Cannabis And Men’s Mental Health - Part 1

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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 mus HI. I'm highly outweigh your host from this
Conversations on Cannabis Virtual form, broughtto you by the Medical Marijuana Education and

(00:21):
Research Initiative at Florida and M University. In this conversation, we're talking about
the pros and cons of using cannabisas 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 and anationally recognized mental health expert working to end

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

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

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

(01:49):
to the forum. Thank you gladto be here. Great to everyone join
joining us on this live program.Please share post and tager friend on Facebook
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to send us your questions in thecomment box and we'll do our best to

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

(02:34):
this conversation on cannabis. So,Doctor Delvina and doctor Rayley, there's this
growing conversation across the nation about mentalhealth and there are a lot of efforts
underway to provide more support for thosein need. Yet I keep hearing that
men are holding out on talking abouttheir mental health or getting help. So,
Doctor Delvina, I want to startwith you. What are some of

(02:54):
the common societal barriers or stereotypes thatprevent men from seeking mental health support.
Men don't want to seek any typeof medical support, whether it be mental
health or physical health. And it'samazing, Heidi, because men are more
likely to die than women, soyou would think that they would be the

(03:15):
first ones going to the doctor.They also use excessively tobacco and alcohol more
than women, but they're the lastto go. And a lot of studies
and surveys show that men are afraidthat there's some sort of belief that they're
weak if they go to the doctor. Some of them say that they're too

(03:37):
busy to go to the doctor.Some of them use excuses like the waiting
room is too cold, they don'tlike to be naked under the gown.
They don't like what's going to happento them, specifically that prostate exam,
the digital recto exam. So thoseare some of the top reasons why men

(03:57):
will not go to the doctor,and you know, it can lead to
fatal outcomes. I have a friendwho wouldn't go to the doctor for years
and he was diagnosed with prostate cancer, which is a very very sad occurrence
considering it's something that can be treatedsuccessfully. Yeah, doctor, really,
I know you got a lot tosay about this. Well, well,

(04:18):
you know, I actually I'm notsure how much more I can how much
more I can act to that thatI would say that I think there's something
about this thing that men have tobe strong, you know, where you
have to you know, it showsweakness when you when you get help.
I think that's it. That's probablythe most saling factor. And and men

(04:40):
not willing to get help because theyappear to be weak. But also I
do have to agree that that oneof the underlying issues. And maybe they'll
they'll tend to play off, whichis more a lot more because there's some
few actually I think in many ways, women are way more emotionally strong than
than men. It's not even close. Actually not. Yeah. So,

(05:00):
doctor Wylie, I'll start with you. How can we address societal barriers or
misconceptions surrounding mental health and encourage menand women to have more open conversations and
discussions on their experiencing mental health issues. Well, I think that's the in
my opinion, that's the long termproject. I think we have to people

(05:24):
like me. I've got three sons, uh. And I talked to my
sons openly about about taking care ofthemselves, about starting now and not waiting.
Uh. And you know, justa personal experience. And my sister
died a colon cancer back in twentyten. She waited, you know,
and she made me promise that Iwould, you know, we're really close.

(05:44):
She made me promise that I would. I get myself checked out every
year, probably if I hadn't,if I hadn't been at her death bed.
Her making me promise that. I'mnot sure how seriously I would have
taken what it did cause me tolook closely at it. Uh. And
then I have to do the samething for my son. So I think
the suggrasstional effort. I do thinksome some public information, some ad campaigns

(06:08):
that's going to help too. Butwhen it comes down to it, I
think what we have to do.It's a part of parenting. As we
know, once you have our children, they become just offspring. There are
thoughts they can do what they wantto do. We still have a lot
of responsibility to them, and Ithink, um, we have we have
some some credibility, credibility with themin terms of um you know, like

(06:30):
I always telling us where you're going, I've already been there, and so
now I'm telling you this is whatyou have to do. And sometimes I
share with them some anecdotes, uhin my practice when I'm seeing men who
they say they wish that. Umso those I think that's where it starts.
It starts with us parenting um O, our young men to help them

(06:51):
understand this is important. This isjust as important as being a bread winner,
so to speak. Doctor Delvina,any any idea, any recommendations on
how we can address these societal barriersand misconceptions. Yes, I like what
doctor Rayley said about prevention, becauseprevention is so important. So prevention and

(07:13):
the attitude of prevention starts in ourhouseholds. It starts when our children are
young, so we can teach them. Ensuring that people know to take their
kids to the pediatrician for those wellchild visits. That's what sort of sets
the pace and sets the standard sothat your kids know that there are certain
things we must do at certain ages, and that continues into adulthood. The

(07:34):
other thing I'll add is self love. If we love ourselves, will take
care of ourselves. So taking careof yourself includes the prevention piece. Prevention
includes going to your wellness visits,getting your blood pressure check, getting your
cholesterol check, getting that EKG bythe time you're forty, getting that colonoscopy.

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And if folks look like you andme and doctor Rayley, they should
get that colonoscopy when they in theirforties isation and be waiting until they're in
their fifties. But you don't learnthese types of things unless you go to
the doctor. So self love,I think really just it trumps everything because
if you love yourself, you'll takecare of yourself. So doctor, really,

(08:15):
I want to ask you a followup question based so much to what
doctor Delvina said, and that isyou know when we talk about self love,
I rarely hear that in a conversationsurrounding men and having men having self
love for themselves. So can youaddress that place from your experience? You
know when when when she said that, I'm like, well, wow,

(08:37):
yeah, that's so that the topof list, which is why men have
a hard time with it, Becausewe have a hard time with that thing
called love. I mean, that'sjust not part of our certain way and
part of mine, right, AndI think you can talk to anybody if
that's around me, if I don'tcare where I am, if I'm finishing
up the phone conversation with any oneof my sons. We always he sees

(09:00):
for managed that love you to hisdaughter in public, But can you say
it to your son and publican meaningand not feel weird about it? So
I do think that's the that's thebiggest issue, and so we have to
we have to in this grados effort, and we've got we've got to help
men, young men understand what itmeans, what it needs to love yourself?

(09:24):
What does that mean? How doesthat playing? Yeah, So then
then the follow up would be,so how do you know what love is?
But then Also, because we're talkingabout mental health, how do you
know if you're what are the signsto let someone know that, hey,
you might be in mental distress andyou may need some professional help. Anything

(09:48):
that's different than their usual routine istypically a red flag. Um So,
if they're doing things differently, ifthey're behaving differently, if they look like
they're us engaged. If you knowthe person personally and you live with them,
let's say, as your child orit's your significant other, you may
notice changes in their appetite. Maybethey're eating a lot more than they usually

(10:11):
do, or they're eating a lotless than they usually doom. Maybe they're
sleep hygiene or their sleep habits havechanged. They have difficulty falling asleep,
they're staying up late into the night, they have multiple nighttime awakenings during the
night, so you're hearing them aroundthe house. Maybe they're turning on the
television. They might appear sad toyou. They may look like something's wrong.

(10:33):
Oftentimes a lot of women will cry. Men don't cry, and typically
men are not going to walk aroundmoping and looking sad. However, they
may get angry easier, they maybe snappy. Oftentimes men also lose interest
in their insects and sexual appetite,their libido decreases. That is a telltale

(10:54):
sign of depression in men as well. So there are a lot of different
ways you can tell that someone isnot themselves and maybe in emotional distress or
engaging or experiencing a crisis. Doctor, really, what you like to add
to that? Um, you knowthis is going to sound like a mutual

(11:16):
admiration society, But I think Ithink doctor Thomas really did a good job
and covering all of that. Theonly I would say that would or maybe
we can use these things. Itry to use those things, especially the
leado quite honestly as a hook mancorberate, because if you're going to get
if you're gonna move with man,that's the thing you have to move in

(11:37):
with. That's the thing. Becausethey you know, they take that really
seriously, but they don't understand allthis. It's sort of like you know,
you want to lose weight, butyou know you have a piece of
pound cake every night before you goto bed. I mean that's kind of
you know, that's kind of counterintuitive, and so we have to help men
understand that it's the same thing there. I mean, if you say you
want to you want to be young. So it's then you have to do

(12:01):
things that people do or get ora functional way of doing people doing that
energy and you maintain your energy byby exercise and by taking care of yourself.
If you have an issue, goto doctor M's That I think is
the only thing I give today.So I want to segue into you know
how cannabis plays a role when itcomes to being a treatment for someone that's

(12:26):
experiencing a mental health issue. 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
for someone who has PTSD or qualifyingcondition related to their mental health. So

(12:52):
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 to
treat depression and or anxiety or PTSD. The caveat here is that PTSD post

(13:18):
traumatic stress disorder doesn't have necessarily amedication specific only for PTSD. So what
happens when we're treating folks with PTSD, we're pulling from a variety of categories
of medications to try to attenuate theiranxiety, to help them sleep so they
can have less nightmares, maybe tohelp boost their libido if libido's an issue

(13:45):
for them, because libido and aswell as erectile dysfunction is commonly seen in
men who have PTSD, So youhave to look at all those target symptoms
and address those things. If someonehas tried medication, and they've tried different
medications to no avail, that's whenI start thinking about medicinal cannabis. They've

(14:07):
also tried psychotherapy. I talked toall of my patients and their initial assessment
about their diet. I talked tothem 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 sometimes youcan have physical situations that are influencing the
mental stuff, such as your thyroid, So we have to do a comprehensive

(14:31):
assessment. You know, I wasone of those people in the past that
did not believe in the use ofcannabis. But when you do the research
and from seeing with my own Iseeing my patients and how some of them
still struggled. I had a ladywho went through every classification of an antidepressant

(14:52):
to treat her symptoms. And thiswas this woman was a principle, She
had integrity. I had no reasonnot to bel lead 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
her sleep issue that was associated withher depressive illness. So everyone is different.

(15:15):
I have colleagues who will suggest medicinalcannabis right off the bat, immediately
in the treatment plan. For me, I try to do other things first
and lead that as kind of notnecessarily the last resort, but not the
first primary thing that we that wego to. Yeah, and doctor Raley,
I know that you're not a qualifyingphysician for the medical cannabis here in

(15:37):
Florida, but you had you sharedwith me that you do have patients that
come to you and say, Doc, how can I get a weed card?
So tell me how you respond tothose requests from your patients. Well,
I'm trying to inflication piece. Ikind of talking about the things that
I personally feel about that is ofthe exercise and health diet source of things.

(16:03):
But I also share with them thatprobably if they go to anyone,
any any prescriber who's uh, who'sdoing it the right way, they're not
going to give them that. They'regoing to ask them have it done these
things? So go ahead and trythis stuff now, and I will refer
you to a psychiatrist, and andand and together you guys can make that
determination. But you can already tellat that point, we can tell the

(16:25):
psychiatrist, well, I've done allthis stuff in my referral documentation out you
know, I'll monitor all that andI'll put that in there. I think,
um, I think at that pointa good psychiatrist is gonna it's gonna
take that to I mean, they'regonna put more value what this patient is
saying because they try some other stufffirst, just like just like an example,

(16:47):
she said, with the principle,I mean, that's the kind of
thing you want to see first.So and I gave you some of validation
that this person is not just comingto you just for a quote unquot we
come. Yeah, yeah. SoI think that's a great segue into my
next question. And then doctor Delvina, I think this would be a good
response, good one for you.What are some of the benefits of using
medical marijuana as a mental health treatment? Wow? For some people it's the

(17:12):
only thing that helps them to sleep. The thing about inducing sleep for folks
who they may have had a sleepstudy, they may have tried over the
counter things like vina drille aka diphenhydramine, melatonin, and so in my office,

(17:33):
myself and my practitioners, we don'tjump straight to the narcotics, to
the controlled substances to induce sleep.You're doing a big disservice to a patient
when you just give them ambient offthe bat, you give them to masapam
right off the bat, you givethem luness the right away. It's a
disservice because those things have addictive potential, whereas what medicinal cannabis. We're using

(17:56):
a low quantity of cannabis to treatpatients and to help them relieve whatever symptom
that may be Medicinal cannabis does notcause euphoria. It doesn't make people high,
which is why some folks who loveresorting to street cannabis, some of
them don't appreciate the cannabis that youacquire in the dispensary or from a certification.

(18:22):
So I've seen it relieve insomnia andpatience. We know that when folks
are not sleeping, that can bea vicious cycle. When you don't sleep,
it ruins your mood. The nextmorning, you wake up cranky,
you wake up disenchanted, You're irritable. That may cause issues with the people
you're interacting with because you're irritable andyou can't manage that. It can lead

(18:45):
to higher rates of excuse me,higher rates of depression. It can worse
than anxiety. So sleep, notsleeping after several days can be detrimental to
a person's mental health. I've seenmedicinal cannabis help people who having anxiety disorders.
Everyone again does not respond to thetraditional medication that's offered in our pharmacies.

(19:08):
And again, the easy fix thatsome of my physician colleagues will do
is give someone some addivan or somecolonipin. Those things lead to issues with
cognition, the ability to think andrecall and maintain information and recall information.
Those things are associated with premature onsetof dementia. So additional cannabis is not

(19:32):
associated with dementia. It's not associatedwith addictive potential. So that's where I
appreciate the difference between the two.Okay, so then we talked about the
benefits. What are the risks ofusing medical cannabis? Yes, yes,
So this is why it's important forpatients to go to a qualified certifier,

(19:56):
which a qualified certifier will be aposition, but you want to go to
someone who seems like they care aboutyou. They're not just charging you money
to come in and get this cardand then you know, after five minutes
you're on your way. You wantthis person to sit down with you and
take your history, because this personshould be asking you things like does your

(20:17):
family have a history of schizophrenia,is there a history of any type of
psychosis? Is there a history ofbipolar or mania in your family? Because
those things would present a concern.We know from old studies. I was
telling you, miss Otway that whenI was in residency back in the early
two thousands, we saw studies thatstreet marijuana weed Mary Jane could actually induce

(20:42):
psychosis, and it induces psychosis alot, and our young boys and our
young men. So for me,I don't endorse medicinal cannabis for anyone under
the age of anyone who's not intheir twenties, because the brain is still
developing well into our mid twenties.We know the brain is probably still developing

(21:03):
until the age of twenty five.So if you introduce any type of cannabinoid
in amounts that are more than thenormal baseline amount that our bodies and our
brains are used to, and there'sa risk or there's a family history of
schizophrenia, there might be some induction. Now we know the levels are lower
and medicinal, but you still haveto be cautious. So I'm not a

(21:26):
person who supports medicinal cannabis and achild for qualifying illnesses like seizure disorder.
I'm a psychiatrist first, so andI've seen the impact and the consequences that's
created for folks who did not knowthey were amenable to psychotic episodes or high
risk for those things. Yeah,doctor Riley, would you like to add

(21:48):
to that, what are the risksthat you see in your patients who may
come to you after using cannabis.You mean street cannabis or or yeah,
any kind of cannabis. Well,I've always had more faith and I'm additional
because I know that it's regulated andand and the way it is manufactured.

(22:11):
Uh, the TC levels of muchlower because I do know. Actually I
was having just a casual conversation withwith a Mental Health Council's apartment OFFCTS that
we've gotta talking about it is say, well, you need to know that
umkilos of TSHCU does affect exacerbate orit can It can it can cause um

(22:36):
latent uh psychotic features to sort ofcome to the surface really quickly. So,
Uh, that's why I believe ifwe're going to do it, then
it should be done the way it'sthe way it's being done now. Regulated.
Thank you so much you and doctorRiley for being guests on these Conversations
on Cannabis Live virtual form brought toyou by the Medical Marijuana Education and Research

(23:00):
Initiative at Florida and M University.Thank you to everyone watching this program.
Tell us what you think about thisform by completing the survey that will be
posted in the comment boxes on YouTubeand Facebook after this live program. If
you complete the survey, your namewill be entered into a drawing on August
eleventh, twenty twenty three, towin a one hundred dollars gift car provided

(23:22):
by one of Mary's partners. Wealso want to encourage you to go to
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obtain a legal medical marijuana card inthe state of Florida. We also encourage
you to go to the Florida andM University's MARY website to learn more about
this initiative, it's educational programs andadditional information about cannabis use in Florida.

(23:45):
Goodbye and thanks. The views andopinions of our invited guests are not necessarily
the views and opinions are Florida Agriculturaland Mechanical University or the Medical Marijuana Education
and Research Initiative.