0:03

No, really,

0:09

no, really, they really don't really fans.

0:11

It's David Google.

0:12

I'm Google.

0:12

I'm here with you today with a bonus

0:15

edition of really No Really

0:17

Now. In the most recent edition

0:19

of the show, we had doctor Ryan

0:22

Sultan, the assistant professor of clinical

0:24

psychiatry at Columbia University.

0:27

Now he came on to talk about people behaving

0:30

badly, the Karens at the pool

0:32

or the people going crazy on airport,

0:34

right, and so we were having that discussion.

0:37

But during the taping, Peter

0:39

admitted that he was coming

0:42

could Turkey off of the use of marijuana

0:45

that had gotten out of hand since

0:47

COVID, so much so that

0:49

when he went off of it, he was he was

0:51

having a hard time. Well, thankfully

0:54

for us. Doctor Sultan is

0:56

an expert in the areas

0:59

of anxiety disorders depression ADHD,

1:02

and substance abuse ketamine

1:04

and cannabis youth, so he

1:07

was the perfect person to talk

1:09

to the research the

1:11

new extensive research showing

1:14

issues with heart issues

1:16

with parts of the brain actually shrinking

1:19

with extended cannabis youth.

1:22

So we wasn't.

1:23

Really part of the behaving Badly type

1:25

of show that we were doing for you, but we

1:27

felt that it was an important, helpful

1:30

conversation that we wanted to share with you.

1:32

So without further ado, let's go to Jason

1:34

and Peter for really, no,

1:37

really, it's.

1:39

Starting because the oscars happened recently

1:42

and.

1:43

You got through them without smoking.

1:44

Leave. That's really I've given up.

1:46

So I gave up.

1:48

I could do a medical podcast and

1:52

we just did a report. Just literate

1:54

the latest report. I'm having a tough

1:57

time even talking today.

1:58

So what should I call renegade Parana and

2:00

get it back over.

2:01

Boot roller blood.

2:03

So in the report, and this is not a

2:05

small sampling, this is like over four hundred thousand

2:07

people now that's been not legalized for all,

2:10

they found the stroke risk is.

2:11

Through the roof.

2:12

The lord caught smoking for smoking even

2:14

for edibles. The lung cancer risk

2:17

is through the roof. And I went out the

2:19

other night, and you know, I've been smoking heavily. Heavily,

2:21

Oh I know. Yeah, And I'm not proud

2:24

of it because I started using it to go to sleep, and I was

2:26

using it to eat dinner, and then I was using it to have.

2:28

Cereal, right, So and it was so easy

2:30

to do.

2:31

I sprinkle it knowing that I'm not going to go dumpster

2:33

diving and throw it out. And it's been three

2:35

days and I've quit before, but

2:38

this time has been really difficult. My cold

2:40

turkey cold turkey, and I

2:42

can feel it. I can really feel it because the

2:44

stroke. When I read those statistics, it

2:47

was incredible. But as far as the oscar,

2:49

I'm the same way with sugar.

2:50

I've been off sugar now for twenty

2:53

three twenty four days.

2:54

And congratulationships down and wait your cholesterols

2:57

down. My cholesterol fell one hundred points.

2:59

So today's lesson is if you lose

3:02

weight, your cholesterol goes down down, and

3:04

if you stop pot you're ready to kill

3:06

the guy whose cholesterol has gone down. So

3:10

joining us now is doctor Ryan Sultan,

3:13

Assistant Professor of Clinical Psychiatry

3:15

in the Department of Psychiatry at Columbia

3:18

University and the Irving Medical

3:20

Center in New York State Psychiatric Institute.

3:22

He's an expert in the area's ADHD

3:25

and cannabis use. Will talk about that. Welcome well,

3:27

but I wanted to ask you something really important. We had

3:30

opened this by talking about cannabis, and I'm very

3:32

candid about my cannabis use that I got really out

3:34

of hand during COVID.

3:35

Oh boy, yeah, and a lot

3:37

of people's did well.

3:38

And I didn't even realize it started for bed that

3:40

The story I told myself was I needed to go to sleep because

3:43

I don't sleep well, and then I needed to eat dinner

3:45

and I needed to get up, and I needed this.

3:46

Because my kids are going through this stuff.

3:48

You specialize in cannabis

3:50

use ADHD and

3:52

especially with antipsychotic

3:55

treatment and teen if you had

3:57

to give us an umbrella, because as I said,

3:59

to start this, the cannabis you is, they just found

4:01

out with one of the bigger tests ever

4:03

that they've done that increases

4:06

the risk of stroke tremendously and

4:08

lung disease, et cetera. So I threw it out

4:10

and this is day three and I can

4:12

feel it. I can feel that I'm

4:14

a different guy. I'm a bit scattered, and

4:17

I'll come coming down. Do I

4:19

also noticed that when I was using it, the more and

4:21

more I used it, the more I got edgy, the

4:23

more I got shaky, and I knew that rationally,

4:25

Buddy didn't stop. So if you can address

4:27

that, so.

4:28

Many things going on with cannabis right now, you

4:31

know one of the main things that has come up

4:33

is that we had this pendulum

4:35

shift from cannabis

4:38

is the worst thing ever to

4:41

it's a totally natural, benign

4:44

tennessee. And like both of those things are wrong, actually

4:47

right, Like those are those are extreme examples.

4:50

And and so there's this idea that that cannabis

4:52

has no negative side effects,

4:54

which is just incorrect. Another

4:56

thing that's important about cannabis is the cannabis

4:58

that you have access to now is not the

5:01

cannabis you had access to when you were a teenager.

5:03

It is substantially stronger by

5:05

design. By design, it is substantially

5:07

stronger than the stuff that you had

5:09

before. And when you think about

5:12

like whenever we've done that before, right,

5:14

like morphine versus fentanyl, Like fentyl

5:16

is like one hundred times stronger

5:18

than morphine, like and we didn't have

5:20

an opioid crisis when we only had fentanyl,

5:24

when we only had a morphine, right like

5:26

it was when we created this much stronger version.

5:28

So like the cannabis of today,

5:31

it's it's you know, you got natural cannabinoids

5:33

in your in your body that we all

5:35

just have that are binding to the cabina receptors,

5:37

and like you know the weed of probably

5:40

my parents' generation. You put a little bit

5:42

in a joint, you take one hit, like it would bind

5:44

to that, it would feel nice. The weed now

5:46

is much stronger, is binding to

5:48

that receptor and is clinging on to it so

5:50

much. And then now that it's binding to it so

5:53

much, your body says, oh, oh, I don't

5:55

need as many cannabina receptors, so they make well

5:57

less caannabino receptors. We can see that on a

5:59

function MRI that you have reduction of the cannabinoid

6:02

receptors.

6:02

So now when you stop, you

6:05

feel awful.

6:06

You feel awful because there isn't enough

6:09

naturally circulating cannabinoids to

6:11

compensate, and you don't have the

6:13

the receptors that you had before

6:16

because it's down regular and the more potent is the

6:18

stronger it is, the more that phenomenon

6:21

is going to happen.

6:22

So when you talk about it, because I had done this on the

6:24

radio years, this is why you.

6:26

Have this rebound anxiety. By the way, how long does that

6:28

last?

6:28

By the way, Uh, you know, the

6:31

fMRI data shows that you

6:33

know, on a scan it

6:36

looks pretty much normal after about thirty days

6:38

of no use.

6:40

You're almost there, Pete, No not. But I

6:42

got to push back anytime I talk about this on radio.

6:44

And this was before I had to use that I do.

6:46

Now you get to call from every stone in the world

6:48

going that's because you're doing it wrong.

6:50

You got the wrong dude, you got the wrong strain. Yep.

6:52

So the point being, I always got the pushback

6:55

people yelling everybody does podcast, you're

6:57

doing it, You're doing it wrong, you got the wrong kind

6:59

of pot. You have to this that. How do you even answer

7:01

that? Because people on pod that are using a lot of it

7:03

are going to be really resistant because, like

7:05

I said, if you said it's thirty days of this, I'm

7:08

in. I'm in because I don't want have a stroke. But

7:10

how do you tell somebody thirty years old who's

7:13

taking it because they're convinced that

7:15

it helps with their ADHD or it's helping me whatever

7:17

they have.

7:18

And and and and it might actually

7:20

it might help with their ADHD. There's a little bit

7:22

of data that that that that some that

7:26

strains, and we don't have this downright,

7:28

meaning we can't replicate it in a medical way

7:31

that it might it might do that. So I want

7:33

to validate for them, it does reduce

7:35

anxiety and it does improve

7:37

mood symptoms. So everyone

7:39

who says, hey, like, no, it actually made me feel

7:41

better, they're right. But

7:44

but the thing that that they need to think about is the flip

7:47

side of it, particularly with the anxiety and depression

7:49

stuff, which is that you

7:51

know, if you the more you're using it,

7:54

it's probably making that condition.

7:56

Worse for you. I can feel

7:58

it. I can feel and you don't realize that.

8:00

You don't realize it, and and and and

8:02

and the cannabis is sneaky. It's

8:04

really sneaky. It plays a trick on

8:06

you. You're using it more and more.

8:10

Eventually you get to a point where where

8:12

if you you need it just to feel

8:14

normal, uh,

8:17

and and to just sort of function. I

8:19

really I spend a lot of time talking with people

8:21

about that. And you know, one of the ways I start with is

8:24

just like, let's let's just write down

8:26

how often and like how much we think we're

8:28

using Like you don't have to change anything, like just write

8:30

it down, just record it, like no judgments, like

8:33

because most of the time when we do that, it

8:35

turns out it's it's more than we thought

8:38

it was, right and same thing with drinking. You ask anyone

8:40

how much they drink, almost everyone is going to

8:42

underestimate.

8:43

And the amazing thing about the phenomena is aware

8:45

of it. As I was, I'd be in

8:47

my day and I'd be going, I feel pretty good, feel

8:50

pretty good today, everything's going well on PERF doing

8:52

whatever, and I go, but I'm still going

8:54

and I know what it's doing that, but I'm still going to do I'm.

8:56

Still going to do it.

8:57

Of that, it wasn't

9:00

I always will with sugar. And I realized

9:02

that when I was in an acting class. My

9:04

acting teacher said, you

9:06

go out for an audition and you do a bad

9:08

job.

9:09

What do you do?

9:10

I go get a Snickers bar? Right

9:14

now? You go out for the audition, you do a great

9:16

job. What are you doing?

9:19

I go out for I

9:22

think as well, there you go.

9:23

Yeah, but just thing scared. This thing scared me,

9:25

I mean it scared. This report was a pretty valid

9:27

report.

9:28

And again I'm sure people are going to work and there are

9:30

other aspects of it, so that one is is

9:33

uh, in some ways not surprising because uh,

9:36

you're you're the inhalation of any

9:39

kind of smoke damage is going to damage your

9:41

runks, right, I mean this is like you are burning

9:43

something, okay, like so like you know, just

9:45

like if you were in a fire, that wouldn't be good for you either.

9:48

The other thing that I worry actually more

9:50

about, because the lung thing is the obvious

9:52

thing to be worried about.

9:54

The thing that I worry.

9:55

About is all this data that

9:57

we have on the on the changes

10:00

in the structure of your brain.

10:02

That's what I worry about.

10:03

So in kids, which by the way, is under twenty

10:05

five, okay, under twenty five, is

10:08

your brain is developing to lease till twenty five your

10:10

ADHD it's probably even later than that, there's

10:13

evidence of structural changes. And then

10:15

in long term cannabis users, and

10:17

you know in in Scandinavian

10:19

countries, they you know, their socialized system, they monitor

10:21

everyone, they have records and everyone, so they are to look at

10:23

people for many years. Cannabis users,

10:26

their hippo campus is smaller. Your

10:28

hippo campus is a big memory center.

10:31

And one of the most acute effects

10:34

of cannabis is the effect on memory. I mean, anyone who smokes

10:36

pot is aware of this, and

10:39

so like what does that what does that mean? I actually

10:42

don't know the answer, right, like I don't. I

10:44

don't know the answer. No one has the answer.

10:46

Thing.

10:47

But then you get the superstars, like I'm

10:50

assuming based on what they themselves have

10:52

said, superstars like Snoop Dogg

10:54

or who

10:57

are who are able to I mean, they

10:59

seem to be completely functional.

11:02

In fact, there seth Rogen's probably doing

11:04

a hundred times more in a day that I'm.

11:06

Capable of do it.

11:08

And you know, the thing

11:10

with with uh mind

11:12

altering substances, and this was true for alcohol

11:15

too, is that uh, we

11:17

all don't respond the same

11:20

to them. And also the situation

11:22

that we're in the life, we're in, the

11:24

environment we're in is going to affect that

11:26

too. And and and yes, there are people that seem

11:29

to be really heavy cannabis users and there

11:32

does not appear to be any negative comment for

11:34

them, but that's not gonna be everyone.

11:36

May I wrap this episode up by saying, in

11:38

the words of your mother, don't worry so much

11:41

about Snoop Dogg.

11:41

Worry about you, your

11:45

mother, your mother, we should hear.

11:46

Sorry to wrap every episode, don't

11:49

don't worry about seth Rog.

11:50

Seth Rogen jumps off of U right

11:53

now as another episode

11:55

of Really No Really comes to a close. Let's thank

11:57

our guest, doctor Ryan Sultan. He's

11:59

the director of Integrative psych as well

12:01

as being director of Sultan Live at Columbia

12:04

University. You can follow him on Instagram

12:06

where he is at Our Sultan MD and

12:09

on x where he is at Doctor Ryan Sultan.

12:12

Our little show hangs out on Instagram,

12:14

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12:16

No Really podcast And of course you

12:18

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12:21

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12:23

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12:25

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12:52

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