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)