Cannabis And Men’s Mental Health - Part 2

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Episode Transcript

(00:01):
From the WA and M Studio onthe campus of Florida A and M University.
This is Mariform Radio, a weeklyconversation on the education and research or
medical marijuana being conducted at MUNI.Hi. I'm highly outweigh your host from
this Conversations on Cannabis Virtual form,brought to you by the Medical Marijuana Education

(00:21):
and Research Initiative at Florida and MUniversity. In this conversation, we're talking
about the pros and cons of usingcannabis as a mental health treatment for men.
So let's talk and learn about thissubject with our guests. Doctor Delvina
Thomas is a board certified psychiatrists anda nationally recognized mental health expert working to

(00:44):
end the stigma of mental illness andeducate the public about the brain. Doctor
Thomas is based in South Florida andmaintains a private practice in psychotherapy, psychopharmacology,
and alternative health, which includes CBDproducts and medicinal cannabis certifications. She's
also a combat veteran and a memberof the Army Reserve and has developed programs

(01:07):
to support individuals and high stress careers. Doctor Delvina is good to have you
back on the forum. Thank youso much. It's great to be back.
Great. Our other guests is doctorMichael Rayleigh, a psychologist with more
than two decades of experience in themental healthcare industry at the local, national,

(01:27):
and international level. Based in NorthFlorida. He also has a private
practice that provides mental health counseling andassessments. Doctor Rayleigh is also a combat
veteran and a member of the ArmyReserve. He is a family graduate and
a professor who has conducted gradual graduatelevel instruction and research. Doctor Rayley,

(01:49):
Welcome to the forum. Thank youglad to be here. Great to everyone
join joining us on this live program. Please share post and tager friend on
Facebook to have them join this conversation. If you're on YouTube, share the
links so others can join us aswell. During the forum, we want
you to send us your questions inthe comment box and we'll do our best

(02:12):
to have the guests to answer them. We also want you to tell us
what you think about this forum bycompleting the survey that will be posted in
the comments on YouTube and Facebook.After the live program, your name will
be entered into a drawing. OnAugust eleven, twenty twenty three, to
win a one hundred dollars gift cardprovided by one of Mary's partners. Now

(02:32):
let's start this conversation on cannabis andso in Florida, we know that post
traumatic stress disorder is a qualifying conditionthat could be treated legally with medical cannabis.
So, doctor Delvina, you're aqualified physician in Florida. What are
some of the factors that you considerwhen recommending medical cannabis as a treatment option

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for someone who has PTSD or qualifyingcondition related to their mental health? So,
for me, cannabis is never myfirst go to when I'm treating someone.
I like to educate them fully onthe options and the potential treatment protocols.
So meaning psychotherapy, pharmacological interventions suchas medications that are FDA are proved

(03:19):
to treat depression and or anxiety orPTSD. The caveat here is that PTSD
post traumatic stress disorder doesn't have necessarilya medication specific only for PTSD. So
what happens when we're treating folks withPTSD, We're pulling from a variety of
categories of medications to try to attenuatetheir anxiety, to help them sleep so

(03:45):
they can have less nightmares, maybeto help boost their libido if libido's an
issue for them, because libido andas well as erectile dysfunction is commonly seen
in men who have PTSD, soyou have to look at all those target
symptoms and address those things. Ifsomeone has tried medication, and they've tried

(04:09):
different medications to no avail, that'swhen I start thinking about medicinal cannabis.
They've also tried psychotherapy. I talkedto all of my patients and their initial
assessment about their diet. I talkedto them about their exercise routine and what
they're doing to take care of themselves. I asked them about their visits to
their primary care doctor, because sometimesyou can have physical situations that are influencing

(04:32):
the mental stuff, such as yourthyroid, so we have to do a
comprehensive assessment. You know. Iwas one of those people in the past
that did not believe in the useof cannabis, but when you do the
research and from seeing with my ownI seeing my patients and how some of

(04:53):
them still struggled. I had alady who went through every classification of an
antidepressant to treat her symptoms, andthis was this woman was a principle,
she had integrity. I had noreason not to believe the report she was
giving me in our sessions. Infact, she was not even thinking about
medicinal cannabis. That was something thatI recommended to her as an option for

(05:16):
her sleep issue that was associated withher depressive illness. So everyone is different.
I have colleagues who will who willsuggest medicinal cannabis right off the bat,
immediately in the treatment plan. Forme, I try to do other
things first and lead that as kindof not necessarily the last resort, but
not the first primary thing that wethat we go to. Yeah, and

(05:40):
doctor Raley, I know that you'renot a qualifying physician for the medical cannabis
here in Florida, but you hadyou shared with me that you do have
patients that come to you and say, Doc, how can I get a
weed card? So tell me howyou respond to those requests from your patients.
Well, I try to piece.I try to talk to them about

(06:01):
the things that I personally do aboutand that is of the exercise and health
and diet source of things. ButI also share with them that probably if
they go to anyone, any anyprescriber, who's uh, who's doing it
the right way. They're not goingto give them that. They're going to
ask them have it done these things? So we had to try this stuff

(06:23):
now, and I will refer youto a psychiatrist and and and together you
guys can make that determination. Butyou can already tell ye at that point,
you can tell the psychiatrist, well, I've done all this stuff in
my referral documentation out you know,I'll monitor all that and I'll put that
in there. I think, um, I think at that point a good
psychiatrist is gonna it's gonna take thatto I mean, they're gonna put more

(06:47):
value what this what this patient issaying because they try some other stuff first,
just like just like an example,she said, with the principle,
I mean, that's the kind ofthing you want to see first. So
and I gave you some validation thatthis person is not just coming to you
just for a quartufo we come.Yeah. Yeah. So I think that's
a great segue into my next question. And then doctor Delvina, I think

(07:10):
this would be a good response,good one for you. What are some
of the benefits of using medical marijuanaas a mental health treatment? Wow.
For some people, it's the onlything that helps them to sleep. The
thing about inducing sleep for folks whothey may have had a sleep study,

(07:30):
they may have tried over the counterthings like vina drille aka diphenhydramine, melatonin,
and so in my office, myselfand my practitioners, we don't jump
straight to the narcotics, to thecontrolled substances to induce sleep. You're doing
a big disservice to a patient whenyou just give them ambient off the bat,
you give them to masapam right offthe bat, you give them luness

(07:55):
the right away. It's a disservicebecause those things have addictive potential, Whereas
what medicinal cannabis. We're using alow quantity of cannabis to treat patients and
to help them relieve whatever symptom thatmay be. Medicinal cannabis does not cause
euphoria, it doesn't make people high, which is why some folks who love

(08:18):
resorting to street cannabis, some ofthem don't appreciate the cannabis that you acquire
in the dispensary or from a certification. So I've seen it relieve insomnia and
patience. We know that when folksare not sleeping. That can be a
vicious cycle. When you don't sleep, it ruins your mood. The next

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morning, you wake up cranky,you wake up disenchanted, You're irritable.
That may cause issues with the peopleyou're interacting with because you're irritable and you
can't manage that. It can leadto higher rates of excuse me, higher
rates of depression. It can worsenanxiety. So sleep, not sleeping after
several days can be detrimental to aperson's mental health. I've seen medicinal cannabis

(09:05):
help people who have anxiety disorders.Everyone, again, does not respond to
the traditional medication that's offered in ourpharmacies. And again, the easy fix
that some of my physician colleagues willdo is give someone some adavan or some
colonipin. Those things lead to issueswith cognition, the ability to think and

(09:28):
recall and maintain information and recall information. Those things are associated with premature onset
of dementia. So medicinal cannabis isnot associated with dementia. It's not associated
with addictive potential. So that's whereI appreciate the difference between the two.
Okay, So then we talked aboutthe benefits. What are the risks of

(09:54):
using medical cannabis? Yes, yes, So this is why it's important for
patients to go to a qualified certifier, which a qualified certifier will be a
physician. But you want to goto someone who seems like they care about
you. They're not just charging youmoney to come in and get this card
and then you know, after fiveminutes you're on your way. You want

(10:16):
this person to sit down with youand take your history, because this person
should be asking you things like doesyour family have a history of schizophrenia,
Is there a history of any typeof psychosis? Is there a history of
bipolar or mania in your family?Because those things would present a concern.
We know from old studies. Iwas telling you, miss Otway that when

(10:39):
I was in residency back in theearly two thousands, we saw studies that
street marijuana weed Mary Jane could actuallyinduce psychosis, and it induces psychosis a
lot and our young boys and ouryoung men. So for me, I
don't endorse medicinal cannabis for anyone underthe age of anyone who's not in their

(11:03):
twenties, because the brain is stilldeveloping well into our mid twenties. We
know the brain is probably still developinguntil the age of twenty five. So
if you introduce any type of cannabinoidin amounts that are more than the normal
baseline amount that our bodies and ourbrains are used to, and there's a
risk or there's a family history ofschizophrenia, there might be some induction.

(11:26):
Now we know the levels are lowerand medicinal, but you still have to
be cautious. So I'm not aperson who supports medicinal cannabis and a child
for qualifying illnesses like seizure disorder.I'm a psychiatrist first, so, and
I've seen the impact and the consequencesthat's created for folks who did not know

(11:50):
they were amenable to psychotic episodes orhigh risk for those things. Yeah,
doctor Raley, would you like toadd to that, what are the risk
that you see in your patients whomay come after using cannabis? Um?
You mean street cannabis or or anykind of cannabis. Well, Um,
I've always had more faith in additionalbecause I know that it's regulated and and

(12:16):
and the way it is manufactured.Uh, the THHC levels are much lower
because I do know, Actually Iwas having just a casual conversation with with
a mental health councils, a partmentof fects that we were contacting about it,
say, well, you you canknow that uh uh howles of tshc
uh does affectum exacerbate or it canit can it can cause um latent uh

(12:45):
psychotic features to sort of come tothe surface really quickly. So, um,
that's why I only even if we'regoing to do it, then it
should be done the way it's theway it's being done now, regulated,
and you need to have it's it'sit's a medication point should be halengars,
lack of medication, food, youradministration. Only qualified providers need to be

(13:07):
prostratedant stuff. Not as far asthe people who are self medicating. And
that's never a good idea to selfmedicate with anything anything, And we have
much more of that anything else atthis point. Everybody, I guess is
bigger pharmacists. And there they are. They're a physician because they're they're diagnosing
themselves, they're treating themselves. Um, So as long as I'm pretty comfortable

(13:30):
at this point with medicinal marijuana,but I do agree that obviously you have
to monitor and you do. Youhave to know what the history is and
just like with other medications, youhave to do follow ups and this sort
of thing to make sure that thereare no problems, no unintended problems that
they want to surface because of theuse of medicinal a want. Yeah,
and dator davina. I mean maybefor our listening, our viewers and listeners

(13:54):
who are listening to the program,can you kind of plane what you get
when you get when you go toa dispensary versus what you could get if
you go get it off the streetthe legacy. Yeah, so off the
street you could get something that hasother things mixed in. We know that

(14:16):
folks are including fentanyl and other typesof opiates or opioids in some of the
cannabis that's out in the community.There might be the the weed it will
call it. Street cannabis might bedipped in some type of buckspray or fromalde
hyde or some type of chemical tohelp with getting high. So those are

(14:41):
the things you get when you takethe risk of purchasing cannabis in the community
or out in the street. Whenyou go to the dispensary, it's clean,
you know, it's it's from theplant and as doctor Rayley's mentioned,
it's monitored and it's it's certified,so it's it's safe or because all of
this foreign extra foreign stuff, it'snot. It's not in the strains that

(15:07):
you get in the dispensary, andthey talk to you about the different strains
at least you know on the dispensarythe different types you're getting in general,
what those types are used for versuswhen you buy it in the street.
Yeah, tell us a little bitmore about the strains. For those who
are considering medical cannabis as a treatment, can you talk a little bit about
what the strains mean. Well,just to put it simply, one strain

(15:31):
helps with the calming effect. We'llgive that to folks who want it for
sleep. The other strain is moreactivating strain, so it's more. So's
to keep it simple. The twoare activating, calming and so and that's
putting it simply. Okay, Well, I liked how earlier we were talking

(15:54):
about what the risks are You talkedabout you know, the research that's been
done that showed that cannabis, youknow, can cause some risk for people,
and more recently we've seen a reportcome out from the National Institutes of
Health that talks about cannabis use disorderand how it can increase the risk of

(16:15):
sizophrenia, especially in young men.So can you doctor to Delvina tell us
a little bit about what is cannabisused disorder and what are the symptoms associated
with it? Sure, so,a youth disorder, whether it be cannabis
or alcohol or some other type ofcreation drug, it's created because the person

(16:37):
continues to use regardless of the effectsthat it's having on their lights. So
they may have had consequences from possessingor using it, such as consequences on
the job where they're late to worka lot, or they're not doing their
job the same as before, sothey've been written up. It may cause

(16:59):
a change in their every day ortheir usual daily life routine, such as
getting up late, having apathy,and not caring about certain things. And
they continue to use regardless of theseconsequences. So that's what makes it a
use disorder, along with some otherthings as well, but specific for cannabis
use disorder, it's a person who'susing cannabis regardless of the negative outcomes that

(17:22):
have occurred in their life. Wow, and so I know you've had a
chance to review the study. Whatare your thoughts on it? With the
increased psychosis, especially among young menages eighteen to thirty, I appreciate the
transparency, and this is why wehave to have clinical trials. We have
to have a balance of science,medicine, social chemical. We need a

(17:48):
balance, and I appreciate that transparencybecause folks who practice medicine, we know
what we see in the community,we know what we see in the hospitals.
I've never seen as many black menwith a diagnosis of psychosis or schizophrenia
than what I've seen in the lastten years. And most of them have
been college age boys, which isthe textbook age for the onset of schizophrenia,

(18:12):
but even more so than what itused to be. And I know
that street cannabis or weed is associatedwith these things. Yeah, doctor Railey,
would you like to add some ofthoughts on that about the study and
then just the growing the growing numberof young men as doctor Delvina just stated,
plus what we saw in the study, you know, experiencing psychosis and

(18:37):
schizophrenia. Oh you can't hear,doctor Rayleigh. Okay, sorry about that.
Well, we'll keep the conversation goingwith doctor Delvina. So, doctor
Devina, let's say you know someoneis experiencing these things, what resources do
you recommend for people who want toget mental health support or they want to

(19:00):
support a family member or a friendthat they think may need some mental health
support. So the first thing youcan do if you happen to have health
insurance is contact your health insurance andask them to email you a list of
providers in your catchment area and yourZIP code in the space where you live,
so you can ask for And sometimespeople they don't know what to ask

(19:22):
for. They don't know if toask for a psychiatrist like myself, a
psychologist like doctor Railey, a licensedclinical social work, or a license mental
health counselor they don't know who toask for. So if that's the case,
back up and you can start withyour primary care physician your PCP.
Your primary care physician is like basicallythe pilot of your plane. PCPs drive

(19:45):
our healthcare. They help us toarrange and help us to know the things
that we need in our life medicallyto treat us to help maintain our health.
So you can start with your PCPagain, if you do have some
idea. You know you're not onmedication, and you feel like you don't
want medication, then you don't haveto go to a psychiatrist. You can
go to a psychologist, you cango to a licensed clinical social worker,

(20:07):
you can go to a licensed mentalhealth counselor you can go to someone that
your insurance is saying, hey,these people are on your plan. The
way you choose someone is most ofus have a website. Most of us
are on the internet. You cangoogle. You could google doctor Delvina Thomas,
you know, and you'll find information. If they've written a paper,

(20:29):
if they're in a scholarly journal,if they have a website, that'll pop
up. If they're on social media, it'll pop up, and now I'll
tell you a lot about a person. And oftentimes the insurance plans will have
bios for their providers. If youdon't have insurance, your community mental health
center is your friend. Community mentalhealth centers you can go to and seek
care. They will give you.They will charge you based on a siting

(20:52):
scale. If they charge you atall, they may not charge you anything.
And the great thing about community mentalhealth centers is that oftentimes they have
base managers and social workers who canalso help you if you qualify apply for
health insurance. So I would saythat's the start, yeah, and that's
great. And then you know there'sanother resource that we're seeing more of,

(21:14):
and that's you know, if youhave a mobile device or a phone,
you just stile two one one,yes. Yes, And they were a
great resource, especially for local mentalhealth care that could be free to no
cost. So absolutely I want tothrow that out there. Okay, well,
doctor Thomas, you know we're havinga couple of issues getting done to

(21:36):
really back on, would you liketo provide some closing thoughts with this show
before we wrap up? Um,so we're the topic is men's health awareness.
To all my fellas out there,please don't be afraid. Your families
want you around as long as youare meant to be here. And I
know sometimes people say, oh,it was meant to be, but sometimes

(21:57):
oftentimes we don't know. We haveno idea what's meant to be. So
don't give into that. Try tolive life and be healthy. Go to
your doctor, go see someone.Even when you're not sick, you should
be going to the doctor. Youshould be going for your yearly or your
biannual examination, so you can getchecked. They can check your cholesterol,

(22:18):
your blood pressure, Go and seea mental health professional just to talk.
Don't wait until you're in crisis.So that would be another recommendation is that
people should have some sort of connectionto some mental health professional. So when
something does happen, you've already metwith this person, they kind of know
you, You've been acquainted. Thenyou can go in for that crisis visit.

(22:41):
And also love, teach your kidslove, have love for yourself.
You gotta have self love. Yougotta love your kids, You have to
love your family. And forgiveness isour friend. Oftentimes people just maintain baggage
from their past and they bring itinto their future and it just makes a
whole grimy mess. So learn toforgive people because tomorrow is not promised.

(23:03):
Tomorrow is not promised, So forgive. I'm not saying you gotta forgive and
still allow the person to do thosethings to you they did to you,
but you can forgive and move on. Yeah, so much more, but
I'll leave it at that. Thatis so well said. So thank you
so much you and doctor Riley forbeing guests on this conversations on Cannabis Live

(23:25):
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(23:47):
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(24:08):
it's educational programs and additional information aboutcannabis use in Florida. Goodbye and thanks.
The views and opinions of our invitedguests are not necessarily the views and
opinions of Florida Agricultural and Mechanical Universityor the Medical Marijuana Education and Research Initiative