 Welcome! My name is Katherine Antley. I'm a physician in South Burlington and we're here in the Old North End of Burlington in a park because it's COVID and we're doing the next episode after a long hiatus of the science of effective prevention. Today I have a very special guest with me, Anne Hassel, who is a former budtender in the cannabis industry, former proponent of selling cannabis commercially. Also a physical therapist and she's up to share from Massachusetts to Vermont to share some of her insights. I'd like to start with an intro about just some general words about prevention. The science of effective prevention depends on a foundation of science. So first we need good scientists to give us data. That data then needs to be communicated both to the public, to caregivers who are in touch with children and in the community, and then that needs to be communicated to legislators who make laws, affect policy, leaders throughout the state. And in Vermont we have a fantastic group of really brave, courageous, highly intelligent, recognized physicians and other professionals who understand what the implications of some of the policies that are happening in Vermont. So today we're talking about the commercialization of marijuana and what sort of guardway it rails to the public health that we need to put in place. So there's two things that we want to be sure to touch on and I'll just mention them first before I jump in. One is in the legislature right now they're changing the law. In the past we had a limit of 60 percent THC and 30 percent, which is a little bit like a speed limit of 200 on the highway, but it was the first in the nation, Vermont's been first in the nation for a lot of things and this is first in the nation. Very good, very commendable. Right now they're considering lifting that, creating a loophole for increased THC levels if they're used in creating cakes and candies or other products. So we think the public should know about that and if you don't, if you disagree with that perhaps call your legislature your house member and let them know. The other thing that has happened is when this bill first passed the legislature many of people in Vermont contacted their legislators and we don't want advertising. We don't want it in the newspapers, we don't want it on the radio, we don't want the industry to be using advertising to create more addiction because as we know more addiction is what creates profit in this industry and the first law that passed had no advertising. Now they're adding advertising so if you disagree with that it's also a reason to definitely contact your legislator and tell them you don't want advertising in the bill. So we have good precedent for that in 1964 when physicians and scientists finally linked smoking to cancer, there was public outcry and as a result we had warning labels that were attached to tobacco. Advertising eventually was banned on broadcast media and an annual review and report was ordered by the Committee on the Health Consequences of Smoking. All things we need and have good legal precedent for putting into Vermont law. So I'm gonna start with or continue I guess. Just want to talk for a minute about media matters. We have fantastic scientists in Vermont, they're communicating to the legislators, they're doing great scientific research and the legislators understand that there are health risks to cannabis. How do we know that? Number one the industry admits that it causes for example psychosis and we'll go into that more in a minute. But the lawmakers have also understood the cannabis causes psychosis, they put it in the law. So there's a part of the Vermont law that has the word psychosis and it's some speculations that is supposed to mitigate that. So why would they put that? So here's some of the testimony that has happened from a medical doctor in the legislature. This is what your legislator is hearing and we think that Vermonters want to know this information as well. I spent last weekend on call in the ER department talking to kids, talking to adults and I've observed over my time on call that a significant portion of young people who are hospitalized psychiatrically or come to the ED are heavy cannabis users and we also know that the cannabis that is used today has high THC nowhere near what is used was used in the 60s and the research is that there is a significant psychiatric risk for a whole host of problems, most notably psychosis but I think also suicide and aggression. It is becoming increasingly recognized at the same time. Why this is becoming increasingly recognized by scientists and physicians at the same time the public perception of cannabis is going exactly the opposite way. So I really hope that people will pay attention to this and because it could really impose a really large burden on our mental health and substance abuse treatment system moving forward. So this is testimony from one of the leading physicians in our state not me to our legislators and in response in partly in response it's in the law and I'll quote the Vermont law says honor before January 15th 2020 the executive director of the cannabis control board shall submit to the general assembly recommendations as to whether different things should be associated with cannabis in order to decrease the possibility that sorry to increase the prevention to prevent sorry cannabis induced psychosis that can occur. So the legislators heard the doctor and they put this into the law. I'd like to interject here 5A Dr. Antley in Massachusetts we had legalization before Vermont and in order to supposedly safely regulated the Department of Public Health was supposed to is issued by our laws in Massachusetts they're supposed to conduct research and determine what a safe level of THC was to have in a product and that was never done. So I when I hear something like that and for what I understand is that's not enforceable I don't know if you got to that part where they're already changing what was presented to the people and they're making these assurances but what happens is the industry is so powerful that it prevents those I guess guardrails to preserve and protect public health and that's been documented in various states. The only other thing I'm and then I'm gonna do the second half of the program almost entirely yourself but the only other thing I wanted to bring up before we leave this portion is that you know why is it that that physician is recognizing that while physicians providers all recognize that this is a serious concern and it contributing to psychiatric illness in our in our kids and teens why is it that the public is not aware of this so we pulled an article from just last week from the VT digger and it's the headline is a crisis kids seeking mental health care are waiting days in the emergency room this isn't the only article it's been in three other papers it's been on the news this is a crisis in Vermont in this article nowhere is cannabis mentioned so physicians realize that cannabis is a significant contributing factor but in our articles that are coming down out of our respected news organizations the the the public is not being informed so this is is broken this is a broken chain and this is a foundation of effective prevention we must have good scientists and that information must be communicated not only to policymakers as it is but also to the public so I'm going to turn it over to Ann and Ann is it has worked for the cannabis industry in Vermont I mean in Massachusetts and has enormous experience with that whole situation well as Dr. Anthly said I went into the industry I was someone who believed in marijuana is being natural healthy and non-addicting however I discovered that that is not true I'm not the only one who's made these actual who's had a change of heart in addition I started consuming the flower which was 30% THC that went later to the concentrates that was 98% THC and consuming that via dabbing which is when you take a small amount of the concentrate with a butane torch and a glass rig like a bong when I started consuming that I had I had severe mental problems that escalated I developed a cannabis use disorder I also started to experience cannabis and do psychosis now it's been proven the literature is there the science is there that cannabis is a factor in psychosis there's something called cannabis and do psychosis and it's really upsetting that states such as Vermont following Colorado following Massachusetts are falling in the same pitfall and I just want to talk about someone else in terms of my terrible psychological effects is that I started to again have a cannabis addiction consuming more and more I had these escalating violent thoughts that I wanted to harm people first it was property then it was killing people escalating and at that point I just wanted to kill myself and that's where I was at the point of only having cannabis in my body and that was bringing me to the point of suicide so when doc when the doctor mentions that it may cause aggression that it causes suicidal thoughts well that actually is true I experienced it I'm not the only one there's a very big Colorado cannabis proponent Robert Corey had to change a heart he himself experienced some very detrimental effects of he was actually dabbing also and he actually came to understand that what he strove to enact the cannabis industry the commercialized industry was dangerous he said flat out that he says that he is the outcome of the legalization of Colorado is shameful hurts people and Colorado is not safer and he goes on like me we went into it thinking it would be about so-called healthy plant it's about creating I would say the most dangerous disgusting product imaginable and as you increase the level of potency you're increasing the addiction and the mental harm there was also another individual he came before Robert Corey he was also a cannabis site reviewer called the gentleman toker was the name of the site and also Joe Tierney he was dabbing he noticed that he was coughing up blood and he decided to quit dabbing the thing is what's going on here people are being told that cannabis is a safe medicine when that's the absolute opposite of what's happening and I feel really bad for the young people because I was a middle-aged woman with a fully developed frontal lobe with no access to weapons what would have happened if I was younger what have I have developed schizophrenia Dr. Anjali that's my question is that there is a connection maybe you can talk about the connection of when you are in cannabis do some psychosis how many then go into schizophrenia so we have a number of so when there's a number I guess we'll just address it there are a number of people who say this is association it's not causality and what is the evidence that we have that cannabis causes psychosis it's very strong and just as an example you can't take a group of kindergartners a class of kindergartners and divide them into two and then give one THC or give one tobacco and watch them over 45 years or 60 years and see which one which group develops more cancer that's unethical we can't do that this is the reason that we rely on these other studies to support and come to the conclusion which we have that tobacco causes cancer so the same types of studies that we came to the conclusion that tobacco causes cancer are the same sorts of studies that we're now coming to the conclusion that cannabis is a component cause of psychosis and as Robin Murray says no serious scientist continues to dispute that cannabis is a component cause of of psychosis and what is the evidence I mean some of the evidence we can run through the more potent product you use the more likely you are to become psychotic the more often you use it the younger you use it the more likely you are to have a psychotic break nearly 50% this is important for people to know I think 50 and almost 50% of people who have a full-blown psychotic event on on cannabis will go on to schizophrenia and and if your child or if your husband or or lover or or friend has had a serious psychotic break on marijuana they emphatically should never be using cannabis again because if they do they're at 50% risk of developing schizophrenia which is a life just you know quote the quality of life is just isn't nearly completely destroyed it's very difficult to treat it with anti-psychotics it's very difficult to stop using very difficult to treat the addiction so that's why in this particular array prevention is the most important part so why is it so devastating people hear voices they see they see hallucinations they have paranoid delusions and so there's one other factor that has happened even with with research in cannabis and that is if you give two groups of people who are they have the same amount of childhood trauma and age and sex and and all the other adverse there in other words they're quote they're controlled groups and you double blind them and you give one group placebo and you give the other group THC the THC illicit psychosis that's one of the in a prospective double-blind study that's a very powerful study to support the idea that cannabis causes psychosis so that's that's a summary where we are I think it's important now if people don't want the legislature to put in the loophole for the high THC call your representative if you don't want advertising broadcast media in the newspapers or call call your representative absolutely right now because this is important this is not about you know the advertising and high THC is not about civil justice or social justice it's it works against public health and so I think that there's every reason to to make your voice heard and I guess we'll finish in Massachusetts they put these things in the law but they weren't able to enforce them or get them to actually be part of what people experience in the law and that's got to do with that the the requirement was given to the cannabis control board and the cannabis control board is controlled basically by the governor if the governor doesn't have control over the cannabis control board to make sure these things happen then they don't happen or they might not happen and that's the situation the same situation we had in Massachusetts where it didn't happen we have the setup apparently in Vermont where we don't have the ability to make sure these things that are written into the law do happen well you mentioned advertising in Massachusetts advertising is not allowed if the audience if there's an audience of 15 percent of people under 21 but there'll be a bus stop that has a huge marijuana advertising right at the children's bus stop and nothing is done about that and as for the cannabis control commission what I've observed in my state over the past couple of years is that people are on board for a little while and they go to work in the industry so where are their priorities? It's called actually Robert Corey called it crony capitalism. You're crony cat, cannabis, cannabis cronyism, he called it cannabis cronyism listen to this part this also is how I feel what I have changed my mind on applying current reality I was too naive to anticipate 10 years ago is the wisdom of a commercialized for-profit elitist government protected privilege monopolistic industry that perpetuates itself and its obscene profits to the detriment of the public good and the planet earth well I think he summed it up pretty well that's a great place to end this program thank you so much for being with us thank you and for coming down from Massachusetts you're welcome as an awesome quote and you know I hope that you've you've enjoyed tuning in today and we'll see you next time on the science of effective prevention