Episode Transcript
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Speaker 1 (00:01):
From the WANM studio on the campus of Florida A
& M University, this is Mary Form Radio, a weekly
conversation on the education and research of medical marijuana being
conducted at FAMU. Hi, I'm Heidi Otway, your host for
this conversation on Cannabis Virtual Forum, brought to you by
the Medical Marijuana Education and Research Initiative at Florida A
(00:23):
& M University. In this conversation... We're talking about the
relationship between high-potency cannabis use and psychosis. So let's talk
and learn about this subject with our guest. Dr. Barry
Gordon has built a career working on the front lines
of the American healthcare system. After years of working in
emergency rooms, he established the Compassionate Cannabis Clinic in Florida
(00:48):
to treat patients with chronic illnesses through cannabis therapy.
Speaker 2 (00:52):
Dr.
Speaker 1 (00:52):
Barry, it's good to have you back on the forums.
Speaker 2 (00:55):
Listen, it's such an honor every time that you ask, Heidi,
and it's such a pleasure. Educating the public is what
it's always going to be about in medical cannabis, for sure.
Speaker 1 (01:05):
Exactly. And to everyone watching, please share the link to
this forum on your social media channels so others can
learn about this topic. We also want you to tell
us what you think about this forum by completing the
survey posted in Mary's social media pages. Your name will
be entered into a drawing in September 2026. to win
(01:26):
a $ 100 gift card provided by one of Mary's partners. Now,
let's start this conversation on cannabis. A number of studies
across the U.S. and Europe have found that cannabis use
is associated with an earlier onset of psychosis. The findings
add to a growing body of research examining the relationship
between cannabis use and high THC potency. Before we talk
(01:50):
about this correlation, Dr. Berry, can you explain what psychosis
is in layman's terms?
Speaker 2 (01:56):
Yeah, sure. You know, it's funny when you say in
layman's terms, you know, my training was in emergency medicine,
of course, and, you know, 34 years on the front line.
So I don't hold myself out to be a psychiatrist,
of course. But listen, psychosis is so critical and the
understanding of it and the complications from any substance, of course,
you know, and in the case of cannabis, it can
(02:17):
include psychosis, which is a Psychosis in general, it's a
disconnection from reality in some way, either hallucinations, which are
hearing things or seeing things, delusions where you believe either
a paranoid delusion that someone's chasing you or tracking you,
(02:38):
but a disconnection from the reality of the circumstance. And
you know, of course, can be very dangerous, very concerning,
can lead to trauma, suicidal, homicidal behaviors, you know, any
number of things. So it's surely a critical issue that
needs to be discussed in a very upfront and open fashion,
(03:01):
as once again, all substances will have their complications. And
we are seeing by research that there are absolute circumstances
that we need to be paying attention to. Yeah.
Speaker 1 (03:12):
So who is most at risk of developing psychosis? Are
there any, like, certain genetic, environmental, or behavioral factors that
can increase someone's risk?
Speaker 2 (03:21):
All of them, you know, Heidi, to that extent. So
you are going to see subsets that are going to
be more prone towards developing psychosis. And, you know, surely
the youngest, right? amongst us. We always need to be cautious,
especially in the teenage years, into the college years, definite
(03:41):
onset of many of the psychotic breaks, so to speak,
that we see. In the elderly as well, elderly on medications,
sometimes in the sleep deprivation or otherwise stress type of circumstances, alcohol, Absolutely.
So there are definitely things that can lead towards people
(04:05):
being more prone. There is absolutely a genetic component to psychosis. Interestingly,
one of the absolute contraindications towards the medical cannabis program
here in Florida is is a past history of psychosis
that's documented, and actually psychosis in a first-degree relative as well.
(04:27):
So the screening for the appropriate patient absolutely is critically important.
There are sets of patients that we worry about.
Speaker 1 (04:38):
Yeah, no, that's actually what my next question was going
to be. So for someone who's using medical cannabis, what
are the most important things that they should know about
their potential for psychosis, especially if they're using high THC doses.
Speaker 2 (04:52):
For sure. The other critical thing about the research, of course,
is what is the patient actually consuming? What's the potency
of the cannabis? How frequently are they using the cannabis?
What's the purpose of their cannabis use? It's very confusing
because we know that many patients at a younger age,
(05:14):
some start to use cannabis in an attempt to self-treat
some of their mental illness problems. There's always been that
discussion about causation and correlation that gets very difficult to
ascertain to the extent of, the amount of causation that
(05:35):
cannabis has in actually each specific case. But if you're
ignoring it as a general issue of concern, then that's
not fair. Anybody who's involved in medical cannabis seriously knows
of these risks. Pay attention to it, of course. And,
you know, we need more research, not less. We know that.
Speaker 1 (05:56):
And I would assume that as you're bringing in patients
who want to use legal medical cannabis, that you're screening
them to make sure that whatever you recommend for them
doesn't create mental health issues. Am I correct in that?
Speaker 2 (06:14):
Yes. It opens up the discussion, Heidi, to I think
really what's so important about today's discussion. First off, let's
make sure that we recognize the risk, right? Let's make
sure that we're beginning to accept the fact that cannabis
is not without its complications, both within the social setting,
of course. which has been around for years and will
(06:36):
always continue to be around, but also within other markets today.
We have the entire hemp market that is a major
part of today's discussion because a lot of the products
that we're seeing that are causing problems are not coming
out of the medical cannabis world. They're coming from the
Delta H space. from the hemp derived beverage space, things
(07:01):
that are not as well tested within the medical cannabis
space to the extent of labeling and potency and quality.
The medical products, of course, have their potency, their labeling,
So you have the legal adult use world in some states.
(07:21):
You have the medical world here in Florida. You have
what we call the gray market world, which are the
smoke shop, gas station products. And then you have the
legacy market world. So there's different qualities of cannabis, different
potencies of cannabis, different ways of using your cannabis, be
it orally, tincture, smokable inhaled form. So it's a little
(07:47):
bit more complicated than just simply stating that this particular
product is going to cause this particular complication. There's an
entire spectrum these days of various cannabinoids and various ways
of using them. So it's a great time to have
the discussion because we're seeing a lot of movement at
the federal level. Here at the state level, there'll be
(08:09):
some trickle-down effects, but it's always going to be about
public health, public education, and public safety in every venue.
A lot of your listeners may not remember, but I
was the chief physician spokesman during the Amendment 3 campaign,
now almost two years ago. That was me on the
television commercials. I'm standing up for what I do believe
(08:33):
as both emergency medicine physician and medical cannabis physician is
that public health, public safety. and public education are always
going to be what's most important. And anybody that uses
a cannabinoid in the state of Florida should always be
able to access it in the safest manner possible, which
(08:56):
to me is going to be a regulated system with
the appropriate childproof packaging and age gating with the appropriate
labeling as to what exactly is in that product with
the appropriate testing standards. And absolutely in the best case
scenario should always come with that education behind it. Now
(09:17):
here in Florida, in the doctor office environment, that's the ideal.
Does that go on in every case and setting? Unfortunately not.
And I still think there's a high standard that every
doctor and every clinic should be meeting here in Florida
to make sure that every patient gets that initial education.
Speaker 1 (09:36):
Yeah. So, so as you were talking about, um, what
you've experienced and what you've done. I'm just thinking about
that patient who's listening right now. And we're seeing this
research that says that, you know, there is a potential
for psychosis based on what you take from modalities to dosing.
So what's your advice to them to ensure that if
(09:59):
they are using chemo, legally in the state of Florida,
that they are not putting themselves at risk?
Speaker 2 (10:07):
Great question. So here's the key thing is that you
must recognize that the potency does make a difference. The
frequency does make a difference. The ratio of THC and
the other cannabinoids absolutely does make a difference. So I
(10:27):
think the first thing to recognize is that not all products,
not all medicines are gonna be created equal, right? We
need to remember that Delta 9 THC is the main
active ingredient in cannabis, right? Always has been, always will be.
In the old days, that potency of the Delta 9
(10:48):
THC may be a 2% to 3%, 5% to 7%, right?
In today's cannabis products, in the flower products, you'll see 20%, 25%,
up to 30%. Is that necessarily dangerous as compared to
the 3% to 7%? No, in no way, shape, or form.
(11:09):
There's not going to be any respiratory depression additions, right?
Is any exposure to that in a short-term basis going
to cause psychosis as compared to the 3% to 7% product?
I don't think any research has ever shown that, right?
But you have to understand that that Delta-9 THC is
the main ingredient in in your cannabis, and the potency
(11:32):
will always be discussed to that extent. The other cannabinoids, CBD, CBC, CBG,
are what's called the minor cannabinoids. They don't participate in
that intoxication effect of cannabis, thus presumably not that psychotic
(11:54):
inducing effect as well. So a balanced product with THC
and the other cannabinoids seemingly would be a product that
by potency should be a less psychotic inducer, right? So
you want to make sure that you're getting the advice
of your doctor to the extent of the potency of
(12:17):
the cannabis product, to the extent of THC, but also
the use of the other cannabinoids, right? Yeah. We know
that a lot of our patients, even though they do
take a cannabis product daily, many of my patients take
a gummy at night for sleep, right? Mm-hmm. And to
that extent, even though it's a daily use type of circumstance,
(12:41):
the vast majority of our patients never have any psychotic issues,
any psychotic concerns. That's why while we pay attention to
the research, we surely are not stopping us. It's not
stopping us from making sure that each and every patient
is getting the appropriate advice and the appropriate products. So
(13:04):
it is a concern. We need to screen our patients
to that extent and know who's more at risk than
others and then try to recommend the appropriate products for them.
But it's a potency and a frequency issue. So to
a certain extent, with the right advice, we personally, in
the 10 years now, Heidi, that my clinic's been operating,
(13:25):
which is a, right, 10 years. How could we have
been doing it this long? But we have. So we
have a really large body of evidence within the clinic
that in general adult patients with the appropriate products and
the appropriate advice can very safely utilize cannabis and not
have these psychotic concerns. So while we know of the
(13:48):
issues and the problems, we know of the things proactively
that we can do to prevent them. Yeah.
Speaker 1 (13:54):
So does the age someone begins using cannabis matter when
it comes to psychosis risk?
Speaker 2 (14:01):
Age is important. Absolutely. And we know that anybody under
the age of 25 still has a developing brain. We
know that. That's why every single patient under the age
of 25 that comes into my clinic always gets that
discussion to respect age. the developing brain, right? And to
(14:21):
make sure that they don't overuse their cannabis products. You
have to remember that the patients that come into the
medical clinic in general, they want the same three things,
no matter what their age. They want to feel the
best they can. They want to try to do it
the safest, most controlled by them way that they can.
And they want to be legal in doing so. Here
(14:43):
in Florida, the beauty of that is that those patients
do come in through a medical system where they should
receive the appropriate advice on the appropriate usage, reasons and purposes,
and the amounts and the way they're going to use it.
So people talk about a legal adult use system, which
(15:06):
may or may not come to Florida. I think inevitably,
of course, it will. And at that time, we need
to make sure that FAMU, and I give you all
the credit for making sure that this public education message
that you've always delivered is going to continue to be
delivered as we move forward in whatever that's going to
(15:28):
look like here in Florida. We know that there are
products out there now, the Delta 9 hemp-derived beverages, for example,
10 milligrams per can. Those have been out there. And
we'll see what the Farm Bill loophole tie up around
December or so. We don't know what it's going to
look like yet. Drinks are not going to go away.
(15:51):
My prediction is big alcohol will probably get control of
that sector. They're going to have to figure out what
to do about the hemp-derived Delta 9 gummies, be it
10 milligram or 5 milligram that are sold in the
smoke shop setting. you know, right now and things of
that nature. So you can be an adult and be
(16:13):
exposed to cannabinoids, not just through the medical world these
days or the legacy world. There's a lot of different ways.
I always make the point, you can go to the
wrong doctor office and not get the appropriate education within
the doctor office setting be a new timer to cannabis
(16:33):
and walk out of your medical dispensary with a completely
inappropriate product yeah right that may end up you up
in the emergency room that happens thank goodness all those
patients go home the next day But an overtoxicity or
an overexposure to Delta-9 THC, Delta-8 THC, other intoxicating cannabinoids
(16:57):
without the right education can end you up in the
emergency room. Overexposures and toxicities to THC are very uncomfortable,
and they're expensive too. If your dog or your cat
get into gummies, They may get a $ 5, 000 overnight ER
(17:17):
veterinary visit. And no five-year-old ever smoked a joint. But
they will find gummies now.
Speaker 1 (17:23):
Yeah, that's what I was going to ask you about that.
What should parents know, especially those who may be concerned
about their kid using these products?
Speaker 2 (17:34):
With your teenager, know what's going on in their life.
I had a high school counselor the other day. I
was talking to her, extensive conversation about what are the
teenagers doing, you know, in the bathrooms and behind the school?
What are they vaping, right? In general, it's a Delta
8 vape from a smoke shop, something bought on the internet,
(17:54):
something bought on the legacy market, completely untested. We know
that a lot of those products have a significant amount
of Delta 9 THC in them, you know, There's stuff
bought on the legacy market. So if you have a
team these days, you need to be acutely aware of
what's going on, you know, there. What I did tell
(18:14):
the counselor, what I was fairly certain of was that
what they're not using in the bathroom is a behind
the school or medical cannabis products, medical cannabis patients products.
are very protective of their medicines. They are. That's not
to say that no child has ever found grandma or
grandpa or parents gummies. It happens. It's rare, but it happens.
(18:37):
Or their vape or whatever. But what much more common
would be that product purchased outside of the medical environment
that's not treated with the same amount of respect. So
you have to be concerned with all of those exposures
And they do exist. And if you deny that they exist,
then you're also not on the right side of the
recognition of every substance has its uses and the potential
(19:02):
for abuse. Fortunately for cannabis, it's never a danger towards death,
but can be uncomfortable and expensive. Yeah.
Speaker 1 (19:09):
Well, earlier in the program, you kind of laid out
what people could experience if they're using cannabis and they
experience symptoms of psychosis. So you mentioned hallucinations, paranoia, delusions,
and these other symptoms. So let's say someone does use
a cannabis product, whether it's medical or illicit, what should
(19:32):
they do and how quickly should they seek professional help?
Speaker 2 (19:35):
Yeah, it's a great question, Heidi, because once again, you
have to remember emergency room physician, you know, that I am,
you know, obviously we think safety first, you're going to
think safety of self, safety of patient, of course. And listen, um,
certain things that were always the, you know, case in
the emergency medicine environment, any suspicion of abuse, quite frankly,
(19:57):
suspicion of suicidal ideation, things like that. You're obligated to
act upon those things. And I would say that to
the extent of any family member or friend, If you
see acute danger to self or others, then that's an
immediate step in. That's a 911 call. That's activate the
system to get the assistance that you may need acutely.
(20:20):
I think more commonly it would be just a recognition
that something's not right with your loved one or your friend, okay?
That could be anything from not maintaining the normal activities
of daily living, okay? Somebody that's not going to work,
somebody that's not eating or sleeping appropriately, you know? Obviously,
(20:41):
anybody that's complaining of delusions, paranoia, hallucinations, those are the
kind of things that, quite frankly, you may not need
to call 911 about. Absolutely should be addressed with either
the primary care physician, if that exists and is involved. Absolutely,
the medical cannabis clinician, if the person's involved in the
(21:03):
medical side. So it's important to recognize, once again, that
911 type of circumstance. And then so that would be
the emergent. And then, of course, the urgent would be
just a recognition that something's not right. You don't want
things to continue. You don't want things to spiral. You know,
so I think when you notice a hallucination circumstance or
(21:25):
significant delusions, that's when you're obligated to step in. Listen,
we now and again, it's rare. You know, patient will
be Baker acted. You know, that's for protection of self
and family and others. And, you know, that happens, but rare,
you know, in the practice. And I'm very gratified to
the extent that we have very little psychiatric impact you know,
(21:48):
within our practice. And that's true. In fact, we get
patients referred now in from the psychiatric environment. That's an
interesting circumstance. Now patients feel a little bit more comfortable
in bringing it up to their psychiatrist within the psychiatric environment.
And I always advise my patients to make sure that
(22:08):
every other doctor that they see is aware of them
being in the medical cannabis program. That's a key thing.
I have an entire lecture on my computer. It's called
how to talk to your doctor about medical cannabis. My
suggestion is to always bring it up right in the encounter.
But sometimes you leave yourself out of the initial conversation.
(22:29):
So you see how your provider, your practitioner is going
to come back at you. Because if you know that
cannabis is working well for you, right. You don't necessarily
want them to say, hey, you know, that's a drug, pot, dope, weed, grass. So,
you know, I always recommend the patient bring it up
in third person. How do you feel about the medical
(22:51):
cannabis program? Do you have any patients in the medical
cannabis program? If you say any other patients, then you're
outing yourself. To keep a third person. But my point is,
many psychiatric providers now recognize that their patients are going
to use cannabis. They'd rather have them using it safely,
(23:14):
appropriate testing with a doctor on the other side who's
advising them. And the interesting circumstance is sometimes that patient
will tell their psychiatric doctor, you have me on three
different meds, but I'm only taking one because cannabis has
supplanted the other two. So to me, that's why the
(23:35):
honesty between provider and patient is always critical. So that
type of don't ask type of thing still goes on
in hospitals. People go in for surgeries. I want the
surgeon to know. I want the anesthesiologist to know. I
want everybody to know that that patient has their medical
cannabis card. We're not quite there, but we're so much
(23:58):
better off than we were 10 years ago.
Speaker 1 (24:00):
Yeah, that's really interesting.
Speaker 2 (24:02):
Yeah. It's that honest discussion prompted by you. And I
mean it, FAMU and Mary and the whole bit that's
continuing to facilitate that. And it's going to be a
long-term process in Florida, you know, with the clinic being
open for 10 years now. And Heidi, thank you so
much for every bit of it. It's the long game.
It is. It's the long game. Nothing happens in a
(24:25):
day or a month. It's continued discussion of this public health,
public education, public safety focus.
Speaker 1 (24:32):
Yeah. So as we wrap up this conversation, which has
been very enlightening to me, and I'm sure our listeners
and viewers, if you could leave one takeaway about this
topic on cannabis and psychosis, what do you want people
to know and remember?
Speaker 2 (24:49):
For sure. Listen, I have a lot of quick phrases
and this is one of them. It's respect the patient,
respect the plant. You have to respect the patient to
give them the education that each and every one of
them is looking for. You have to respect the patient
in making sure that you're doing the appropriate screening, right?
And you're making sure that that patient has the appropriate
(25:12):
expectations about what they can and should be getting out
of their usage of cannabis. Then you have to respect
the plant for what it is and what it does.
We have an endocannabinoid system within us. And then we
have the phyto cannabinoids within the miracle cannabis plant, but
you had to respect it for all the positives, of course,
(25:35):
but some of the negatives too, it's a medicine, it's
a substance and it needs to be treated as such.
So if you respect both the patient with education and
the plant for the positives and the negatives, then that's
where the magic occurs with the appropriate usage of cannabis
for And, you know, we're always going to continue to
(25:57):
be here to try and preach that public health, public safety,
public education message.
Speaker 1 (26:03):
Yeah. Well, Dr. Berry, I want to thank you so
much for being a guest on this conversation on Cannabis
Virtual Forum, brought to you by the Medical Marijuana Education
and Research Initiative at Florida A & M University. Thank
you to everyone watching this program. Tell us what you
think about this forum by completing the survey posted in
the comment boxes on Mary's Facebook and YouTube pages. If
(26:24):
you complete the survey, your name will be entered into
a drawing in September 2026 to win a $ 100 gift
card provided by one of Mary's partners. Stay connected with
FAMU Mary to access educational information and resources about legal
medical cannabis use and the consequences of illegal marijuana use
in Florida. You can follow them on their social media
(26:48):
pages or visit their FAMU Mary website. We also want
to encourage you to go to the Florida Department of
Health Office of Medical Marijuana Use website to learn how
to obtain a legal medical marijuana card in the state
of Florida. Thanks, everyone.
Speaker 2 (27:06):
The views and opinions of our invited guests are not
necessarily the views and opinions of Florida Agricultural and Mechanical
University or the Medical Marijuana Education and Research Initiative.
From the WANM studio on the campus of Florida A
& M University, this is Mary Form Radio, a weekly
conversation on the education and research of medical marijuana being
conducted at FAMU. Hi, I'm Heidi Otway, your host for
this conversation on Cannabis Virtual Forum, brought to you by
the Medical Marijuana Education and Research Initiative at Florida A
(00:23):
& M University. In this conversation... We're talking about the
relationship between high-potency cannabis use and psychosis. So let's talk
and learn about this subject with our guest. Dr. Barry
Gordon has built a career working on the front lines
of the American healthcare system. After years of working in
emergency rooms, he established the Compassionate Cannabis Clinic in Florida
(00:48):
to treat patients with chronic illnesses through cannabis therapy.
Speaker 2 (00:52):
Dr.
Speaker 1 (00:52):
Barry, it's good to have you back on the forums.
Speaker 2 (00:55):
Listen, it's such an honor every time that you ask, Heidi,
and it's such a pleasure. Educating the public is what
it's always going to be about in medical cannabis, for sure.
Speaker 1 (01:05):
Exactly. And to everyone watching, please share the link to
this forum on your social media channels so others can
learn about this topic. We also want you to tell
us what you think about this forum by completing the
survey posted in Mary's social media pages. Your name will
be entered into a drawing in September 2026. to win
(01:26):
a $ 100 gift card provided by one of Mary's partners. Now,
let's start this conversation on cannabis. A number of studies
across the U.S. and Europe have found that cannabis use
is associated with an earlier onset of psychosis. The findings
add to a growing body of research examining the relationship
between cannabis use and high THC potency. Before we talk
(01:50):
about this correlation, Dr. Berry, can you explain what psychosis
is in layman's terms?
Speaker 2 (01:56):
Yeah, sure. You know, it's funny when you say in
layman's terms, you know, my training was in emergency medicine,
of course, and, you know, 34 years on the front line.
So I don't hold myself out to be a psychiatrist,
of course. But listen, psychosis is so critical and the
understanding of it and the complications from any substance, of course,
you know, and in the case of cannabis, it can
(02:17):
include psychosis, which is a Psychosis in general, it's a
disconnection from reality in some way, either hallucinations, which are
hearing things or seeing things, delusions where you believe either
a paranoid delusion that someone's chasing you or tracking you,
(02:38):
but a disconnection from the reality of the circumstance. And
you know, of course, can be very dangerous, very concerning,
can lead to trauma, suicidal, homicidal behaviors, you know, any
number of things. So it's surely a critical issue that
needs to be discussed in a very upfront and open fashion,
(03:01):
as once again, all substances will have their complications. And
we are seeing by research that there are absolute circumstances
that we need to be paying attention to. Yeah.
Speaker 1 (03:12):
So who is most at risk of developing psychosis? Are
there any, like, certain genetic, environmental, or behavioral factors that
can increase someone's risk?
Speaker 2 (03:21):
All of them, you know, Heidi, to that extent. So
you are going to see subsets that are going to
be more prone towards developing psychosis. And, you know, surely
the youngest, right? amongst us. We always need to be cautious,
especially in the teenage years, into the college years, definite
(03:41):
onset of many of the psychotic breaks, so to speak,
that we see. In the elderly as well, elderly on medications,
sometimes in the sleep deprivation or otherwise stress type of circumstances, alcohol, Absolutely.
So there are definitely things that can lead towards people
(04:05):
being more prone. There is absolutely a genetic component to psychosis. Interestingly,
one of the absolute contraindications towards the medical cannabis program
here in Florida is is a past history of psychosis
that's documented, and actually psychosis in a first-degree relative as well.
(04:27):
So the screening for the appropriate patient absolutely is critically important.
There are sets of patients that we worry about.
Speaker 1 (04:38):
Yeah, no, that's actually what my next question was going
to be. So for someone who's using medical cannabis, what
are the most important things that they should know about
their potential for psychosis, especially if they're using high THC doses.
Speaker 2 (04:52):
For sure. The other critical thing about the research, of course,
is what is the patient actually consuming? What's the potency
of the cannabis? How frequently are they using the cannabis?
What's the purpose of their cannabis use? It's very confusing
because we know that many patients at a younger age,
(05:14):
some start to use cannabis in an attempt to self-treat
some of their mental illness problems. There's always been that
discussion about causation and correlation that gets very difficult to
ascertain to the extent of, the amount of causation that
(05:35):
cannabis has in actually each specific case. But if you're
ignoring it as a general issue of concern, then that's
not fair. Anybody who's involved in medical cannabis seriously knows
of these risks. Pay attention to it, of course. And,
you know, we need more research, not less. We know that.
Speaker 1 (05:56):
And I would assume that as you're bringing in patients
who want to use legal medical cannabis, that you're screening
them to make sure that whatever you recommend for them
doesn't create mental health issues. Am I correct in that?
Speaker 2 (06:14):
Yes. It opens up the discussion, Heidi, to I think
really what's so important about today's discussion. First off, let's
make sure that we recognize the risk, right? Let's make
sure that we're beginning to accept the fact that cannabis
is not without its complications, both within the social setting,
of course. which has been around for years and will
(06:36):
always continue to be around, but also within other markets today.
We have the entire hemp market that is a major
part of today's discussion because a lot of the products
that we're seeing that are causing problems are not coming
out of the medical cannabis world. They're coming from the
Delta H space. from the hemp derived beverage space, things
(07:01):
that are not as well tested within the medical cannabis
space to the extent of labeling and potency and quality.
The medical products, of course, have their potency, their labeling,
So you have the legal adult use world in some states.
(07:21):
You have the medical world here in Florida. You have
what we call the gray market world, which are the
smoke shop, gas station products. And then you have the
legacy market world. So there's different qualities of cannabis, different
potencies of cannabis, different ways of using your cannabis, be
it orally, tincture, smokable inhaled form. So it's a little
(07:47):
bit more complicated than just simply stating that this particular
product is going to cause this particular complication. There's an
entire spectrum these days of various cannabinoids and various ways
of using them. So it's a great time to have
the discussion because we're seeing a lot of movement at
the federal level. Here at the state level, there'll be
(08:09):
some trickle-down effects, but it's always going to be about
public health, public education, and public safety in every venue.
A lot of your listeners may not remember, but I
was the chief physician spokesman during the Amendment 3 campaign,
now almost two years ago. That was me on the
television commercials. I'm standing up for what I do believe
(08:33):
as both emergency medicine physician and medical cannabis physician is
that public health, public safety. and public education are always
going to be what's most important. And anybody that uses
a cannabinoid in the state of Florida should always be
able to access it in the safest manner possible, which
(08:56):
to me is going to be a regulated system with
the appropriate childproof packaging and age gating with the appropriate
labeling as to what exactly is in that product with
the appropriate testing standards. And absolutely in the best case
scenario should always come with that education behind it. Now
(09:17):
here in Florida, in the doctor office environment, that's the ideal.
Does that go on in every case and setting? Unfortunately not.
And I still think there's a high standard that every
doctor and every clinic should be meeting here in Florida
to make sure that every patient gets that initial education.
Speaker 1 (09:36):
Yeah. So, so as you were talking about, um, what
you've experienced and what you've done. I'm just thinking about
that patient who's listening right now. And we're seeing this
research that says that, you know, there is a potential
for psychosis based on what you take from modalities to dosing.
So what's your advice to them to ensure that if
(09:59):
they are using chemo, legally in the state of Florida,
that they are not putting themselves at risk?
Speaker 2 (10:07):
Great question. So here's the key thing is that you
must recognize that the potency does make a difference. The
frequency does make a difference. The ratio of THC and
the other cannabinoids absolutely does make a difference. So I
(10:27):
think the first thing to recognize is that not all products,
not all medicines are gonna be created equal, right? We
need to remember that Delta 9 THC is the main
active ingredient in cannabis, right? Always has been, always will be.
In the old days, that potency of the Delta 9
(10:48):
THC may be a 2% to 3%, 5% to 7%, right?
In today's cannabis products, in the flower products, you'll see 20%, 25%,
up to 30%. Is that necessarily dangerous as compared to
the 3% to 7%? No, in no way, shape, or form.
(11:09):
There's not going to be any respiratory depression additions, right?
Is any exposure to that in a short-term basis going
to cause psychosis as compared to the 3% to 7% product?
I don't think any research has ever shown that, right?
But you have to understand that that Delta-9 THC is
the main ingredient in in your cannabis, and the potency
(11:32):
will always be discussed to that extent. The other cannabinoids, CBD, CBC, CBG,
are what's called the minor cannabinoids. They don't participate in
that intoxication effect of cannabis, thus presumably not that psychotic
(11:54):
inducing effect as well. So a balanced product with THC
and the other cannabinoids seemingly would be a product that
by potency should be a less psychotic inducer, right? So
you want to make sure that you're getting the advice
of your doctor to the extent of the potency of
(12:17):
the cannabis product, to the extent of THC, but also
the use of the other cannabinoids, right? Yeah. We know
that a lot of our patients, even though they do
take a cannabis product daily, many of my patients take
a gummy at night for sleep, right? Mm-hmm. And to
that extent, even though it's a daily use type of circumstance,
(12:41):
the vast majority of our patients never have any psychotic issues,
any psychotic concerns. That's why while we pay attention to
the research, we surely are not stopping us. It's not
stopping us from making sure that each and every patient
is getting the appropriate advice and the appropriate products. So
(13:04):
it is a concern. We need to screen our patients
to that extent and know who's more at risk than
others and then try to recommend the appropriate products for them.
But it's a potency and a frequency issue. So to
a certain extent, with the right advice, we personally, in
the 10 years now, Heidi, that my clinic's been operating,
(13:25):
which is a, right, 10 years. How could we have
been doing it this long? But we have. So we
have a really large body of evidence within the clinic
that in general adult patients with the appropriate products and
the appropriate advice can very safely utilize cannabis and not
have these psychotic concerns. So while we know of the
(13:48):
issues and the problems, we know of the things proactively
that we can do to prevent them. Yeah.
Speaker 1 (13:54):
So does the age someone begins using cannabis matter when
it comes to psychosis risk?
Speaker 2 (14:01):
Age is important. Absolutely. And we know that anybody under
the age of 25 still has a developing brain. We
know that. That's why every single patient under the age
of 25 that comes into my clinic always gets that
discussion to respect age. the developing brain, right? And to
(14:21):
make sure that they don't overuse their cannabis products. You
have to remember that the patients that come into the
medical clinic in general, they want the same three things,
no matter what their age. They want to feel the
best they can. They want to try to do it
the safest, most controlled by them way that they can.
And they want to be legal in doing so. Here
(14:43):
in Florida, the beauty of that is that those patients
do come in through a medical system where they should
receive the appropriate advice on the appropriate usage, reasons and purposes,
and the amounts and the way they're going to use it.
So people talk about a legal adult use system, which
(15:06):
may or may not come to Florida. I think inevitably,
of course, it will. And at that time, we need
to make sure that FAMU, and I give you all
the credit for making sure that this public education message
that you've always delivered is going to continue to be
delivered as we move forward in whatever that's going to
(15:28):
look like here in Florida. We know that there are
products out there now, the Delta 9 hemp-derived beverages, for example,
10 milligrams per can. Those have been out there. And
we'll see what the Farm Bill loophole tie up around
December or so. We don't know what it's going to
look like yet. Drinks are not going to go away.
(15:51):
My prediction is big alcohol will probably get control of
that sector. They're going to have to figure out what
to do about the hemp-derived Delta 9 gummies, be it
10 milligram or 5 milligram that are sold in the
smoke shop setting. you know, right now and things of
that nature. So you can be an adult and be
(16:13):
exposed to cannabinoids, not just through the medical world these
days or the legacy world. There's a lot of different ways.
I always make the point, you can go to the
wrong doctor office and not get the appropriate education within
the doctor office setting be a new timer to cannabis
(16:33):
and walk out of your medical dispensary with a completely
inappropriate product yeah right that may end up you up
in the emergency room that happens thank goodness all those
patients go home the next day But an overtoxicity or
an overexposure to Delta-9 THC, Delta-8 THC, other intoxicating cannabinoids
(16:57):
without the right education can end you up in the
emergency room. Overexposures and toxicities to THC are very uncomfortable,
and they're expensive too. If your dog or your cat
get into gummies, They may get a $ 5, 000 overnight ER
(17:17):
veterinary visit. And no five-year-old ever smoked a joint. But
they will find gummies now.
Speaker 1 (17:23):
Yeah, that's what I was going to ask you about that.
What should parents know, especially those who may be concerned
about their kid using these products?
Speaker 2 (17:34):
With your teenager, know what's going on in their life.
I had a high school counselor the other day. I
was talking to her, extensive conversation about what are the
teenagers doing, you know, in the bathrooms and behind the school?
What are they vaping, right? In general, it's a Delta
8 vape from a smoke shop, something bought on the internet,
(17:54):
something bought on the legacy market, completely untested. We know
that a lot of those products have a significant amount
of Delta 9 THC in them, you know, There's stuff
bought on the legacy market. So if you have a
team these days, you need to be acutely aware of
what's going on, you know, there. What I did tell
(18:14):
the counselor, what I was fairly certain of was that
what they're not using in the bathroom is a behind
the school or medical cannabis products, medical cannabis patients products.
are very protective of their medicines. They are. That's not
to say that no child has ever found grandma or
grandpa or parents gummies. It happens. It's rare, but it happens.
(18:37):
Or their vape or whatever. But what much more common
would be that product purchased outside of the medical environment
that's not treated with the same amount of respect. So
you have to be concerned with all of those exposures
And they do exist. And if you deny that they exist,
then you're also not on the right side of the
recognition of every substance has its uses and the potential
(19:02):
for abuse. Fortunately for cannabis, it's never a danger towards death,
but can be uncomfortable and expensive. Yeah.
Speaker 1 (19:09):
Well, earlier in the program, you kind of laid out
what people could experience if they're using cannabis and they
experience symptoms of psychosis. So you mentioned hallucinations, paranoia, delusions,
and these other symptoms. So let's say someone does use
a cannabis product, whether it's medical or illicit, what should
(19:32):
they do and how quickly should they seek professional help?
Speaker 2 (19:35):
Yeah, it's a great question, Heidi, because once again, you
have to remember emergency room physician, you know, that I am,
you know, obviously we think safety first, you're going to
think safety of self, safety of patient, of course. And listen, um,
certain things that were always the, you know, case in
the emergency medicine environment, any suspicion of abuse, quite frankly,
(19:57):
suspicion of suicidal ideation, things like that. You're obligated to
act upon those things. And I would say that to
the extent of any family member or friend, If you
see acute danger to self or others, then that's an
immediate step in. That's a 911 call. That's activate the
system to get the assistance that you may need acutely.
(20:20):
I think more commonly it would be just a recognition
that something's not right with your loved one or your friend, okay?
That could be anything from not maintaining the normal activities
of daily living, okay? Somebody that's not going to work,
somebody that's not eating or sleeping appropriately, you know? Obviously,
(20:41):
anybody that's complaining of delusions, paranoia, hallucinations, those are the
kind of things that, quite frankly, you may not need
to call 911 about. Absolutely should be addressed with either
the primary care physician, if that exists and is involved. Absolutely,
the medical cannabis clinician, if the person's involved in the
(21:03):
medical side. So it's important to recognize, once again, that
911 type of circumstance. And then so that would be
the emergent. And then, of course, the urgent would be
just a recognition that something's not right. You don't want
things to continue. You don't want things to spiral. You know,
so I think when you notice a hallucination circumstance or
(21:25):
significant delusions, that's when you're obligated to step in. Listen,
we now and again, it's rare. You know, patient will
be Baker acted. You know, that's for protection of self
and family and others. And, you know, that happens, but rare,
you know, in the practice. And I'm very gratified to
the extent that we have very little psychiatric impact you know,
(21:48):
within our practice. And that's true. In fact, we get
patients referred now in from the psychiatric environment. That's an
interesting circumstance. Now patients feel a little bit more comfortable
in bringing it up to their psychiatrist within the psychiatric environment.
And I always advise my patients to make sure that
(22:08):
every other doctor that they see is aware of them
being in the medical cannabis program. That's a key thing.
I have an entire lecture on my computer. It's called
how to talk to your doctor about medical cannabis. My
suggestion is to always bring it up right in the encounter.
But sometimes you leave yourself out of the initial conversation.
(22:29):
So you see how your provider, your practitioner is going
to come back at you. Because if you know that
cannabis is working well for you, right. You don't necessarily
want them to say, hey, you know, that's a drug, pot, dope, weed, grass. So,
you know, I always recommend the patient bring it up
in third person. How do you feel about the medical
(22:51):
cannabis program? Do you have any patients in the medical
cannabis program? If you say any other patients, then you're
outing yourself. To keep a third person. But my point is,
many psychiatric providers now recognize that their patients are going
to use cannabis. They'd rather have them using it safely,
(23:14):
appropriate testing with a doctor on the other side who's
advising them. And the interesting circumstance is sometimes that patient
will tell their psychiatric doctor, you have me on three
different meds, but I'm only taking one because cannabis has
supplanted the other two. So to me, that's why the
(23:35):
honesty between provider and patient is always critical. So that
type of don't ask type of thing still goes on
in hospitals. People go in for surgeries. I want the
surgeon to know. I want the anesthesiologist to know. I
want everybody to know that that patient has their medical
cannabis card. We're not quite there, but we're so much
(23:58):
better off than we were 10 years ago.
Speaker 1 (24:00):
Yeah, that's really interesting.
Speaker 2 (24:02):
Yeah. It's that honest discussion prompted by you. And I
mean it, FAMU and Mary and the whole bit that's
continuing to facilitate that. And it's going to be a
long-term process in Florida, you know, with the clinic being
open for 10 years now. And Heidi, thank you so
much for every bit of it. It's the long game.
It is. It's the long game. Nothing happens in a
(24:25):
day or a month. It's continued discussion of this public health,
public education, public safety focus.
Speaker 1 (24:32):
Yeah. So as we wrap up this conversation, which has
been very enlightening to me, and I'm sure our listeners
and viewers, if you could leave one takeaway about this
topic on cannabis and psychosis, what do you want people
to know and remember?
Speaker 2 (24:49):
For sure. Listen, I have a lot of quick phrases
and this is one of them. It's respect the patient,
respect the plant. You have to respect the patient to
give them the education that each and every one of
them is looking for. You have to respect the patient
in making sure that you're doing the appropriate screening, right?
And you're making sure that that patient has the appropriate
(25:12):
expectations about what they can and should be getting out
of their usage of cannabis. Then you have to respect
the plant for what it is and what it does.
We have an endocannabinoid system within us. And then we
have the phyto cannabinoids within the miracle cannabis plant, but
you had to respect it for all the positives, of course,
(25:35):
but some of the negatives too, it's a medicine, it's
a substance and it needs to be treated as such.
So if you respect both the patient with education and
the plant for the positives and the negatives, then that's
where the magic occurs with the appropriate usage of cannabis
for And, you know, we're always going to continue to
(25:57):
be here to try and preach that public health, public safety,
public education message.
Speaker 1 (26:03):
Yeah. Well, Dr. Berry, I want to thank you so
much for being a guest on this conversation on Cannabis
Virtual Forum, brought to you by the Medical Marijuana Education
and Research Initiative at Florida A & M University. Thank
you to everyone watching this program. Tell us what you
think about this forum by completing the survey posted in
the comment boxes on Mary's Facebook and YouTube pages. If
(26:24):
you complete the survey, your name will be entered into
a drawing in September 2026 to win a $ 100 gift
card provided by one of Mary's partners. Stay connected with
FAMU Mary to access educational information and resources about legal
medical cannabis use and the consequences of illegal marijuana use
in Florida. You can follow them on their social media
(26:48):
pages or visit their FAMU Mary website. We also want
to encourage you to go to the Florida Department of
Health Office of Medical Marijuana Use website to learn how
to obtain a legal medical marijuana card in the state
of Florida. Thanks, everyone.
Speaker 2 (27:06):
The views and opinions of our invited guests are not
necessarily the views and opinions of Florida Agricultural and Mechanical
University or the Medical Marijuana Education and Research Initiative.
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