January 31, 2025 • 36 mins
What if the rapidly increasing potency of cannabis is silently fueling a mental health crisis? Join us on Head Inside Mental Health as we sit down with Dr. Rocco Marotta, a distinguished psychiatrist and neurologist with Silver Hill Hospital, to unravel the intricate link between cannabis use and psychosis. Dr. Marotta shares his compelling journey from a liberal perspective on cannabis to a tale of caution, shaped by firsthand experiences in the medical field. Explore the complex divide in cannabis perception—some hail it as a remedy for anxiety and pain management, while others see the potential dangerous consequences, particularly in psychiatric settings.
The conversation takes a critical turn as we examine the skyrocketing THC levels in modern cannabis and the resulting public health challenges. Discover the staggering increase in potency from Woodstock-era levels to today's potent strains, with some products reaching up to 80% THC. This shift places our youth at an unprecedented risk, raising urgent questions about substance use in schools and the role of education in mitigating these risks. The episode amplifies the need for systemic support and informed discussions to address these pressing societal issues.
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Episode Transcript
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Speaker 1 (00:00):
Hello folks, thanks for joining us on Head Inside
Mental Health, featuringconversations about mental
health and substance usetreatment, with experts from
across the country sharing theirthoughts, insights and practice
perspectives on the world ofbehavioral health care.
Broadcasting on WPVM 1037, thevoice of Asheville, independent
commercial free radio.
I'm Todd Weatherly, your host,therapeutic consultant and
(00:21):
behavioral health expert.
With me today I have the widelyesteemed Dr Rocco Murata,
affectionately known as Rocky.
I can say that in the world ofneuropsychiatric treatment,
rocky is a fitting comparativeicon.
Dr Murata is a board-certifiedpsychiatrist and licensed
psychologist with fellowshiptraining in neuropsychology.
He serves as assistant clinicalprofessor at Yale University
(00:43):
and associate clinical professorfor psychiatry at New York
Medical College.
He holds a PhD in psychologyand neuroscience from the City
University of New York.
He completed the NationalInstitute of Health Fellowship
in biology, psychology andpsychiatry and is a fellow of
the American PsychiatricAssociation.
For decades now Dr Murata hasbeen the service chief for the
(01:05):
adult residential program atSilver Hill Hospital, serving
those with complexneuropsychiatric conditions, and
the director of their Centerfor Treatment Study of
Neuropsychiatric Disorders.
His pedigree of credentials andaccolades are these and many
more.
But I got to be with Dr Muratain Connecticut for a conference
hosted by Silver Hill Hospital,where he gave a very insightful
(01:26):
presentation on the dangers ofcannabinoids and their use, and
specifically, as it relates toindividuals suffering from
psychotic disorders andexperiencing psychosis as a
result of drug use, and theepidemic that the hospitals are
experiencing because of theyoung adults that are
(01:47):
experimenting with drugs andother kinds of things, and
especially the high dosages ofTHC that are in the products
that are coming out on themarket.
First of all, dr Murata, thankyou and welcome to the show.
Speaker 2 (01:59):
It's a pleasure.
I have family just across theborder in South Carolina and in
Chapin and Columbia and inCharleston.
I'm a secret Charlestonian.
Speaker 1 (02:11):
You're a northerner feeling, the southern draw.
I can feel it.
Speaker 2 (02:15):
You come in this way I jokingly say we're of southern
Italian extraction, soCharleston is very sympathetic
to us.
Speaker 1 (02:27):
Those stoic Italians right.
Speaker 2 (02:30):
Absolutely stoic.
Speaker 1 (02:32):
Well, you know, I tell you I enjoyed your
presentation and one of theissues that I think that shows
up is that you've got this bigsegment of the world that feels
like weeds Okay, and you knowthey.
There are people out there whoare daily users.
(02:52):
They experience benefits fromit, whether it's reduced anxiety
or medical symptomology.
You'll even get medical medicaldoctors saying that
cannabinoids are the answer inthe medical industry to the
opiate epidemic.
If they start switching fromone to the other for pain
management, they're going to geta lot better results.
(03:13):
But in a psychiatric hospital,watching people come off the
street with these high doses ofTHC and whatever they're taking
and having psychotic features orlaunching latent psychosis, and
having psychotic features orlaunching latent psychosis and
you know you gave some numbersand I'm not prepared to cite
them, but I mean they areincredible in terms of what the
(03:34):
psychiatric hospitals areexperiencing.
What's the solution Like?
How do we bridge the dividebetween these two kind of
interested parts of the society?
One says it's okay, one it'sdefinitely not.
Where's the middle?
Where's the middle ground inyour view?
What's the solution to that?
Speaker 2 (03:53):
These ideas, these processes are really complex and
I don't think I could just saythis is what to do.
Right, I mean I jokingly, butit's true.
I was at Woodstock and I livedin a commune for a while when I
was a kid, in college, and so Ididn't think of cannabis as
(04:20):
being dangerous, but I did seethings happen in my dormitory.
People had psychotic breaks.
We didn't know, but we didn'tknow what it was.
We just thought somebody wasweird, you know.
Right and my changing positionsover the years to being opposed
to its general availability cameout of working in hospitals Now
(04:46):
.
So I was raised in a very, veryliberal progressive.
You know left-wing New Yorkenvironment, politically and
socially, and you know mysainted mother-in-law once had
tea with me and said you knowwhat's happened to you.
You used to be such aKachotskyist and I actually said
(05:12):
to Mr Doug Rester if you're aphysician, you see things in the
world that people don'tnormally see.
You see the vulnerability, yousee the suffering and when you
see that, know you have to ifyou're trained as a scientist.
Also, you have to say what iswhat is really going on around
(05:34):
us?
Right, and it's especiallydifficult with something like
cannabis and psychosis, forexample, where it's not
everybody, it's not likeeverybody who's young.
There is a vulnerablesub-population and it's another
thing about it is that there's avulnerable period of exposure.
And so to try to make sense ofwhat's happened, you could talk
(06:00):
about it historically overgenerations, because you know,
in India in the 19th century andover the 20th century it was
the suspicion of many physiciansthat cannabis was dangerous and
they even made the connectionthat it was the potency.
You know, a little bit was fine.
(06:22):
You could use it in religiousceremony.
High potency cannabis wasdangerous.
Interestingly, this isdiscussed in Berenson's book on
the history of cannabis.
You know, in Mexico outlawedcannabis Long before he did
Because.
Speaker 1 (06:42):
Isn't that fascinating.
Speaker 2 (06:43):
Yeah, and they outlawed it because when, when
cannabis was introduced to thatculture, which was late in their
history, which was again in the19th century, they saw a change
in behavior.
this, they saw violence, theysaw psychosis, right right and
and so on our side of the borderwe didn didn't.
(07:03):
So these things to me arefascinating.
So you could see a case ofsomebody especially say to me
it's fascinating because I wastrained at Cornell.
So Cornell Medical School is inNew York City, not in the
countryside where the universityis, and we were in a very nice
(07:25):
neighborhood of Manhattan, butwe also I also did research at
St Luke's Hospital, which was onthe edge of what that at
Columbia University wasessentially on the campus, but
we, we took the patients fromthe border outlying regions, and
so what I was seeing as a youngdoctor and researcher was the
(07:47):
difference in exposure, right,so the difference in the age of
starting and the potency of themedicines, so that the degrees
of bizarre psychotic behavioruptown were much, much worse
than the degrees of behavior onthe east side of Manhattan,
(08:08):
which in my early time was likethey used to call this sort of
the silk stocking region.
You know it really, you knowbeautiful townhouses etc.
It was, and but you didn't knowexactly what it was.
Was it the family structure?
Was it stress?
(08:29):
Was it the co-exposure toalcohol and cocaine?
And all those things were true,but there was something
percolating through that there,which is that kids were using
really early in one part of thecity and later in the other.
But by 1980 or so that waschanging.
And now you know the estimateis that in New York City roughly
(08:56):
a quarter of teenagers highschool students use cannabis on
a regular basis.
Yeah, so that's an amazingnumber to me.
So, but you don't necessarilysee change instantaneously if
something depends on dose,potency, right and time of
(09:17):
exposure and if there's acritical period, and then
something will appear, notinstantaneously but begin a
process that appears over years.
It'll take you years to clearlysee what's going on, right.
So so what we began to see in,say, the 70s and 80s, I think
(09:37):
only has become clear now aswe've changed into a new century
.
So there's hints of that dataall along as being there, and
the United States keeps terriblemedical records of things
compared to Okay so, whereascertain other parts of the world
(10:00):
don't, a place where there'sincredibly good medical records
is Scandinavia, whereeverybody's in the system as a
number.
So they're not following you asa person, they're following you
as an entity in a mathematicalspace.
Speaker 1 (10:16):
Well, the health care is freely available.
So your participatingdemographic is everyone and
you've got their record frombirth, right, you know you even
know what medicines they'vetaken, what the doctor said.
Speaker 2 (10:30):
So you can actually access on the computers enormous
piles of data.
So I'll try to work through ita little bit.
So they've known since for overa hundred and something years
to take one terrible illness,schizophrenia, which is a
chronic psychotic illness whichis often terrible, debilitating.
People don't work.
(10:51):
They never marry.
Not every one of them, largepercentages of them.
In Western countries roughly 1%of the population exhibits some
form of that illness.
Right, and so you could seechanges in long-term data in
scandinavia and it was prettystable until the last 30 years
(11:14):
and it began.
The incidence rates began goingup a little bit, but you
couldn't tell what it was causedby right at the turn of the
century, basically yeah, thelast century not yeah, yeah,
rightyeah, yeah and and so you get a
report from an interestingreport of that from Finland.
And then you know in Denmarksomebody notices something.
(11:36):
You know and it kind of hasthat.
You know it's bleeping.
But the numbers that have comeout in just the last couple of
years, especially in the Danishdata, which is pretty strong
data, is that the rates areaccelerating and that the rate
may have increased.
In other words, that the numberof cases that are building up
(11:57):
is about a quarter more.
So, instead of moving towardsan incidence rate higher and a
prevalence rate of over one anda quarter, that means that over
time take the United Statesright.
So if we have an illness with a1% rate in the whole country
(12:22):
that's like 160,000, 180,000,how you count it cases right,
you go up a quarter.
You're going up a lot of cases.
That's a lot yeah.
Speaker 1 (12:34):
We would call that statistically significant, would
we not?
Speaker 2 (12:38):
Yeah, so you have a lot more people to take care of.
I mean Lou Berenson in his bookon this.
You know, goes over it in somedetail, you know, and so you
have these numbers going up.
So those are the chronic cases.
Those aren't just kids comingto the ERs having trouble.
Those are the cases building upthat will be in the system.
That will demand enormous timeand energy.
(13:00):
So you have that going on inone place and then you have the
overdose business going on,right.
Right 120,000 overdose deathsreported, and we begin to get a
feel that the younger generationis being exposed to early death
from overdose, exposure toviolence, with relatively high
(13:23):
rates of accidents, and now eventhis.
And so what are the factors?
Well, one of the factors seemsto be exposure to cannabis.
So you take New York City, youhave a half a million kids
almost in the teenage years.
Right, if you say 1% of half amillion, right, you know what
(13:46):
are we talking.
That's 50,000?
50,000.
50,000.
Yeah, that's right, out of thatcohort, over the next eight
years, 50,000.
And then, if it goes up by youknow the percentage, it's
another 10, 15,000 cases,minimal, of a chronic
(14:06):
debilitating illness.
I mean, how do you so?
On one hand you could say, well, yeah, sure, 50,000, but the
other millions don't have it.
But the physician has to dealwith and treat the kids who are
sick, and this is an illnessthat not only affects the
individual, it affects theirfamilies and it affects their
(14:28):
families, it affects the culture.
In the 1960s, in the wholecountry there was 500 and
something thousand beds inhospitals for psychiatric
patients, a lot of them in statehospitals and stuff.
Now the number is under 50,000,and so it's not strange.
(14:51):
If I go downtown in manhattanand I get off the grand central,
the main train station, youknow that you literally are
stepping over people sleeping inthat beautiful grand concourse
there, which is like a work ofart right.
And if you go down in thestreets it could be raining or
pouring and cold and there arepoor creatures living in the
(15:11):
streets and everywhere.
Well, those people should becared for.
They should be in a hospital.
They're ill.
Speaker 1 (15:22):
You and I are in a bit of a minority, thinking that
everybody should receive careat whatever level they need it.
I'm with you there, but we knowthat it doesn't happen.
Speaker 2 (15:32):
Right.
And so, you know, world-classpeople are walking to dinner at
a fancy expensive restaurant andstepping over people in the
streets.
It's out of a bad, you knowmovie of the medieval times,
right, yeah.
Speaker 1 (15:48):
Well, and you know it begs some of the other
questions.
I think that you're pointing atsome of the desensitization
that happens.
Right, the most dangerous thingto human life is an automobile,
technically speaking.
You're riding around and threeor four tons worth of metal and
(16:10):
people die every day on thehighways, et cetera, et cetera,
and and and a lot of thesestatistics.
I think it got used with the gunargument, it got used with all
kinds of other things, butthey're used to diminish and
minimize, um, the severity ofwhat's happening to people when
they interact with thissubstance.
Um, and they did it for yearswith opiates.
And then, you know, we went,however long, and then all of a
(16:33):
sudden it's like, wow, thesenumbers are.
They went from the numbers thatyou're talking about 50,000,
and then another half percent,maybe 25 more, or 15 more
thousand, and then all of asudden you're talking about
millions, you're talking about agreat percentage of the
population, and suddenly you'vegot the epidemic.
You know, um, and you know, Istill don't believe that it's
(16:54):
that you should put people injail for substance use,
regardless of the legal or theillegal or the whatever else,
like putting them in jail mainlybecause that's not a care
environment, right, um, andalcohol.
Of course, you know there'splenty of individuals who suffer
(17:15):
from alcoholism.
There's plenty of individualswho are in recovery and are able
to successfully be aroundplaces where you can buy alcohol
anywhere and still manage tostay sober.
So there's this practice oftheirs.
But I think that THC is a bitdifferent in its scenario.
Now, one thing I think is onething I think is you know,
(17:36):
there's not so much of analcohol content in alcohol that
you can buy.
You go to the ABC store.
You have to have a license tobuy something that's over and
above a certain percentagealcohol content, right?
We don't have that with thc wehave.
Speaker 2 (17:52):
I mean, I live on the um, the border of new york and
connecticut.
Now, all right, and the lawsare different, depending on if
you can see this here in mymailbox encouraging me to buy my
cannabis products on one sideof the border or the other who
has the highest potencies cometo us because you could buy
(18:17):
greater quantities at a time,and so we live in a region where
you could go to four differentstates and purchase, and so
they're now fighting over marketshare right.
Speaker 1 (18:31):
Yeah, that's right.
Speaker 2 (18:32):
What's the thing you know it's about?
You know you can buy higherpotency from us, and that's the
kicker.
So at Woodstock the potency ofthe cannabis there was between
one and a half and 2% potency.
The potency now of streetmarijuana is 18-20%.
(18:54):
But also they're selling allkinds of products, too, right,
gummies and things.
That's potencies of 35%, soyou're talking about 17-18 times
.
They're selling products nowwith potencies of 80%, so that's
40 times the potency in anygiven hit.
I mean right and generallyavailable, which is the other
(19:18):
thing.
So in the city there are legalmarijuana dispensaries.
All right, you can go by, youhave to be 21 there.
But they're also illegaldispensaries and the authorities
have real trouble dealing withthem.
Right, and in fact they've evendiscussed not even trying to,
(19:42):
because it's impossible toenforce the law.
Well, where do your teenagersgo to?
Right?
Speaker 1 (19:48):
to those.
Speaker 2 (19:53):
Where do you go to on the way to school?
You know I mean, I grew up in aschool system in the city that
if you smoked a cigarette youwere in jail, you were in
punishment.
Right Now you have a systemwhere kids go to school
intoxicated, where they'resmoking marijuana on the way to
school, and no one can besearched for anything in the
school and they're vaping it,which is hard to find.
Speaker 1 (20:13):
Or they've got gummies which is impossible to
detect, and you've got gummiesthat have got 600 milligrams of
THC.
Speaker 2 (20:21):
High potency THC.
Speaker 1 (20:22):
I mean it's insane and literally that's where we're
seeing a very significantportion of the population get
driven to is psychosis andhaving the symptoms.
Speaker 2 (20:38):
That's why there's a relationship between potency and
toxicity and long-term outcome,and the neurobiology of it's
interesting because it's hittingcritical parts of the brain.
Now I have a hypothesis that wehave another problem,
especially where I come from,which is everybody's using
(20:58):
stimulants yeah this isamphetamines and you know,
ritalin is so high and highpotency use of those things are
toxic too.
And if you're going to schooland you're smoking, like in
colleges I mean college campuseshave dealers in the dorms.
Speaker 1 (21:20):
It's a tradition.
Right College campuses don'thave addictions problems.
Dr Murata, don't you know that?
Speaker 2 (21:25):
Well, I've spoken to college professors.
The problem is that they can'tdo anything about it and they
can't get any help in dealingwith it.
Speaker 1 (21:32):
Well, I think that every time I go to a college
campus, they will throw theirhands up about responsibility oh
, we just can't do anything.
It's like I don't believe that,and I think that one of the
answers to this problem thoughit is complicated, is something
you stated in your presentationis we've got to educate people
(21:54):
about this.
It's like, you know, aneducated consumer is a far, far
more protected you know, buyerbeware, protected consumer than
a person who's just going in andfollowing these kind of
impulses, especially withteenagers and young adults.
It's like, well, I have ahigher potency, I took a higher
potency than you did.
It's like, well, I could beatthat by.
(22:15):
You know, that game, that gamecan throw you down the.
You know, we see young adultprogramming and adolescent
programming popping up all overthe place to handle these
conditions.
They're expensive too.
Speaker 2 (22:27):
The way I try to get people to understand is you know
, if I go down to admissions ofthe residents, of the doctors,
and you ask somebody who's beenbrought into the hospital, you
ask do you drink?
No, I don't drink, right, youdon't drink at all.
Well, only on weekends.
Speaker 1 (22:44):
But not much.
You say well, how much is notmuch?
Speaker 2 (22:46):
They say, well, I almost never black out.
And I said, well, if you almostnever blackout, how often do
you blackout?
Once every couple of months.
Now it's like getting hit onthe head with a baseball bat,
right from a biologicalstandpoint.
But they don't drink becauseit's only on weekends.
But when does the weekend begin?
(23:07):
It begins on Thursday.
Speaker 1 (23:09):
Right, right, friday's part of the weekend,
right.
Speaker 2 (23:12):
Yeah, and it's the same thing.
You use drugs?
No, not at all.
Just a little cannabis.
How often?
Well, only to sleep.
Speaker 1 (23:20):
That's every night.
It's Russian roulette, right?
You're loading one bullet intothis chamber by engaging in the
use of this substance at highlevels and high dosages.
In the use of this substance athigh levels and high dosages,
(23:41):
and maybe you and and you knowif it's a six bullet chamber
five of the five of thoseindividuals in that chamber are
not going to experience the thedire consequences of high use
and maybe they can go on in lifeand do whatever they need to do
and maybe it doesn't impactthem.
But that one person and youknow one out of six, even one
out of ten and millions is stilla lot of people and a lot of
(24:01):
care that experiences mooddisorder or psychosis or a
variety of neuropsychiatricconditions that they end up at
the hospital for.
Speaker 2 (24:13):
That's right, and it can be in and out of the
hospital for the rest of theirlives or require lifelong care
and not be likely to have afull-time job, you know or and
be socially isolated.
And those kids are really hardto treat.
We use the most complexmedication you know algorithms
(24:38):
to try to get them better.
And we do get lots of thembetter, but it was.
Even.
If we get them better and backto school, they've lost three or
four years before we get themback.
Speaker 1 (24:47):
Yeah, from the treatment side, you know you're
handling them.
At the acute care side I seethem a lot.
On the rest, you know, and ifyou got a person who went to get
your care in the hospital andthey're getting ready to come
out, I tell parents consistentlyyou're looking at 18 months
worth of continuing care.
(25:08):
Residential environments,supported living environments,
coaching, therapy, continuedmedication monitoring you know
these are, I mean you therapy,continued medication monitoring
you know these are.
I mean you're talking aboutintensive care.
You're talking about thisperson now suffers from a
medical condition that willrequire intensive care,
long-term intensive care andlikely some version of that care
for the rest of their lives.
Speaker 2 (25:30):
You got.
You touched it exactly, and thegovernment no longer really
helps with that right, so theburden is on the family.
Speaker 1 (25:38):
Right.
Speaker 2 (25:39):
And what I say is you know, we, just because of where
we are in the world, we live inan incredibly privileged area,
where I live right now, you know, and it can impoverish upper
middle class families Becauseyou're talking about care that
costs not $10,000 a year, tensof thousands of dollars a year
(26:01):
at the lowest level, you knowand but they do it, but so many
families can't.
I mean, one of the things thatyou know, we talk about, we're
going to talk about when we havemeetings in Charleston in April
, is how can you put thesethings together so that you can
deal with some working classfamilies, with poor families?
(26:23):
Dead children can get aid too,very difficult.
You know, I spoke to KathleenRadius yesterday.
She's the vice chancellor ofthe medical college in
Charleston.
Speaker 1 (26:37):
Abuse, yeah, yeah.
Speaker 2 (26:38):
Yeah, wonderful woman .
She went to Florida and that'swhy we say you know abuse.
But you know, I said you knowwe're spending billions because
of the drug epidemic, billionsand billions of dollars, and
we're having relatively pooroutcomes.
We can't scale it properlyright.
(27:00):
We just can't seem to getpeople to understand and do
something.
It's education, but it's alsoeducation of the people, but not
only the families and thepossible patients, but the
politicians and the educatorsand the people who get to
organize these systems.
(27:21):
It's daunting, but to me it's amoral equivalent.
It's struggling to save soulshere.
It's a big, big thing.
Speaker 1 (27:33):
We got to this topic when we were at the conference.
But insurance, there's ourother.
You know, the getting insuranceto actually pay for treatment
and pay for it long enough for aperson to actually recover was
a big part of our topic.
It's the other half of thisequation.
Speaker 2 (27:49):
Well, after we had that meeting right that the
assassination of that you know,by that young man from the
University of Pennsylvania witha master's degree in computer
science and economics.
Speaker 1 (28:06):
Educated guy, you know.
Speaker 2 (28:09):
So he killed.
So what it brought out, atleast for a while, was some
strange numbers.
So I may be misremembering it,but four major health insurance
companies had combined profitsof $600 billion last year.
That was after they paid them.
(28:30):
The executives paid themselvesmillions, and you know right.
And now to say we got 50,000more beds for dual diagnosis in
the country which was, whichwould be nothing compared to
what we used to have 30 yearsago.
How many billion would thatcost?
(28:51):
Maybe 10, 10 or 12.
Speaker 1 (28:54):
Yeah, if that.
Speaker 2 (28:55):
Yeah, if we did it right.
Speaker 1 (28:58):
To bid you high facility and everything else,
yeah.
Speaker 2 (29:01):
If we did it right, if we didn't build them in
downtown Manhattan, in thecountryside or in states without
access to regulation, if youwant, we could treat 20,000,
30,000 more people well over ayear, and that would be what 8%
(29:24):
of their excess profit.
Speaker 1 (29:27):
Yeah, barely a scratch.
Speaker 2 (29:29):
Those four companies.
I think there's 10 or 12 ofthem, I don't know.
So my guess is that theirprofit from the insurance
industry is in the range of atrillion dollars a year.
Speaker 1 (29:43):
Yeah, and it's not going back to the American
public.
Speaker 2 (29:46):
No, it's going into the hedge funds and the rich get
richer.
Now you know what party I wasraised in.
Speaker 1 (29:57):
Well, I think that what you and I are talking about
I don't.
I'm grateful that I navigatedmy young years and didn't end up
suffering from a condition thatcaused me lifelong care
problems or debilitating issues.
I certainly did my share ofexperimentation, but I also, not
(30:20):
unlike you, over a period oftime especially when I started
in the behavioral health fieldjust witnessed people who were
impoverished and could notreceive care and were suffering
from conditions that needed alot, including your Medicaid
populations, the people who arehomeless, the people who are
(30:40):
addicted, but they've also gotchildren the whole nine yards,
and you know it caused me to bealigned towards.
You know I can vote for.
I can vote for policies orpoliticians or party lines that
don't necessarily benefit medirectly.
Speaker 2 (30:57):
Right.
Speaker 1 (30:58):
I'm not one of these people, but I believe that they
need care and I believe that weshould have stuff in place that
gives them, you know, a path toa better life, a path to care.
And you know we're seeing a lot.
I think the mentality at thehigh corporate levels is that,
you know, it's a very insulatedkind of population of people
(31:21):
community, if you will and theiraim is that profit, not a
community care.
And I wonder what's going tomake it trip Like.
What's the thing?
And I think I asked thisquestion and Dr Gerber, the CEO,
there at Silver Hill.
He had a pretty good response,but I still think it's going to.
(31:41):
I still think it's financiallybeneficial to incentivize care
outcomes that are positive.
What do you, what is yourthought about like?
Where do you think the turn is?
Speaker 2 (31:53):
I believe we have a mixed economy.
What I've seen in bureaucraciesif something is overly
bureaucratized, things don't getdone.
I've been blessed here with anenormous amount of support, but
what it allows us to do is to besurrounded by a bunch of saints
, people who are so committed tothe cause of helping others,
(32:17):
and I think that you have to tryto have systems that allow
those people to grow and dotheir job.
I mean one of our people youknow who worked with us, dr
Irene Beal.
I mean, they said you know,bridgeport is a city in
Connecticut which is not in goodshape.
All right, yeah, and she said,get care to them.
(32:40):
She says, well, they raise themoney on their own, some from
the government, mostly on herown.
They build a clinic, right, theysaid, how do you bring in the
street people to get help?
You know how do you treat theschizophrenics there?
Well, you build a clinic totake care of general problems
and when the people come in,you're going to get all of them
and then, and so you know, theywork like that.
(33:03):
I mean, one of the other guysyou didn't meet was with us at
the schizophrenia meetings.
You know, chris landry.
You know they're in.
They're in times square, in thestreet, going to the people.
You know, yeah and so, andthat's what you have to do, but
you also, you need more to it.
You need institutions, some ofthose people and, right now,
(33:27):
large numbers of them, becauseit hasn't been done for a
generation.
Speaker 1 (33:29):
They need containment .
Speaker 2 (33:31):
Yeah, they need to be fed.
Yeah, they need to be kept warm.
They need to be fed.
Yeah, they need to be formed,they need to be cared for.
You know, um, and it can't beoverly bureaucratized or it
won't work, right and so, buthow do you get those people?
I don't know.
But, um, dr doherty, you mighthave met her.
(33:52):
She told me a couple of weeksago to see a movie called
Cabrini.
Speaker 1 (33:57):
Cabrini.
Speaker 2 (33:58):
Cabrini, C-A-B-R-I.
Well, if you're a New Yorker,you know that that's Francesca
Xavier Cabrini.
She was this under five foottall nun.
And a force of nature, a forceof nature and a force of nature
and she founded orphanages,schools, hospitals, first in
(34:23):
Italy, because she was bornthere like one there, and she
came to New York with sixsisters and she came to New York
in her 30s and by her 60s Ithink they had founded 60
orphanages, hospitals, schools,colleges, and so there's an area
in New York that's named forher, you know, but she's part of
(34:46):
the mythology of certain partsof New York.
She's called Mother.
Speaker 1 (34:52):
Called.
Speaker 2 (34:52):
Mother, yeah, mother, mother, you know, um, and I
watched it and I watched thatand I said, yes, you, you said a
force of nature, she was.
You know, this movie tells astory about how she's trying to
get the mayor of new york to dosomething that's right and she
power plays him by saying thatshe's organizing the vote.
(35:14):
So if, if he expects to getreelected, he's just working,
you know, she's working with theIrish and with the Italians and
he says you know, mother, Icould, I could talk to you.
You know.
He says you should have been aman.
He says, you know, I'm a woman,the officer, a glass of scotch
and she drinks it, and he lookshim right in the eye.
(35:40):
And she says, no, I'm a woman,can you office her?
A glass of scotch, and shedrinks it, and she looks him
right in the eye and she says dowe have a deal?
Speaker 1 (35:41):
Wow, that would have been cool to meet her.
Well, I mean, you know you'retalking about how you make
change, right?
That's?
Those are the.
I think you're doing that, drMurata.
You're doing, you're doing thegood work out there and you're
passing on the message.
I really appreciate the workthat you're doing and I really
(36:04):
appreciate the fact that,despite all the degrees and
credentials and accolades thatyou have, you're also just a
neat and decent guy who wants tocare for human beings, and I
couldn't be more grateful toknow you.
I thank you for coming on theshow today.
This has been Head InsideMental Health, wpbm 1037, the
voice of Asheville, toddWeatherly, your host, dr Murata,
thank you so much.
Speaker 2 (36:22):
All right, bye-bye now.
Speaker 1 (36:25):
I feel so lonely and lost in here.
I need to find my way home.
I feel so lonely and lost inhere.
I need to find my way home,find my.
Hello folks, thanks for joining us on Head Inside
Mental Health, featuringconversations about mental
health and substance usetreatment, with experts from
across the country sharing theirthoughts, insights and practice
perspectives on the world ofbehavioral health care.
Broadcasting on WPVM 1037, thevoice of Asheville, independent
commercial free radio.
I'm Todd Weatherly, your host,therapeutic consultant and
(00:21):
behavioral health expert.
With me today I have the widelyesteemed Dr Rocco Murata,
affectionately known as Rocky.
I can say that in the world ofneuropsychiatric treatment,
rocky is a fitting comparativeicon.
Dr Murata is a board-certifiedpsychiatrist and licensed
psychologist with fellowshiptraining in neuropsychology.
He serves as assistant clinicalprofessor at Yale University
(00:43):
and associate clinical professorfor psychiatry at New York
Medical College.
He holds a PhD in psychologyand neuroscience from the City
University of New York.
He completed the NationalInstitute of Health Fellowship
in biology, psychology andpsychiatry and is a fellow of
the American PsychiatricAssociation.
For decades now Dr Murata hasbeen the service chief for the
(01:05):
adult residential program atSilver Hill Hospital, serving
those with complexneuropsychiatric conditions, and
the director of their Centerfor Treatment Study of
Neuropsychiatric Disorders.
His pedigree of credentials andaccolades are these and many
more.
But I got to be with Dr Muratain Connecticut for a conference
hosted by Silver Hill Hospital,where he gave a very insightful
(01:26):
presentation on the dangers ofcannabinoids and their use, and
specifically, as it relates toindividuals suffering from
psychotic disorders andexperiencing psychosis as a
result of drug use, and theepidemic that the hospitals are
experiencing because of theyoung adults that are
(01:47):
experimenting with drugs andother kinds of things, and
especially the high dosages ofTHC that are in the products
that are coming out on themarket.
First of all, dr Murata, thankyou and welcome to the show.
Speaker 2 (01:59):
It's a pleasure.
I have family just across theborder in South Carolina and in
Chapin and Columbia and inCharleston.
I'm a secret Charlestonian.
Speaker 1 (02:11):
You're a northerner feeling, the southern draw.
I can feel it.
Speaker 2 (02:15):
You come in this way I jokingly say we're of southern
Italian extraction, soCharleston is very sympathetic
to us.
Speaker 1 (02:27):
Those stoic Italians right.
Speaker 2 (02:30):
Absolutely stoic.
Speaker 1 (02:32):
Well, you know, I tell you I enjoyed your
presentation and one of theissues that I think that shows
up is that you've got this bigsegment of the world that feels
like weeds Okay, and you knowthey.
There are people out there whoare daily users.
(02:52):
They experience benefits fromit, whether it's reduced anxiety
or medical symptomology.
You'll even get medical medicaldoctors saying that
cannabinoids are the answer inthe medical industry to the
opiate epidemic.
If they start switching fromone to the other for pain
management, they're going to geta lot better results.
(03:13):
But in a psychiatric hospital,watching people come off the
street with these high doses ofTHC and whatever they're taking
and having psychotic features orlaunching latent psychosis, and
having psychotic features orlaunching latent psychosis and
you know you gave some numbersand I'm not prepared to cite
them, but I mean they areincredible in terms of what the
(03:34):
psychiatric hospitals areexperiencing.
What's the solution Like?
How do we bridge the dividebetween these two kind of
interested parts of the society?
One says it's okay, one it'sdefinitely not.
Where's the middle?
Where's the middle ground inyour view?
What's the solution to that?
Speaker 2 (03:53):
These ideas, these processes are really complex and
I don't think I could just saythis is what to do.
Right, I mean I jokingly, butit's true.
I was at Woodstock and I livedin a commune for a while when I
was a kid, in college, and so Ididn't think of cannabis as
(04:20):
being dangerous, but I did seethings happen in my dormitory.
People had psychotic breaks.
We didn't know, but we didn'tknow what it was.
We just thought somebody wasweird, you know.
Right and my changing positionsover the years to being opposed
to its general availability cameout of working in hospitals Now
(04:46):
.
So I was raised in a very, veryliberal progressive.
You know left-wing New Yorkenvironment, politically and
socially, and you know mysainted mother-in-law once had
tea with me and said you knowwhat's happened to you.
You used to be such aKachotskyist and I actually said
(05:12):
to Mr Doug Rester if you're aphysician, you see things in the
world that people don'tnormally see.
You see the vulnerability, yousee the suffering and when you
see that, know you have to ifyou're trained as a scientist.
Also, you have to say what iswhat is really going on around
(05:34):
us?
Right, and it's especiallydifficult with something like
cannabis and psychosis, forexample, where it's not
everybody, it's not likeeverybody who's young.
There is a vulnerablesub-population and it's another
thing about it is that there's avulnerable period of exposure.
And so to try to make sense ofwhat's happened, you could talk
(06:00):
about it historically overgenerations, because you know,
in India in the 19th century andover the 20th century it was
the suspicion of many physiciansthat cannabis was dangerous and
they even made the connectionthat it was the potency.
You know, a little bit was fine.
(06:22):
You could use it in religiousceremony.
High potency cannabis wasdangerous.
Interestingly, this isdiscussed in Berenson's book on
the history of cannabis.
You know, in Mexico outlawedcannabis Long before he did
Because.
Speaker 1 (06:42):
Isn't that fascinating.
Speaker 2 (06:43):
Yeah, and they outlawed it because when, when
cannabis was introduced to thatculture, which was late in their
history, which was again in the19th century, they saw a change
in behavior.
this, they saw violence, theysaw psychosis, right right and
and so on our side of the borderwe didn didn't.
(07:03):
So these things to me arefascinating.
So you could see a case ofsomebody especially say to me
it's fascinating because I wastrained at Cornell.
So Cornell Medical School is inNew York City, not in the
countryside where the universityis, and we were in a very nice
(07:25):
neighborhood of Manhattan, butwe also I also did research at
St Luke's Hospital, which was onthe edge of what that at
Columbia University wasessentially on the campus, but
we, we took the patients fromthe border outlying regions, and
so what I was seeing as a youngdoctor and researcher was the
(07:47):
difference in exposure, right,so the difference in the age of
starting and the potency of themedicines, so that the degrees
of bizarre psychotic behavioruptown were much, much worse
than the degrees of behavior onthe east side of Manhattan,
(08:08):
which in my early time was likethey used to call this sort of
the silk stocking region.
You know it really, you knowbeautiful townhouses etc.
It was, and but you didn't knowexactly what it was.
Was it the family structure?
Was it stress?
(08:29):
Was it the co-exposure toalcohol and cocaine?
And all those things were true,but there was something
percolating through that there,which is that kids were using
really early in one part of thecity and later in the other.
But by 1980 or so that waschanging.
And now you know the estimateis that in New York City roughly
(08:56):
a quarter of teenagers highschool students use cannabis on
a regular basis.
Yeah, so that's an amazingnumber to me.
So, but you don't necessarilysee change instantaneously if
something depends on dose,potency, right and time of
(09:17):
exposure and if there's acritical period, and then
something will appear, notinstantaneously but begin a
process that appears over years.
It'll take you years to clearlysee what's going on, right.
So so what we began to see in,say, the 70s and 80s, I think
(09:37):
only has become clear now aswe've changed into a new century
.
So there's hints of that dataall along as being there, and
the United States keeps terriblemedical records of things
compared to Okay so, whereascertain other parts of the world
(10:00):
don't, a place where there'sincredibly good medical records
is Scandinavia, whereeverybody's in the system as a
number.
So they're not following you asa person, they're following you
as an entity in a mathematicalspace.
Speaker 1 (10:16):
Well, the health care is freely available.
So your participatingdemographic is everyone and
you've got their record frombirth, right, you know you even
know what medicines they'vetaken, what the doctor said.
Speaker 2 (10:30):
So you can actually access on the computers enormous
piles of data.
So I'll try to work through ita little bit.
So they've known since for overa hundred and something years
to take one terrible illness,schizophrenia, which is a
chronic psychotic illness whichis often terrible, debilitating.
People don't work.
(10:51):
They never marry.
Not every one of them, largepercentages of them.
In Western countries roughly 1%of the population exhibits some
form of that illness.
Right, and so you could seechanges in long-term data in
scandinavia and it was prettystable until the last 30 years
(11:14):
and it began.
The incidence rates began goingup a little bit, but you
couldn't tell what it was causedby right at the turn of the
century, basically yeah, thelast century not yeah, yeah,
rightyeah, yeah and and so you get a
report from an interestingreport of that from Finland.
And then you know in Denmarksomebody notices something.
(11:36):
You know and it kind of hasthat.
You know it's bleeping.
But the numbers that have comeout in just the last couple of
years, especially in the Danishdata, which is pretty strong
data, is that the rates areaccelerating and that the rate
may have increased.
In other words, that the numberof cases that are building up
(11:57):
is about a quarter more.
So, instead of moving towardsan incidence rate higher and a
prevalence rate of over one anda quarter, that means that over
time take the United Statesright.
So if we have an illness with a1% rate in the whole country
(12:22):
that's like 160,000, 180,000,how you count it cases right,
you go up a quarter.
You're going up a lot of cases.
That's a lot yeah.
Speaker 1 (12:34):
We would call that statistically significant, would
we not?
Speaker 2 (12:38):
Yeah, so you have a lot more people to take care of.
I mean Lou Berenson in his bookon this.
You know, goes over it in somedetail, you know, and so you
have these numbers going up.
So those are the chronic cases.
Those aren't just kids comingto the ERs having trouble.
Those are the cases building upthat will be in the system.
That will demand enormous timeand energy.
(13:00):
So you have that going on inone place and then you have the
overdose business going on,right.
Right 120,000 overdose deathsreported, and we begin to get a
feel that the younger generationis being exposed to early death
from overdose, exposure toviolence, with relatively high
(13:23):
rates of accidents, and now eventhis.
And so what are the factors?
Well, one of the factors seemsto be exposure to cannabis.
So you take New York City, youhave a half a million kids
almost in the teenage years.
Right, if you say 1% of half amillion, right, you know what
(13:46):
are we talking.
That's 50,000?
50,000.
50,000.
Yeah, that's right, out of thatcohort, over the next eight
years, 50,000.
And then, if it goes up by youknow the percentage, it's
another 10, 15,000 cases,minimal, of a chronic
(14:06):
debilitating illness.
I mean, how do you so?
On one hand you could say, well, yeah, sure, 50,000, but the
other millions don't have it.
But the physician has to dealwith and treat the kids who are
sick, and this is an illnessthat not only affects the
individual, it affects theirfamilies and it affects their
(14:28):
families, it affects the culture.
In the 1960s, in the wholecountry there was 500 and
something thousand beds inhospitals for psychiatric
patients, a lot of them in statehospitals and stuff.
Now the number is under 50,000,and so it's not strange.
(14:51):
If I go downtown in manhattanand I get off the grand central,
the main train station, youknow that you literally are
stepping over people sleeping inthat beautiful grand concourse
there, which is like a work ofart right.
And if you go down in thestreets it could be raining or
pouring and cold and there arepoor creatures living in the
(15:11):
streets and everywhere.
Well, those people should becared for.
They should be in a hospital.
They're ill.
Speaker 1 (15:22):
You and I are in a bit of a minority, thinking that
everybody should receive careat whatever level they need it.
I'm with you there, but we knowthat it doesn't happen.
Speaker 2 (15:32):
Right.
And so, you know, world-classpeople are walking to dinner at
a fancy expensive restaurant andstepping over people in the
streets.
It's out of a bad, you knowmovie of the medieval times,
right, yeah.
Speaker 1 (15:48):
Well, and you know it begs some of the other
questions.
I think that you're pointing atsome of the desensitization
that happens.
Right, the most dangerous thingto human life is an automobile,
technically speaking.
You're riding around and threeor four tons worth of metal and
(16:10):
people die every day on thehighways, et cetera, et cetera,
and and and a lot of thesestatistics.
I think it got used with the gunargument, it got used with all
kinds of other things, butthey're used to diminish and
minimize, um, the severity ofwhat's happening to people when
they interact with thissubstance.
Um, and they did it for yearswith opiates.
And then, you know, we went,however long, and then all of a
(16:33):
sudden it's like, wow, thesenumbers are.
They went from the numbers thatyou're talking about 50,000,
and then another half percent,maybe 25 more, or 15 more
thousand, and then all of asudden you're talking about
millions, you're talking about agreat percentage of the
population, and suddenly you'vegot the epidemic.
You know, um, and you know, Istill don't believe that it's
(16:54):
that you should put people injail for substance use,
regardless of the legal or theillegal or the whatever else,
like putting them in jail mainlybecause that's not a care
environment, right, um, andalcohol.
Of course, you know there'splenty of individuals who suffer
(17:15):
from alcoholism.
There's plenty of individualswho are in recovery and are able
to successfully be aroundplaces where you can buy alcohol
anywhere and still manage tostay sober.
So there's this practice oftheirs.
But I think that THC is a bitdifferent in its scenario.
Now, one thing I think is onething I think is you know,
(17:36):
there's not so much of analcohol content in alcohol that
you can buy.
You go to the ABC store.
You have to have a license tobuy something that's over and
above a certain percentagealcohol content, right?
We don't have that with thc wehave.
Speaker 2 (17:52):
I mean, I live on the um, the border of new york and
connecticut.
Now, all right, and the lawsare different, depending on if
you can see this here in mymailbox encouraging me to buy my
cannabis products on one sideof the border or the other who
has the highest potencies cometo us because you could buy
(18:17):
greater quantities at a time,and so we live in a region where
you could go to four differentstates and purchase, and so
they're now fighting over marketshare right.
Speaker 1 (18:31):
Yeah, that's right.
Speaker 2 (18:32):
What's the thing you know it's about?
You know you can buy higherpotency from us, and that's the
kicker.
So at Woodstock the potency ofthe cannabis there was between
one and a half and 2% potency.
The potency now of streetmarijuana is 18-20%.
(18:54):
But also they're selling allkinds of products, too, right,
gummies and things.
That's potencies of 35%, soyou're talking about 17-18 times
.
They're selling products nowwith potencies of 80%, so that's
40 times the potency in anygiven hit.
I mean right and generallyavailable, which is the other
(19:18):
thing.
So in the city there are legalmarijuana dispensaries.
All right, you can go by, youhave to be 21 there.
But they're also illegaldispensaries and the authorities
have real trouble dealing withthem.
Right, and in fact they've evendiscussed not even trying to,
(19:42):
because it's impossible toenforce the law.
Well, where do your teenagersgo to?
Right?
Speaker 1 (19:48):
to those.
Speaker 2 (19:53):
Where do you go to on the way to school?
You know I mean, I grew up in aschool system in the city that
if you smoked a cigarette youwere in jail, you were in
punishment.
Right Now you have a systemwhere kids go to school
intoxicated, where they'resmoking marijuana on the way to
school, and no one can besearched for anything in the
school and they're vaping it,which is hard to find.
Speaker 1 (20:13):
Or they've got gummies which is impossible to
detect, and you've got gummiesthat have got 600 milligrams of
THC.
Speaker 2 (20:21):
High potency THC.
Speaker 1 (20:22):
I mean it's insane and literally that's where we're
seeing a very significantportion of the population get
driven to is psychosis andhaving the symptoms.
Speaker 2 (20:38):
That's why there's a relationship between potency and
toxicity and long-term outcome,and the neurobiology of it's
interesting because it's hittingcritical parts of the brain.
Now I have a hypothesis that wehave another problem,
especially where I come from,which is everybody's using
(20:58):
stimulants yeah this isamphetamines and you know,
ritalin is so high and highpotency use of those things are
toxic too.
And if you're going to schooland you're smoking, like in
colleges I mean college campuseshave dealers in the dorms.
Speaker 1 (21:20):
It's a tradition.
Right College campuses don'thave addictions problems.
Dr Murata, don't you know that?
Speaker 2 (21:25):
Well, I've spoken to college professors.
The problem is that they can'tdo anything about it and they
can't get any help in dealingwith it.
Speaker 1 (21:32):
Well, I think that every time I go to a college
campus, they will throw theirhands up about responsibility oh
, we just can't do anything.
It's like I don't believe that,and I think that one of the
answers to this problem thoughit is complicated, is something
you stated in your presentationis we've got to educate people
(21:54):
about this.
It's like, you know, aneducated consumer is a far, far
more protected you know, buyerbeware, protected consumer than
a person who's just going in andfollowing these kind of
impulses, especially withteenagers and young adults.
It's like, well, I have ahigher potency, I took a higher
potency than you did.
It's like, well, I could beatthat by.
(22:15):
You know, that game, that gamecan throw you down the.
You know, we see young adultprogramming and adolescent
programming popping up all overthe place to handle these
conditions.
They're expensive too.
Speaker 2 (22:27):
The way I try to get people to understand is you know
, if I go down to admissions ofthe residents, of the doctors,
and you ask somebody who's beenbrought into the hospital, you
ask do you drink?
No, I don't drink, right, youdon't drink at all.
Well, only on weekends.
Speaker 1 (22:44):
But not much.
You say well, how much is notmuch?
Speaker 2 (22:46):
They say, well, I almost never black out.
And I said, well, if you almostnever blackout, how often do
you blackout?
Once every couple of months.
Now it's like getting hit onthe head with a baseball bat,
right from a biologicalstandpoint.
But they don't drink becauseit's only on weekends.
But when does the weekend begin?
(23:07):
It begins on Thursday.
Speaker 1 (23:09):
Right, right, friday's part of the weekend,
right.
Speaker 2 (23:12):
Yeah, and it's the same thing.
You use drugs?
No, not at all.
Just a little cannabis.
How often?
Well, only to sleep.
Speaker 1 (23:20):
That's every night.
It's Russian roulette, right?
You're loading one bullet intothis chamber by engaging in the
use of this substance at highlevels and high dosages.
In the use of this substance athigh levels and high dosages,
(23:41):
and maybe you and and you knowif it's a six bullet chamber
five of the five of thoseindividuals in that chamber are
not going to experience the thedire consequences of high use
and maybe they can go on in lifeand do whatever they need to do
and maybe it doesn't impactthem.
But that one person and youknow one out of six, even one
out of ten and millions is stilla lot of people and a lot of
(24:01):
care that experiences mooddisorder or psychosis or a
variety of neuropsychiatricconditions that they end up at
the hospital for.
Speaker 2 (24:13):
That's right, and it can be in and out of the
hospital for the rest of theirlives or require lifelong care
and not be likely to have afull-time job, you know or and
be socially isolated.
And those kids are really hardto treat.
We use the most complexmedication you know algorithms
(24:38):
to try to get them better.
And we do get lots of thembetter, but it was.
Even.
If we get them better and backto school, they've lost three or
four years before we get themback.
Speaker 1 (24:47):
Yeah, from the treatment side, you know you're
handling them.
At the acute care side I seethem a lot.
On the rest, you know, and ifyou got a person who went to get
your care in the hospital andthey're getting ready to come
out, I tell parents consistentlyyou're looking at 18 months
worth of continuing care.
(25:08):
Residential environments,supported living environments,
coaching, therapy, continuedmedication monitoring you know
these are, I mean you therapy,continued medication monitoring
you know these are.
I mean you're talking aboutintensive care.
You're talking about thisperson now suffers from a
medical condition that willrequire intensive care,
long-term intensive care andlikely some version of that care
for the rest of their lives.
Speaker 2 (25:30):
You got.
You touched it exactly, and thegovernment no longer really
helps with that right, so theburden is on the family.
Speaker 1 (25:38):
Right.
Speaker 2 (25:39):
And what I say is you know, we, just because of where
we are in the world, we live inan incredibly privileged area,
where I live right now, you know, and it can impoverish upper
middle class families Becauseyou're talking about care that
costs not $10,000 a year, tensof thousands of dollars a year
(26:01):
at the lowest level, you knowand but they do it, but so many
families can't.
I mean, one of the things thatyou know, we talk about, we're
going to talk about when we havemeetings in Charleston in April
, is how can you put thesethings together so that you can
deal with some working classfamilies, with poor families?
(26:23):
Dead children can get aid too,very difficult.
You know, I spoke to KathleenRadius yesterday.
She's the vice chancellor ofthe medical college in
Charleston.
Speaker 1 (26:37):
Abuse, yeah, yeah.
Speaker 2 (26:38):
Yeah, wonderful woman .
She went to Florida and that'swhy we say you know abuse.
But you know, I said you knowwe're spending billions because
of the drug epidemic, billionsand billions of dollars, and
we're having relatively pooroutcomes.
We can't scale it properlyright.
(27:00):
We just can't seem to getpeople to understand and do
something.
It's education, but it's alsoeducation of the people, but not
only the families and thepossible patients, but the
politicians and the educatorsand the people who get to
organize these systems.
(27:21):
It's daunting, but to me it's amoral equivalent.
It's struggling to save soulshere.
It's a big, big thing.
Speaker 1 (27:33):
We got to this topic when we were at the conference.
But insurance, there's ourother.
You know, the getting insuranceto actually pay for treatment
and pay for it long enough for aperson to actually recover was
a big part of our topic.
It's the other half of thisequation.
Speaker 2 (27:49):
Well, after we had that meeting right that the
assassination of that you know,by that young man from the
University of Pennsylvania witha master's degree in computer
science and economics.
Speaker 1 (28:06):
Educated guy, you know.
Speaker 2 (28:09):
So he killed.
So what it brought out, atleast for a while, was some
strange numbers.
So I may be misremembering it,but four major health insurance
companies had combined profitsof $600 billion last year.
That was after they paid them.
(28:30):
The executives paid themselvesmillions, and you know right.
And now to say we got 50,000more beds for dual diagnosis in
the country which was, whichwould be nothing compared to
what we used to have 30 yearsago.
How many billion would thatcost?
(28:51):
Maybe 10, 10 or 12.
Speaker 1 (28:54):
Yeah, if that.
Speaker 2 (28:55):
Yeah, if we did it right.
Speaker 1 (28:58):
To bid you high facility and everything else,
yeah.
Speaker 2 (29:01):
If we did it right, if we didn't build them in
downtown Manhattan, in thecountryside or in states without
access to regulation, if youwant, we could treat 20,000,
30,000 more people well over ayear, and that would be what 8%
(29:24):
of their excess profit.
Speaker 1 (29:27):
Yeah, barely a scratch.
Speaker 2 (29:29):
Those four companies.
I think there's 10 or 12 ofthem, I don't know.
So my guess is that theirprofit from the insurance
industry is in the range of atrillion dollars a year.
Speaker 1 (29:43):
Yeah, and it's not going back to the American
public.
Speaker 2 (29:46):
No, it's going into the hedge funds and the rich get
richer.
Now you know what party I wasraised in.
Speaker 1 (29:57):
Well, I think that what you and I are talking about
I don't.
I'm grateful that I navigatedmy young years and didn't end up
suffering from a condition thatcaused me lifelong care
problems or debilitating issues.
I certainly did my share ofexperimentation, but I also, not
(30:20):
unlike you, over a period oftime especially when I started
in the behavioral health fieldjust witnessed people who were
impoverished and could notreceive care and were suffering
from conditions that needed alot, including your Medicaid
populations, the people who arehomeless, the people who are
(30:40):
addicted, but they've also gotchildren the whole nine yards,
and you know it caused me to bealigned towards.
You know I can vote for.
I can vote for policies orpoliticians or party lines that
don't necessarily benefit medirectly.
Speaker 2 (30:57):
Right.
Speaker 1 (30:58):
I'm not one of these people, but I believe that they
need care and I believe that weshould have stuff in place that
gives them, you know, a path toa better life, a path to care.
And you know we're seeing a lot.
I think the mentality at thehigh corporate levels is that,
you know, it's a very insulatedkind of population of people
(31:21):
community, if you will and theiraim is that profit, not a
community care.
And I wonder what's going tomake it trip Like.
What's the thing?
And I think I asked thisquestion and Dr Gerber, the CEO,
there at Silver Hill.
He had a pretty good response,but I still think it's going to.
(31:41):
I still think it's financiallybeneficial to incentivize care
outcomes that are positive.
What do you, what is yourthought about like?
Where do you think the turn is?
Speaker 2 (31:53):
I believe we have a mixed economy.
What I've seen in bureaucraciesif something is overly
bureaucratized, things don't getdone.
I've been blessed here with anenormous amount of support, but
what it allows us to do is to besurrounded by a bunch of saints
, people who are so committed tothe cause of helping others,
(32:17):
and I think that you have to tryto have systems that allow
those people to grow and dotheir job.
I mean one of our people youknow who worked with us, dr
Irene Beal.
I mean, they said you know,bridgeport is a city in
Connecticut which is not in goodshape.
All right, yeah, and she said,get care to them.
(32:40):
She says, well, they raise themoney on their own, some from
the government, mostly on herown.
They build a clinic, right, theysaid, how do you bring in the
street people to get help?
You know how do you treat theschizophrenics there?
Well, you build a clinic totake care of general problems
and when the people come in,you're going to get all of them
and then, and so you know, theywork like that.
(33:03):
I mean, one of the other guysyou didn't meet was with us at
the schizophrenia meetings.
You know, chris landry.
You know they're in.
They're in times square, in thestreet, going to the people.
You know, yeah and so, andthat's what you have to do, but
you also, you need more to it.
You need institutions, some ofthose people and, right now,
(33:27):
large numbers of them, becauseit hasn't been done for a
generation.
Speaker 1 (33:29):
They need containment .
Speaker 2 (33:31):
Yeah, they need to be fed.
Yeah, they need to be kept warm.
They need to be fed.
Yeah, they need to be formed,they need to be cared for.
You know, um, and it can't beoverly bureaucratized or it
won't work, right and so, buthow do you get those people?
I don't know.
But, um, dr doherty, you mighthave met her.
(33:52):
She told me a couple of weeksago to see a movie called
Cabrini.
Speaker 1 (33:57):
Cabrini.
Speaker 2 (33:58):
Cabrini, C-A-B-R-I.
Well, if you're a New Yorker,you know that that's Francesca
Xavier Cabrini.
She was this under five foottall nun.
And a force of nature, a forceof nature and a force of nature
and she founded orphanages,schools, hospitals, first in
(34:23):
Italy, because she was bornthere like one there, and she
came to New York with sixsisters and she came to New York
in her 30s and by her 60s Ithink they had founded 60
orphanages, hospitals, schools,colleges, and so there's an area
in New York that's named forher, you know, but she's part of
(34:46):
the mythology of certain partsof New York.
She's called Mother.
Speaker 1 (34:52):
Called.
Speaker 2 (34:52):
Mother, yeah, mother, mother, you know, um, and I
watched it and I watched thatand I said, yes, you, you said a
force of nature, she was.
You know, this movie tells astory about how she's trying to
get the mayor of new york to dosomething that's right and she
power plays him by saying thatshe's organizing the vote.
(35:14):
So if, if he expects to getreelected, he's just working,
you know, she's working with theIrish and with the Italians and
he says you know, mother, Icould, I could talk to you.
You know.
He says you should have been aman.
He says, you know, I'm a woman,the officer, a glass of scotch
and she drinks it, and he lookshim right in the eye.
(35:40):
And she says, no, I'm a woman,can you office her?
A glass of scotch, and shedrinks it, and she looks him
right in the eye and she says dowe have a deal?
Speaker 1 (35:41):
Wow, that would have been cool to meet her.
Well, I mean, you know you'retalking about how you make
change, right?
That's?
Those are the.
I think you're doing that, drMurata.
You're doing, you're doing thegood work out there and you're
passing on the message.
I really appreciate the workthat you're doing and I really
(36:04):
appreciate the fact that,despite all the degrees and
credentials and accolades thatyou have, you're also just a
neat and decent guy who wants tocare for human beings, and I
couldn't be more grateful toknow you.
I thank you for coming on theshow today.
This has been Head InsideMental Health, wpbm 1037, the
voice of Asheville, toddWeatherly, your host, dr Murata,
thank you so much.
Speaker 2 (36:22):
All right, bye-bye now.
Speaker 1 (36:25):
I feel so lonely and lost in here.
I need to find my way home.
I feel so lonely and lost inhere.
I need to find my way home,find my.
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