WEBVTT - Does Cannabis Cause Schizophrenia? 0:00:03.670 --> 0:00:06.820 We have this attitude in our society that it's sort 0:00:06.820 --> 0:00:08.289 of a benign drug. 0:00:08.920 --> 0:00:12.610 All three of my sons claim that their smoking marijuana 0:00:12.610 --> 0:00:16.150 in high school with their friends brought on the symptoms 0:00:16.150 --> 0:00:20.860 of psychosis. Well, I'm sure that it did not help 0:00:21.040 --> 0:00:24.790 because I have read that if they already have the 0:00:24.790 --> 0:00:28.440 structure in their brain, the neurons in their brain, they 0:00:28.480 --> 0:00:33.550 are going to be schizophrenic, then the use of drugs 0:00:33.550 --> 0:00:35.900 can make it come on earlier. 0:00:36.880 --> 0:00:40.239 My doctor, who is probably in his late 60s now, he says 0:00:40.450 --> 0:00:44.470 he knows for a fact that marijuana brings on psychosis. 0:00:44.890 --> 0:00:47.019 He says, "why don't they ask me? I've been treating people 0:00:47.020 --> 0:00:48.610 for this all my life." 0:00:48.940 --> 0:00:53.080 We went to a family sort of training thing that 0:00:53.080 --> 0:00:55.330 they had. It went on for several weeks. So there 0:00:55.330 --> 0:00:57.430 were quite a few people. And one of the first 0:00:57.430 --> 0:01:03.160 questions the facilitator asked was about marijuana and and how 0:01:03.160 --> 0:01:07.420 many people here. Their loved one first started to show 0:01:07.600 --> 0:01:11.619 symptoms of psychosis after marijuana use and almost every hand 0:01:11.620 --> 0:01:12.009 went up. 0:01:13.480 --> 0:01:17.380 In addition to just the health efforts, it's made their 0:01:17.380 --> 0:01:21.130 treatment much more complicated. Some of them, they'll be admitted 0:01:21.130 --> 0:01:23.470 to a hospital because they're off meds and they say, well, 0:01:23.650 --> 0:01:27.040 we can't do anything until we use marijuana because it 0:01:27.040 --> 0:01:30.730 complicates all our observations. I'm thinking it's kind of a 0:01:30.730 --> 0:01:35.170 chicken and the egg thing, marijuana. You wonder if they 0:01:35.170 --> 0:01:37.510 took the marijuana and brought on the psychosis or they 0:01:37.510 --> 0:01:40.899 got the psychosis. So they took the marijuana to cope 0:01:40.900 --> 0:01:45.100 with their symptoms. I don't know. It's a tough one, but, yeah, 0:01:45.130 --> 0:01:47.880 definitely complicates everything. That's a good way to say it. 0:01:56.840 --> 0:02:00.140 My name is Faydra Aldridge . Welcome to Look Again. Mental 0:02:00.140 --> 0:02:03.440 Illness Re-examined, a podcast brought to you by the BC 0:02:03.440 --> 0:02:08.030 Schizophrenia Society, otherwise known as BCSS, as well as our 0:02:08.389 --> 0:02:15.790 partner organizations. Today on the show, we're talking about weed, weed, marijuana, pot, 0:02:15.910 --> 0:02:19.270 lots of terms... there's an idea out there right now 0:02:19.270 --> 0:02:21.880 in society at large, which I'm sure we've all heard of, 0:02:21.880 --> 0:02:25.480 that cannabis is a harmless drug. It appears in nature. 0:02:25.510 --> 0:02:27.940 It's fine for us. Some people even use it to 0:02:27.940 --> 0:02:32.049 self medicate. But for those with a predisposition for serious 0:02:32.050 --> 0:02:36.160 mental illness, such as schizophrenia, science now tells us that 0:02:36.160 --> 0:02:39.399 it's not so cut and dry. So how do we 0:02:39.400 --> 0:02:42.880 as a society grapple with this knowledge in a time 0:02:42.880 --> 0:02:47.440 of greater legalization? And how can cannabis be both helpful 0:02:47.800 --> 0:02:52.049 and dangerous to people with mental illness? Today on the show, 0:02:52.240 --> 0:02:53.470 we're going to find out. 0:03:00.760 --> 0:03:03.579 Today, we have the great honor of speaking with Dr. 0:03:03.580 --> 0:03:06.820 Nick Mathew, he has a very long title, but here's 0:03:06.820 --> 0:03:09.970 just a little bit about him. Dr. Mathew completed an 0:03:09.970 --> 0:03:14.889 addiction psychiatry fellowship at Yale University and a forensic psychiatry 0:03:14.889 --> 0:03:18.490 fellowship at the University of British Columbia. He is board 0:03:18.490 --> 0:03:25.540 certified in addiction, psychiatry, addiction medicine and forensic psychiatry. He's 0:03:25.540 --> 0:03:29.769 a clinical associate professor at UBC and he's currently serving 0:03:29.770 --> 0:03:33.430 as the medical director of Complex Mental Health and Substance 0:03:33.430 --> 0:03:37.810 Use Services at the Provincial Health Services Authority. That's quite 0:03:37.810 --> 0:03:40.870 a mouthful. We are so honored to have you. You're 0:03:40.870 --> 0:03:43.720 joining us from your home in Vancouver, B.C. And we 0:03:43.720 --> 0:03:45.880 understand your kids are playing in the background. So we 0:03:45.880 --> 0:03:48.490 might hear a little bit of noise from them. Thanks 0:03:48.490 --> 0:03:51.580 for being a multitasking dad and for joining us today. 0:03:51.850 --> 0:03:53.110 Welcome to the show. 0:03:53.410 --> 0:03:54.160 Thanks for having me. 0:03:54.760 --> 0:03:58.450 So, let's get right into it. Cannabis. We talk about it. 0:03:58.450 --> 0:04:01.990 We smell it. It's everywhere. And there's even some people 0:04:01.990 --> 0:04:05.170 that are saying now that it's being used as a 0:04:05.170 --> 0:04:08.110 miracle drug, it's helped them immensely and it's actually good 0:04:08.110 --> 0:04:12.340 for you and perhaps even a substitute for medication. So 0:04:12.340 --> 0:04:15.430 I'd love to get your perspective and your thoughts on this. 0:04:15.460 --> 0:04:18.390 Can cannabis be useful as a medication? 0:04:18.730 --> 0:04:22.039 We should think of cannabis as a drug. Is cannabis 0:04:22.040 --> 0:04:24.700 a medicine? Well, it is. I mean there is a 0:04:24.700 --> 0:04:29.410 lot of good uses for cannabis and cannabinoids, but we 0:04:29.410 --> 0:04:33.070 have to get an idea of the effect size of 0:04:33.070 --> 0:04:36.160 these things, and are there other alternatives that are better? So 0:04:36.370 --> 0:04:40.510 if we're looking at mental health. They've looked at things 0:04:40.510 --> 0:04:46.150 like depression, PTSD, anxiety, psychosis, Tourette's, and they really haven't 0:04:46.150 --> 0:04:50.110 found good outcomes using THC for any of those things 0:04:50.830 --> 0:04:55.300 with anxiety. It's pretty non-specific. So if we drill down 0:04:55.300 --> 0:04:58.410 to the positive studies for cannabis, the things that it's 0:04:58.420 --> 0:05:01.779 been used for is one, performance anxiety. The second thing 0:05:01.779 --> 0:05:08.270 is using CBD for the treatment of anxiety caused by THC. 0:05:08.320 --> 0:05:11.410 So we really have to drill down into the terms 0:05:11.410 --> 0:05:14.380 when people say this is good for. hat exactly do 0:05:14.380 --> 0:05:17.739 you mean? They have used it for psychosis and what 0:05:17.740 --> 0:05:21.640 they found is with THC, you can actually worsen the symptoms of psychosis. 0:05:22.330 --> 0:05:26.679 So, Dr. Mathew, you talked about CBD and THC. You 0:05:26.680 --> 0:05:29.580 touched on it. But I would love to hear, number one, 0:05:29.589 --> 0:05:32.530 what is CBD and THC? If you could just give 0:05:32.529 --> 0:05:35.770 us a little elevator pitch. And number two, what is 0:05:35.770 --> 0:05:40.900 the connection between THC and severe psychosis or severe mental 0:05:40.900 --> 0:05:42.870 illness such as schizophrenia? 0:05:43.510 --> 0:05:48.690 So the more psychoactive compound within the cannabis plant is THC. 0:05:49.120 --> 0:05:51.940 And so this is the compound that's going to cause 0:05:51.940 --> 0:05:57.310 the intoxicating effects of cannabis. The opposite compound would be CBD, 0:05:57.310 --> 0:06:01.090 which helps attenuate some of the psychoactive effects of THC 0:06:01.089 --> 0:06:04.570 over time. So over time, plants have been bred with 0:06:04.570 --> 0:06:08.589 higher amounts of THC and lower amounts of CBD. So 0:06:08.589 --> 0:06:13.570 for people who have severe mental illness, the higher potency 0:06:13.570 --> 0:06:16.390 plants with the higher THC and lower CBD are more 0:06:16.390 --> 0:06:19.780 likely to cause negative mental health issues in those patients. 0:06:20.170 --> 0:06:23.980 I'd like to delve into the connection with mental illness. 0:06:24.020 --> 0:06:27.219 I think it's so valuable to hear from experts such 0:06:27.220 --> 0:06:29.930 as yourself with so much knowledge in this area, to 0:06:30.190 --> 0:06:34.510 really dig into the link -- or the possible links -- between 0:06:34.510 --> 0:06:39.580 a drug like cannabis and serious mental illnesses such as schizophrenia. 0:06:40.150 --> 0:06:43.599 A lot of times when people have severe mental illness, schizophrenia, 0:06:43.600 --> 0:06:48.130 bipolar depression, it tends to be that using cannabis will 0:06:48.130 --> 0:06:52.390 worsen the progression of these illnesses as far as if 0:06:52.390 --> 0:06:55.989 something's a risk factor or causative. So risk factors can 0:06:55.990 --> 0:06:59.800 be something that can predict something occurring, and it can 0:06:59.800 --> 0:07:03.460 also be causative. And those two aren't the same thing. So, 0:07:03.460 --> 0:07:07.029 for example, if you're looking at breast cancer, being not 0:07:07.029 --> 0:07:10.510 married predicts having breast cancer, but it's not cause of 0:07:11.080 --> 0:07:16.270 it. The BRCA1 and BRCA2 genes are both predictive and causative of breast cancer. 0:07:16.630 --> 0:07:19.540 So when we look at the link between cannabis and schizophrenia, 0:07:19.690 --> 0:07:22.840 there's four main theories. The first theory is that it's 0:07:22.840 --> 0:07:25.300 a component cause. So what does that mean? That means 0:07:25.300 --> 0:07:29.140 that it's something that can cause schizophrenia but is not 0:07:29.140 --> 0:07:33.610 necessary for schizophrenia. The other link between schizophrenia and cannabis 0:07:33.610 --> 0:07:36.670 is that it can speed up the debut of symptoms 0:07:36.670 --> 0:07:40.030 of people who would already get schizophrenia. Then the third 0:07:40.030 --> 0:07:44.110 thing is common genetic vulnerability so somebody who's going to 0:07:44.110 --> 0:07:47.590 get schizophrenia might already have a predilection to using cannabis. 0:07:47.830 --> 0:07:50.080 And then the fourth thing is that people might be 0:07:50.080 --> 0:07:54.970 self-medicating prodromal symptoms of schizophrenia. So we don't really know 0:07:55.300 --> 0:07:58.660 which of these or which combination of these causes or 0:07:58.660 --> 0:08:02.500 the link between cannabis and schizophrenia are true. We're not 0:08:02.500 --> 0:08:07.000 seeing a flood of increased schizophrenia at a population level 0:08:07.150 --> 0:08:10.000 depending on cannabis use, and it doesn't seem to be related. 0:08:10.300 --> 0:08:13.540 And even in hospitals, it's not like our psychiatric wards are 0:08:13.780 --> 0:08:17.710 suddenly being flooded by people using cannabis, even though there's 0:08:17.710 --> 0:08:21.040 more cannabis in the population and there's a greater potency 0:08:21.130 --> 0:08:24.670 of cannabis. So my suspicion is, out of the four causes, 0:08:24.790 --> 0:08:27.360 I think it might be some combination of the last three. 0:08:28.390 --> 0:08:31.330 That is a perfect tie-in because a mother that we 0:08:31.330 --> 0:08:34.300 spoke to, Dr. Matthew, told us that her son started 0:08:34.300 --> 0:08:38.470 self medicating when he first started to experience his symptoms 0:08:38.470 --> 0:08:42.220 of schizophrenia. So how common is it within your practice 0:08:42.220 --> 0:08:45.939 for people with schizophrenia or other serious mental illnesses to 0:08:45.940 --> 0:08:50.840 attempt to self medicate using cannabis or other drugs like cannabis? 0:08:51.400 --> 0:08:54.910 I think concurrent disorders is more the rule rather than 0:08:54.910 --> 0:08:58.030 the exception. I mean, the people that we actually see 0:08:58.030 --> 0:09:01.450 in the psych emergency rooms, on the psychiatric wards, most 0:09:01.450 --> 0:09:04.600 of these people are using substances as well, and they 0:09:04.600 --> 0:09:08.750 are getting benefits from the substances, I mean, the self-perceived benefits. 0:09:08.770 --> 0:09:12.670 I'm not saying that they're good strategies as treatment overall 0:09:12.670 --> 0:09:15.640 or long term, but there is an immediate benefit. So 0:09:16.030 --> 0:09:20.020 one thing that all these substances that people use have 0:09:20.020 --> 0:09:21.970 in common is that they increase dopamine. 0:09:22.420 --> 0:09:25.300 And you've already given us some very interesting stats. But 0:09:25.300 --> 0:09:28.750 here's another one. This is from the BMC Medicine Journal. 0:09:28.750 --> 0:09:31.929 And the Journal states that up to 64 percent of 0:09:31.929 --> 0:09:36.280 individuals who have experienced a first episode of psychosis have 0:09:36.280 --> 0:09:40.619 used cannabis and 30 percent of these individuals have a 0:09:40.620 --> 0:09:45.360 cannabis use disorder. Those are some pretty high numbers. So 0:09:45.360 --> 0:09:47.100 what do you think we can do to get the 0:09:47.100 --> 0:09:50.550 message out there to the general population around these risks? 0:09:50.970 --> 0:09:54.160 I think the thing with cannabis use is it is ubiquitous. 0:09:54.540 --> 0:09:58.290 I'm not sure if there's a way to prevent high 0:09:58.290 --> 0:10:02.190 schoolers from dabbling or trying cannabis, but I think some 0:10:02.190 --> 0:10:04.710 of the things to consider are the risk factors. So 0:10:04.710 --> 0:10:07.860 if people had a family history of psychosis, you might 0:10:07.860 --> 0:10:09.929 want to stay away from cannabis. So that might be 0:10:09.929 --> 0:10:11.890 a message to put out there. 0:10:13.110 --> 0:10:17.400 You're listening to Look Again, Mental Illness Re-examined, a podcast 0:10:17.400 --> 0:10:20.500 brought to you by the BC Schizophrenia Society and B.C. 0:10:20.520 --> 0:10:25.830 Partner organizations. I'm your host, Faydra Aldridge. This podcast would not 0:10:25.830 --> 0:10:29.910 be possible without the support of the entire community. Thank 0:10:29.910 --> 0:10:34.110 you for caring about mental illness. Together, we truly can 0:10:34.110 --> 0:10:45.200 make a difference. [PROMO INSERTED] Welcome back to Look Again, Mental Illness Re-examined. I'm Faydra. Thanks 0:10:45.200 --> 0:10:48.160 for sticking with us. And here's where we left off. 0:10:49.040 --> 0:10:51.500 This is just so fascinating and you've been able to 0:10:51.500 --> 0:10:54.920 provide us with so much valuable information. So now I'd 0:10:54.920 --> 0:10:57.290 like to share some thoughts from one of our panelists. 0:10:57.290 --> 0:11:00.590 We talked to some people on Look Again. And here's 0:11:00.590 --> 0:11:03.920 a clip from a young man with schizophrenia. So listen, 0:11:03.920 --> 0:11:05.900 because I'd love to get your thoughts on what this 0:11:05.900 --> 0:11:07.069 young man has to say. 0:11:09.580 --> 0:11:12.790 I started smoking weed when I was like 16, and 0:11:12.790 --> 0:11:14.870 at first, it was just like once a month or 0:11:14.920 --> 0:11:19.510 once every three months. But once I got to university, 0:11:19.840 --> 0:11:22.840 I started smoking like every day, like when I got 0:11:22.840 --> 0:11:26.440 up in the morning to like all the time. And 0:11:27.490 --> 0:11:30.429 I -- up until the point I got arrested -- I 0:11:30.429 --> 0:11:34.230 was pretty much smoking weed the whole time. But yeah, 0:11:34.270 --> 0:11:37.990 I used to, my kind of tongue-in-cheek joke was "I'm not addicted, 0:11:38.020 --> 0:11:45.760 I just can't eat or sleep without it." It did make me paranoid, definitely, 0:11:46.220 --> 0:11:50.420 but the time when I first had delusions was when 0:11:50.420 --> 0:11:52.819 I took two hits of acid, two grams of shrooms, 0:11:53.480 --> 0:11:57.110 and yeah, I started, that's when I started thinking undercover 0:11:57.110 --> 0:12:04.170 cops were following me. So weed definitely didn't help. Once 0:12:04.200 --> 0:12:07.650 I got arrested, I took a six and a half 0:12:07.650 --> 0:12:11.010 year break from weed, but then just recently, before I 0:12:11.010 --> 0:12:12.750 went to the psych ward, when I start hearing voices 0:12:12.750 --> 0:12:17.550 again and stuff, I did smoke it. And it was, 0:12:17.660 --> 0:12:20.340 I was told it was a really, really, weak. It was supposed 0:12:20.340 --> 0:12:22.050 to be really, really weak. But I did I definitely 0:12:22.050 --> 0:12:26.810 did feel high from it. And yeah, I mean, is was 0:12:26.820 --> 0:12:31.109 a culmination of a lot of things that made my auditory hallucinations come back. 0:12:31.110 --> 0:12:34.199 But that was probably one of the big, one of 0:12:34.200 --> 0:12:38.820 the big reasons. And I regret doing that. Yeah, I 0:12:38.820 --> 0:12:43.469 think there's there's definitely a link between resurgence of my mental 0:12:43.470 --> 0:12:48.110 health symptoms and smoking weed. There's a link. There's a link. 0:12:51.530 --> 0:12:55.819 So, Dr. Mathew, that was obviously one young man's perspective 0:12:56.210 --> 0:12:59.930 and his last quote there said, "There's a definite link" 0:12:59.929 --> 0:13:04.400 between mental health issues and cannabis use. What are your 0:13:04.400 --> 0:13:05.210 thoughts on that? 0:13:05.840 --> 0:13:08.239 I would definitely agree with him. I definitely believe that 0:13:08.240 --> 0:13:11.710 there is a link between cannabis use and mental illness. 0:13:11.750 --> 0:13:14.990 This might have been a speed up of the debut of mental 0:13:14.990 --> 0:13:18.199 health symptoms, and it seemed to be linked. But one 0:13:18.200 --> 0:13:22.760 thing with substance-induced psychosis is that it's a neurotoxic event. 0:13:23.179 --> 0:13:25.670 So the general pattern that you tend to see is 0:13:26.030 --> 0:13:29.870 people use substances and they don't really have any kind 0:13:29.870 --> 0:13:32.540 of issue with them. And then when we relate it to psychosis, 0:13:32.720 --> 0:13:38.660 someone might start getting some minor psychotic symptoms during intoxication. 0:13:39.290 --> 0:13:43.400 And then these symptoms become more severe, then these symptoms 0:13:43.400 --> 0:13:46.250 last to the withdrawal phase than they last longer and 0:13:46.250 --> 0:13:49.250 longer over a period of time. And it seems like 0:13:49.250 --> 0:13:52.040 that's what's happened with this gentleman. And that is what 0:13:52.040 --> 0:13:55.189 I tend to see. If you do have a severe 0:13:55.190 --> 0:13:59.120 mental illness such as schizophrenia or bipolar or depression, you 0:13:59.120 --> 0:14:01.790 might want to stay away from cannabis because it hasn't 0:14:01.790 --> 0:14:06.980 been shown to benefit these syndromes. There's some nuance in 0:14:06.980 --> 0:14:12.260 there with CBT, with high doses, it can help attenuate 0:14:12.260 --> 0:14:15.380 some positive symptoms of schizophrenia, but people tend to use 0:14:15.380 --> 0:14:19.010 cannabis as a recreational drug. And that's another thing to 0:14:19.010 --> 0:14:22.670 consider with this person was that you saw the development 0:14:22.670 --> 0:14:26.480 of a cannabis use disorder long before they had a psychosis. 0:14:26.630 --> 0:14:29.840 I mean, this was affecting his ability to function and 0:14:29.840 --> 0:14:32.760 continue to use, despite these negative consequences. 0:14:33.290 --> 0:14:35.690 So as we talked about, Dr. Mathew, schizophrenia is a 0:14:35.690 --> 0:14:38.570 disorder that usually affects people in their late teens or 0:14:38.570 --> 0:14:41.960 early adulthood. And we've mentioned that, of course, this is 0:14:41.960 --> 0:14:43.790 also a time when many young people are starting to 0:14:43.790 --> 0:14:47.990 experiment with drugs. So according to the BC Early Psychosis 0:14:47.990 --> 0:14:51.800 Intervention Program, studies have shown that heavy use of cannabis 0:14:51.800 --> 0:14:55.910 increases the risk of developing schizophrenia -- ready for this -- two 0:14:55.910 --> 0:15:00.110 to four times. But as we've talked about, the vast 0:15:00.110 --> 0:15:03.560 majority of users never end up developing psychosis and never 0:15:03.560 --> 0:15:07.130 end up developing schizophrenia. So how do we explain this? 0:15:08.120 --> 0:15:10.730 Some years ago, there was a highly touted study where 0:15:10.730 --> 0:15:13.130 they showed that there was an eight-point drop in IQ 0:15:13.250 --> 0:15:17.870 for kids who started using cannabis, and it was really 0:15:17.870 --> 0:15:20.900 interesting how that whole thing rolled out, because after that 0:15:20.900 --> 0:15:23.840 study was published, there were letters published, the editors saying, well, 0:15:24.050 --> 0:15:28.730 maybe this is associated and not causative. And so the 0:15:28.730 --> 0:15:31.989 same author actually came up with a study later with twins. 0:15:32.000 --> 0:15:35.180 And what they showed was that they had twins, one 0:15:35.360 --> 0:15:38.120 who would use cannabis, one who wouldn't. And they started 0:15:38.120 --> 0:15:40.880 at the age of 13 and they followed them over 0:15:41.480 --> 0:15:44.060 to the second study was into their 20s. And what 0:15:44.060 --> 0:15:46.640 they found was the drop in IQ actually occurred with 0:15:46.640 --> 0:15:50.090 both twins and it wasn't actually increased. So maybe there's 0:15:50.090 --> 0:15:54.350 a fundamental difference in kids who are able to use 0:15:54.350 --> 0:15:57.860 cannabis at the age of 13, then ones that aren't. 0:15:58.310 --> 0:16:02.840 There's risk factors that can help predict something that will occur, 0:16:03.290 --> 0:16:06.200 but it doesn't mean they're causative. And I think that's 0:16:06.200 --> 0:16:08.870 what might be going on with the two-point four times, 0:16:08.870 --> 0:16:12.890 that is, that it might be an associated risk, but 0:16:12.890 --> 0:16:14.870 not a causative risk. Does that make sense? 0:16:15.500 --> 0:16:18.530 Yeah, because I could see how people would argue that 0:16:18.530 --> 0:16:20.960 people would say, OK, you have all these stats, the 0:16:20.960 --> 0:16:22.940 stat that we talked about before, you know, up to 0:16:22.940 --> 0:16:26.330 64 percent of individuals have experienced a first episode of psychosis, 0:16:26.330 --> 0:16:29.300 have used cannabis or the stat we just talked about. 0:16:29.480 --> 0:16:32.690 I can see people saying, so there's these high numbers. 0:16:32.690 --> 0:16:37.010 But yet schizophrenia is in quotations, "only" one out of 0:16:37.010 --> 0:16:39.260 one hundred people. So I could see people using that 0:16:39.260 --> 0:16:41.030 as an argument. So that's why I wanted to get 0:16:41.030 --> 0:16:43.080 into it a little bit more. If people are saying, OK, 0:16:43.550 --> 0:16:47.000 you're showing me all these stats, but how does this 0:16:47.000 --> 0:16:48.590 translate into reality? 0:16:49.040 --> 0:16:52.370 My opinion is that I'm not sure if cannabis is 0:16:52.370 --> 0:16:55.230 a component cause of schizophrenia. I'm not sure if you 0:16:55.230 --> 0:16:58.670 can take someone who would never develop schizophrenia, give them 0:16:58.670 --> 0:17:03.140 cannabis and cause schizophrenia in somebody. And I think we're 0:17:03.140 --> 0:17:06.050 seeing that at a population level. We're not seeing our 0:17:06.050 --> 0:17:09.980 hospital beds flooded with people with schizophrenia. The cannabis now 0:17:09.990 --> 0:17:13.129 is more potent than it's ever been. The rates of 0:17:13.130 --> 0:17:17.750 cannabis use are higher than it is unusual for someone 0:17:17.750 --> 0:17:20.810 to graduate high school and not to have tried cannabis. 0:17:21.619 --> 0:17:25.409 Seventy percent of people who graduate high school have tried cannabis. 0:17:25.550 --> 0:17:29.270 So the number of people who have first episode psychosis, 0:17:30.320 --> 0:17:34.160 sixty four percent, is actually less than the population that's 0:17:34.160 --> 0:17:35.030 tried cannabis. 0:17:35.600 --> 0:17:40.250 Wow. That's really fascinating, Dr. Mathew. So if I hear 0:17:40.250 --> 0:17:43.760 you correctly, what you're saying is that cannabis use on 0:17:43.760 --> 0:17:48.500 its own doesn't necessarily cause schizophrenia. But I'm also hearing 0:17:48.500 --> 0:17:51.109 you say that if you have a combination of other 0:17:51.109 --> 0:17:55.310 factors like genetic history, the presence of high THC levels, 0:17:55.310 --> 0:17:58.070 smoking pot at a young age, then you can put 0:17:58.070 --> 0:18:00.850 yourself at greater risk for the onset of mental illness. 0:18:01.520 --> 0:18:04.370 You're obviously a father, Dr. Mathew. I can still hear your 0:18:04.369 --> 0:18:07.610 little one playing in the background. So what message would you, 0:18:07.790 --> 0:18:11.720 as a father, give your own child around cannabis use? 0:18:12.410 --> 0:18:16.700 First, I would ask them to delay this. Or if 0:18:16.700 --> 0:18:19.070 you have to try now, please, one, get it from 0:18:19.070 --> 0:18:21.290 a safe source. And I think some of the things 0:18:21.290 --> 0:18:24.020 that we talked about earlier... if they could delay it, 0:18:24.020 --> 0:18:26.030 if they could use less, if they can use less 0:18:26.030 --> 0:18:30.800 potent versions, because I think it's very hard to get 0:18:30.800 --> 0:18:34.550 kids to stop trying these things. I mean, I think 0:18:34.550 --> 0:18:36.800 most kids are going to try things like alcohol. They're 0:18:36.800 --> 0:18:39.500 going to try things like cannabis. So if they're going 0:18:39.500 --> 0:18:41.960 to do it, do it in the safest possible manner. 0:18:42.080 --> 0:18:44.350 Of course, the best outcome is if they didn't try it, 0:18:44.930 --> 0:18:46.399 I'm not sure if that's realistic. 0:18:47.150 --> 0:18:50.720 So, as you said, 70 percent of youth are going 0:18:50.720 --> 0:18:54.800 to try most likely to try cannabis. So if somebody 0:18:54.950 --> 0:19:00.920 does start using and does start to experience psychosis in 0:19:00.920 --> 0:19:03.510 some form, what should they do? 0:19:04.160 --> 0:19:08.440 So one is to get help early. So with your supports, 0:19:08.510 --> 0:19:11.840 try to see a physician and try to get a 0:19:11.840 --> 0:19:15.350 referral to a psychiatrist as early as possible. If you 0:19:15.350 --> 0:19:18.860 start developing those symptoms, after getting help, you also need 0:19:18.859 --> 0:19:23.060 to abstain from substance use. It's something that's not good 0:19:23.060 --> 0:19:26.210 for your body and it will only worsen over time. 0:19:26.750 --> 0:19:33.620 I hear from even friends, colleagues, it's natural. Cannabis is everywhere. 0:19:33.619 --> 0:19:38.960 It's been around forever. It's a plant. It's a natural product. 0:19:38.990 --> 0:19:42.110 Why shouldn't I use it? It's better for me than alcohol. 0:19:42.290 --> 0:19:43.879 What's your response to that? 0:19:44.600 --> 0:19:47.600 I mean, I think the fact is that they have 0:19:47.600 --> 0:19:50.360 a lot of valid points. And the way I would 0:19:50.359 --> 0:19:54.710 liken it is to something like alcohol. So most people 0:19:54.920 --> 0:19:58.100 in the population drink alcohol. In the same way, a 0:19:58.100 --> 0:20:01.220 lot of people use cannabis and it's the minority that 0:20:01.220 --> 0:20:03.950 have issues with it. And so if you start developing 0:20:03.950 --> 0:20:07.040 a substance use disorder, you start developing mental health symptoms, 0:20:07.340 --> 0:20:08.760 then it's not for you. 0:20:09.380 --> 0:20:13.550 This has been such an informative conversation and a very, 0:20:13.550 --> 0:20:17.869 very important topic. The fact is that, as you said, cannabis 0:20:17.869 --> 0:20:20.990 is everywhere right now and there's so much emphasis on 0:20:20.990 --> 0:20:24.379 the legalization of it. And I'm just thrilled that we 0:20:24.380 --> 0:20:27.320 can now start to really focus on the health and 0:20:27.320 --> 0:20:30.920 possible health implications of cannabis. So thank you so much 0:20:30.920 --> 0:20:33.320 for joining me today, Dr. Mathew. And we look forward 0:20:33.320 --> 0:20:34.389 to speaking with you again. 0:20:34.880 --> 0:20:35.690 Thank you for having me. 0:20:37.609 --> 0:20:40.490 And now it's time to thank my incredible guest today 0:20:40.490 --> 0:20:43.879 on Look Again, Mental Illness Re-examined. And I want to 0:20:43.880 --> 0:20:49.850 thank you for listening. Your support means absolutely everything. Mental 0:20:49.850 --> 0:20:54.500 illness literacy is so important. It's important to you, to 0:20:54.500 --> 0:20:58.310 me and to us as an entire society. We have 0:20:58.310 --> 0:21:01.190 to talk about this. And together, I know we can 0:21:01.190 --> 0:21:04.729 do a better job of taking action. Talk to you soon. 0:21:07.410 --> 0:21:09.960 This podcast is brought to you by the BC Schizophrenia 0:21:09.960 --> 0:21:12.930 Society and the B.C. Partners for Mental Health and Substance 0:21:12.930 --> 0:21:16.350 Use Information, where a group of non-profit agencies providing good 0:21:16.350 --> 0:21:20.040 quality information to help individuals and families maintain or improve 0:21:20.040 --> 0:21:24.030 their mental well-being. The B.C. Partners Members are Anxiety. Canada, 0:21:24.030 --> 0:21:28.740 BC Schizophrenia Society, Canadian Institute for Substance Use Research. Canadian 0:21:28.740 --> 0:21:33.119 Mental Health Associations, B.C. Division, Family Smart, Jessie's Legacy, the 0:21:33.119 --> 0:21:37.410 North Shore Family Services Program, and Mood Disorders Association of B.C., 0:21:37.410 --> 0:21:40.320 a branch of Lookout Housing and Health Society. The B.C. 0:21:40.320 --> 0:21:43.379 partners are funded and stewarded by B.C. Mental Health and 0:21:43.380 --> 0:21:47.160 Substance Use Services, an agency of the Provincial Health Services Authority. 0:21:47.290 --> 0:21:48.870 For more information, visit heretohelp.bc.ca