulse control problems.
And then the other thing I would really pay attention to is if they seem more irritable and more angry and, and aggressive, because that's withdrawal. And so withdrawal to, to, if somebody's using pretty regularly, withdrawal is gonna be increased Anxiety, increased irritability, increased anger problems, eating problems sleeping, because marijuana helps with all those things, right?
And so when kids are not eating as well, they're not sleeping as well. Those are, those can all be signs that something's going on.
Brenda Zane: Right, and I had a question about form factor, I guess you could call it. If a kid says, oh, you know, dad, I'm just, I'm [00:40:30] just doing gummies, right? I'm just, I'm not smoking it, it's not going into my lungs, I'm just doing gummies.
Like, is that better than No, something else. Cuz I, I think we get a lot of that rationalization.
Dr. Stuyt: Yeah, no, in fact, it's worse in the fact that smoking is not good for you period. And Vaping's not good for you, they're not good for your lungs. However, you only get about 25% of the dose smoking. Okay? If you eat something, you get a hundred percent of the dose.
And so it's much more powerful. And so it's like five times as strong. Oh. If people are limiting themselves to one gummy, like a five milligram THC dose, they don't. That's what's, there's such insane thing about the edibles. Um, I, I really don't like the edibles, mainly because they're packaged to look just like, you know, other stuff.
Candy, mm-hmm. Doritos and or whatever. And that should be illegal. I mean, that should totally change. But we have, you know, in, in Colorado we were able to get a limit on, um, recreational marijuana so that each piece is no more than 10 milligrams, only 10. It should be five milligram, but each piece is 10 milligram.
And a package can have no more than a hundred milligrams. That is a lot of [00:42:00] t hc, but that's like, you know, the whole cookie or something in the medical market, you can actually get a cookie with a thousand milligrams in it. So one cookie and, and you know, when they sell these things to naive people, the bud tenders tell people, well, you only should eat a sixth of a cookie.
Who eats a sixth of a cookie? You know, we had, our first death in Colorado was this young man who was an exchange student, I think he was from Nigeria, and he was in a college in Wyoming. And he and his girlfriend came to Denver and he was not old enough to purchase anything, but she was. And so she purchased some cookies and they took him back to a hotel and they were told to eat a sixth of a cookie.
And apparently he'd started by doing that and then he ended up eating the whole cookie. And then he quickly became completely psychotic and he started. Mouthing things about religion and, and then he jumped off of the balcony in a high story hotel and, and died. I mean, he was out of his mind. And that was just from one cookie and somebody who's, you know, naive to all this.
Yeah. And what
Brenda Zane: I, what I hear is that because the edibles take longer to, cuz they have to go through everything in your stomach, right. So they take longer. So especially a young person who's a new user will take one and wait 15 minutes and go, huh, I'm not feeling anything, I'll take another one. Yeah. Huh.
Still not feeling anything, you know, cuz it [00:43:30] could take up to an hour to really kick in. So by then, if you've taken four or five, 10 milligram gummies or cookies or whatever it is, you're gonna be in a world of hurt.
Dr. Stuyt: Right, exactly. I agree. And then the issue with the young children is really, it's incredibly expanding.
And, and what's so interesting is to look at data coming out of Canada where they had this kind of biphasic approach to legalizing. And in the first phase, the edibles were restricted. In the second phase, in most of the provinces, it was expanded so that edibles were available. But in Quebec, they were not available.
And they show there was like an 800% increase in kids showing up in the emergency room. Little kids, less than nine years old, eating these things because they find them leave out somewhere. And in Quebec, they did not have that increase because they didn't have these edibles. And this happened in the provinces in Canada, even when they have even more strict thing than we do because their whole package is 10 milligrams.
Our package is a hundred milligrams and they have, you know, child proof packages and. Because they look just like it. I mean, if you have a gummy outside of a package, it looks like, like any other gummy, I'm
Brenda Zane: wondering [00:45:00] if a young person has gotten into this a little over their head and they're like, oh my gosh, I'm, I'm having all these horrible, you know, uh, side effects.
I can't sleep, I can't eat. I'm, you know, feeling like I may have some of these psychotic breaks. You had mentioned earlier that sometimes the only way to really get off of them is in an in inpatient treatment setting. Is there anything that they could do at home? Like, is this something that you can taper down or is this really like, you gotta just.
Go a hundred percent cold Turkey.
Dr. Stuyt: Well, I mean, a lot of people do try, what I would call is harm reduction and have encouraged many people to do that. One of the problems is, you know, harm reduction approach should be, well, let's get less and less potent products. So go get the stuff that's less than 10%.
It doesn't exist. That's a big part of the problem. But if it does, then that's why you try and encourage people to smoke the less potent stuff and then slowly try and wean them off of that. But I haven't been able to really find that stuff. There is nothing like m i t, like we have for opiates, right? Um, there are companies that are working on that right now trying to come up with something because some people have been using the prescription, um, THC drugs that we have to kind of help people.
I don't know. That's very off-label, and I don't know if it's helping or not, but [00:46:30] then there is a thing called n acetylcysteine, which is an herbal preparation kind of, I mean, it's available in health food stores, so it's over the counter. And there is some research on that that people have been able to use that to help, um, people get off of marijuana and other drugs actually.
And normally I think what I've heard is that you have to take like 1200 milligrams twice a day, but that's available in health food stores. And, and then the other thing I, I use that I find helpful is, uh, ear acupuncture protocol that I train people to. It's a standardized protocol, so it's not really acupuncture per se.
Uh, and in Colorado we've been able to get the law changed to where pretty much anybody can learn to do this and help people with it. So I've been training people like peer coaches to use this to help people. It was originally developed, um, back in the seventies to help detox people off of opiates and it really does help with that.
But we found that it helps for a lot of other things. And so I started using it mostly to help people quit smoking because my program was tobacco free and it really did help keep people in treatment when they were like, couldn't stand the fact they couldn't smoke. If they got a treatment, they were much more likely to stay longer.
And so the more treatments they got, the longer they stayed. And so I've started finding that was helpful [00:48:00] with, um, the cannabis as well. It is very helpful for people who are really trying to quit, and I also found that it was helpful for people with the cannabinoid hyperemesis syndrome symptoms.
Interesting. So that's something to think about. People need to find an acupuncturist or somebody who is been trained in NADA or a pka. So NADA is an organization called the National Acupuncture Detoxification Association, and Polka is people's Organization of Community Acupuncture. And so people that work with or been trained by those, either those organizations know this protocol and can help people with it.
Brenda Zane: Like you would go and get it while you're potentially in an outpatient program. Right,
Dr. Stuyt: right. Okay. Well, I, I've been trying to use it everywhere, like in Colorado, since we've got this law passed, we use it everywhere. Uh, and the place I have found it most powerful was in a harm reduction center actually.
So, um, the woman who ran the needle exchange, uh, got trained and then I went to supervise her because you have to do supervised treatments after you take the training. And when I went there, there was just one man in the room and he was kind of your prototypical heroin addict that people think of. I mean, he was an old gentleman.
He looked homeless, he didn't look very clean, he had no teeth, and he was sitting there with needles in his [00:49:30] ears. And so they were trying to encourage all, all these other young people that were coming in for their needle exchange to go get a treatment. And so these young ladies would look in there and go, Oh, you have needles in your ears.
That's so gross. And he, and then he said, oh no, you gotta come in here. I came here last week and I have never slept better in my entire life. Wow. And so next week when I went, the room was full of people getting treatment. And that's where I saw the magic. The magic was they had these peer counselors that were volunteering at the harm reduction center, and somebody would be sitting there with needles in their ears and say, how do I get off this stuff?
And so somebody would say, well, I did methadone and this is how I did it, and this is where you go. Somebody else said, well, I did buprenorphine and this is how I did it, and this is where you go. And the other person said, well, I went to treatment and this is where you can get treat. And that was like amazing.
So it was like people starting the process of talking about it because it really does help calm people down and it helps with cravings, it helps with anxiety. And the biggest one is it helps with sleep.
Brenda Zane: That is amazing. I've never heard of that before. So I'm gonna put in the show notes, I will put links to the two organizations that you talked about.
And do they have like a provider directory? Like could you find, let's say you're in New Mexico, like could you
Dr. Stuyt: search and find Yes, yes, yes. That's
Brenda Zane: [00:51:00] amazing. I love that. I love finding new resources because at this point I think we need everything that we can get. Right. I think we've talked about some of, you know, the difficulties in getting this messaging out, but are there other or any myths that you think are out there?
Other than the fact that it's medicinal, any mist that you think should be cleared up about T h C specifically when you're thinking about a young person? So, you know somebody who's maybe under 25.
Dr. Stuyt: Well, the, the biggest ones are, you know, the industry still says it's not addicting. And, you know, I have a picture of the New York Times front page 19, i, I think it's 1995 with the, um, all the tobacco executives standing in front of Congress with their right hand raise, swearing that nicotine is not addicting.
Yeah, yeah. And so the message is, it is very addicting and in fact it's probably as addicting as nicotine. So that's a problem. And then the other message is that it really will affect your IQ if you use it regularly. You have this significant. Risk of losing IQ points. Uh, this one study out of New Zealand, I think it was New Zealand, followed these people and they've continued to follow people.
So they picked these people up over a thousand people at the age of 13 when they did an IQ test before they ever had marijuana. And then they followed them to 38 and did another IQ [00:52:30] test. And they found that the people that never used marijuana had a stable IQ over that period of time, but those who used it regularly dropped eight points in their iq.
And you know, if, if you're mensa, that's probably not a big deal, but if you're the average, so average IQ is a hundred and you drop eight points, you're in the significantly impaired range. And, and so that group has continued to follow these people. And they just recently published the results at 45. And that's kind of fascinating because what they're showing is the drop in IQ is worse for marijuana than it is for alcohol or for tobacco.
Two things that we know affect your, you know, iq.
Brenda Zane: I wonder is there any messaging that you have seen or heard that really cuts through to a young person? Because obviously you're dealing with a brain that's not fully formed, then you layer on marijuana, that brain. I just wonder how, because I think as adults I hear this and I'm just horrified and I think most adults are, but how do we get this message to the kids?
Like is there anything that you have seen that has been impactful?
Dr. Stuyt: Not yet because, you know, the, the fried egg never spoke to anybody. Exactly. This is your brain. This is your brain on drugs.
Brenda Zane: I think the egg was not effective. Well, the other thing that I see happening, and [00:54:00] this is just a, a real challenge, is that because parents are now so much more aware of fentanyl, that they will say, okay, well at least it's not fentanyl.
Right? And maybe that's true in the short term, right? Maybe that's harm reduction, however, in the long term, not harm reduction. So it's, it's really, it's something I wrestle with because, you know, I almost lost my son to fentanyl. And, um, so yes, I want people to be aware of that, and I am incessantly talking about it, but I, are we losing the messaging around the dangers of THC because of what's happening with the, with fentanyl?
Dr. Stuyt: If you're worried about fentanyl, you need to be worried about marijuana because there's more and more research showing that those two receptors are ally linked in the brain, and marijuana increases the risk of using opiates. So there's a really nice study looking at the number one risk factor for developing opiate use disorder is using marijuana before the age of 18.
Uh, and there have been many studies showing this correlation and, and then there was recently a study looking at people who have opiate use disorder on M A T. And if those use cannabis, they have a significantly increased risk of suicide over those not using cannabis. [00:55:30] With opiate use disorder. And, and then they've also shown studies that naltrexone actually, um, can augment the effect of cannabis.
Um, and, and so they, they're working together very integrally and, and what we've seen in Colorado for sure is cannabis has not stopped the opiate epidemic at all. We have had a massive increase in fentanyl overdoses, and we've had more marijuana available than any other state. And so it is, it's, I think it's actually making it worse.
And there is a brand new study looking at the states that have legalized marijuana and the opiate overdose deaths in showing that the opiate overdose deaths have been much higher, significantly in states that have legalized versus those that have not legalized cannabis.
Brenda Zane: That is interesting because here in Washington, we had billboards all over the place a couple years ago that said, in states that have legalized marijuana, opiate overdoses have gone down.
And I thought, what? Yeah. Was that possible? And I noticed that those are not up anymore. No.
Dr. Stuyt: The industry will still keep bringing up that one study. And that was a one study that was done early. This was before all the concentrates and stuff really hit the market. And it was done with a Medicare population.
So it was done with older [00:57:00] people who, um, you know, were on opiates and their doctor were telling 'em they had to get off. And, and so another group came in and replicated that study after multiple other states had legalized and they found the exact opposite. It was a total reversal. So even though initially they said there was like a 23%.
Less opiate overdose deaths in the states that had legalized medical and then it reversed, then it was like a 23% increase. Overdose deaths.
Brenda Zane: Is the link there due to tolerance that if somebody has reached a tolerance with marijuana, that the next kind of most logical step is opiates?
Dr. Stuyt: No, I, I think it actually stimulates the use of opiate.
They did this study in women, so this is in humans with aborted fetuses. So these were elective abortions, and they were looking at the brains of the offspring, and they found that there was a totally, um, the opiate receptors were totally affected in the brain by cannabis during pregnancy. Now, you don't know what happened to those kids, obviously, but if you look at animal research where they, they have pregnant rats and they give them cannabis while they're pregnant, and then they look at the offspring.
The offspring were much more likely to push the lever for heroin or opiates than if they were not exposed to cannabis. [00:58:30] So it's, it's like the cannabis exposure affects the opiate receptors in some. Very
Brenda Zane: interesting. Well, you are a wealth of knowledge. I feel like I could talk for days about this. Um, hopefully by now parents have said like, okay, this is a problem.
Um, this is not just marijuana and it's gotta be a lot for you. Just knowing all of this and talking with so many people. So I'd love to find out what do you love most about what you do?
Dr. Stuyt: What I love about working in the field of addiction is we don't fix people. We teach people how to fix themselves. And when people actually get it and start doing, you know, what they need to do to take care of themselves, it's just amazing.
Brenda Zane: Well, and that's also, um, I think a hopeful thing for parents to recognize that this isn't forever. Kids can come back from this and turn around and
Dr. Stuyt: so my message is recovery is completely possible, but it takes a lot of work.
Brenda Zane: Yes, yes. And especially it takes work on the parent's part too, if you have a young person just to understand all of this and figure out where to find the resources.
So I'm thrilled to have all the resources that you mentioned today, and I'll put all of those in the show notes for people. So thank you for joining us. This has been amazing, and I just appreciate your time so much.
Dr. Stuyt: Well, thank you. I appreciate it.
Brenda Zane: Okay, that is it for [01:00:00] today. If you would like to get the show notes for this, You can go to brenda zane.com/podcast.
All of the episodes are listed there and you can also find curated playlists there, so that's very helpful. You might also wanna download a free ebook I wrote, it's called Hindsight. Three Things I Wish I Knew When My Son Was Misusing Drugs. It'll give you some insight as to why your son or daughter might be doing what they are.
And importantly, it gives you tips on how to cope and how to be more healthy through this rough time. You can grab that free from brenda zane.com/hindsight. Thank you so much for listening. I appreciate it and I hope that these episodes are helping you stay strong and be very, very good to yourself, and I will meet you right back here next week.