Translator: Rhonda Jacobs
Reviewer: Peter van de Ven I'm a clinical psychologist
and I'm a researcher. I study drugs and human behavior. So I'm really interested in who uses drugs
and what drugs they're using, and why do they use them, and what are the consequences
for mental health? And like a lot of people
in the past couple of years, my team and I have been
turning our attention towards cannabis. And we've conducted a series of studies of medical and recreational
cannabis users. So one question that people
often ask me when they find out that I research recreational
and therapeutic cannabis use is how can you tell the difference? What's the difference
between recreational and medical use? And I think that's a great question because it raises some
really important issues about just how porous the barriers can be between well-being, health and pleasure. And I don't think
there's really an easy answer. I don't think there's going to be
one, sort of, objective criteria that we can use to distinguish
medical from recreational use. There are people out there
who have conditions that respond very well
to cannabis-based medicines. And they might still use cannabis
a lot of the time because they like the way
it makes them feel. There are also people who might
not think of themselves as medical users, but they get substantial symptom relief
from using cannabis - people with back pain who smoke a joint
before they go to bed and find they can get through the night
with a good sleep undisturbed by pain even though they're having
a bit of a flare-up. But for a lot of people it is clear cut. They have serious and severe
symptoms and illnesses that they treat effectively with cannabis
and cannabis-based medicines, and they don't like the feeling;
it's an unwelcome side effect. For a lot of people, it's both: They treat very legitimate symptoms
using cannabis medicines, and maybe they like
some of the other aspects as well. But whether it's recreational
or therapeutic or both, what we do know is
that a lot of adults in Canada choose to use cannabis. They weigh the costs and the benefits, and they make a reasonable
and rational choice to use cannabis. It's well over half of Canadians
across their lifetime, and about 20 percent of us
in the past year. So if so many Canadian adults
are making this rational choice, what's the big deal? Why do we have
this complex and conflicted fearful relationship
with this ancient plant? I think that's really
the important question. How did we get where we are today? And where might we go from here? And that's what I want to talk about. I want to talk about
where we are with cannabis. You know, when we think about
our relationship with the cannabis plant, we tend to have very short memories. A lot of us will start off, you know, with some of the cultural
changes of the 1960s - there's Jerry Garcia. Some of us will even go back to the 1950s and jazz culture. But really, if we want
to think about our relationship between human beings and cannabis, we have to go back
a whole lot further than that. This is a pictographic representation
of hemp plants being hung out to dry. It's about 5,000 years old;
it comes from central Asia. And that's where our best estimates
of early human use of cannabis come from, several thousand years ago in Asia. And whether that use was medical,
whether it was spiritual, whether it was just for fun, I don't think we really know,
it's an ongoing debate. But what we do know
is that this is a very old relationship. By some estimates, cannabis
was the first cultivated plant. You could say that cannabis
and human beings grew up together. Cannabis has been described
as a camp follower. It's a plant that follows
human beings wherever we go and wherever we disturb the earth
and make a place for it to take root. Cannabis can, of course, grow wild, but it doesn't mind some help. And for most of our
many-millennia-long relationship, we've gotten along pretty well. Even as recently as just
a little over 100 years ago, Queen Victoria was using cannabis extracts
for therapeutic purposes. But like any long relationship,
there have been ups and downs. And cannabis and human beings had a bit of a falling out
around the 1930s. That's when you first see
the term "marijuana" become popular, and it was a term that was coined
by cannabis prohibitionists to make the familiar cannabis plant
seem foreign and scary. That's why I don't favor that term. I like to think that
my great-grandchildren won't recognize it. And if they do, they'll laugh
when they hear "marijuana." I'm pretty sure
that they're going to look back on our current era as a strange
and confusing time of misunderstanding. So, since we've had this falling out, cannabis and people, how have we both fared? I mean, we're both distinct species
with our own biological imperatives. So what has this interspecies battle meant for people
and for the cannabis plant? It's been noted that the psychoactive
resin of the cannabis plant, the part that has most
of the medical properties, the part that people use to get high, it's been proposed that that evolved
to protect and cool the seeds, and that's certainly true. But when we think about how much help
the cannabis plant has got from people, we can imagine that the resin
may have evolved to serve other purposes as well. The writer Michael Pollan, in a great TED Talk
from a couple of years ago, encourages us to take
a plant's eye view of things, to try to see things
from the plant's perspective. And I think that perspective
can be really helpful when we try to estimate
what the impact of this battle has been on the evolutionary path
of the cannabis plant. I think when we take
this plant's eye perspective, particularly here in BC, it seems like the cannabis plant
is doing pretty well. It's not native to this region
but it grows widely throughout the area. You know, I think that
if I were to take the perspective of another plant species,
one that is native to BC, the Ponderosa pine. So if I was a Ponderosa pine
and I had an ego and a self-reflective consciousness, I think I'd be a little aggravated
when I looked at the cannabis plant. You know, there used to be
stands of Ponderosa pine, and now there are caverns
and basements full of cannabis. So it seems like cannabis
is having a bit of a moment. You know, and not only has cannabis
gained a whole lot of territory over the last several decades, it's also diversified. The number of distinct
and robust strains of cannabis has skyrocketed
over the last couple decades. So in the 75 years or so
since people declared war on cannabis, the cannabis plant is bigger,
better and stronger than ever. So how have people fared
since we started this battle? What's it meant for us as a species? And I think it's cost us dearly. It's certainly cost us a lot in resources. The most recent estimates from the U.S. suggest that the cost
of cannabis prohibition is over 40 billion dollars per year. That's over ten billion dollars
in enforcement, 30 billion dollars in lost revenue. And we can imagine that it's
proportionally similar here in Canada. But the cost hasn't only
been economic, of course, it's been a terrible cost
in terms of human misery and suffering. Countless families
have been disrupted by crime and by incarceration. And a lot of those come from some
of our most vulnerable communities. On top of that, until very recently, we've been deprived
of a very safe and effective medicine. So, if we look at this as a zero-sum game, it seems that cannabis
is coming out way ahead, and people are really on the losing end. And as much as I respect
and admire the cannabis plant, I'm a human psychologist,
not a plant psychologist. So my job is to support
human health and well-being. And so I'm compelled
to imagine a different way that we can maybe tip the scales back
in favor of humanity. What would it look like
if we called a truce with cannabis? As we seem tantalizingly close to doing. So my team and I just published a study looking at over 600
medical cannabis users from across the country. These are people
with many of the conditions that characterize the use
of cannabis for therapeutic purposes - people with serious conditions,
like cancer, AIDS, multiple sclerosis, arthritis, chronic pain. And what we found was that in addition
to treating some of the distinct features of these disorders, people were using cannabis
for three primary reasons: to help sleep, to reduce pain and to alleviate anxiety. These are things that so many
of us seek treatment for. And our medicine cabinets
are full of pharmaceutical products that are designed
to treat these very symptoms. Our team is particularly interested
in the co-occurrance of anxiety and pain. We know these things
go very close together - that anxiety and pain
really make each other worse. So we conducted a follow-up study that focused on people who use cannabis
to treat anxiety and pain together. And what we found was
that cannabis was most effective amongst individuals
who were anxious, in pain, and were trying hard
to cope effectively with that pain. Cannabis was least effective for people who used avoidant
and self-blaming type of coping. We also found that among the people
for whom cannabis was most effective, nearly 80 percent reported that cannabis allowed them
to be more active despite the pain. And over 85 percent said that cannabis
helped them to think less about the pain. And that makes a lot of sense
given what we now know about how cannabis works in the brain. A few decades ago,
neuroscientists discovered that we have our own system
in our brains and throughout our bodies that is uniquely tuned
to working with cannabis and cannabis-like substances. It's called the endocannabinoid system. And we've also found that there's a concentration of activity
of this cannabis system in the amygdala. That's the part of the brain
that's focused on processing anxiety, fear and the emotional content of fear. And the activity of cannabis
in the amygdala raises a lot of really
interesting possibilities. We spend billions and billions
of dollars every year on pharmaceutical medications
designed to treat anxiety, and our existing medications
are problematic for a number of reasons. So our team is also really interested
in how cannabis might work for anxiety amongst people who
don't also have pain conditions. We just wrapped up a study
led by my student Kim Crosby looking at anxiety, cannabis use and psychological well-being
amongst college students, and we found something
that was pretty surprising, something that runs counter
to what you might expect to see in studies of substance use
and mental health. The frequent cannabis users
in our study - those who used cannabis
two or more times a week - were less anxious than the non-users, and they were less sensitive
to the anxiety that they did have. They worried less, and they worried less
about their worrying. So, maybe if we can
make peace with cannabis, it can help us to start
and make peace with ourselves, at least for some people. I think it's worth looking into. So, if we can start to see cannabis as a tool for assisting
with our mental health, what's next? Well, the best studies
have yet to be done. Studies that side by side compare cannabis with other popular medicines
to treat anxiety. And the reason those studies
haven't been done is largely due to barriers
that have been set up by governments over the last couple of decades
as part of the war on drugs. Fortunately, this is all
starting to change. Just a few weeks ago, the United States
Department of Health and Human Services gave a green light
to the first clinical trial of cannabis for the treatment
of post traumatic stress disorder, one of the most severe and debilitating
of the anxiety disorders. So it's a very exciting time. And if we can start to use cannabis
in this way, what's next? I think there are a lot
of other plant medicines that we could make peace with and that might help us
with our well-being. Among the most promising is psilocybin,
also known as magic mushrooms. A recent study found that just a few treatments with psilocybin help people reduce anxiety and depression when they're dealing
with terminal illness. There's also an ongoing study
looking at the effectiveness of psilocybin for treating obsessive-
compulsive disorder. So this is a really exciting time
for those of us who are interested
in the psychotherapeutic potential of ancient plant medicines like cannabis,
like psilocybin, like ayahuasca. There's new studies
coming out all the time, and the rate of discovery
is accelerating rapidly. What this might mean in a more broad sense is that in the coming years and decades, we may have access
to some of the very same medicines that our ancestors used
effectively for millenia. It might also mean that
we might be able to start to address some of our mental health concerns
using our gardens or green houses, and I think that in itself
could be tremendously empowering. It could also help us to reduce
the tremendous environmental cost of producing and disposing
of tons and tons of pharmaceutical products
into our land and water. And finally, I think it means that the drug talk
we're going to have with our kids will be a lot more fact based
and straightforward than the drug talk
that many of us got as kids. Thank you very much. (Applause) (Cheers)
Which is why procrastination is so strong