My name is Adie Wilson-Poe, I am an instructor-level scientist, actively conducting pre-clinical research. I received my Ph.D. in Neuroscience from Washington State University. I have been studying cannabinoids and opioids for my entire career (received my first grant as an undergrad in 2004). I study drug pharmacology and physiology, and I’m an expert in the neurobiology of pain.

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Edit 1: PLEASE NOTE: I am not a licensed medical provider, and nothing I say here should be construed as medical advise! Anything discussed on this AMA is based upon my own knowledge of the scientific literature, and much of this literature includes animal studies. My responses are from my heart, I am passionate about my work: they do not reflect the opinions or stance of my employer. CANNABIS IS A SCHEDULE 1 CONTROLLED SUBSTANCE, and is illegal on a federal level. These discussions are occurring in a very gray legal area. I would never condone the commission of a crime, or endanger my own career by doing so.

Edit 2: Wow, what an amazing day! Thank you all so much for your questions, and for sharing your experiences! It's getting late, I'm signing off for the day. I'll continue to check back here periodically, but please feel free to engage with me on social media at any time; FB link above, Insta below.

@dradiepoe

Edit 3: Obligatory RIP inbox. The thing that has become the most clear to me from this process is that SO many of you are suffering, I am truly moved by your words. Thank you for being a part of this. I'm done here, but feel free to discuss amongst yourselves!

Comments: 1181 • Responses: 86  • Date: 

everythingisforants783 karma

Hey, I'm 8 months clean off of heroin, living in Seattle. Have there been any long term studies into the effect of using marijuana during cravings? That's what I've been doing - smoke a big bowl and sleep through it til tomorrow. But am I actually just putting off an inevitable relapse without learning better coping mechanisms?

Edit: Holy wow! I was not expecting such a response from my little throwaway comment. I am totally overwhelmed by this show of support and I'm going to send the day getting to everyone. Thank you!

CannabisScientist1231 karma

Oh my god, thank you THANK YOU THANK YOU for sharing your story. There are absolutely ZERO long term studies about this, but I hope to be the author of those one day!!! Based on the literature, the only things that could definitely enhance your recovery are social support (being meaningfully connected with humans around you) and mindfulness meditation. YOU CAN DO IT.

_tupac20 karma

what if theres no one out there to connect to for me?

CannabisScientist59 karma

There is always someone.. all these fine folks, for instance! A new hobby maybe?

justrandomguy2911447 karma

I'm currently baked. Any questions for me LUL?

CannabisScientist392 karma

How does your cannabis use affect your craving for alcohol? Would you rather just smoke another bowl?

nightroad700 karma

The more cannabis I started to smoke, the less alcohol I felt like drinking. When i became a daily smoker, my cravings for alcohol are pretty much zero to none.

CannabisScientist265 karma

Thank you for your feedback! I'd love to hear from more of you about this!

AlmostTheNewestDad341 karma

Hello. I was a homeless alcoholic by 19. I managed to weasel into the military, where my alcoholism was accelerated to comical levels. Just, hilarious. Upon separation, I took up smoking pot to try and replace the alcohol with something else. It worked.

Marijuana quite literally saved my life. I now hold multiple degrees and have a very nice University desk job. If anyone ever says it's just replacing one addiction with another, they're right. But only one has negative consequences. The other has been an unimaginable boon to the successes I've had over the past decade.

CannabisScientist262 karma

This is exactly how I've phrased it before! In my opinion, and granted, I am not a recovery professional: One addiction has major life consequences, the other far less so. Harm reduction has very real value! Thanks so much for sharing. Edit: disclaimer.

milhousevh80 karma

I've had two board certified, well respected pain doctors recommended it (in certain words, and with the caveats they can't and won't prescribe it, etc etc) to me over my alternative pain regimen: Norco. I'm totally off opiates now, something I never thought possible and don't have to go through grueling monthly withdrawals anymore, since I started using cannabis. It's been a godsend, and I was devastated to move from CA to TX.

CannabisScientist105 karma

I'm so sorry you don't have access to the medicine that has been working for you. Our healthcare system has failed you, it shouldn't have to be this way.

MrGnomeAndGrown52 karma

If you'd like more feedback, come join us over at /r/trees

CannabisScientist182 karma

Oh, you think I haven't been lurking there for like, ever? But yes, I will take you up on your offer to participate in scientific research. My compensation for your contribution will be witty quips and gracious thanks.

Aerokuda66 karma

I would definitely rather smoke a bowl. In fact, i choose not to smoke hours before going out to a bar.

CannabisScientist104 karma

Thanks for your answer, I have a hypothesis that cannabis reduces ethanol craving, this is great!

Oatz369 karma

I'd love to see a study done on this.

Personally, I've stopped drinking alcohol completely. It just doesn't interest me as much anymore.

CannabisScientist112 karma

I'd love to see this too! QUICK, SOMEONE GET SOME MONEY!

Maladjusted_vagabond26 karma

I started drinking socially in my late teens and through my early 20s. Nothing out of the ordinary for that age group, but I could drink a fair bit when I was partying or whatever. I started smoking cannabis at about 22/23 and have now not touched alcohol for 5 years. Never made a conscious decision to stop drinking, I just completely lost any desire to.

CannabisScientist21 karma

Awesome! thanks for sharing!

Joeranius20 karma

Cannabis kills my craving for food(can make me hungry sometimes) and alcohol. How do you feel about teenage use of cannabis? or teenage use of non-psychoactive cannabis extracts such as CBD?

CannabisScientist141 karma

TL;DR: Don't mess with your developing brain, unless you absolutely have to because of medical reasons (intractable epilepsy etc).

Research has clearly shown that consistent adolescent use of cannabis (under 21 yrs of age) is strongly associated with cognitive deficits as an adult. The human brain does not finish developing until approximately 21 years of age, and intervening with its normal development is usually not worth the short-term benefits of cannabis.

If you or your child are considering medicinal cannabis for your condition, you should have lengthy discussions with your doctor about short vs. long term effects of cannabis. This includes CBD, which we don't fully understand.

CourageousKoala20 karma

What do you mean specifically by cognitive deficits?

CannabisScientist82 karma

Retention of information. Reaction time. Learning new tasks and the like.

Aerokuda13 karma

What about how combining the two effects you? I know that if i've had a few drinks, having a puff will immediately make me puke ! (Getting the spins, etc)

CannabisScientist29 karma

Hyperemesis is a very well documented side effect of cannabis. It affects some people more than others, most likely because of the differences in people's endogenous cannabinoid systems. Lucky you?

CannabisScientist272 karma

Holy crap you guys, have you seen the comments on imgur? That place is the sewer of the internet.

tastelessbagel162 karma

If that's your bar for "sewer of the internet", do yourself a favor and keep that bubble unburst.

Also: Thank you so much for everything you do to improve the accuracy of our public knowledge and perception of cannabis. Over the last year or so, I've really had my eyes opened to what that drug actually is. It's so strange to me now to think about how many people hold completely unfounded beliefs regarding that plant, and I really respect people like you for doing everything you can to see how far this medical goldmine goes.

CannabisScientist82 karma

  1. HA! Bubble shall remain intact, thank you kind bagelmeister!
  2. Thank YOU for being open minded and allowing knowledge to trump stigma! It's only by "coming out on cannabis" that we can truly begin to have progress on this issue!

jonnyg16188 karma

What are your thoughts concerning use of cannabis in the NFL?

CannabisScientist528 karma

Man, I can't even express how much this issue means to me. From a brain/concussion perspective, a chronic pain perspective, as well as a cannabis perspective.

There is clear evidence that these guys experience REALLY nasty consequences of bodily trauma and chronic pain. CTE is a devastating disease. Based on the data, cannabis appears to be a safer alternative to opioids for chronic pain relief. In my opinion, it's irresponsible for professional sports leagues to allow their athletes to engage in activities that would endanger their lives and livelihood, while also preventing them from utilizing safer alternative therapies. Edit: for clarity.

discospaceship78 karma

So if these things can be proven by someone who has researched it for over 10 years, what more steps need to be taken to change the law?

CannabisScientist214 karma

The DEA is expected to follow the advice of the Food and Drug Administration (FDA) when new drugs come onto the medicine market (which is basically what’s happening here). The FDA, rightly so, has very strict rules about this process (clinical trials), to ensure our health and safety. Here’s the rub: The FDA’s criteria is so stringent, that whole-plant cannabis will never, by its definition and nature, live up to these requirements. It will take an act of congress or an arbitrary decision by the POTUS or attorney general to change the law.

imonmyphoneirl56 karma

Could you go into why it wouldn't pass fda approval? If it is safe it should be fine right?

CannabisScientist235 karma

The FDA can only approve a new drug based on the safety and efficacy data that results from a clinical trial. Clinical trials can't be done on cannabis, because it is an illegal schedule I substance: catch 22. Also, the FDA requires that a drug company provide a single symptom or disease (indication) for which the drug should be used... which would we choose? Furthermore, a number of processes are in effect to ensure all participants in a clinical trial receive the exact same drug/molecule at the same dose. Even if we COULD do that for the clinical trial phase, it wouldn't ever apply to the real world of cannabis medicine, due to the vast variety of strains/plants that are in use. The best we could ever get from the FDA would be approval of a clone of one specific mother plant, refined/extracted to a specific dose/chemical profile, and approved for one specific ailment. In theory.

blahblahyaddaydadda153 karma

Many of my fellow physicians use urine drug screens as part of pain contracts with patients receiving opioid narcotics. They will refuse to prescribe narcotic medications if patients test positive for any illegal drugs, marijuana included. I've always found this odd because they rarely screen for alcohol use, nor do they refuse narcotics to patients who use alcohol.

My question is, what are the effects of marijuana on opioids from a patient safety perspective? Does marijuana interfere with the metabolism of opioids?

CannabisScientist236 karma

From a safety perspective, all signs point to cannabis LOWERING the opioid risk. When patients have access to cannabis, they self-taper their opioid intake by roughly half. In states with medicinal cannabis laws, there is a 25% drop in opioid overdose deaths.

In terms of basic pharmacology, cannabinoids and opioids interact synergistically to produce pain relief (the two together provide much greater relief than they do alone). However, this does not appear to be true for the side effects like sedation and motor coordination (cannabis enhances the good effects of opioids, but not the bad effects). EDIT: A lot of this work was done in animals.

We don't have any evidence of cannabis interfering with opioid metabolism. The precise mechanisms of the drugs' interactions are poorly understood, and the topic of my ongoing research!

blahblahyaddaydadda37 karma

Is there any evidence that cannabis increases the half-life of opioids? Or that it can worsen the most severe side effects such as respiratory depression?

CannabisScientist109 karma

No, in fact there is evidence to the contrary. The timecourse of opioids is unaffected by cannabinoid administration. Opioids induce respiratory depression, whereas cannabinoids induce tachycardia (increased heart rate). I actually answered this very question at my Ph.D. thesis defense! Edit: to be concise.

blahblahyaddaydadda40 karma

I'd be hesitant to say that tachycardia cancels out bradypnea. Heart rate doesn't matter if your aren't oxygenating your blood.

However, it's reassuring to know that cannabis doesn't further depress respiration. Thanks for the answers!

CannabisScientist60 karma

I appreciate your hesitation, just trying to keep things relatively readable for the reddit audience. Thanks for the questions!

CourageousKoala21 karma

I am a person who uses both opioids and cannabis for chronic pain, if you have any questions fire away.

CannabisScientist28 karma

/u/CourageousKoala keep an eye on your inbox!

Seiyorah77 karma

What is your take on the legalization of the recreational use of cannabis? With so many doctors are even wary of it's medicinal uses still, I'd love to hear the thoughts from a Neuroscientist!

CannabisScientist448 karma

I am all for recreational cannabis for this reason: adult-use laws create a genuinely separate market for medicinal use. These laws completely eliminate the guise of "I need it for my (insert bogus condition here)." In this space, we can tackle medical issues rigorously, head-on, and in the absence of haters. With the law on our side, we can conduct the research and collect the data that will benefit science and medicine at large.

followerofbalance79 karma

Knowing people like you exist makes me happy. Thank you!

CannabisScientist28 karma

:)

uncreativescientist75 karma

Hi! My question is about the obstacles you might face with your research since cannabis remains illegal at the federal level. What has been the biggest setback in that regard? Can you receive federal funding? From whom/where do you receive the majority of your funding? (I'm a physiology PhD student in Colorado, and I've always wondered about funding for cannabis studies.) Thanks for doing this!!

CannabisScientist209 karma

I have been funded by the National Institutes of Health for my entire career. My funding comes from NIDA, the National Institute on Drug Abuse, which is the only federal funding agency that can currently give out money to study cannabis. The rub is, that they will only give you money to study the "addictive" or bad effects of cannabis, rather than the potentially medicinal/useful effects. This is the reason that there is a huge negative bias in cannabis research. The biggest setback to medicinal science is the inability of the NIH to give us money to study the potential benefits. I'm hoping that eventually the controlled substances act issue will go away so that we can overcome this barrier.

The reason NIDA has always had an interest in my work is that my goal has always been to reduce opioid use/abuse/bad stuff. I got in the back door.

Colorado has a state-level grant program, so all is not lost!

TrsPls48 karma

Wow. Love how unbiased those grants are. Do you feel this also has an impact in the how published peer-reviewed results are framed?

CannabisScientist89 karma

I would like to think not. Data is data. You can spin it however you like in your discussion, but data doesn't lie. It just is. Regardless of an investigator's hypothesis, bias, or funding agency... ball don't lie.

jtt12357 karma

Have you ever heard of depersonalization/derealization?

Smoked for the first time around 8 years ago and have never been the same since

CannabisScientist71 karma

I have heard of this, and I suspect that some people may experience this based upon the unique properties of their own endogenous cannabinoid system. Mysteries abound, people...

IKnowDifferently48 karma

I use CBD oil to reduce inflammation from my JRA (didn't feel so juvenile before the CBD) and I feel so liberated! I can make a complete fist again and I feel like I have my 25 y/o body back! When I heard that CBD is going to be Schedule 1 I was devastated and wanted to kick a lead ingot. Reading about the side effects caused by "real" RA meds scare me half to death and I'm nowhere near desperate enough to take them. Why is it that the DEA like to keep barbed sticks up their asses?

CannabisScientist67 karma

Dang, what I wouldn't give to know why the DEA insists upon this wretched self-sodomy. I too, was devastated by their recent decision, which, fortunately, seems to be totally illegal and a gross over-stepping of their duties. We'll see what happens there. I'm SO happy to hear that you've found a way to get some relief. I have a close friend with JRA, I truly know your pain, I've had hour upon hour of conversation about this. Thanks for sharing!

Medieval-Maggot48 karma

Hay Adie, Thanks for doing this AMA, and for the importaint work you do. From reading your answers, there seem to be many upsides to Cannabinoids. Are there any downsides or dangers?

CannabisScientist119 karma

YES, FOR ADOLESCENTS. Research has clearly shown that consistent adolescent use of cannabis (under 21 yrs of age) is strongly associated with cognitive deficits as an adult. The human brain does not finish developing until approximately 21 years of age, and intervening with its normal development is usually not worth the short-term benefits of cannabis.

Three scholarly articles come to mind: An evidence based review of acute and long-term effects of cannabis use on executive cognitive functions. Effects of cannabis on the adolescent brain. Considering Cannabis: The Effects of Regular Cannabis Use on Neurocognition in Adolescents and Young Adults.

flannelisnecessary18 karma

Hi /u/CannabisScientist!

As an adolescent (age 17) who hasn't smoked before, how much would it affect someone like me to smoke once?

Also, I actually have SVT, a heart condition that can make my heart rate randomly go up to around 250bpm whenever it pleases. Would cannabis exaggerate this, lower the chance of it happening, or have any heart related effects? I'm curious about its effects, but am worried about trying it out with my condition.

CannabisScientist27 karma

If I were you, I'd be worried too. Definitely discuss this in detail with your doctor.

joe_nasty35 karma

In a perfect world, how do you see cannabinoids being used in the treatment of opiate addiction?

CannabisScientist136 karma

I see cannabis as an exit drug, not a gateway drug! That is, I see it as one tool (of several) that could help people transition away from opioids. By substituting a dangerous, potentially fatal behavior, with one that is far less risky, people may be able to re-engage in their lives. Addiction is often discussed as a disease of disconnected-ness. That is, people are looking for a connection with something, and often the only thing they feel connected to is their drug. Why be connected with something that can kill you? Edit: to be succinct.

Karadra31 karma

Have you smoked it yourself... Since you know.. You study it?

CannabisScientist43 karma

Answered earlier; yes, but not in a way that would endanger my career.

subtropicalyland26 karma

I work in a detox facility for people with a wide range of dependencies including Cannabis. We do not use Benzodiazepines to manage anxiety. At the moment the only medication we have available to support the anxiety we see in Cannabis withdrawal or Opiate withdrawal is Quetiapine. I feel this is lacking something.

Could you point me to any studies or give me any suggestions based on pharmacology as to how we might better support our patients?

CannabisScientist42 karma

WOW, I wish I had something less disappointing to say about this, because this is really the reason I got into science in the first place: to help people with substance use disorders. Mindfulness meditation is really gaining traction for a wide variety of psychiatric and biological disorders. This review might be a great place to start: https://www.ncbi.nlm.nih.gov/pubmed/27111302

WiseApe24 karma

What do you think about Pharmaceutical corperations in general? They hold alot of lobbying power in government. And seem to only care about profits rather than opioid addiction (big problem here in Portland OR metro area).

Bonus question what's the percentage of success if someone with a GED asked someone with a PhD out on a date? (this is a purely hypothetical question by the way, just random)

CannabisScientist55 karma

We need big pharma, they are a necessary evil. There are a lot of VERY effective, life-saving medicines out there that would not exist if it weren't for them. I agree that their motives are not always the best, but one of the great things about cannabis is it's existence in the public, rather than patented sphere. If they want to develop more cannabis-based medicines, I say bring it on! WE NEED HALP. Bonus answer: hypothetically, if the PhD had a spouse, as evidenced by AMA proof (wedding ring) then the statistical probability of a date would be around 0.001%.

CannabisScientist27 karma

Dang! You beat me to it!

helpmesleep66621 karma

What exactly does "how cannabis interacts with opioids" mean? From a physiological POV?

Having been a heavy pot smoker most of my life.. and having a few years where I was an opiate addict, I've mixed the two more than I'd care to admit..

CannabisScientist21 karma

Yes, from a physiological standpoint.

In my career, I have studied the acute effects of combined cannabinoid/opioid administration (for pain relief). I have also looked at how chronic cannabinoid exposure effects opioid pain relief, and opioid tolerance (the loss of effectiveness with repeated use). I have also studied how chronic opioid exposure effects cannabinoid pain relief.

My ongoing and future studies are to examine the cellular and molecular mechanisms behind enhanced pain relief and reduced opioid tolerance, as well as the addictive potential (or lack there of) of combined opioid/cannabinoid administration.

littlebitsofspider19 karma

Considering the attention given to THC, how much of your research focuses on cannabidiol? Has it been shown to be more or less useful than the psychoactive cannabinoids for things like pain management?

CannabisScientist43 karma

CBD does not seem to provide as much pain relief as THC or other CB1 receptor agonists. The reason is that CBD does not directly activate the CB1 receptor. My work and others has shown that CB1 activation in the part of your brain that is the headquarters for pain control (the periaqueductal gray) shuts off pain for the whole body. CBD seems to have some anti-inflammatory effects, probably mediated by the immune system, so this may be a different mechanism for pain relief. My personal research does not involve CBD, but I follow this VERY closely!

OveraHype18 karma

Do you use cannabis yourself?

CannabisScientist89 karma

I currently live in the state of Missouri, which does not yet have any legal uses for cannabis. In other legal contexts/states, when I did not have anything at stake (for instance, a DEA license for conducting research), I was known to partake. It would be a bit hypocritical for me to lack a first-person perspective!

DiscGolfFreak14 karma

I think missouri will be one of the last states to make weed legal.

CannabisScientist100 karma

Not if I have anything to do with it! I was just at the state capitol yesterday, meeting with Republican law makers on the verbiage for the new medical cannabis bill. Headed back in a few weeks once the new legislative session is underway.

Gigglykat18 karma

  1. Wow, good for you! You are a true inspiration.

  2. My mother and I argue constantly about the uses of marijuana and she claims that "even if it could cure cancer", she would be against it (which I HIGHly doubt). What are some solid researches/studies I could show her to prove that it is more than just a recreational habit, and some to prove that marijuana in fact does not kill all of our brain cells?

CannabisScientist40 karma

Unfortunately, overcoming stigma like this is going to be a generation-long process. In my experience, this stigma is harder to overcome by showing someone solid data, and the shift really happens when there is an emotional appeal. Lots of videos on Youtube of kids' seizures stopping after an oral tincture, or parkinson's patients having normal conversations after a j. If you REALLY want a list of solid studies, there are literally thousands of them, too many to link here!

BSnod17 karma

I'm about 6 months clean from a crippling opioid addiction. I've used, and continue to use, kratom in my battle. I still smoke cannabis from time to time, but only in very small amounts. I've had more than one cannabis-induced panic attack since quitting opioids. My anxiety is still severe, even after 6 months. Have you done any research on kratom (Mitragyna Speciosa)?

I've found that the two go very nicely with each other. Since kratom doesn't cause respiratory depression, much like cannabis, there's no real danger in ODing. Kratom has literally saved my life, and if you haven't done any research on it, I would strongly recommend that you do. For me, it also does a better job than cannabis at attenuating alcohol consumption.

I'd be more than willing to answer any questions you may have to the best of my ability. Thank you for doing this AMA!

CannabisScientist14 karma

Thanks for the guidance, I think you're really onto something, I will definitely look into this! As far as the anxiety goes, the side effects that cannabis can have on cardiac activity could definitely contribute to that: your mood and your heart rate are very closely related. That's why beta blockers are so good as anti-anxiety meds: they directly reduce heart rate and "trick" your brain into thinking everything is chill.

Frentis14 karma

Hello Adie

Super interesting research you're doing! What kind of results have have you made toward how cannabis effects chronic pain?

Also where do you see the future of your field going?

Cheers from Denmark.

CannabisScientist35 karma

Thanks for the interest!

Cannabis has huge potential in the treatment of chronic pain. The most commonly prescribed pain relievers are opioids, which have very nasty side effects (cue apocalyptic epidemic). When chronic pain patients are given access to cannabis, they drop their opioid use by about half. There is also some recent data that suggests cannabis actually improves cognitive function in these people, probably because they are lowering their opioid usage. The most common reason people seek out medicinal cannabis is for pain relief, and it appears to be very beneficial, because the US states with medical cannabis have 25% fewer opioid overdoses... this is HUGE.

Let me know if you want links to scholarly articles :)

BeeverCleaver20 karma

Thank you for you work, first and foremost. I use cannabis for pain management. I was injured in the military and have chronic low back pain, for which I was prescribed many things, starting with ibuprofen 200mg-800mg, Lortab, Vicodin, and Methadone, among others. The side effects of the prescription meds were awful, such as bleeding ulcers, constipation, hemorrhoids, cramping, etc.

I tried cannabis for the first time at age 31, and it has been a life-saver. I don't understand why, but the cannabis does not exactly eliminate the pain, but rather causes me to not really be concerned with it. Can you explain why/how (aside from the high feeling) that cannabis has this effect on pain?

CannabisScientist23 karma

First of all, thank you for your service and sacrifice. What you are describing, in terms of your ability to cope with pain, is the same thing that we observe with cognitive behavioral therapy and mindfulness meditation for pain. I can't, based on data, explain why this phenomenon occurs, but I think what you are describing has serious clinical usefulness!

Frentis9 karma

Damm I wasn't aware it was that significant. That sounds super promising! I really interested in what future research will bring.

I'd love some articles! I'm not involved in any medical/neuroscientific studies or research, I'm just a philosophy student who find neuroscience really fascinating. That said, I'll read whatever you'll recommend!

CannabisScientist13 karma

A colleague in my department used to do clinical pain research in Isreal, where cannabis medicine is booming: https://www.ncbi.nlm.nih.gov/pubmed/?term=haroutounian+cannabis

Same result, this time out of Harvard: https://www.ncbi.nlm.nih.gov/pubmed/27790138

Frentis7 karma

Oh this is great thanks!

I'm curious as to what methods you use, when you're doing research?

Also are there other areas of neuroscience that you find interesting or have made fascinating advances?

CannabisScientist14 karma

I am in fundamental (I hate the word "basic") research. I use animal models, and brain tissue from animals. We observe how animals react to drug treatments, and as an electrophysiologist, I record the electrical activity of brain cells when I wash drugs onto the tissue. COOL, HUH? Some overachieving redditor may dig up my Instagram, where I posted a short video explaining electrophysiology.

randmcc12 karma

Hi, I'm a 45yr old male stuck in a wheelchair, I have C.M.T. and E.D.S. and I suffer from lots of chronic pain, plus depression. For pain I take 2 Tylenol 3s 4 times daily and 1MG of Nabilone twice daily. I don't think my doctor really approves of either, I had to fight a bit to get anything. I don't smoke pot or drink alcohol. I don't think these meds are working very well any more. Do you know of any other options? Or is that it for me?

CannabisScientist33 karma

Honestly, it sounds like you need a more compassionate doctor. You need someone who is supportive of your health and your personal goals. That's where I'd start if I were in your wheels. Best of luck <3

tehyahoo9 karma

Does recreational use ever become physically harmful at a point? Basically, how often is too often?

CannabisScientist26 karma

I'll refer you to the DSM-5 for the criteria on cannabis use disorder. If those items start to creep into your life (and granted, I'm no recovery professional) it's probably time to chill. Yes, cannabis can definitely become harmful, but probably not in the way you're thinking: more likely in the psycho-social realm than the biological health/longevity realm. Edit: disclaimer.

Raptor018 karma

I recently had knee surgery done and was prescribed Norco for pain. I felt side effects from it that may have been purely in my brain (fever dreams, lethargy, and a few other things), so I stopped using it. My knee still aches during the day and it's still difficult to get a good nights sleep. Since marijuana is pretty much legal here in California now, I was thinking about it as an alternative to popping Advil all the time. My question is this: Aside from trial and error, is there a way to find the right amount and the right type of marijuana to help with the pain and/or help me sleep at night?

CannabisScientist10 karma

aaaaaaaaaaahhhhhhhh! I wish there was a better way than trial and error! This is my life's mission, you shouldn't have to be your own guinea pig, health care professionals SHOULD be able to answer this question for you! Edit: to be concise

Myeloma_fighter8 karma

I am currently suffering from myeloma and a resultant complete collapse of 4 discs I'm my back. I have been on oxycontin continually for almost 3 yrs. I hadn't smoked weed since the 70's, but I found a dealer, and have been smoking weed daily for the last 6 months. It seems like it helps me in numerous ways, the best being that it seems to help neuropathy. My pain doc doesn't know, but I doubt he would have an issue. My question is does this seem like a sustainable regime? I never feel any desire to take more opioids than prescribed. How safe am I on OxyContin in the long term?

CannabisScientist15 karma

Thanks for sharing your experience! Long-term opioid therapy is NOT sustainable. Anything you can do to maximize your quality of life, and minimize your opioid exposure is probably going to be beneficial. Talk with your doctor. Edit: to be concise.

arma__virumque8 karma

Can you explain why smoking weed makes the effects of alcohol so much stronger in some people, but not at all in others? (Not sure if your expertise covers this)

CannabisScientist11 karma

Differences in endogenous cannabinoid functionality. Your brain cells are studded with proteins that are the site of activation for cannabis (CB1 and CB2 receptors). Your brain also produces its own endogenous cannabinoid agonists (anandamide and 2AG). The natural variability in this system is most likely reason for differences between people when it comes to cannabis consumption.

Oatz36 karma

Any current research that the community should be aware of?

Personally really interested in potential cannabinoid treatments for epilepsy (Charlotte's web).

CannabisScientist20 karma

I have a strong bias, so I'll use this as an opportunity to push my anti-opioid agenda:

For decades, scientists have been well aware of the analgesic (pain-relieving) properties of cannabis, and its constituent molecules, called cannabinoids. My own research, and that of many other dedicated scientists, provides compelling support for the use of cannabis in pain management.

Opioids are among the most important drugs used to treat pain, however, their use is significantly limited by side effects such as the development of tolerance and the possibility of addiction. Despite their harmful side effects, opioids are very frequently prescribed for the treatment of a variety of pain disorders. Yet, many patients still experience pain that is poorly managed by opioids, either because opioids simply don’t dull the pain, or because people can’t tolerate the drugs’ powerful side effects. The multitude of issues created by rampant opioid prescription, consumption, and diversion (to the black market) has come to a head, leaving us with an epidemic that is arguably the greatest health challenge of the 21st century. How do we begin to tackle this issue?

When pain patients have access to cannabis, we observe some very promising effects. For instance, in states with medicinal cannabis, there is a 25% drop in opioid overdose death. I cannot overstate the impact of this finding; these are millions of lives that are being saved. This powerful effect may largely be due to the roughly 50% drop in the amount of opioids patients consume after beginning cannabis therapy. As a result, Medicare costs go down, and so do the number sick days employees take. A wide variety of studies, ranging from animal models to large-scale human populations, suggest that cannabis can simultaneously protect against the negative side effects of prescription opioids, while maximizing their pain-relieving properties.

Opioids are the most powerful analgesics known to man, and their continued use in the treatment of severe pain is inevitable. Blanket restriction of opioid therapy and replacement with cannabis is not a desirable or realistic goal. However, our understanding of cannabinoid/opioid interactions is rapidly developing, and every day it becomes clearer that cannabis is going to play an important role in modern pain management.

In states with medicinal cannabis laws, the vast majority of patients seek out cannabis to treat chronic pain. Interestingly, 84% of patients report that cannabis effectively provides relief from their symptoms. Moreover, few people report negative consequences of cannabis use, and lethal cannabis overdose is basically non-existent. Unfortunately, legal and practical barriers diminish both the use of cannabis as a first-line pain reliever, as well as our ability to rigorously research the long-term effects of cannabis for pain relief. I’d like to see these things change. I’d like to see knowledge trump perception.

rdrnation19846 karma

There have been many cases where cannabis has been used to ease chronic pain, as well as instances where using it to treat disease has cured the malady. Now, I understand why more research isn't being done (no money in the cure, only in treatment) but coming from a researchers point of view why aren't more studies being done especially on the benefits?

CannabisScientist10 karma

Most scientific research in the US is funded by the NIH, which is a federal institution. The federal government does not recognize any medicinal benefits of cannabis, because of its status as a Schedule I controlled substance. There is currently no federal funding mechanism to study the medicinal benefits of cannabis. Huge catch 22: we don't have data because it's illegal, and it's illegal because we don't have data to show its safety and efficacy.

lonelychapstick5 karma

Do you live pretty comfortable with your PhD in neuroscience? I have gave some thought about going into virology/immunology/neuroscience/biochemistry and would like to know about your life. Financially, socially, work-wise, what are the good and bad things that comes along with being a scientist?

Thanks

CannabisScientist14 karma

I can only speak about academic neuroscience research (working within the University system), which is incredibly rewarding… and frustrating, and difficult.

The biggest thing you need in order to succeed is a proactive approach to your education/career. I have found that the most successful people treat their science as their own small business: you are in charge of your own success, no one is going to remind you when your deadlines are, or push you as much as you need to push yourself. Some people don’t do well under these circumstances.

Graduate school consists of many, many long days of straining your brain. There are a lot of sacrifices: you might miss your own birthday because you’re in the middle of an experiment (true story).

As a post-doc, you will still be working hard, and all of your friends who don’t work in science will probably make way more money than you. The payoff is huge though: you don’t punch a time clock. You get to decide what you work on, and you often come to work without feeling like it’s actually work: you just enjoy it. The schedule is flexible, and you get to travel a lot to present your work at conferences (if you/your boss has money anyway… money is always an issue).

These things are also true when you become a P.I. (Principle Investigator/professor). At this point you somewhat become a slave to the NIH, and the stress of writing grants and maintaining funding (so you don’t have to fire everyone when you run out of money) is pretty intense.

At some point in this process, a lot of people realize that the stress is not worth the autonomy, and they choose a different path: there are a lot of careers out there that you can use a neuro PhD for, without having to constantly write grants and deal with the super slow/frustrating academic bureaucracy.

If you pour a TON of effort and practice into the thing that you are both good at, and interested in, you are very likely to be happy. Good luck.

knowoneshero4 karma

any interest or previous experience with psylocin and its serotoninergic properties? opinions on ssris, snris, or maois?

CannabisScientist5 karma

I can say that CBD is a partial agonist at one of the serotonin receptors. Probably not the answer that you're looking for, but that's about all I got!

RichSynthol2 karma

Is there ANY negative to smoking cannibas? Anything long term?

CannabisScientist3 karma

Yes, there are plenty of of negative effects, especially for daily adolescent users (detailed answer elsewhere in this AMA). There is also some data to suggest that there may be increased risk for cardiac failures in individuals who have pre-existing heart conditions. Also, the side effects can be really unpleasant, especially if eaten or the dose is too high (nausea, psychosis/feeling like you're going to die, couch lock, fuzzy headed. Granted, the side effects are whole reason some people consume cannabis to begin with).

CannabisScientist3 karma

OH, and specifically, smoking cannabis is really bad for your lungs: tar and hydrocarbons are bad, mmmmkay? Cannabinoid binding to the receptors is the same for smoking as vaporizing, although both forms of consumption are illegal on a federal level. Edit: for clarity.

SeanMyklKing2 karma

What are your thoughts on people using cannabis in conjunction with other forms of treatment for drug (opiate and alcohol come to mind) addiction?

CannabisScientist4 karma

First off, I will say that I am making it my life's work to answer this question based upon tangible data. In the absence of that data, and granted, I am not a recovery professional, I think there is a HUGE potential for cannabis to act as an "exit drug" from other forms of addiction. Abstinence clearly is not the answer. Opioid replacement therapy, combined with social support, seems to be the best thing we have for opioid recovery at the moment. Substituting something potentially lethal with something potentially harmless seems very logical to me. Finally, as evidenced by other redditors' comments on this AMA, cannabis seems to curb alcohol craving (hypothesis supported?). Edit: for clarity.

avonhun2 karma

Are you experiencing less regulatory hurdles in recent years with the country moving in a direction to legalize?

CannabisScientist4 karma

No, my personal (funding) hurdles are the same today as they were when I started. It will be an overnight shift when the feds either deschedule, or downgrade cannabis from Schedule I to Schedule II.

loverofaltmedicine2 karma

Do you work in a "legal" state?

CannabisScientist6 karma

At the moment, no. I currently live in Missouri. However, just yesterday I was meeting with Republican legislators in our state capitol to work on verbiage for a medicinal program here. The ballot measure failed this year, so we're going for a top-down approach.

BurritoBanditos2 karma

What is your opinion on people under 18 using cannabis?

CannabisScientist6 karma

As I've said elsewhere in this AMA, I am totally opposed, unless you have a debilitating condition such as severe epilepsy which is not responsive to traditional medical intervention.

Research has clearly shown that consistent adolescent use of cannabis (under 21 yrs of age) is strongly associated with cognitive deficits as an adult. The human brain does not finish developing until approximately 21 years of age, and intervening with its normal development is usually not worth the short-term benefits of cannabis.

If you or your child are considering medicinal cannabis for your condition, you should have lengthy discussions with your doctor about short vs. long term effects of cannabis.

Jammer19482 karma

I am an older person and have been prescribed opioids for pain. I tend to avoid their use at all as the side effects for me are so uncomfortable, to me as bad or worse then the pain. I have had one complete shoulder replacement, and both hips (last one a week ago) Would the use of cannabis before, during, or after lessen the side effects for me?

CannabisScientist5 karma

THANK YOU for being here. Honestly, it is people like you that I think could benefit the most from true medical guidance on this topic. Some of your questions are the subject of my upcoming projects (does pre-surgical cannabis help post-surgical pain?). Based on the data we do have, we know that people with a very wide variety of pain disorders achieve very desirable outcomes with the help of cannabis (effective pain relief without the mental fog of opioids, the ability to get a good night's sleep, etc). They also experience very few undesirable outcomes. I would encourage you to talk to your doctor about it, or find a doctor who is compassionate, and in line with your goals!

dope-priest2 karma

How hard it is to study drugs? What is the most difficult part? Im majoring at psychology and i really would like to work in that field, specially with researches about psychedelics.

CannabisScientist7 karma

The most difficult part is making sure that your research ideas are fundable. Will the government give you money for your project? If it has the potential to have a big effect on public health or a specific disease, then yes, if you sell your idea hard enough and support it well enough, they will probably give you money. If you are trying to get money to study the benefits of a Schedule I drug... you'll have to look somewhere other than the fed government for research dollars.

BillEMumphrey2 karma

Have you done any research with kratom?

CannabisScientist3 karma

nope!

Kimuraa2 karma

Hi Adie!

Thanks for taking time to answer questions. I've read several studies that are leaning towards cannabis inhibiting the brains natural ability to create dopamine. So when a regular user tries to quit, they become depressed. Have you witnessed anything like this in your studies?

CannabisScientist7 karma

Frantically trying to dig up the study I think you're referring to, I'll be back later with it.

If it's the one I'm thinking of, the problem is that the participants were cannabis dependent. They were not healthy/control people. Anyone with a physical or psychological dependence, whether it be upon opioids, gambling, or chocolate, is not going to be representative of the population, nor are they going to have a normal dopamine response after being exposed to something they are evolutionarily supposed to enjoy. LOTS of things, chronic cannabis use included, have tangible effects on the brain's reward pathway, and we need a lot more data to really understand what's going on here.

Kimuraa2 karma

Wow that was a quick reply. I think you're right, it was all people who had been regularly using several times a day. If that is the case, would switching these opioid dependants to cannabis require another weaning afterwards?

Thank you for your reply!

CannabisScientist4 karma

This is an excellent question! I would also love to know whether cannabis could alleviate the withdrawal symptoms of opioids... there just isn't enough data out there about this!

Grilled_Oyster1 karma

Question about cannabis dependence. To what degree of dependence do you consider dependent? People who have smoked for years daily, seem to experience quite different symptoms when they stop smoking. Would you consider the dependence more aligned with symptoms and what someone has to go through to stop? The frequency of use alone? Both? I know people who have smoked as much as me and then just stopped cold turkey with almost no side effects. I had to stop for legal reasons and it really messed with me. Night sweats, hyperdehydrosis in my hands, I couldn't touch coffee or it really screwed my up. Clearly this is a description of someone who would not be a good test subject, but I am curious where the line is drawn. Can someone who has almost no experience smoking still be a good text subject. I ask this because people react so differently to it, especially when they haven't smoked it much.

CannabisScientist2 karma

I personally, do not give any consideration to what qualifies as dependence. The DSM-5 however, has very explicit criteria for people to qualify as having a cannabis use disorder. Yes, one of the criteria is that withdrawal symptoms appear when people stop using. Withdrawal is seldom pleasant, for those people who do develop a physical dependence. In my opinion, drug naive and drug tolerant people are both equally valuable in scientific research! We need to know everything!

w00t891 karma

As a professor of anesthesiology, do you see any cannabinoid compounds that show promise for application in clinical anesthesiology?

Also, any other notable clinical interactions between cannabinoids and other anesthetics and/or opioids?

Thanks!

CannabisScientist6 karma

I can't answer your first question because it's the topic of an R01 grant proposal that I'm writing. Ain't no redditor gonna scoop this gal!

For pretty much every combination of cannabinoids and opioids, we see synergistic pain relief. Morphine, codeine, fentanyl... THC, WIN, HU210... mouse, rat, human... oral, intra-cerebral, spinal... you name it, the pharmacology comes out about the same. Edit: much of this work is in animal models.

dhaas7101 karma

Have you conducted any research on the different consumption methods i.e. smoking raw flower, edibles, tinctures, or vaporized concentrates, and how the different types of THC interact with opioid receptors?

CannabisScientist4 karma

delta-9-THC is only one cannabinoid molecule of HUNDREDS in the botanical flower. Lots of research has shown (I'll summarize here) 1. Vaping is better for you than smoking. 2. A suite, or combination of cannabinoids (whole flowers) works much better than single cannabinoids in isolation. 3. CBD is a positive allosteric modulator of the mu-opioid receptor (it doesn't activate the opioid system itself, but it gives a little "boost" whenever opioids are floating around in the brain... even your own endogenous ones that are produced naturally). 4. Eating cannabis puts the compounds through first-pass metabolism by the liver... the liver makes 11-hydroxy-THC which is even more potent than delta-9. That's why its easy to have a bad time on edibles, but it's much harder to get "too high" by inhalation.

dhaas7102 karma

"3. CBD is a positive allosteric modulator of the mu-opioid receptor (it doesn't activate the opioid system itself, but it gives a little "boost" whenever opioids are floating around in the brain... even your own endogenous ones that are produced naturally)." Exactly what I was looking for, but has there been any research conducted that you know of on Delta-8-THC or THC-A or how effecive Delta-9-THC vs. 11-Hydroxy-THC in different treatments?

CannabisScientist3 karma

None to my knowledge, but this is EXACTLY the kind of rigor we need in cannabis science!!!!!!!!!!

randooooom1 karma

I just found this question in /r/trees and thought I should forward it to you, maybe you are the right person to answer it:

Out of 100 THC molecules ingested (smoking) at the same time, how many THC molecules are actually absorbed by the human body on average? How many are excreted from the body unused?

original question by /u/KingDingledork

CannabisScientist2 karma

A very disappointing answer, I'm afraid: We have no idea. Even in states with the most rigorous testing requirements, we are still only measuring between FIVE AND NINE cannabinoids. This is a huge opportunity for research.

Catfish_King1 karma

Was getting your P.h.D. the hardest thing you've ever had to do?

CannabisScientist3 karma

Nope. Keeping up with my inbox for this AMA is WAY harder. So many more people will be disappointed by my failure!!!

KingDingledork1 karma

How do you know cannabis molecules actually exist since you can't see them with your eyes? Or do you have some sort of X-ray vision which will one day, no doubt, be used for Evil?

CannabisScientist3 karma

Oh, my X-ray vision has been used for evil since DAY ONE, SON!

KingDingledork1 karma

Don't call me son because back when you were still crapping yellow baby shit in your diapers, I was experimenting with marijuana out in the field.

CannabisScientist2 karma

Thanks for your data, old timer!

Ediblesthrowaway11 karma

Thank you for doing this AMA. My question is: Do you need to decarboxylate the cannabis you use in research? If so, what method do you use?

CannabisScientist3 karma

Nope. I get THC directly from NIDA, purified in ethanol. It's crap. I'd much prefer a whole-plant extract, but it's impossible for me to legally obtain.

cardiovasculasaurus1 karma

Would you agree that cannabis isn't really meant to be combusted? I'm truly a supporter of what cannabis could be, but it seems that a lot of users look past the damage it could do to your lungs. What's your thought on this?

CannabisScientist2 karma

I wouldn't necessarily say that it's incorrect, but it's definitely not optimal. Any combusted/burning plant matter creates tar and hydrocarbons that you should, by all means, avoid breathing. The quick onset of inhalation, ease of dose control, and wicked technology of modern vaporizers makes vaporizing the most sensible choice, in my opinion.

cardiovasculasaurus1 karma

I must say, I'm grateful for you replying! This is my first question on an AMA!! One last question please. Say I asked you what you wanted to do with your life freshman year of high school, what would it be?

CannabisScientist2 karma

When I was a freshman, this term didn't exist, but I was really interested in the concepts of behavioral economics. That translated to being a marketing, then psychology major. It worked out!