Dr. Wendy is talking to Dr. Eva Ritvo about AI and mental health. We are also talking to Dr. Timothy Fong about cannabis use disorder and what we can do. It's all on KFIAM-640!
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Speaker 1 (00:00):
You're listening to KFI AM six forty on demand.
Speaker 2 (00:04):
Welcome back to the Doctor Wendywall Show on ki AM
six forty Live everywhere on the iHeartRadio app. So this
week I was asked by a reporter, actually a reporter
from a travel magazine. Isn't it funny? Like I think
of myself as a relationship journalist, if you will, an
educated relationship journalist. But so I get requests for comments
(00:27):
from all kinds of media sources when it has to
do with relationships. But this was a travel magazine. And
do you know why? Because they wanted to know what
I thought of a new dating trend called adrenaline dating. Okay,
here's what it means. I mean you set up a
date and you schedule events that might feel scary or
(00:51):
excite exciting to cause like a heightened sense of arousal,
to make your automatic nervous system go, oh my god,
I'm so scared. So that might include things like, maybe
you hike up a tall mountain together, you bring a
picnic and share it at the top. Well, you're breathless
from the heights. Maybe you go rock climbing. If you
know of any suspension bridge around you can walk across
(01:14):
that together and let it shimmy and shake in the wind.
If you're a bit athletic, you might want to try
bungee jumping or hang gliding. I mean, you could go
for it. This is all examples of adrenaline dating. So
here's the thing. I know it sounds like fun, but
my personal opinion is that it's just a way to
(01:35):
trick the brain into thinking that it's falling in love. Right,
So if you are hoping that it's going to actually
create love, it's important that you know you work to
do the other stuff afterwards. I'll tell you where the
idea of adrenaline dating came from. It's based on a
(01:55):
famous suspension bridge study. I believe it was Canadian stuff.
There's this big suspension bit bridge. I've actually walked across
it in Vancouver and I don't know how far down
and it's like half a mile or something, and it's
a very long bridge and it does sway in the wind,
and I do have vertigo. Okay, So I walked across
(02:16):
it with my children and I think my oldest daughter
was probably like a teenager then, like fifteen or something,
and there was no way I was going to get
across this bridge. Because when you have vertigo. Here's the thing.
You can't outthink it. You can't say no, it's perfectly safe.
I'm going to be fine. I'll just walk past it. Instead,
every muscle in your body just freezes, just look like
(02:36):
it's paralyzed. You can't move. So no matter what your
brain says, you can't move. So what I did is
I put both my hands on my daughter's shoulders and
walked behind her and I stared at her ponytail. I
would not look down, I would not look to the right,
not to the left, And somehow I got through it.
But still my heart was beating like crazy. Right, So,
(02:57):
there was a study done on this particular bridge by
Canadian researchers where when men were walking across the bridge,
they were questioned by a young woman. They you know,
she came up to them and they chatted and had
a little conversation about nothing. Right, it's a terrifying walk.
So once they got to the other side, another researcher
came up to them and said, hey, by the way,
(03:17):
we're doing a little story on you know, we're doing
some research on suspension bridges, and by the way, we
noticed you were talking to a young woman over there,
can you tell us how you feel about her? And
almost always they talked about feelings of attraction or feelings
of love for this total stranger. So in psychology this
is called a misattribution of arousal. They were feeling aroused,
(03:42):
they had shortness of breath, their heart beat faster, and
while they were also they're very visually wired. Looking at
this beautiful young woman, they thought they must be falling
in love. So here's what we do know. They didn't
follow these people for a long period of time, so
we don't know how quickly they fell out of that love.
I also know that it can be exciting on a
(04:05):
first date to have those feelings, But could it lead
to something long term? I don't know, but I'll tell you,
if you want to try adrenaline dating, you might be
somebody who's in general a sensation seeker anyway, that means
somebody who just has feelings, like positive feelings of exhilaration
when your heart races. I'm not one of those. I
(04:26):
don't even like the roller coasters, none of those things. Also,
there are people who are just open to new experiences.
I would suspect that younger people might like it more
than older people. Look, we get to a certain age
and we're like, I made it, I'm still alive. I'm
not trying anything that might metch with that. Okay, Okay,
there are some risk takers over the age of fifty,
(04:47):
but in general, there's so much research to support the
idea that ultimately the thing that really does create love
and keep love alive is not just a beating heart art,
it is emotional intimacy. If you are going to use
(05:08):
adrenaline dating for anything, I would think it would be
a good idea during that moment of heightened arousal to
use your bravery to be more authentic and expressed honesty
about your true feelings, because ultimately it is emotional intimacy
that is the glue that keeps couples together. And I
(05:30):
do want to remind everybody adrenaline dating isn't for everybody.
There are some obvious physical risks, right if you're out
of shape, If you do have a heightened I don't
know what it's called a fight or flight response of
your sympathetic nervous system like I do, it could be
downright terrifying. Don't try it and also remember that adrenaline
(05:51):
dating is a brain trick, right, it's misattribution of arousal.
You still have to do the work of real love
after the date. I should say this though, if you've
been in a long term relationship and things that are
being a little boring, maybe you want to reagnite some passion,
strengthen your bond, have some excitement together, do some adrenaline dating.
(06:13):
Then if you're a long term couple and needs a
little boost, have an adrenaline date. It could be just
the thing you need to get your heart racing again
and remind you of those feelings of love you have
for your partner. Hey, when we come back, have you
ever thought of consulting a robot ai as your therapist?
Speaker 3 (06:31):
Well?
Speaker 2 (06:32):
I thought it would be terrifying. I thought it would
be a mistake. But the psychiatrist who I'm going to
have on the show next actually disagrees with me. We'll explain.
You're listening to The Doctor Wendywall Show on KFI AM
six forty were live everywhere on the iHeartRadio app.
Speaker 1 (06:46):
You're listening to KFI AM six forty on demand.
Speaker 2 (06:50):
Welcome back to The Doctor Wendywall Show on KFI AM
six forty live everywhere on the iHeartRadio app. Robots as therapists.
Oh my goodness. Look, artificial intelligence, we know is making
waves everywhere, but lately, also in mental health care, there
are such things as chat bought therapists. Uh huh. Now
(07:14):
what they promise, of course, is accessible, affordable support that's
just a click or tap away. Are they a game
changer for mental wellness? Are they a passing fad? Or
are they something we should approach with caution? My guest,
doctor Eva Ritfo, a Miami based psychiatrist with over thirty
(07:36):
years practicing in Miami Beach, Florida. Also the author of
one of my favorite books, be Kinder, The Transformative Power
of Kindness, and also co founder of the Bold Beauty Project,
where we've had you on the show before, a nonprofit
that pairs women with disabilities with award winning photographers to
create art exhibtions, exhibits, and raise awareness. Doctor Ritfo, you're
(08:00):
a real human, right, You're not a robot.
Speaker 4 (08:03):
I'm not a robot, definitely not.
Speaker 2 (08:07):
So what is your take on robot therapy?
Speaker 4 (08:11):
Well, I think it's really fascinating, and you know, I'm
a skeptic about these new things, but I have to
tell you it's pretty impressive. You know, there's a lot
of different ones out there, but they are trained. Some
of them are trained very very well, and they deliver
(08:33):
really good advice and they help a lot of people.
So I think that they are a very important tool,
and I think they're here to stay. I don't think
they're going away.
Speaker 2 (08:45):
Cruise aren't gaining ground on California's largest ones.
Speaker 4 (08:48):
With caution, and there's times when it would be very
dangerous to use AI and inappropriate to use AI. So
I think, you know, buyer beware, But in the right circumstances,
with the right support, I think they're wonderful. I particularly
like them as a supplement to the work that I
do with people.
Speaker 2 (09:07):
So for if I can call it the regular run
of the mill depression, anxiety, or an adjustment disorder, somebody
going through a divorce or a loss, in some way,
I'm sure they can be very helpful. But what about
if somebody is expressing suicidal ideation? Is there something I mean,
not a good idea, right, So what happens is if
someone comes into your office and they're expressing suicide ideation,
(09:31):
you can sort of say excuse me, I have to
step outside for a moment and make a phone call
and get some medical assistance for them immediately, right, But
what's a robot going to do?
Speaker 3 (09:42):
Right?
Speaker 4 (09:42):
Well, I think that whenever you have a very serious
medical illness, you don't want to trust it to AI.
You really need that human with the years of experience.
And that's certainly true, not just with suicidal ideation. That's
obviously an extreme, but you know, there's many forms of
mental health illness that are really complicated, difficult to diagnose,
(10:04):
and it's very important to have somebody with experience, say
if it's a substance abuse problem, bipolar problem, as you mentioned,
severe depression, severe trauma. There's many illnesses when a robot
is not going to be your best answer. Robot is
very good, as you mentioned, anxiety, situational I want advice.
(10:26):
You know, I've just got in a conflict with a
friend and I don't know how to handle it. Those
are the sorts of things that they're really good at
because they're trained to handle those sorts of problems. They're
there twenty four to seven. Most of them are free
and you're not going to go that far wrong. They're
also very trained in cognitive behavioral therapy, which is sort
(10:47):
of taking a look at your own thoughts, seeing which
thoughts may not make sense, and helping you find substitution.
So I think that is where it's going to be
the most helpful, particularly for people who can't access therapist,
if they don't have any that are readily available, if
they can't afford therapy. I think there's a real niche there.
(11:07):
I think any sort of complicated mental or physical illness,
you really want to go in. You want somebody to
see you, and you want to you know, even have
multiple opinions. You know, remember, if you've got a robot,
you've got one opinion.
Speaker 3 (11:20):
That's right.
Speaker 2 (11:23):
Yeah.
Speaker 4 (11:23):
If you go into, you know, a psychiatrist and you say,
you know, these are my symptoms, what do you think.
Oftentimes you can go home and you can see another
psychiatrist a week later and digest the information and then
you know, you can feed some of that into your
AI therapists and they can really walk you through some
of the risks and benefits of medication very well. They
(11:45):
can also do a great job. Let's say you have
somebody with a complicated medical history. They're wonderful at looking
at drug drug interactions, figuring out what other types of
things might be going on that you know, we may
as a human might forget to ask every little thing.
So they're they're very good for you know that second flash,
third opinion, But anything serious, we are really not there yet,
(12:09):
and I don't know if we're ever really going to
get there, you know.
Speaker 2 (12:12):
Doctor Britfox. Just this morning, because I'm going on vacation
and a medication that I take needs to be refrigerated,
so I asked them. I asked the robot which is
better to take it with a little frozen pack hoping
that it will never get warm anywhere, to take it early,
or to take it after I get back, And it
laid down all the pros and cons and apparently told
me I should take it early, best idea.
Speaker 4 (12:34):
That's the thing, you know, That's the thing. When you
wear it is more patient. And I always find like,
if I'm in a session with somebody and I want
to explain something, I only get to talk sort of
a little bit because it's their session. And so oftentimes
what I'll do when I finished with a patient is
all feed the problem into chat GVT and then it'll
give me a whole page of things, and then I'll
send it over to patient. I'll say this is what
(12:55):
we talked about today, and it gives them a more
in depth way to look at it.
Speaker 2 (13:01):
It's like you can outsource the psycho education.
Speaker 4 (13:03):
Part absolutely and you could say bring this to your partner,
bring this to your child, et cetera. And you know
they do prompt you with very very good questions. So
I think that's another thing as well that can be
quite useful. Say I'm discussing with somebody, how do you
deal with their narcissistic partner, and we get to like,
you know, the tippy top of the iceberg. But you
(13:24):
can stay with CHATGVD for hours and then say.
Speaker 2 (13:27):
They never tire, doctor Rifo, we have to go, We
have to go. But it is always it's always so
quick on radio. But I want to say that I'm
very thrilled to hear that you, as a medical doctor
and psychiatrist, aren't afraid that the robots are going to
replace you. Good news.
Speaker 4 (13:46):
Oh no, no, no, no no no. I think it's
a it's a wonderful supplement. We work together and everybody,
you know needs more support and mental health. So I'm
delighted that you know more people can access it and
you don't forget their sole as stigma with mental illness.
And so some people who might never come to a
therapist will at least get online and start to get
some good advice and hopefully, you know, can lead a better, happier,
(14:10):
more fulfilling life.
Speaker 2 (14:11):
Well, thanks so much for being with us. When we
come back, I have another special guest, this one from
UCLA who specializes This psychiatrist in cannabis use disorder, doctor
Eva Ritfo. Thanks so much for being with us. We'll
see you next time. You're listening to the Doctor Wendy
Wall Show on KFI AM six forty live everywhere on
the iHeartRadio app.
Speaker 1 (14:32):
You're listening to KFI AM six forty on demand.
Speaker 2 (14:36):
Welcome, that's a Doctor Wendywall Show on KFI AM six
forty live everywhere on the iHeartRadio app. Now I promise
you a very special guest. This is a guest who
I was begging, begging to come into the studio because
he is a wealth of knowledge. And sit back because
some of the facts he's going to tell you might
(14:57):
actually be completely opp of what you believe I'm talking about.
Cannabis use. Look, we know that marijuana has been used
by humans for thousands and thousands of years, both medicinally recreationally.
We also know in the last few decades here in America,
(15:19):
attitudes have shifted a lot. Right, we had at one
point complete prohibition. I actually knew somebody, poor guy who
spent nine months in prison for being caught with a
little bit of marijuana. And now look, it's on every
street corner, in a shop, in a legal shop right now.
(15:40):
I also want to say that my next guest is
going to tell us that there's a big gap between
our ideas, our perceptions about marijuana use, and the real
science because our perceptions are influenced by the companies that
want to make a book and the government that wants
to make some tax money. My guest is doctor Timothy Fong.
(16:00):
He is a professor of psychiatry at for Human Behavior
at UCLA. He's a board certified adult and addiction psychiatry specialist,
co director actually of the UCLA Gambling Studies Program. Oh,
that's another thing. We should talk about gambling sometime. But
I like to say when I introduced him, he is
the guy in LA when it comes to knowing the
(16:22):
science about marijuana. Welcome, doctor Pong. It's a pleasure to
have you here.
Speaker 3 (16:28):
It is absolutely my pleasure to be here. Doctor Walt Wendy,
thank you for having me here in studio.
Speaker 2 (16:34):
Yeah, it's wonderful. And I understand you're a KFI listener.
Speaker 3 (16:36):
I love KFI And when it came to ucilea psychiatry
residency nineteen ninety eight, one of the first shows I
started listening to was Handled the big giant billboards everywhere.
It's only been twenty seven years. I haven't listened to KFI.
Speaker 2 (16:48):
We love our Handle. He's a great guy. So I
was listening to videos on lectures that you did, and
you talk about our current marijuana use as this growing
public health crisis. Can you talk a little bit about that, well.
Speaker 3 (17:05):
Suirre, certainly. And again, if you rewind where we were
twenty years ago, think about LA There was no above
board cannabis dispensary, there were no billboards. People didn't talk about.
It was in the shadows. Right fast forward to twenty
twenty five. Right now in our state, we have about
thirty five hundred cannabis dispensaries that legally sell cannabis. We
(17:26):
have a massive amount of unregulated and unrestricted cannabis as well.
Speaker 2 (17:30):
That's the word I want to talk about. Unregulated. Is
the stuff in the stores regulated at all? Do we
know if what they say is in it is the
stuff that's in it? Oh?
Speaker 3 (17:39):
Absolutely. So you go back to when we first did
this November twenty sixteen, it's been nine years since our
state has legalized cannabis used for adults twenty one and
zero stress that. Yeah, they did stress that. And so
what we then have created is a very strange California
market right where on one hand, the above board dispensaries
that are doing it by the book, licenses, regulations, policies,
(18:03):
and procedures, and they're protecting our health, are selling products
it's really sophisticated and safe. On the other hand, there
are a lot of brick and mortar dispensaries that are
not regulated, or they're doing delivery services and they're giving
things to the public that they think are safe but
actually are not fully and wholly tested. So nine years
(18:23):
we've created a very very tight California regulatory policy, and
you can imagine when you put a lot of rules
in place, there are gonna be some folks that don't
follow it. So that's why there's this weird split between Yes,
things that are on the shelves and regulated above boards,
trusted dispensaries are exactly what they say they are, versus
things that are in unregular dispensaries or things that are
(18:44):
delivered and certainly things that are handed to you by
a friend or a family mateer or an aunt or
an uncle maybe at a July fourth barbecue.
Speaker 2 (18:52):
And someone told me, the little bit of pot that
we smoked on back in college in the seventies and
eighties is not the same as the product that's around
today today. Suppose to be stronger.
Speaker 3 (19:01):
Oh absolutely, And that's one of the first myths that
we hear all the time. It's just weed, it's mother nature. Well,
it's very different than in the eighties or nineties, whereas
about on average about four percent THCHD content. Now that
percentage is about twenty five thirty percent THHC that are
quote seized by officials. But we have products on the
(19:23):
shelves cannabis dispensaries that can go as high as seventy
eighty ninety percent THHD concentration. So it's a different product.
So imagine you know again, you were born fifteen years
ago and now you're growing into a world where you
only know high concentrated, high potency cannabis, right, And the
message to you as a young person says, hey, it's
(19:44):
just weed. I did it.
Speaker 2 (19:46):
Do you know how many times I hear this? You know,
I teach health psychology at cal State Channel Islands, and
whenever I do my little addiction lecture, how many students
put up their hands. Only weed or just weed are
what I hear all the time. And they just think
it's hard less, right, So that is myth number one,
myth number two. And they also say this, oh, thank
goodness it's weed, because nobody's going to overdose from it, right,
(20:10):
is it possible?
Speaker 3 (20:11):
Well, again, the myth about why is it harmless?
Speaker 1 (20:13):
Is number one.
Speaker 3 (20:14):
You know, cannabis intoxication can be dangerous in the sense
that's some folks for the very first time they use
cannabis develop psychosis or nausea, or impulsivity or aggression. Right,
So that's part of it. Number two. Although it's very
rare to die from an overdose of cannabis, you can
die while intoxicated car accidents, falling off a root. In fact,
(20:36):
one of the byproducts of increased legalizations. That's in the
number of calls of poison control related to cannabis, right,
and even like babies and toddlers. And but again, I
don't want to be the oh my gosh, this guy's
falling kind of thing. But these are just the scientific facts.
The second part about is why is it not harmless? Again,
is just straight addiction. When you develop a cannabis use
(20:56):
disorder or an addiction, it really significantly damage your life.
Speaker 2 (21:01):
So there's this perception though that it's not addictive.
Speaker 3 (21:03):
Oh, it absolutely is. And again, pound for pound, if
you say opioids, heroin, fetnyl cocaine, yes, there's a quote
more addictive. If you look at say broccoli or kale, though,
or quenoa, you know, other Mother Nature's plants, they're much
less addictive than cannabis. This is about a nine percent
chance of developing addiction from the very first time you
(21:25):
use cannabis, Which is why we stress so importantly that
this is a product for adults. This is a product
that's meant to be used when your brain and your
body are ready for it. That means twenty one and up.
Speaker 2 (21:36):
And here's the big question. This myth out there that
there are no withdrawal symptoms that you can just quit,
And you use the word in one of your lectures
tapering just tapering off. How possible is that?
Speaker 3 (21:48):
So in twenty thirteen, when we diagnose cannabis withdrawal as
an actual medical condition, there was controversy. Well, people say, well,
you don't die from withdrawal, But for anyone out there
who's gone through cannabis withdrawal, it is a it is suffering.
It's like the flu. You can't eat right, you can't
think straight, you can't function. So it creates a lot
(22:09):
of just damage, a lot of suffering that's unnecessary. So
and when the strength of the cannabis is much stronger,
you can develop withdrawal symptoms much quicker, literally within about
seven to ten days of using on a daily basis.
Speaker 2 (22:23):
Wow, Okay, we need to go to break. When we
come back, I want to talk about whether there is
any real medical use and if so, what specifically, And
then let's talk about treatment. A lot of people listening
may themselves or have children who have cannabis use disorder
and not even realize how addictive.
Speaker 3 (22:41):
They are.
Speaker 2 (22:41):
So let's talk about treatments. When we come back, my
guest is doctor Timothy Fong of UCLA. We're talking about
cannabis use disorder. You're listening to the Doctor Wendy Wall
Show on KFI AM six forty Live everywhere on the
iHeartRadio app.
Speaker 1 (22:54):
You're listening to KFI AM six forty on demand.
Speaker 2 (22:57):
Welcoming back to the Doctor Wendy Wall Show five AM
six forty Live everywhere on the iheartradiore. My guest doctor
Timothy Fong from UCLA. He's the go to person when
it comes to cannabis research and knowledge. Doctor Pong, Let's
talk about this medical marijuana that everyone seems to say
is but we needed it's such a good treatment? Is
(23:19):
marijuana good to treat anything?
Speaker 3 (23:21):
We're trying to find out, and you think about our
history in California. We were one of the first states
that created medical cannabis, and back in twenty seventeen when
we started our ucle Center for Cannabis and Cannabinoids, we're
really excited to find out how can we use cannabis
in a way that helps people and it helps get
rid of suffering. There's no doubt in my mind and
the hands of the right properly trained physicians that cannabis
(23:44):
probably could be a useful product, but we're not there yet.
We're not there yet, and so the science falls much
farther behind. We have actually a really interesting study looking
at just recently, when medical cannabis is used by doctors
that are trained in it, see the patients properly that
do it right, that patients do get better. However, that's
(24:05):
the vast majority of doctors aren't trained in how to
use medical cannabis.
Speaker 2 (24:09):
But we're talking to treat things like you know, nausea
from chemotherapy, right, or maybe if you're wasting from a
disorder where you're getting too skinny and you can't eat,
that's right, sleep disorders perhaps, or PTS.
Speaker 3 (24:22):
I actually know, and that's the myth, right, So our
science tells us, yes, it's effective for pain, it's effective
for chemotherapy to induce nausea and vomiting, and for mulcile
spasticity from multiple sclerosis. Now all that other stuff you
hear about for insomnia, anxiety, PTSD, hangnails, growing hair, sexual reality,
(24:42):
the scientific studies don't bear that out.
Speaker 2 (24:45):
And depression and anxiety it actually increases, right, it.
Speaker 3 (24:47):
Makes things worse and So that's a real fascinating area.
And I really wish we could say with confidence that
our medical field has moved in the last twenty five
years to say that, yes, this product of medical cannabis
is really effective for X. Unfortunately we're not there yet.
And the two things I see the number one, autentized
patients then say oh, I'm not going to use the
standard treatments. I'm going to go straight to medical cannabis.
(25:10):
And then number two they do it on their own.
You know, this isn't a DIY kind of thing. You know,
this is a very powerful plant with a lot of
potential effects, but positive and negative. So all folks out
there again the idea that we all want to reach
for something quick and easy and affordable that makes our
lives better. But unfortunately, if you're going to do that,
(25:32):
you have to do it under the supervision of a
physician that has experienced in using medical cannabis. Again, if
I said, hey, you know, go see a doctor, he
or she has signed off on a form and then
he won't tell you what to do, and you're supposed
to go pick out the product in the shelves, take
as much as you want or as little as you want,
and if you have problems, don't call that doctor back.
Speaker 2 (25:52):
Well, that's not that's not how it works.
Speaker 3 (25:55):
It works.
Speaker 2 (25:56):
So let us talk about treatment. First of all, I
read somewhere that your estimate eating that two percent of
the American population suffers from cannabis use disorder.
Speaker 3 (26:04):
That number globally is probably higher now that we've seen
expansion of cannabis in at least forty eight or twenty
four states and forty eight medical cannabis states. It's probably
almost up to like three or four percent of the
general popula.
Speaker 2 (26:15):
I read somewhere that four percent of twelve to seventeen
year olds twelve to seventeen year olds.
Speaker 3 (26:20):
Yeah, and stats are hard, I think. The way I
think about it, this is very simple. A look, this
is a new generation gen Z, gen Y, whatever you
wanna call Generation Alpha, who are growing into a world
where cannabis use is accepted, normalized, permissible, and in some
ways promoted very much promoted, versus again a world whether
the cannabis products are using and how they're using it
(26:43):
we now know scientifically not great for them. More kids
right are not smoking, they're vaping, vaping, and the biggest
concern of my our young kids using those vaping products
a lot more potency, a lot more chemicals, but there's
also use of a lot more synthetic cannabinoids. So these
are the delta THC eight, the thhca, the delta TC ten.
(27:04):
These are human made products from like them. They're not
the naturally grown flowers. So it's just another synthetic compound
that unfortunately young kids are getting into much more popular.
Speaker 2 (27:16):
All right, So let's say somebody wants to quit. How
do they do it? So?
Speaker 3 (27:20):
Number one, if you want to quit, really seeking professional help. Again,
this is not a DIY project, and there's not shame,
stigma and oh my gosh, you're addicted, paw, you're adicted marijuana.
How could that be? No, if you're going to do it,
do it in the hands of professional, a physician, a psychologist, somebody.
Speaker 2 (27:36):
Who specializes in addiction. Not just your primary care no.
Speaker 3 (27:40):
I mean primary care. Many primary care doctor are starting
to see this all the time, emergency room doctors, anyone
who has experienced with cannabis and health and behavioral health
and who's really well connected. And we say in our
addiction field, it takes a village, you know, to really
get people better. It's not just me, you know, seeing
you once for every thirty minutes, like you know, you know,
once a month. So getting professional help is step one.
(28:01):
I think get incredible information online is really probably step zero.
And a lot of folks who are doing that are like, well,
they just google cannabis addiction, treatmentabis withdrawal and you get
literally millions of hints. And I think it starts with
get incredible information like from our state California Department of
Public Health has a lot of really great information, or
the National Institute on Drug Abuse, or our on website
(28:24):
at the Cannabis Center that we have at Cannabis dot
Semio dot Ucla dot edu.
Speaker 2 (28:30):
And I did some calling around for a friend. And
most insurance, private health insurance does not cover marijuana detox
does it. Well, they all say it's not medically necessary.
Speaker 3 (28:38):
Right. They won't cover it in a quote hospital based
setting or a residential setting because I'll say, oh, this
person doesn't need to be in a contained environment. They'll
cover a lot of outpatient visits and maybe an intensive
outpatient program, but when people need full containment, probably not.
Speaker 2 (28:56):
So is there any medication that people can take to
help them through the withdrawal.
Speaker 3 (29:01):
Well, right now July twenty twenty five, we do not
have an FDA proved medication with cannabis use disorder or
canvas withdrawal. However, we have some stuff in the research
toolbox that kind of works that does help. And again,
just think about going through withdrawal. You stop cannabis tonight Sunday,
right after July fourth weekend, you might not have withdrawal
(29:21):
symptoms until Wednesday or next Friday, and you might be
realize that what you're going through is withdrawal. So usually
for a lot of folks, the first thing is recognized
that the symptoms that they're having are withdrawal, and then
we give comfort medications, we hydration, you know, we do
things that take away the symptoms of withdrawal that are
really difficult, like the nausea, the vomiting, and the inability
(29:44):
to eat or sleep, just the feeling queasy. Those are
the things that we do right away.
Speaker 2 (29:48):
I actually read somewhere that there some chronic cannabis use
can cause people to lose a lot. We always think
of getting the munchies and eating a lot when you're high,
but something goes on with your intestines with chronic use for.
Speaker 3 (30:00):
Some folks that can. I mean, we see intoxicated case
and cannabis hyper emesis syndrome where they're constantly vomiting so much.
We see I've had a number of patients who just
taken on a daily basis and content vicious cycle where
they use to get rid of the nag in vomiting
and they use too much and then the byproduct, the
side effect of using is what more noge than vomiting.
So again, we don't want to be the fear mongering
(30:23):
at all, which is these are just some things that
happen out there. For the vast majority of people, they
don't experience these horrible things, but they can happen. And
I think for people to realize it's not just you know,
not just weed anymore. It's all sorts of things that
can happen.
Speaker 2 (30:37):
But we need to be having this conversation because we
are counteracting the kind of messaging out there, the myths
out there given by the producers of this drug and
maybe even you know, people that want to collect tax
money or sell it, et cetera. If left untreated. What
is the most common progression of cannabis use disorder is
(30:58):
a gateway drum.
Speaker 3 (31:01):
Old school term. We don't use gateweight drugs anymore now
I go back. It was really interesting to me is
that when I first got into it, what I didn't
realize is that untreated addiction leads to death. It's as
simple as that. And this is probably the most shocking
thing that I think listeners will hear about that cannabis
use disorder is associated with a higher rate of morbidity
and mortality. People die suicides, unintentional drug overdoses on other
(31:24):
stuff that they're not they didn't they're not aware of
that are in their cannabis. Other co occurring mental health
and medical conditions that are not treated again, untreated depression,
untreated anxiety, untreated PTSD. These are things that if people
are using cannabis to treat, that actually make it worse
and subsequently could actually shorten their life. Lung cancer there's
another one that sometimes we see, and right before pandemic.
(31:47):
I don't know if people remember twenty nineteen, but there
were about eighty deaths in America from electronic vap being associated.
Speaker 2 (31:54):
Lung the mysterious vaping disease. Remember that we're trying to
warn our teenagers.
Speaker 3 (31:59):
Right you remember that I did some content on that
in twenty nineteen. You know, those are all deaths. So
I think that's the thing people get shocked at when
they think, oh my gosh, there's increased death in cannabis addiction,
and the best way to prevent addiction, of course, is
obviously not to use on a daily basis, but also
sort of weight weight in your body and brain are
(32:19):
fully developed to begin to use it as an adult, right.
Speaker 2 (32:22):
So it's definitely not for kids, definitely not for teenagers.
Speaker 3 (32:26):
Yeah, and you know, I have one quick story. I
had a number of social workers. I said, you know,
when the kids using and the parents know they're using,
isn't that something we need to call a Department of
Family childcare services? And I've never had a social worker sey, Well,
nobody's going to take a kid away for giving them cannabis, said,
but isn't the law twenty one and over? Yeah, so
(32:46):
I get.
Speaker 2 (32:46):
I mean, if you, as a parent drive drunk with
a kid in the car seat, you can lose your
kid for that. So if you're giving your kid a
drug or allowing them to use in front.
Speaker 3 (32:54):
Of you, if you're allowing them to use an edible
allowing them to have a vappen and a lot of
parents don't even know unfortunately that the kid is in
Cannaba because they don't smell it.
Speaker 2 (33:03):
Right.
Speaker 3 (33:03):
Edible, Yeah, the edible, the vate pens, the drinks, all
these things are very very.
Speaker 2 (33:09):
Different, Doctor Timothy Fong. I know this sounds like bad news,
but it's going to help lots and lots of people
to hear it. And it is just my pleasure to
have you here in the studio with us. As your
research breaks, as you continue to come up with new breakthroughs,
please keep in touch with us so that we can
make sure that the public gets this information that they need.
Speaker 3 (33:26):
Absolutely, thank you for having me.
Speaker 2 (33:28):
I'm happy to have you here you and that brings
Doctor Wendywell Show to a close. If you want to
follow me on the social media, you may The handle
is at doctor Wendy Walsh, but I'm always here for you.
Every Sunday night from seven to nine, you've been listening
to the Doctor Wendywall Show on KFI AM six forty
live everywhere on the iHeartRadio app
Speaker 1 (33:46):
KFI AM six forty on demand
You're listening to KFI AM six forty on demand.
Speaker 2 (00:04):
Welcome back to the Doctor Wendywall Show on ki AM
six forty Live everywhere on the iHeartRadio app. So this
week I was asked by a reporter, actually a reporter
from a travel magazine. Isn't it funny? Like I think
of myself as a relationship journalist, if you will, an
educated relationship journalist. But so I get requests for comments
(00:27):
from all kinds of media sources when it has to
do with relationships. But this was a travel magazine. And
do you know why? Because they wanted to know what
I thought of a new dating trend called adrenaline dating. Okay,
here's what it means. I mean you set up a
date and you schedule events that might feel scary or
(00:51):
excite exciting to cause like a heightened sense of arousal,
to make your automatic nervous system go, oh my god,
I'm so scared. So that might include things like, maybe
you hike up a tall mountain together, you bring a
picnic and share it at the top. Well, you're breathless
from the heights. Maybe you go rock climbing. If you
know of any suspension bridge around you can walk across
(01:14):
that together and let it shimmy and shake in the wind.
If you're a bit athletic, you might want to try
bungee jumping or hang gliding. I mean, you could go
for it. This is all examples of adrenaline dating. So
here's the thing. I know it sounds like fun, but
my personal opinion is that it's just a way to
(01:35):
trick the brain into thinking that it's falling in love. Right,
So if you are hoping that it's going to actually
create love, it's important that you know you work to
do the other stuff afterwards. I'll tell you where the
idea of adrenaline dating came from. It's based on a
(01:55):
famous suspension bridge study. I believe it was Canadian stuff.
There's this big suspension bit bridge. I've actually walked across
it in Vancouver and I don't know how far down
and it's like half a mile or something, and it's
a very long bridge and it does sway in the wind,
and I do have vertigo. Okay, So I walked across
(02:16):
it with my children and I think my oldest daughter
was probably like a teenager then, like fifteen or something,
and there was no way I was going to get
across this bridge. Because when you have vertigo. Here's the thing.
You can't outthink it. You can't say no, it's perfectly safe.
I'm going to be fine. I'll just walk past it. Instead,
every muscle in your body just freezes, just look like
(02:36):
it's paralyzed. You can't move. So no matter what your
brain says, you can't move. So what I did is
I put both my hands on my daughter's shoulders and
walked behind her and I stared at her ponytail. I
would not look down, I would not look to the right,
not to the left, And somehow I got through it.
But still my heart was beating like crazy. Right, So,
(02:57):
there was a study done on this particular bridge by
Canadian researchers where when men were walking across the bridge,
they were questioned by a young woman. They you know,
she came up to them and they chatted and had
a little conversation about nothing. Right, it's a terrifying walk.
So once they got to the other side, another researcher
came up to them and said, hey, by the way,
(03:17):
we're doing a little story on you know, we're doing
some research on suspension bridges, and by the way, we
noticed you were talking to a young woman over there,
can you tell us how you feel about her? And
almost always they talked about feelings of attraction or feelings
of love for this total stranger. So in psychology this
is called a misattribution of arousal. They were feeling aroused,
(03:42):
they had shortness of breath, their heart beat faster, and
while they were also they're very visually wired. Looking at
this beautiful young woman, they thought they must be falling
in love. So here's what we do know. They didn't
follow these people for a long period of time, so
we don't know how quickly they fell out of that love.
I also know that it can be exciting on a
(04:05):
first date to have those feelings, But could it lead
to something long term? I don't know, but I'll tell you,
if you want to try adrenaline dating, you might be
somebody who's in general a sensation seeker anyway, that means
somebody who just has feelings, like positive feelings of exhilaration
when your heart races. I'm not one of those. I
(04:26):
don't even like the roller coasters, none of those things. Also,
there are people who are just open to new experiences.
I would suspect that younger people might like it more
than older people. Look, we get to a certain age
and we're like, I made it, I'm still alive. I'm
not trying anything that might metch with that. Okay, Okay,
there are some risk takers over the age of fifty,
(04:47):
but in general, there's so much research to support the
idea that ultimately the thing that really does create love
and keep love alive is not just a beating heart art,
it is emotional intimacy. If you are going to use
(05:08):
adrenaline dating for anything, I would think it would be
a good idea during that moment of heightened arousal to
use your bravery to be more authentic and expressed honesty
about your true feelings, because ultimately it is emotional intimacy
that is the glue that keeps couples together. And I
(05:30):
do want to remind everybody adrenaline dating isn't for everybody.
There are some obvious physical risks, right if you're out
of shape, If you do have a heightened I don't
know what it's called a fight or flight response of
your sympathetic nervous system like I do, it could be
downright terrifying. Don't try it and also remember that adrenaline
(05:51):
dating is a brain trick, right, it's misattribution of arousal.
You still have to do the work of real love
after the date. I should say this though, if you've
been in a long term relationship and things that are
being a little boring, maybe you want to reagnite some passion,
strengthen your bond, have some excitement together, do some adrenaline dating.
(06:13):
Then if you're a long term couple and needs a
little boost, have an adrenaline date. It could be just
the thing you need to get your heart racing again
and remind you of those feelings of love you have
for your partner. Hey, when we come back, have you
ever thought of consulting a robot ai as your therapist?
Speaker 3 (06:31):
Well?
Speaker 2 (06:32):
I thought it would be terrifying. I thought it would
be a mistake. But the psychiatrist who I'm going to
have on the show next actually disagrees with me. We'll explain.
You're listening to The Doctor Wendywall Show on KFI AM
six forty were live everywhere on the iHeartRadio app.
Speaker 1 (06:46):
You're listening to KFI AM six forty on demand.
Speaker 2 (06:50):
Welcome back to The Doctor Wendywall Show on KFI AM
six forty live everywhere on the iHeartRadio app. Robots as therapists.
Oh my goodness. Look, artificial intelligence, we know is making
waves everywhere, but lately, also in mental health care, there
are such things as chat bought therapists. Uh huh. Now
(07:14):
what they promise, of course, is accessible, affordable support that's
just a click or tap away. Are they a game
changer for mental wellness? Are they a passing fad? Or
are they something we should approach with caution? My guest,
doctor Eva Ritfo, a Miami based psychiatrist with over thirty
(07:36):
years practicing in Miami Beach, Florida. Also the author of
one of my favorite books, be Kinder, The Transformative Power
of Kindness, and also co founder of the Bold Beauty Project,
where we've had you on the show before, a nonprofit
that pairs women with disabilities with award winning photographers to
create art exhibtions, exhibits, and raise awareness. Doctor Ritfo, you're
(08:00):
a real human, right, You're not a robot.
Speaker 4 (08:03):
I'm not a robot, definitely not.
Speaker 2 (08:07):
So what is your take on robot therapy?
Speaker 4 (08:11):
Well, I think it's really fascinating, and you know, I'm
a skeptic about these new things, but I have to
tell you it's pretty impressive. You know, there's a lot
of different ones out there, but they are trained. Some
of them are trained very very well, and they deliver
(08:33):
really good advice and they help a lot of people.
So I think that they are a very important tool,
and I think they're here to stay. I don't think
they're going away.
Speaker 2 (08:45):
Cruise aren't gaining ground on California's largest ones.
Speaker 4 (08:48):
With caution, and there's times when it would be very
dangerous to use AI and inappropriate to use AI. So
I think, you know, buyer beware, But in the right circumstances,
with the right support, I think they're wonderful. I particularly
like them as a supplement to the work that I
do with people.
Speaker 2 (09:07):
So for if I can call it the regular run
of the mill depression, anxiety, or an adjustment disorder, somebody
going through a divorce or a loss, in some way,
I'm sure they can be very helpful. But what about
if somebody is expressing suicidal ideation? Is there something I mean,
not a good idea, right, So what happens is if
someone comes into your office and they're expressing suicide ideation,
(09:31):
you can sort of say excuse me, I have to
step outside for a moment and make a phone call
and get some medical assistance for them immediately, right, But
what's a robot going to do?
Speaker 3 (09:42):
Right?
Speaker 4 (09:42):
Well, I think that whenever you have a very serious
medical illness, you don't want to trust it to AI.
You really need that human with the years of experience.
And that's certainly true, not just with suicidal ideation. That's
obviously an extreme, but you know, there's many forms of
mental health illness that are really complicated, difficult to diagnose,
(10:04):
and it's very important to have somebody with experience, say
if it's a substance abuse problem, bipolar problem, as you mentioned,
severe depression, severe trauma. There's many illnesses when a robot
is not going to be your best answer. Robot is
very good, as you mentioned, anxiety, situational I want advice.
(10:26):
You know, I've just got in a conflict with a
friend and I don't know how to handle it. Those
are the sorts of things that they're really good at
because they're trained to handle those sorts of problems. They're
there twenty four to seven. Most of them are free
and you're not going to go that far wrong. They're
also very trained in cognitive behavioral therapy, which is sort
(10:47):
of taking a look at your own thoughts, seeing which
thoughts may not make sense, and helping you find substitution.
So I think that is where it's going to be
the most helpful, particularly for people who can't access therapist,
if they don't have any that are readily available, if
they can't afford therapy. I think there's a real niche there.
(11:07):
I think any sort of complicated mental or physical illness,
you really want to go in. You want somebody to
see you, and you want to you know, even have
multiple opinions. You know, remember, if you've got a robot,
you've got one opinion.
Speaker 3 (11:20):
That's right.
Speaker 2 (11:23):
Yeah.
Speaker 4 (11:23):
If you go into, you know, a psychiatrist and you say,
you know, these are my symptoms, what do you think.
Oftentimes you can go home and you can see another
psychiatrist a week later and digest the information and then
you know, you can feed some of that into your
AI therapists and they can really walk you through some
of the risks and benefits of medication very well. They
(11:45):
can also do a great job. Let's say you have
somebody with a complicated medical history. They're wonderful at looking
at drug drug interactions, figuring out what other types of
things might be going on that you know, we may
as a human might forget to ask every little thing.
So they're they're very good for you know that second flash,
third opinion, But anything serious, we are really not there yet,
(12:09):
and I don't know if we're ever really going to
get there, you know.
Speaker 2 (12:12):
Doctor Britfox. Just this morning, because I'm going on vacation
and a medication that I take needs to be refrigerated,
so I asked them. I asked the robot which is
better to take it with a little frozen pack hoping
that it will never get warm anywhere, to take it early,
or to take it after I get back, And it
laid down all the pros and cons and apparently told
me I should take it early, best idea.
Speaker 4 (12:34):
That's the thing, you know, That's the thing. When you
wear it is more patient. And I always find like,
if I'm in a session with somebody and I want
to explain something, I only get to talk sort of
a little bit because it's their session. And so oftentimes
what I'll do when I finished with a patient is
all feed the problem into chat GVT and then it'll
give me a whole page of things, and then I'll
send it over to patient. I'll say this is what
(12:55):
we talked about today, and it gives them a more
in depth way to look at it.
Speaker 2 (13:01):
It's like you can outsource the psycho education.
Speaker 4 (13:03):
Part absolutely and you could say bring this to your partner,
bring this to your child, et cetera. And you know
they do prompt you with very very good questions. So
I think that's another thing as well that can be
quite useful. Say I'm discussing with somebody, how do you
deal with their narcissistic partner, and we get to like,
you know, the tippy top of the iceberg. But you
(13:24):
can stay with CHATGVD for hours and then say.
Speaker 2 (13:27):
They never tire, doctor Rifo, we have to go, We
have to go. But it is always it's always so
quick on radio. But I want to say that I'm
very thrilled to hear that you, as a medical doctor
and psychiatrist, aren't afraid that the robots are going to
replace you. Good news.
Speaker 4 (13:46):
Oh no, no, no, no no no. I think it's
a it's a wonderful supplement. We work together and everybody,
you know needs more support and mental health. So I'm
delighted that you know more people can access it and
you don't forget their sole as stigma with mental illness.
And so some people who might never come to a
therapist will at least get online and start to get
some good advice and hopefully, you know, can lead a better, happier,
(14:10):
more fulfilling life.
Speaker 2 (14:11):
Well, thanks so much for being with us. When we
come back, I have another special guest, this one from
UCLA who specializes This psychiatrist in cannabis use disorder, doctor
Eva Ritfo. Thanks so much for being with us. We'll
see you next time. You're listening to the Doctor Wendy
Wall Show on KFI AM six forty live everywhere on
the iHeartRadio app.
Speaker 1 (14:32):
You're listening to KFI AM six forty on demand.
Speaker 2 (14:36):
Welcome, that's a Doctor Wendywall Show on KFI AM six
forty live everywhere on the iHeartRadio app. Now I promise
you a very special guest. This is a guest who
I was begging, begging to come into the studio because
he is a wealth of knowledge. And sit back because
some of the facts he's going to tell you might
(14:57):
actually be completely opp of what you believe I'm talking about.
Cannabis use. Look, we know that marijuana has been used
by humans for thousands and thousands of years, both medicinally recreationally.
We also know in the last few decades here in America,
(15:19):
attitudes have shifted a lot. Right, we had at one
point complete prohibition. I actually knew somebody, poor guy who
spent nine months in prison for being caught with a
little bit of marijuana. And now look, it's on every
street corner, in a shop, in a legal shop right now.
(15:40):
I also want to say that my next guest is
going to tell us that there's a big gap between
our ideas, our perceptions about marijuana use, and the real
science because our perceptions are influenced by the companies that
want to make a book and the government that wants
to make some tax money. My guest is doctor Timothy Fong.
(16:00):
He is a professor of psychiatry at for Human Behavior
at UCLA. He's a board certified adult and addiction psychiatry specialist,
co director actually of the UCLA Gambling Studies Program. Oh,
that's another thing. We should talk about gambling sometime. But
I like to say when I introduced him, he is
the guy in LA when it comes to knowing the
(16:22):
science about marijuana. Welcome, doctor Pong. It's a pleasure to
have you here.
Speaker 3 (16:28):
It is absolutely my pleasure to be here. Doctor Walt Wendy,
thank you for having me here in studio.
Speaker 2 (16:34):
Yeah, it's wonderful. And I understand you're a KFI listener.
Speaker 3 (16:36):
I love KFI And when it came to ucilea psychiatry
residency nineteen ninety eight, one of the first shows I
started listening to was Handled the big giant billboards everywhere.
It's only been twenty seven years. I haven't listened to KFI.
Speaker 2 (16:48):
We love our Handle. He's a great guy. So I
was listening to videos on lectures that you did, and
you talk about our current marijuana use as this growing
public health crisis. Can you talk a little bit about that, well.
Speaker 3 (17:05):
Suirre, certainly. And again, if you rewind where we were
twenty years ago, think about LA There was no above
board cannabis dispensary, there were no billboards. People didn't talk about.
It was in the shadows. Right fast forward to twenty
twenty five. Right now in our state, we have about
thirty five hundred cannabis dispensaries that legally sell cannabis. We
(17:26):
have a massive amount of unregulated and unrestricted cannabis as well.
Speaker 2 (17:30):
That's the word I want to talk about. Unregulated. Is
the stuff in the stores regulated at all? Do we
know if what they say is in it is the
stuff that's in it? Oh?
Speaker 3 (17:39):
Absolutely. So you go back to when we first did
this November twenty sixteen, it's been nine years since our
state has legalized cannabis used for adults twenty one and
zero stress that. Yeah, they did stress that. And so
what we then have created is a very strange California
market right where on one hand, the above board dispensaries
that are doing it by the book, licenses, regulations, policies,
(18:03):
and procedures, and they're protecting our health, are selling products
it's really sophisticated and safe. On the other hand, there
are a lot of brick and mortar dispensaries that are
not regulated, or they're doing delivery services and they're giving
things to the public that they think are safe but
actually are not fully and wholly tested. So nine years
(18:23):
we've created a very very tight California regulatory policy, and
you can imagine when you put a lot of rules
in place, there are gonna be some folks that don't
follow it. So that's why there's this weird split between Yes,
things that are on the shelves and regulated above boards,
trusted dispensaries are exactly what they say they are, versus
things that are in unregular dispensaries or things that are
(18:44):
delivered and certainly things that are handed to you by
a friend or a family mateer or an aunt or
an uncle maybe at a July fourth barbecue.
Speaker 2 (18:52):
And someone told me, the little bit of pot that
we smoked on back in college in the seventies and
eighties is not the same as the product that's around
today today. Suppose to be stronger.
Speaker 3 (19:01):
Oh absolutely, And that's one of the first myths that
we hear all the time. It's just weed, it's mother nature. Well,
it's very different than in the eighties or nineties, whereas
about on average about four percent THCHD content. Now that
percentage is about twenty five thirty percent THHC that are
quote seized by officials. But we have products on the
(19:23):
shelves cannabis dispensaries that can go as high as seventy
eighty ninety percent THHD concentration. So it's a different product.
So imagine you know again, you were born fifteen years
ago and now you're growing into a world where you
only know high concentrated, high potency cannabis, right, And the
message to you as a young person says, hey, it's
(19:44):
just weed. I did it.
Speaker 2 (19:46):
Do you know how many times I hear this? You know,
I teach health psychology at cal State Channel Islands, and
whenever I do my little addiction lecture, how many students
put up their hands. Only weed or just weed are
what I hear all the time. And they just think
it's hard less, right, So that is myth number one,
myth number two. And they also say this, oh, thank
goodness it's weed, because nobody's going to overdose from it, right,
(20:10):
is it possible?
Speaker 3 (20:11):
Well, again, the myth about why is it harmless?
Speaker 1 (20:13):
Is number one.
Speaker 3 (20:14):
You know, cannabis intoxication can be dangerous in the sense
that's some folks for the very first time they use
cannabis develop psychosis or nausea, or impulsivity or aggression. Right,
So that's part of it. Number two. Although it's very
rare to die from an overdose of cannabis, you can
die while intoxicated car accidents, falling off a root. In fact,
(20:36):
one of the byproducts of increased legalizations. That's in the
number of calls of poison control related to cannabis, right,
and even like babies and toddlers. And but again, I
don't want to be the oh my gosh, this guy's
falling kind of thing. But these are just the scientific facts.
The second part about is why is it not harmless? Again,
is just straight addiction. When you develop a cannabis use
(20:56):
disorder or an addiction, it really significantly damage your life.
Speaker 2 (21:01):
So there's this perception though that it's not addictive.
Speaker 3 (21:03):
Oh, it absolutely is. And again, pound for pound, if
you say opioids, heroin, fetnyl cocaine, yes, there's a quote
more addictive. If you look at say broccoli or kale, though,
or quenoa, you know, other Mother Nature's plants, they're much
less addictive than cannabis. This is about a nine percent
chance of developing addiction from the very first time you
(21:25):
use cannabis, Which is why we stress so importantly that
this is a product for adults. This is a product
that's meant to be used when your brain and your
body are ready for it. That means twenty one and up.
Speaker 2 (21:36):
And here's the big question. This myth out there that
there are no withdrawal symptoms that you can just quit,
And you use the word in one of your lectures
tapering just tapering off. How possible is that?
Speaker 3 (21:48):
So in twenty thirteen, when we diagnose cannabis withdrawal as
an actual medical condition, there was controversy. Well, people say, well,
you don't die from withdrawal, But for anyone out there
who's gone through cannabis withdrawal, it is a it is suffering.
It's like the flu. You can't eat right, you can't
think straight, you can't function. So it creates a lot
(22:09):
of just damage, a lot of suffering that's unnecessary. So
and when the strength of the cannabis is much stronger,
you can develop withdrawal symptoms much quicker, literally within about
seven to ten days of using on a daily basis.
Speaker 2 (22:23):
Wow, Okay, we need to go to break. When we
come back, I want to talk about whether there is
any real medical use and if so, what specifically, And
then let's talk about treatment. A lot of people listening
may themselves or have children who have cannabis use disorder
and not even realize how addictive.
Speaker 3 (22:41):
They are.
Speaker 2 (22:41):
So let's talk about treatments. When we come back, my
guest is doctor Timothy Fong of UCLA. We're talking about
cannabis use disorder. You're listening to the Doctor Wendy Wall
Show on KFI AM six forty Live everywhere on the
iHeartRadio app.
Speaker 1 (22:54):
You're listening to KFI AM six forty on demand.
Speaker 2 (22:57):
Welcoming back to the Doctor Wendy Wall Show five AM
six forty Live everywhere on the iheartradiore. My guest doctor
Timothy Fong from UCLA. He's the go to person when
it comes to cannabis research and knowledge. Doctor Pong, Let's
talk about this medical marijuana that everyone seems to say
is but we needed it's such a good treatment? Is
(23:19):
marijuana good to treat anything?
Speaker 3 (23:21):
We're trying to find out, and you think about our
history in California. We were one of the first states
that created medical cannabis, and back in twenty seventeen when
we started our ucle Center for Cannabis and Cannabinoids, we're
really excited to find out how can we use cannabis
in a way that helps people and it helps get
rid of suffering. There's no doubt in my mind and
the hands of the right properly trained physicians that cannabis
(23:44):
probably could be a useful product, but we're not there yet.
We're not there yet, and so the science falls much
farther behind. We have actually a really interesting study looking
at just recently, when medical cannabis is used by doctors
that are trained in it, see the patients properly that
do it right, that patients do get better. However, that's
(24:05):
the vast majority of doctors aren't trained in how to
use medical cannabis.
Speaker 2 (24:09):
But we're talking to treat things like you know, nausea
from chemotherapy, right, or maybe if you're wasting from a
disorder where you're getting too skinny and you can't eat,
that's right, sleep disorders perhaps, or PTS.
Speaker 3 (24:22):
I actually know, and that's the myth, right, So our
science tells us, yes, it's effective for pain, it's effective
for chemotherapy to induce nausea and vomiting, and for mulcile
spasticity from multiple sclerosis. Now all that other stuff you
hear about for insomnia, anxiety, PTSD, hangnails, growing hair, sexual reality,
(24:42):
the scientific studies don't bear that out.
Speaker 2 (24:45):
And depression and anxiety it actually increases, right, it.
Speaker 3 (24:47):
Makes things worse and So that's a real fascinating area.
And I really wish we could say with confidence that
our medical field has moved in the last twenty five
years to say that, yes, this product of medical cannabis
is really effective for X. Unfortunately we're not there yet.
And the two things I see the number one, autentized
patients then say oh, I'm not going to use the
standard treatments. I'm going to go straight to medical cannabis.
(25:10):
And then number two they do it on their own.
You know, this isn't a DIY kind of thing. You know,
this is a very powerful plant with a lot of
potential effects, but positive and negative. So all folks out
there again the idea that we all want to reach
for something quick and easy and affordable that makes our
lives better. But unfortunately, if you're going to do that,
(25:32):
you have to do it under the supervision of a
physician that has experienced in using medical cannabis. Again, if
I said, hey, you know, go see a doctor, he
or she has signed off on a form and then
he won't tell you what to do, and you're supposed
to go pick out the product in the shelves, take
as much as you want or as little as you want,
and if you have problems, don't call that doctor back.
Speaker 2 (25:52):
Well, that's not that's not how it works.
Speaker 3 (25:55):
It works.
Speaker 2 (25:56):
So let us talk about treatment. First of all, I
read somewhere that your estimate eating that two percent of
the American population suffers from cannabis use disorder.
Speaker 3 (26:04):
That number globally is probably higher now that we've seen
expansion of cannabis in at least forty eight or twenty
four states and forty eight medical cannabis states. It's probably
almost up to like three or four percent of the
general popula.
Speaker 2 (26:15):
I read somewhere that four percent of twelve to seventeen
year olds twelve to seventeen year olds.
Speaker 3 (26:20):
Yeah, and stats are hard, I think. The way I
think about it, this is very simple. A look, this
is a new generation gen Z, gen Y, whatever you
wanna call Generation Alpha, who are growing into a world
where cannabis use is accepted, normalized, permissible, and in some
ways promoted very much promoted, versus again a world whether
the cannabis products are using and how they're using it
(26:43):
we now know scientifically not great for them. More kids
right are not smoking, they're vaping, vaping, and the biggest
concern of my our young kids using those vaping products
a lot more potency, a lot more chemicals, but there's
also use of a lot more synthetic cannabinoids. So these
are the delta THC eight, the thhca, the delta TC ten.
(27:04):
These are human made products from like them. They're not
the naturally grown flowers. So it's just another synthetic compound
that unfortunately young kids are getting into much more popular.
Speaker 2 (27:16):
All right, So let's say somebody wants to quit. How
do they do it? So?
Speaker 3 (27:20):
Number one, if you want to quit, really seeking professional help. Again,
this is not a DIY project, and there's not shame,
stigma and oh my gosh, you're addicted, paw, you're adicted marijuana.
How could that be? No, if you're going to do it,
do it in the hands of professional, a physician, a psychologist, somebody.
Speaker 2 (27:36):
Who specializes in addiction. Not just your primary care no.
Speaker 3 (27:40):
I mean primary care. Many primary care doctor are starting
to see this all the time, emergency room doctors, anyone
who has experienced with cannabis and health and behavioral health
and who's really well connected. And we say in our
addiction field, it takes a village, you know, to really
get people better. It's not just me, you know, seeing
you once for every thirty minutes, like you know, you know,
once a month. So getting professional help is step one.
(28:01):
I think get incredible information online is really probably step zero.
And a lot of folks who are doing that are like, well,
they just google cannabis addiction, treatmentabis withdrawal and you get
literally millions of hints. And I think it starts with
get incredible information like from our state California Department of
Public Health has a lot of really great information, or
the National Institute on Drug Abuse, or our on website
(28:24):
at the Cannabis Center that we have at Cannabis dot
Semio dot Ucla dot edu.
Speaker 2 (28:30):
And I did some calling around for a friend. And
most insurance, private health insurance does not cover marijuana detox
does it. Well, they all say it's not medically necessary.
Speaker 3 (28:38):
Right. They won't cover it in a quote hospital based
setting or a residential setting because I'll say, oh, this
person doesn't need to be in a contained environment. They'll
cover a lot of outpatient visits and maybe an intensive
outpatient program, but when people need full containment, probably not.
Speaker 2 (28:56):
So is there any medication that people can take to
help them through the withdrawal.
Speaker 3 (29:01):
Well, right now July twenty twenty five, we do not
have an FDA proved medication with cannabis use disorder or
canvas withdrawal. However, we have some stuff in the research
toolbox that kind of works that does help. And again,
just think about going through withdrawal. You stop cannabis tonight Sunday,
right after July fourth weekend, you might not have withdrawal
(29:21):
symptoms until Wednesday or next Friday, and you might be
realize that what you're going through is withdrawal. So usually
for a lot of folks, the first thing is recognized
that the symptoms that they're having are withdrawal, and then
we give comfort medications, we hydration, you know, we do
things that take away the symptoms of withdrawal that are
really difficult, like the nausea, the vomiting, and the inability
(29:44):
to eat or sleep, just the feeling queasy. Those are
the things that we do right away.
Speaker 2 (29:48):
I actually read somewhere that there some chronic cannabis use
can cause people to lose a lot. We always think
of getting the munchies and eating a lot when you're high,
but something goes on with your intestines with chronic use for.
Speaker 3 (30:00):
Some folks that can. I mean, we see intoxicated case
and cannabis hyper emesis syndrome where they're constantly vomiting so much.
We see I've had a number of patients who just
taken on a daily basis and content vicious cycle where
they use to get rid of the nag in vomiting
and they use too much and then the byproduct, the
side effect of using is what more noge than vomiting.
So again, we don't want to be the fear mongering
(30:23):
at all, which is these are just some things that
happen out there. For the vast majority of people, they
don't experience these horrible things, but they can happen. And
I think for people to realize it's not just you know,
not just weed anymore. It's all sorts of things that
can happen.
Speaker 2 (30:37):
But we need to be having this conversation because we
are counteracting the kind of messaging out there, the myths
out there given by the producers of this drug and
maybe even you know, people that want to collect tax
money or sell it, et cetera. If left untreated. What
is the most common progression of cannabis use disorder is
(30:58):
a gateway drum.
Speaker 3 (31:01):
Old school term. We don't use gateweight drugs anymore now
I go back. It was really interesting to me is
that when I first got into it, what I didn't
realize is that untreated addiction leads to death. It's as
simple as that. And this is probably the most shocking
thing that I think listeners will hear about that cannabis
use disorder is associated with a higher rate of morbidity
and mortality. People die suicides, unintentional drug overdoses on other
(31:24):
stuff that they're not they didn't they're not aware of
that are in their cannabis. Other co occurring mental health
and medical conditions that are not treated again, untreated depression,
untreated anxiety, untreated PTSD. These are things that if people
are using cannabis to treat, that actually make it worse
and subsequently could actually shorten their life. Lung cancer there's
another one that sometimes we see, and right before pandemic.
(31:47):
I don't know if people remember twenty nineteen, but there
were about eighty deaths in America from electronic vap being associated.
Speaker 2 (31:54):
Lung the mysterious vaping disease. Remember that we're trying to
warn our teenagers.
Speaker 3 (31:59):
Right you remember that I did some content on that
in twenty nineteen. You know, those are all deaths. So
I think that's the thing people get shocked at when
they think, oh my gosh, there's increased death in cannabis addiction,
and the best way to prevent addiction, of course, is
obviously not to use on a daily basis, but also
sort of weight weight in your body and brain are
(32:19):
fully developed to begin to use it as an adult, right.
Speaker 2 (32:22):
So it's definitely not for kids, definitely not for teenagers.
Speaker 3 (32:26):
Yeah, and you know, I have one quick story. I
had a number of social workers. I said, you know,
when the kids using and the parents know they're using,
isn't that something we need to call a Department of
Family childcare services? And I've never had a social worker sey, Well,
nobody's going to take a kid away for giving them cannabis, said,
but isn't the law twenty one and over? Yeah, so
(32:46):
I get.
Speaker 2 (32:46):
I mean, if you, as a parent drive drunk with
a kid in the car seat, you can lose your
kid for that. So if you're giving your kid a
drug or allowing them to use in front.
Speaker 3 (32:54):
Of you, if you're allowing them to use an edible
allowing them to have a vappen and a lot of
parents don't even know unfortunately that the kid is in
Cannaba because they don't smell it.
Speaker 2 (33:03):
Right.
Speaker 3 (33:03):
Edible, Yeah, the edible, the vate pens, the drinks, all
these things are very very.
Speaker 2 (33:09):
Different, Doctor Timothy Fong. I know this sounds like bad news,
but it's going to help lots and lots of people
to hear it. And it is just my pleasure to
have you here in the studio with us. As your
research breaks, as you continue to come up with new breakthroughs,
please keep in touch with us so that we can
make sure that the public gets this information that they need.
Speaker 3 (33:26):
Absolutely, thank you for having me.
Speaker 2 (33:28):
I'm happy to have you here you and that brings
Doctor Wendywell Show to a close. If you want to
follow me on the social media, you may The handle
is at doctor Wendy Walsh, but I'm always here for you.
Every Sunday night from seven to nine, you've been listening
to the Doctor Wendywall Show on KFI AM six forty
live everywhere on the iHeartRadio app
Speaker 1 (33:46):
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