Dr. Matthew Hill

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614 appearances 1 recordings 1 series first heard Jul 2024 last heard Jul 2024

Dr. Matthew Hill’s voice in public audio — every appearance, attributed to the second.

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Huberman Lab · How Cannabis Impacts Health & the Potential Risks | Dr. Matthew Hill · 8 Jul 2024 podcast

Why that results in this kind of bizarre vomiting syndrome, I have no idea. But I remember when I first started hearing the stories of this years ago, and I was just like, how? Because I mean, it is, again, surprisingly counterintuitive because one of the medical uses that people have used cannabis for is as an anti-nauseant, especially in the context of chemotherapy.

And so something that typically has anti-nauseant qualities suddenly triggering a vomiting syndrome is kind of a paradoxical.

I think that's how most people have tried to conceptualize what's going on. It seems to involve the insular cortex. At least the anti-nauseant effects of cannabinoids are involved through the insular cortex. Maybe you have burned out those receptors from chronic use. That endogenous mechanism isn't working or it's somehow flipped in the other direction now and that circuit becomes sensitized.

But it is a very bizarre but very real thing that seems to happen. Again, this isn't common. Like I've heard a couple of people I've met describe it, but it's not like – It's happening to every 10th or 20th person or something.

It's a little more infrequent, but it's certainly happening enough that we've now captured it at a federal data level that this is a thing that people are showing up in the ER for. Interesting.

Yeah. So apparently if it happens, a hot shower is what people claim. So for me, I would say the main – harms that people need to be aware of, the schizophrenia, bipolar, possible cardiovascular effects. And then this is one of these syndromes that can come out of it, as well as possible lung damage from smoking.

Those are the main, I think, genuine bona fide health issues associated with cannabis that people should be aware of. I mean, I know we're not going to probably go into depth with it. On the other side, with the medical stuff, it's a little bit more challenging. I mean, a lot of this is just because we really don't have

good studies that have been done in any capacity that have really definitively told us if cannabis has really bona fide medical benefit?

I mean, you look at, I mean, the other one that wasn't on there, but you've mentioned this before, and I have as well, is pain. So chronic pain. Pain, thank you. Pain is, I would say, the number one. So pain is certainly the one that there's the most amount of evidence for. Thank you.

I would say when you talked about this in the previous podcast, you were mostly correct about this component of it in the sense that it's not that cannabis is a profound analgesic. It's that cannabis, it has some analgesic properties, but it's not like super sledgehammer in that sense. But what it does seem to do is it seems to strip away the affective component of pain to some degree.

And so what I have consistently heard from chronic pain patients when they use cannabis is they say, yeah, my pain's still there, but now the pain's background noise. So I can sleep at night. And just being able to sleep, I think, is actually providing a huge amount of the benefit to that community. But it's the day-to-day.

Like, they're able to function with the pain because it doesn't – they don't become focused on it the same way because they're able to kind of push it to the background. That seems to be the main – Ability of cannabis, I mean, yes, there's some mild analgesic properties to it to some degree, but it really seems to be much more of that component of it.

And I think you'd alluded to something like that in the previous podcast. You'd said something about how it's changing the emotional state of pain.

Yeah, so the pain thing, I think, is a central one. And that's one of the only ones that there's a little bit of actual research on. Most of it's either with isolated THC. I think there's one or two studies that have actually looked at smoke cannabis and found small signals of benefit. But so anxiety is an interesting one.

And so, I mean, obviously, this is more near and dear to my heart because I study stress and anxiety as my primary area and cannabinoids and endocannabinoids in that space. And, yeah, you look at questionnaire-based – studies about why people smoke cannabis and like 85% of them will say because it reduces stress and it makes me feel less anxious.

I mean, that was like a big impetus as to why we started studying endocannabinoid regulation of it because similar to feeding and pain where we know endocannabinoids are involved in regulated feeding circuits and endocannabinoids are also integrated into pain circuitry and can provide some endogenous analgesic signals.

We figured the same was going to be true for stress and anxiety, which to some degree it is. But it's very complicated because it can be, like I said before, biphasic where some lower doses are anxiolytic, higher doses can promote anxiety. But for the majority of people who use cannabis regularly, it's because it helps reduce anxiety.

Now, whether that would hold weight in a clinical trial is a different story. There is some old evidence from like

I'd say the 70s, early 80s, where they were using synthetic forms of THC like nabilone, which is something you can get in Canada, or marinol or dronabinol, which I think is what's accessible in the States, where they did find some evidence to suggest it was on par with like a benzodiazepine, like diazepam or something.

I can't remember exactly what the comparator they'd used in there, but there was some evidence for... there being some anti-anxiety properties of THC. And that tracks generally well with the self-reported literature that's out there. Now, whether that's the same as an ability to have benefit in something like PTSD is a different question.

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