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cover of episode The future of cannabis research and regulations

The future of cannabis research and regulations

2024/12/20
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On Point | Podcast

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Jonathan Calkins
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Mahmoud El-Soli
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Maya Solovitz
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Meghna Chakrabarty
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Ziva Cooper
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Meghna Chakrabarty: 本节目探讨了美国大麻每日使用率超过每日饮酒率的现象,并分析了其背后的原因、潜在风险以及研究和监管方面的不足。节目中采访了多位专家和听众,分享了他们对大麻使用的不同观点和经验。 Jonathan Calkins: 大麻使用率上升的原因包括社会和文化接受度提高、法律风险降低以及价格下降(特别是THC价格的下降)。然而,目前对高浓度大麻或大量大麻的长期健康和行为后果知之甚少,这令人担忧。 Maya Solovitz: 大麻使用量增加的复杂性在于,许多人出于医疗原因每日使用大麻。此外,关于酒精的健康建议改变也可能导致每日饮酒人数下降。令人惊讶的是,青少年大麻使用率并未随着大麻价格下降或合法化而上升,甚至有所下降。 Ziva Cooper: 大麻的短期和长期影响会受到使用原因、方式(吸食、食用等)和频率的影响。获取大麻使用模式数据存在障碍,包括大规模调查数据的局限性和直接研究的难度。大麻的合法化虽然提高了安全性,但各州的监管标准不同,存在不一致性。 Mahmoud El-Soli: 密西西比大学作为联邦政府批准的大麻种植者,为研究提供不同THC含量的大麻样品,以满足研究需求。但大麻研究受到严格的限制,这使得研究非常困难和昂贵。 David Schreiber: 如今大麻的THC含量比以前高得多,这与不良事件的增加有关。

Deep Dive

Key Insights

Why has daily cannabis use become more common than daily alcohol use in the U.S.?

Cannabis use has become more socially and culturally accepted, with fewer legal risks due to state legalization. Additionally, the price of THC has dropped significantly, making it more affordable and accessible. These factors, combined with a cultural shift, have led to a 15-fold increase in daily cannabis use since 1992.

How has the price of cannabis changed over the years?

The price per milligram of THC has declined by about 80% without adjusting for potency, and by 90% when factoring in increased potency. This significant price drop has made cannabis more affordable and contributed to higher consumption rates.

What are the potential risks of increased daily cannabis use?

There is limited research on the health and behavioral consequences of consuming higher potency cannabis or larger amounts. The average daily user consumes 320 milligrams of THC, which is eight times more than what has been studied in most research. This gap raises concerns about long-term effects.

How does cannabis use differ between medical and recreational users?

Medical users are more likely to use cannabis daily, often for conditions like pain or sleep disorders. Recreational users may consume less frequently but in higher quantities. The reasons and patterns of use vary significantly between the two groups.

What is the current status of cannabis research in the U.S.?

Cannabis is still classified as a Schedule I drug, which imposes strict restrictions on research. Researchers must obtain cannabis from a single federally approved source, making studies more difficult and expensive. However, there are efforts to reschedule cannabis to Schedule III, which could ease some restrictions.

What are the challenges in conducting cannabis research?

The Schedule I classification requires special procedures, safes, and strict tracking of cannabis, making research costly and complex. Additionally, researchers can only obtain cannabis from a single source, limiting the variety of strains and potencies available for study.

How does the potency of cannabis today compare to previous generations?

The potency of THC in cannabis has increased significantly. In the 1990s, THC concentrations were around 4%, but today they average around 20%. Some products can even reach 90% potency, which is five times higher than previous levels.

What are the potential benefits of cannabis use compared to alcohol?

Many users report that cannabis provides a clearer mind and better control over their body compared to alcohol. It is also perceived as less risky, with fewer negative side effects like hangovers or impaired judgment. Edibles, in particular, are considered less harmful than smoking.

What are the concerns about cannabis use among teenagers?

While teenage cannabis use has not increased with legalization or price drops, there are concerns about the long-term effects on brain development, particularly in emerging adults aged 18-25. Some studies suggest an increased incidence of psychotic disorders among younger users.

How does the legal status of cannabis affect its regulation and consumer trust?

Legal cannabis is generally more regulated and safer than the black market, with better labeling and testing. However, there is no federal oversight, leaving states to set their own standards. This can lead to inconsistencies and gaps in consumer protection, especially with newer products like Delta-8 THC.

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This is On Point. I'm Meghna Chakrabarty. I'm 76. I use the edibles every day and I use it to combat frustration over being invisible as an older American.

and also it just makes me feel really good. I've never been a big alcoholic drinker. However, to help me fall asleep at night, I do take Delta-8, which has a small amount of THC in it. I have been a daily cannabis user for over 40 years. I have maintained good health, good business. Everything functions well. I have no pain. I take no medications. I'm 62 years old.

I'm a happy guy. Weed gives you positivity. That's Dan in Charlotte, North Carolina, Amy in Milwaukee, Wisconsin, and William in Edgewood, New Mexico. Just a few of the On Point listeners who shared their experiences with cannabis use. And obviously they are not the only ones in this country. In fact, daily marijuana use is now more common than daily drinking in America.

Back in 1992, there were about 10 times as many Americans reporting daily or near-daily drinking as daily or near-daily marijuana use. But since then, per capita rates of daily and near-daily cannabis use have increased 15-fold and now actually exceed the rates for alcohol use. Jonathan Calkins is a cannabis policy researcher at Carnegie Mellon University, and he published these findings in a study in May.

The study looked at cannabis use data from the National Survey on Drug Use and Health, and it looked over a 43-year span starting in 1979.

Now, to be clear, there are still more Americans who drink alcohol in absolute numbers than those who use marijuana in absolute numbers. The new thing about marijuana is that about 40 percent of those users are using it at least near daily, according to the study. That's an estimated 17.7 million people.

Professor Calkins says there could be a few reasons why this change is happening. Cannabis use is now more socially and culturally accepted. There are fewer legal risks as states have changed their laws around marijuana.

But the other factor, very important that people talk less about, is an enormous decline in the price per milligram of THC. When we put together the data that we have, both from the illegal market, say from undercover buys and user self-reports on websites, and the official data that we have now in the legal markets, we're seeing declines on the order of 80%.

without adjusting for potency. And when you factor in the greater potency, 90% between, say, 2008 and the present. At the end of the day, cannabis is a consumer good. And when prices go down, people tend to consume more. Okay. Now, specifically, when it comes to this daily use of cannabis, we're talking about all forms of cannabis.

As for smoking pot specifically, about 15% of Americans say they smoke marijuana today, compared to just 7% back in 2013, according to Gallup. That Gallup survey question specifically asked this. Keeping in mind that all of your answers in this survey are confidential, do you, yourself, smoke marijuana?

Okay, so given that question, the poll doesn't actually have higher resolution detail on why people smoke and how much they're smoking. Now, Professor Culkin says that while growth in daily cannabis use makes sense, it should also be cause for concern because relatively little is known about the behavioral and health consequences of consuming higher potency forms of cannabis or much larger amounts.

There have been excellent studies done, randomized control trials in the laboratory exposing people to THC, but the doses involved in those studies are often on the order of 20 or 40 milligrams. And if you realize that the average daily user is consuming something like 1.6 grams of flour per day, that's 20% less.

potent, well, that's 320 milligrams of THC, just vastly more than has been studied in most of the studies that we have available to us now.

Oh, in other words, it's something like at least eight times more than the studies have had a chance to research. So today we're going to talk about this rise in daily cannabis use in the United States. Again, it's superseding daily alcohol use. And we're going to take a look at whether there are dangers in the gap between increased cannabis consumption and research and regulation.

So we're going to start with Maya Solovitz. She's a reporter covering science, public policy and addiction treatment. She's also a contributing opinion writer at The New York Times and author most recently of Undoing Drugs, The Untold Story of Harm Reduction and the Future of Addiction. Maya, welcome to On Point. Thank you so much for having me. So what's your first thought on this increase in daily use of cannabis amongst Americans?

So there's a lot of complexity here, unfortunately. One is that a lot of people use marijuana for medical reasons. And if you're doing that, you are likely to be doing it daily. So that's one thing that's different from alcohol, although I will note that during alcohol prohibition, there was actually medical alcohol as well.

And the other thing that I'm not sure Dr. Calkins has looked into, but I'd be really curious to know about is recently health recommendations have changed around alcohol. It used to be considered the case that if you have one or two drinks a day, that's actually good for your heart.

And that has changed. So the amount of daily alcohol users may also be going down. So there's that complexity. The other thing that we see is that older users are the people who are using more. The people we tend to be worried most about when it comes to marijuana is teenagers. And astonishingly and amazingly and greatly,

Teenage use has not risen during the fall in price of marijuana or during the legalization of it, which is good. Teen use has actually stayed steady or even declined. Yeah, that is so interesting. And we're going to talk about that more a little bit later in the show. So can you take me more into these nuances? And you said it's unfortunately complex. I think it's fortunately complex.

Right. And and nothing is ever truly straightforward, which is why we have experts like you on, Maya. I wonder if there is also a social component.

and legal aspect to the increase, particularly amongst older Americans, as you're saying, right? Because, as we talked about earlier, because of legalization in many states and the social destigmatization that comes along with it, I mean, it was very easy for us to just put one

notice out to listeners asking if they were daily users of cannabis. And we got a lot of responses back. People, you know, it's not something that unlike 20 years ago, you felt like you needed to hide. That is true. And there's definitely, when you're doing these surveys, it's very hard to tell about things because oftentimes people will tell you what you want to hear. But the ongoing surveys seem to be pretty reliable. What's interesting to me about the older people is

is that, for example, women in perimenopause and menopause tend to have an enormously difficult time sleeping. This may be accounting for that. I don't think those users are using anything more than 5 to 10 milligrams of edibles. They're not even smoking. And so when you ask the question about smoking,

you are leaving out these people potentially also. And that's a large population. Yeah. No, point taken. And I think that's why we separated out the smoking figure just to get a sense of how much smoking was going on versus the other forms of consumption. And Professor Calkins, I think his overall study was overall all forms of consumption. So we don't exactly know what the breakdown is internally today.

Right. But to your point, or also about women, is the do we do we know if the gender gap is is there a gender gap in cannabis use now? That's an interesting question. And I have not looked at that lately. I mean, there historically there has always been a huge gender gap in terms of addiction, where two thirds of people with addiction tend to be male.

This, in terms of alcohol, that gap has been closing, and also in terms of other drugs to varying degrees. But when you look at the extreme end of the spectrum, which is people with addiction, it tends to be dominated by men. And in terms of social acceptability, it has always been more acceptable for men to use substances to get high than it is for women. Mm-hmm.

So can we turn our attention just for a second to the drinking part again? Because I think you raised a really important point there. These studies do rely on self-reports. And I actually wonder if there's been a flip, right? Like perhaps now, to your point earlier about recommendations on alcohol, perhaps the social stigma now is on self-reporting of daily drinking. And that might be suppressing those numbers. Yeah.

That's always possible, and it is really difficult to tell. One thing we do know is that self-report is reasonably reliable when you have statements like this is completely confidential and when people will not be punished for telling the truth. But, you know, again, it's difficult to know. Okay. So then tell me overall, what do you think about what this, at least as far as we can understand, increase in use means, including medical use,

of marijuana. Is it a risk-free activity? A lot of the people who called us to leave their stories seem to believe that it is. I don't think anything is risk-free. And I think a lot of people balance risks that they take. For example, it is definitely less risky than daily drinking. And if you are taking it by means of edibles, it's way less risky than smoking. The

Statistics on smoking marijuana and lung cancer have long been interesting because they didn't find any correlation, which obviously is not the case for cigarettes.

So it would be concerning if people were consuming massive amounts of smoke with char in it if they were smoking marijuana the way they smoke cigarettes. But again, we now have vaping and there's a lot of other things going on. So it makes it very difficult to tell.

The issues related to marijuana use have historically been ones that we worry about in teenagers, like are they doing well in school? Are they driving? And driving could be an issue here. But again, the research is pretty clear that if you drive on marijuana, not that you should, it is dangerous.

less safe than driving sober, but it is more safe than driving while on alcohol. Although if you mix the two, that's more dangerous. Well, Maya Solovitz, hang on for just a second. We have a lot more to talk about about daily cannabis use in the United States. This is On Point. Support for the On Point podcast comes from Indeed.

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You're back with On Point. I'm Meghna Chakrabarty. And today we are talking about the increase in daily cannabis use in the United States, that it's more common now than daily drinking. I'm joined today by Maya Salovitz. She's a reporter who covers science, public policy and addiction treatment and author of

Undoing Drugs, the untold story of harm reduction and the future of addiction. And let's listen to a couple of On Point listeners who called in with their stories of cannabis use. Here's Anna Ruth Shipman in Silver Spring, Maryland. I'm not surprised by the findings. When I was young, back in the 70s, at the age of 15, I started using both alcohol and cannabis regularly.

And found both had bad side effects. But I find the side effects of cannabis to be less than the side effects of alcohol. That's Anna Ruth Shipman in Maryland. And here's Evan in Ames, Iowa, with a very similar feeling.

I'm a cannabis user because it's much preferable to the effects of alcohol, you know? I can still be somewhat functional. I don't wake up feeling terrible and doesn't come with all those added calories.

That's Evan in Ames, Iowa. And we'll hear from more On Point listeners in just a moment. I'm joined now by Ziva Cooper. Ziva Cooper is a professor in the Department of Psychiatry and Biobehavioral Sciences at the University of California, Los Angeles, and director of the UCLA Center for Cannabis and Cannabinoids. Professor Cooper, welcome to you.

Thank you so much. It's a pleasure to be here. Okay, so you heard Maya at the beginning of the show raise the first wrinkle here, which is really important, that with this new finding of daily cannabis use, we don't yet have information on how many people are using it for medical purposes versus recreational purposes. And we also don't know the breakdown in terms of types of consumption, smoking, edibles, etc. Why would it be important to know these things, Professor Cooper?

So we know that the effects of cannabis in the short term and the long term are impacted by the reasons why people are using and the ways that they are using it, including the numerous emerging types of products that I think Dr. Calkins mentioned before with the increased potency, so the increased THC concentrations of these products.

the increased variety of products that are available. So Maya mentioned the vape pens, the different types of oral products.

But also another important point here is that when we think about daily use, one critical variable to consider is not just how people are using it or why they're using it, but also the frequency. How often are they using it every single day? So in our own experience, there are people who are using cannabis daily, but they're taking a puff or taking an edible once before sleep.

But then there are also people who are using or smoking many joints per day. And so you would imagine that the effects are going to be quite different in the short term and long term. What are the obstacles to getting that kind of data on use patterns in this country?

So there are a number of obstacles, and it really depends on how you're going to approach answering the issue. And one way that we've just heard about in approaching this question is, you know, where Dr. Calkins looked at large survey data, population data, where we're able to look at

behavioral patterns in millions of people and that is really really powerful but as you discussed before you know there are certain gaps there are nuances that are not captured that are have really important implications another way to study the effects is to actually look directly at the impact of

of cannabis and those different constituents of the cannabis plant and the different ways that people are using them to actually study it. So to give it to people and compare it to a placebo, so an inactive drug or a sugar pill,

And look to see if in people who are using it every single day, are the effects going to be quite different than people who are not using it regularly, both for potential medicinal effects. So the reasons why people might be using it for medicinal reasons such as pain or sleep, as well as some of the adverse effects that Maya touched on, including attention, memory, intoxication, things like that.

So, Maya, this brings us to one of the major hurdles in terms of gathering that research or doing the research and gathering that data. Because as far as I understand, as of this broadcast, marijuana is still a Schedule I drug in the United States, correct? That is true. And so that means what kinds of restrictions are placed on the research of marijuana? Yeah, so it's kind of as though you're doing nuclear research because you have to track every...

tiny bit of it. You have to have special safes, you have to have all kinds of special procedures, and you have to obtain the marijuana from only specific sources. So doing this type of research can be really, really difficult and expensive because of all the restrictions. It is as though, you know, like

The way methadone clinics have that drug locked down, you have to lock down the marijuana, which is, well, it's ridiculous in both cases, but it ends up creating a real hassle for everybody who tries to do it. Okay. My understanding is, though, that I can't remember exactly when, but there was a very recently the DEA made some noises about taking it, taking marijuana off of Schedule 1 and rescheduling it to Schedule

I don't know, another level where it could be easier to perform research and you could actually get the research materials, the cannabis from different locations rather than like the one federally approved grower. Yes. So President Biden actually ordered the rescheduling. And so it is in the process of doing so because it's an enormously complex bureaucratic process that

Nobody has ever really done this before. And there are sort of a lot of measures for scheduling drugs and making them illegal and very few processes for doing the opposite.

The DEA's role is complicated here because it obviously wants to protect its turf and have control over as many substances as possible. Meanwhile, that may not necessarily be in the interest of the general public.

And unfortunately, it's not the health agencies that make the decision about whether something should be legal or illegal or about how to regulate it. It is the law enforcement agency that does. Professor Cooper, did you have some thoughts on this?

Yeah, so it is a really interesting turn of events. And in May 2024, the Department of Justice issued a draft ruling moving cannabis, well, marijuana, so that's cannabis with a certain amount of THC from Schedule 1 to Schedule 3,

And it signified a couple of really important shifts in how the government is thinking about marijuana. So in that report, it talks about how, you know, as a Schedule I substance, there was no accepted therapeutic use for the drug. But with the movement to Schedule III, there is an acknowledgment of the therapeutic effects of marijuana, of THC and marijuana. And so that was really important.

Now, whether or not it eases research, I think it really remains to be seen because there are many other variables, not just the Schedule I classification, that limits the restrictions or the obstacles for research. Yeah. So we're going to go down a little bit of a...

of a rabbit hole on what you just said, Professor Cooper, because to be clear to folks, it was back in 1968 that the federal government finally allowed research on cannabis, but they limited it to just one grower. That grower is at the University of Mississippi. And, you know, one grower can't grow enough to satisfy just research needs.

But as you guys have both been talking about, in 2016, there were signals from the federal government that that would change. By 2019, DEA decided to move forward on applications because they were actually facing a lawsuit for not expanding the number of federally approved growers. And in 2022, DEA finally registered those additional growers for research.

So let's go to the original place where researchers can get cannabis slash THC for study. And that is at the University of Mississippi. And Mahmoud El-Soli joins us now. He's director of the Marijuana Project at the University of Mississippi and previously the only approved grower by the National Institute on Drug Abuse for Cannabis Research. Mahmoud El-Soli, welcome.

Thank you. Good to be with you. Okay, so first of all, tell me a little bit about what it's like growing cannabis for research. How meticulous is it? What's the process? Well, the process, first of all, the growing or production of cannabis itself, the process itself for doing that is really a rather simple process because the plant is a very...

A very cooperative plant, just very easy to grow, very easy to control, doesn't really get affected that much by pests and things like that. So if you give it good environmental conditions and good fertilizing and good soil, it grows well.

Literally like weed. So it's a very, very easy plant to grow. Professor El-Soli, does what is grown at the University of Mississippi, is there variable potency in the THC in the plants that you grow?

Yes, we have every kind of material that any investigator around the country would like to use or would like to investigate. Starting from, of course, we have to have a placebo material, which is

you know cannabis plant material that has been all the cannabinoids and all the other components have been removed so that's what we call the placebo so from placebo material to maybe one percent thc content two percent four percent eight percent and that has been that up to eight has been traditionally what was available in the program until maybe a couple two three years ago

Now investigators started looking for materials that match what is available in the dispensaries or in the illicit market, which is materials that are, you know, maybe 14%, 15% and above. That would be considered as high potency. So we have actually produced those types of material. We have materials that are, you know,

go all the way up to 27%. I just published a paper not too long ago where we compared the potency and the chemical profile of the materials that we have under the NIDA drug supply program with materials available in dispensaries around the country in the illicit market from all the different states, all the different regions of the U.S., and we can definitely

Definitely, certainly, no question, match any materials that any investigator would be looking for to use in their research. Okay. This material was not available before simply because there wasn't really that much demand for it. That's number one. Number two is a very important thing.

The material that is produced in the national program, the drug supply program, is mainly used to manufacture cigarettes for smoking. And the research shows, and this has to be standardized marijuana cigarettes, and the weight of that cigarette is somewhere between around eight-tenths of a gram per cigarette.

And so the subjects that are involved into a clinical trial that is a randomized placebo-controlled trial, everybody will have to get the same exact type of cigarette, same shape, same form, same everything. Only thing of the difference would be the potency of the THC in that cigarette. I just have to jump in here. Forgive me, Professor, but I do have to just jump in here and say I'm Meghna Chakrabarty. This is on point.

Now, I actually appreciate a great deal your detailed answer on the sort of variety of potencies that you can produce for research. And earlier this year, a health care analytics company called Truvada found that rates of cannabis-induced disorders grew more than 50 percent between 2019 and November of 2023. Dr. David Schreiber is a psychiatrist and CEO of Compass Health Center, and he told CBS News one of the most important things about cannabis is that it's a very good

One of the reasons why. Cannabis today is different than cannabis of previous generations. In the 1990s, we had potency, concentration of THC and cannabis hovering around 4%.

Today, that number is closer to 20%, so five times the greater amount of potency. We know because of technology today that there are products being marketed out there that are able to achieve 90% potency. And there are a lot of studies that are shown out there that increased potency concentration also correlates with increased adverse events. Professor El-Souli, I have one more question for you, and that is, obviously, you're at the forefront of this.

the source of materials for cannabis-related research. Are there any specific additional policy changes you'd like to see around this research so that we can actually close the gap in our understanding of positive or adverse effects of the kinds of cannabis on the market today?

Well, I honestly think that as hard as the regulations have been and as difficult as it has been, as Dr. Cooper indicated, to deal with working with cannabis and doing research with cannabis because of all the regulations,

that everything has been and still is in place for anyone who is really interested and wants to put the time and the effort to do a particular study. Everything is there for that person to do what they want to do. Now, the increase in the potency that...

that we're talking about and the fact that there's so much THC in there, this is when you have, when the use of cannabis is what we call ad libitum, meaning you just use as much as you want to use to achieve the end point that you want to achieve. That's not what's happening when you do standardized clinicals.

clinical research. So, and at the end of my previous talking, I was going to tell you that in the clinic, in the actual clinic, no body, no one with, no matter what their experience with the use of cannabis was able to finish the 8% THC marijuana cigarette. So when you have an 8%,

And you can't use it. Of course, you cannot use the same amount of material in a cigarette at 15 or 20 or more percent. So the increase in the potency just allowed the people to use a smaller amount of the cannabis material to reach the goal they are trying to achieve. Not...

The total amount is the same. Whether you use a 4% or a 20%, you're using the same amount of THC to reach the endpoint that you want. But now, because of the development of the babes and all of that, people can use the higher potency material, small amount of plant material, to reach the goal they're trying to reach.

Professor, yes, Professor Mohamed El-Soli, director of the Marijuana Project at the University of Mississippi. Thank you so much for joining us. Thank you. Do you need me to stay on? No, we're all set. We're going to talk about, return to our conversation with Maya Solovitz and Ziva Cooper in just a moment. This is On Point. On Point.

You're back with On Point. I'm Meghna Chakrabarty. And before we get back to our conversation today about the rise in daily cannabis use in this country, I want to give you a quick note about a show we're working on for the new year.

It's about the science of smell. Yes, everything from the smell of pot smoke to the smell of great coffee in the morning, pine indoors at this time of year, a pile of garbage, wet dog, whatever, whatever. Smell is just this compendium of very sophisticated biological processes that really can have an impact and shift how we experience the world around us. So we want to hear...

your stories about smell, about scent. What encounters with smells or scents have helped you learn something new about the world or connected deeply to your memories? Also, given the fact that we're in the COVID pandemic...

If you lost your sense of smell due to COVID, what impact did that have on you? And did it return and did it reconnect you to the fullness of experiencing life? So send us your stories about scent and about smell. You can do that on our On Point VoxPop app.

If you don't already have it, just look for On Point Vox Pop wherever you get your apps. And you can send us your story that way. It's the best, most high-quality way to connect with us. You can also still give us a ring at 617-353-0683. That's for the new year. We're going to be talking about really not just the science but the importance in terms of the human experience that comes through your nose.

I'm joined today in our conversation about cannabis by Maya Salovitz. She's a reporter who covers science, public policy, and addiction treatment and author of Undoing Drugs. Ziva Cooper is with us as well. She's director of the UCLA Center for Cannabis and Cannabinoids.

And I just want to give our listeners a little bit more of a voice here. This is Michael Allen from St. Paul, Minnesota, who tells us he's been a daily cannabis user for about eight years, and it's been incredibly helpful to him. When using cannabis, I use concentrate with an electronic vaporizer, and I only use it while I'm in my own home. For me, cannabis helps to slow down my mind when stressed and break intrusive thought cycles that have in the past led to severe depression and anxiety.

But I also enjoy cannabis as a recreational substance because I can better control my consumption. And even if I do overdo it, I feel in control of my body and mind, which is something I've never felt with alcohol.

So that's Michael in St. Paul. Here's another On Point listener, former member of the United States military, lives in Massachusetts. He talked about his preference for marijuana over alcohol. I began to use marijuana as a civilian and it became exceedingly a better alternative to alcohol. Obviously, there are consequences to using and smoking marijuana, but I'm not...

blackout, belligerent, making stupid decisions. Your faculties are more there when you smoke. Your judgment is present. It's not debilitating in ways that alcohol is. Professor Cooper, let me ask you, these two comments are very, very interesting to me because how much do we know about what a cannabis user is feeling about

about their relative level of control or clarity of mind versus what is actually measurable in terms of the level of control they have over their bodies while consuming cannabis. Meghna, I think this is a really interesting point that also points back to what Dr. Alsoli was talking about with respect to this idea of

that even though the products are higher potency, have more THC, people just take less. So they titrate to get to their desired effect.

And so people like your, um, your listeners who are reporting in, you know, overwhelmingly they've had, it sounds like they've had positive experiences and they're talking about why they've chosen cannabis over alcohol, but there are people who have had uncomfortable and adverse experiences. And something, sometimes that has to do with the fact that there's over intoxication or they've taken an edible and it got them too high for too long of a period of time.

So in the laboratory, we're able to look at and ask people how they feel. We ask them a range of feelings that they have. So we don't just ask them how high they feel. We ask them about the type of high. Is it a good high? Is it a bad high? Would they like to take that cannabis again? We

We also ask them if they feel anxious, right? So feelings of anxiety are common, especially with people who don't use cannabis all that often when they use too much, you know, feelings of anxiety can be, um, perceived as a negative effect. Um, some other researchers look at psychotic like experiences, and this is, I think one of the primary, um,

health outcomes that people are becoming more and more concerned about, especially in youth or adolescents. But what's interesting about... Yeah, I'm sorry. I'm so sorry. I didn't mean to interrupt. But with the question of youth, though, are there sort of ethical restrictions around doing actual studies that involve young people who aren't even legally old enough to purchase cannabis products? Yeah.

Absolutely. And as Maya said before, that when we've looked at the surveys, it's actually kind of been a relief that when you look at youth up to 18 years old, we haven't seen changes and increases in use. But we've heard from emergency room physicians that there seems to be increased incidence of younger people coming in for psychotic treatment.

like disorders that are associated with cannabis. But in the laboratory, we can look at this emerging adult category. And actually, adolescence goes up to age 24. The brain is still developing until that time. And so we have a study where we're comparing the effects of both oral and smoked cannabis.

in 18 to 25 year olds. So the people that are in this vulnerable period and we're comparing them to middle-aged adults, so 35 to 45, as well as those older adults that we know are increasing their use, but we know very little about the effects of

And cannabis might have a very different effect in people who are 55 and older. And so we're looking at that now. Interesting. Maya, bring your experience to the table here, because what I keep hearing is that even though we're actually in quite a new place research wise in terms of trying to understand the various effects, again, both positive and adverse of cannabis consumption here.

There are still significant restrictions. I mean, some of them are ethical, which we don't necessarily want to let go of. But but, you know, at the federal level, do you do you see there being too many obstacles for the kind of follow up research that we would need to answer a bunch of the questions that both of you have actually just raised in the context of this hour? Well, yeah, I mean, I think it.

It was always bizarre to have cannabis in Schedule 1 anyway, because the whole scheduling system is irrational in the first place. Schedule 1 includes LSD, marijuana, and heroin.

It's hard to imagine three more different substances. And that schedule is a higher, more restricted schedule than the schedule in which fentanyl appears. And this is because fentanyl, we have decided as a country, has legitimate medical uses, but heroin does not. So it's just a mess. The reason that

that things are classified the way they are is completely political and has nothing to do with science. I personally think we need to scrap the scheduling system and come up with a new one that actually reflects the real risks and the real benefits and whether medical use is possible.

for all of the substances because we just do this in a terrible way. Taking marijuana out of Schedule 1 and putting it in Schedule 3 would be definitely progress. It's difficult to know what's going to happen in the next administration and whether that change will actually go through now that the administration is changing. But yeah, we certainly need to deregulate this area.

Interesting. We're going to come back to what may happen under the next Trump administration in a second. But the sort of the inconsistency that you're talking about that's led to different things being scheduled differently, the fentanyl comparison is quite something. Are there other countries that you would point to that do this better? Yeah.

Not really. I mean, unfortunately, the United States has had an incredible dominance over drug policy in the world. And part of that is because for a while it was the one thing that the Soviet Union and the United States could agree on. So we all hate drugs. We're all going to crack down on them. And so, you know, they're really in terms of the scheduling system, it's kind of imposed by the U.N. OK, interesting. Professor Cooper, what do you think about that?

I think in general, it's important to remind ourselves that the scheduling system is there are serious issues with it.

But the scheduling system also relates to drugs that have been approved, that have been rigorously studied for certain therapeutic endpoints. So fentanyl and cocaine is also, it's Schedule 2. It's not Schedule 1. So cocaine has been acknowledged to have therapeutic use. And that's because it's used in a prescribed manner. Now, certain drugs are not scheduled at all, right? Alcohol, tobacco, they are not in the Controlled Substance Act.

And so this is another route to go. So here we're talking about moving marijuana, so cannabis with more than 0.3% THC from Schedule 1, no accepted use, federally legal, to Schedule 3 where it has accepted medical use and can be used under federal law for that purpose. But it's important to remember that even if it moves to Schedule 3...

Only certain types of products will fall in that category and it will still not be legal to use it outside of that schedule three category. So it will be different than alcohol and tobacco. And so there will still be restrictions and there will still be issues with that.

Maya, did I hear you? Yeah, go ahead. Oh, yeah. I was just going to say that, again, the insanity of the scheduling system is reflected in the fact that alcohol and tobacco are not scheduled. The fact is that we really don't have a good way of regulating recreational drugs. We have no way for somebody to get a new safe one approved if such a thing existed. And so it's really difficult to...

you know, do things like, okay, well, alcohol is objectively more harmful than marijuana. How do we account for that in terms of advertising and regulation? Tobacco is more harmful than all of them. How do we deal with this in terms of that? And how do we put them in context? Because these things can substitute for one another at various times. People throughout the show have been talking about how they prefer marijuana to alcohol.

I'm Meghna Chakrabarty. This is On Point. Well, Maya, since you did very aptly reference back to our listeners who have been sharing their stories of cannabis use, here's a couple more. This is Matthew Hernandez in Denver, Colorado. Matthew recently quit using cannabis. He's in his mid-30s now, but he used to be a daily consumer.

The culture in Denver specifically had always been friendly toward marijuana users. There was a time that it was assumed that you smoked unless you specifically said otherwise. I would, as they say, wake and bake and would attend school, work. I felt like it really locked in my focus.

It was a great social lubricant. That's how I bonded with a lot of my friends. That's how I met a lot of friends. So that's Matthew in Denver. Here's Grayson in Cedar Rapids. I began smoking marijuana at 18, my senior year of high school. And at 65, I'm retired now and pretty much out of regular smoking in my mid-50s.

These days have turned to unprescribed CBD concentrations to ease arthritic pain. I'm an avid bike rider too, and also as an occasional sleep aid. To get out of the house and supplement my retirement income, I applied for a school bus driving position, but tested positive, of course, for THC.

However, despite not having so much as a parking ticket since my 30s, my employment was rejected. So that's Grayson in Cedar Rapids. And here's Michael Mertica in Duluth, Minnesota. I have smoked cannabis, vaped, edibles, etc. for a good 15 years of my life now. I'm 30 years old and I started way too young. But the truth is, is that there is a lot of downside to daily weed use that

I didn't realize when I was that young. And if I could go back and change when I started to like after 21, that would be great. But I can't change it now. I still like vape once in a while. You know, moderation is key. I still have some problems with it. If I go beyond like your limit, you really just have to know your body, know your limit, know how it affects you individually. So there's benefits and drawbacks to everything. That's Michael in Duluth, Minnesota.

Professor Cooper, you know, I wonder if in terms of the the consumer's point of view in states where marijuana or cannabis has been has been legalized. Can we presume that they are that it's actually much more regulated, obviously, than a black market purchase might be? And can people trust me getting back to the potency question? Can people trust what's on the labels in the places where they're buying cannabis? Yeah.

Meghna, I think that this is a really important question that we have to confront. As more than half of the states have legalized cannabis, yet there is no federal oversight related to the quality assurance and the testing of these products. And so every state is really left on its own to set up the testing facilities and to put forth the standards. So yes, I do think that overall, regulated products in states are

are safer, they have less contaminants, the labeling is better, they're being tested, than products in those same states that are unregulated. So what some people call like the quote unquote black market. So I do think that there are certain safety guards. But you know, as we've seen in the state of California, where I think over half of the testing facilities were shut down by the California Department of Cannabis Control in the beginning of 2024,

There's only so much that the states can do to enforce the testing practices and to ensure that the standardization is there and the labeling is there to be able to educate and protect consumers.

We heard early on, I think, from a caller, Amy, who was talking about her use of Delta-8 THC and how she felt comfortable with it because there wasn't so much THC in it. But, you know, Delta-8 THC, which is generally not regulated, not tested for in most of the states, that acts like Delta-9 THC, that THC that people generally think is

stronger than Delta ATHC. And it's a good example of why we need better consumer education and better controls. Well, Ziva Cooper, director of the UCLA Center for Cannabis and Cannabinoids. Professor Cooper, thank you so much for joining us today. Thank you so much for having me. And Maya Salovitz, author of Undoing Drugs, The Untold Story of Harm Reduction and the Future of Addiction. Maya, thank you.

Thank you as well. By the way, speaking of consumers, when the new year arrives, we're going to be talking with On Point's money ladies, Michelle Singletary and Rana Foroohar. So if you have a question about the economy, whether it's the broad economy or your personal economy, let us know. Use the On Point Vox Pop app or call us at 617-353-0683. This is On Point. On Point.