THC-Induced Psychosis: What Parents Need to Know Now

ABOUT THE EPISODE:

This episode is long overdue, and I know many of you have been waiting for it. Over the past two to three years, the conversations in our community have shifted. It used to be all about opiates and fentanyl. Now a huge number of our moms are watching their kids change right in front of them because of high-potency THC products, and it is happening fast. So I brought together three people with very different vantage points on THC-induced psychosis and what it is doing to developing brains.

First you'll hear from Lynne, a battle-tested mom from The Stream who is living this right now with her son. She shares what the early signs looked like in her home, what she wishes she had known, and the one shift that changed her conversations with him.

Then I sat down with Dr. David Rowe, Director of Neuropsychology at United Assessment. He explains what psychosis actually looks like (it is rarely what you see in the movies), when it becomes a medical emergency, and how a solid psychological evaluation can finally answer the question every parent asks: what is driving the bus?

Finally, Stefan Bate, co-CEO of Jaywalker Lodge, returns to the show. He has spent almost two decades in this field, and what he is seeing in treatment today stopped me in my tracks. The product your kid is using is not the marijuana you remember. Not even close.

This is a heavy topic, but you will leave with real information and real hope, because recovery is possible. My guests see it happen every day.

If you have ever looked at your child and wondered, what am I actually seeing right now, this episode is for you.

YOU'LL LEARN

• Why “it’s just weed” no longer means what it did a generation ago
• The subtle signs of psychosis that are easy to explain away as something else
• What a psychological evaluation can reveal, and the sobriety myth that stops families from getting one
• The reason THC-related psychosis is catching even seasoned treatment providers off guard
• A reframe that could change how urgently you respond to your child’s use

EPISODE RESOURCES:

• Dave Rowe, Ph.D., United Assessment website
• Stefan Bate, Jaywalker Lodge website
• Download our THC Guide For Parents
• Free e-book, Worried Sick
• Try The Stream free for two weeks
• Hopestream episode 259 with Stefan Bate on recovery captial

This podcast is part of a nonprofit called Hopestream Community
Learn about The Stream, our private online community for moms
Find us on Instagram here
Watch the podcast on YouTube here
Download a free e-book, Worried Sick: A Compassionate Guide For Parents When Your Teen or Young Adult Child Misuses Drugs and Alcohol

Hopestream Community is a registered 501(c)3 nonprofit organization and an Amazon Associate. We may make a small commission if you purchase from our links.

Transcript

334  THC-Induced Psychosis: What Parents Need to Know Now 

[00:00:00] The THC potency of the marijuana that we could get back then was 3 to 5% in the flower form. You had to smoke it. You had to sort of hide when you do it. It wasn't necessarily that easy to do. You couldn't do it all day, every day, everywhere. So that's a level of access, frequency, and potency. Fast-forward, as we sit here today, marijuana flower is now 20-plus percent.

The THC products that you can get can be upwards to 90% THC. That is a incredible amount of increase in how much drug is in your system. That, on top of you can use it all day without anyone knowing. You don't even have to leave the room Welcome to Hope Stream, the podcast for parents of teens and young adults struggling with substance use and mental health. I'm Brenda Zane. I've walked this path with my own child's 

[00:01:00] addiction and high-risk lifestyle. Each week, we help you gain clarity, learn new skills, and most importantly, find real hope in what might feel helpless. You're not helpless, and you're not alone anymore. Find more resources at hopestreamcommunity.org

Hi, friend. Well, this episode is long overdue, but I finally pulled it together, and I know you're probably anxious to hear from this group of individuals about THC-induced psychosis and the impact that high-potency THC products are having on young brains today. It is a huge topic. I wanted to start out by saying that we're specifically talking about developing brains, adolescent and young adults who are, you know, 26 or so, whose brains are still in construction mode. And as you know, we have an online community for 

[00:02:00] moms and female caregivers who have teens and young adults wrestling with mental health challenges, substance use challenges. And over the past, I'm gonna say 24 to 36 months, we have seen a radical shift in the conversation happening there. It used to be more focused on opiates, and especially fentanyl, and now a large percentage of our mom members are concerned about what they are seeing as a direct result of THC use in their kids. It is horrifying to hear what they are seeing in their kids' lives, in their moods, in their mental health, and also how quickly it is happening. To get a well-rounded view of where things stand today, I pulled together a battle-tested mom from our community, The Stream, a neuropsychologist, 

[00:03:00] and a treatment program professional to share their current experiences and tell us what they're seeing. My hope is that you will hear different perspectives from different areas of expertise, and that when those are all combined, you'll be able to feel more empowered to deal with whatever it is that you have got going on with your child today. And even if you haven't seen any signs of psychosis, please listen.

This will help arm you with what you can be keeping an eye out for in case things do head in that direction. Now, I know you wanna dive in, so let's start out with our mom from The Stream, Lynn. She is a member of our community. She is a battle-tested mama. She has been through it, and she is someone who, at this very moment, is navigating the impact of THC-induced 

[00:04:00] psychosis in her son. Here's Lynn

Hey, Lynn. Thanks for coming on with me today to talk about what can be kind of a tricky topic, but you are an active member in our community, and I really wanted to get a family's perspective on what it can look like when you have a kiddo who's doing things that you don't understand. And I know that you said you'd be willing to talk, so thanks for coming on and joining me today.

Mm. Thanks for having me. Yeah. Why don't you start with just a little bit of background, whatever you're comfortable sharing about, just to sort of frame up what does your family look like, how old are your- Sure ... your kiddo who brought you to Hopestream, but then whatever else, just to sort of- Okay. Yeah give us some context. So we are a family of six, four kids, ages 24 to 16. My oldest is who brings me to 

[00:05:00] Hopestream, and honestly, I've learned so much, so it's helped all of our family, so I'm really grateful for that. These are, like, life skills, not just addict parent skills, fortunately. Really? Isn't it surprising? Um, yeah. Yeah. So my son started in... Going way back, he was diagnosed with ADHD in third grade. We had... His elementary school teacher was super respective. She was, like, state teacher of the year the year before, and she said, "I wanna meet with you and your husband," and she sat us down. She said, "I've never asked anyone to do this before, but I think you should have him tested."

And so she was very supportive. We had even a psychiatrist come and evaluate him in a classroom setting. I was a little nervous about medication. That was pretty obvious that it might help him. We read a few books and decided after trying, 

[00:06:00] like, all of the supplements on the planet- Right ... that it just wasn't cutting it, so he started Adderall. Just being differently. Yeah, yeah. He was wired different. And, and honestly, we knew it from the jump, from, like, baby times. Yes. So, um- And he was just getting in trouble. Like, he was flooding the bathroom in kindergarten, actually, and getting in fights. And I remember going to my other son's classroom to help out and walking past this classroom, and my son is standing on the desk while his teacher's just up front teaching.

Like, she just didn't even know what to do with him. So anyways, so that was like the beginning of some things, you know, gonna be maybe a little hard. Right. And so he started taking Adderall. I think we did a 

[00:07:00] kind of back and forth between XR and, and the salt tablet from about third grade. In the middle of high school, he started saying, "I don't think it's working for me. I'm feeling anxious. I don't think..." And he always-- He's super smart. He did really well in school, so there were no other really red flags other than he was just kind of my wild child. But he was also just, like, so loving and so fun and so much energy, and I just thought it-- that was part of the package. I didn't really suspect that he had all this internal struggle going on, and I have three younger kids, so I wasn't probably spending the time to dig like I could have.

And so we just kind of didn't see the signs of him starting to use substances. It was probably sophomore for sure by junior year that we started finding, like, vape chargers, and he would say, "Oh, it was my friend's." And I believed him for 

[00:08:00] a minute, but it was more and more frequent. And so it really escalated when he went away to college. We kind of had a family deal that you got a 3.0 or higher where you needed to come home, and somehow I think he didn't go to class at all. But he almost got a 3.0, but we said, "Buddy, you're coming home." And when he got home, I was like, "Oh, shoot." It wasn't just marijuana at that point. He had been drinking a ton.

He'd-- I think, thankfully, he has this genuine fear of needles and a few other things, but I think he'd used pretty much everything he could get his hands on, shy of meth and heroin, to be honest. And That was scary, but also like, okay, now he's home, and he's got all this love and support around him. He doesn't have to, you know, associate with those friends. They're mostly away at 

[00:09:00] school still, and it's gonna be fine. But it totally wasn't. Yeah. He just continued to spiral in our home. We had a, a, a pretty volatile household, and it was hard 'cause we were, you know, just trying to raise a happy, healthy family. And honestly, we just loved him so much, but it was impossible to keep the peace in our home.

So that's when- Well, can- ... that's when all of the drug use started. Yeah. Could I just ask, like, what kinds of things were going on that were disrupting the peace, just sort of in general? Like, what would you have spent- Super... He was extremely sensitive, like very, very defensive. If we'd make any correction, ask him to help with something, change where we wanted to go out to eat. I mean, just little things seemed excessively either difficult, and so I 

[00:10:00] was doing all this research like, you know, I knew he had ADHD, and so there's, you know, some struggle with changing plans, and I was trying to, like, chalk up his behaviors to something rational. Right. But at the end of the day, I think his drug use really escalated any Even normal mental health problems.

Right We had fights, some holes in the walls, some... And very disrespectful. Like, he's a loving kid, but he would say the worst things to me, and swearing and just dragging me through the mud, and then he'd come up and, like, hug me and love me and apologize. But it was just this rollercoaster. Yeah. Okay, that's helpful just- Yeah

to help other parents sort of identify, like, "Oh, I'm kind of seeing the same thing," so. Yeah. And just remind me how, what are, in, like, what time frame this was. So he's, he's like- How long ago was that? ... 20, 19, 

[00:11:00] 20 at this time, that, that first year back from his one semester at college. Yeah. And also, he really struggled with executive function, like, all things responsible. So he had gotten jobs and was fired from a number of jobs, not just because... Well, I think he was probably high on the job a number of times, but he was totally late all the time. Right. He got jobs that had hard hours, and so I kind of gave him a pass. He was opening up the gym for their 5:00 starts. He had to be there at 4:30, and I thought, "Yeah, that would suck," so I get it.

But he just... I think honestly my other kids would have been fine. He just struggled. Hmm. So he's now in your home. You're seeing this behavior. Are you associating this with the substance use, or what are you thinking as far as what this behavior is associated with? Yeah. Good question. I think I was constantly like, "Is this his 

[00:12:00] mental health? Is this normal for- Right ... other families?" Like, I just didn't know. He's always been my hard kid. I just didn't know how not normal it was. Well, and he's your oldest. Yeah, exactly. So it's also, I think, 'cause my oldest struggled as well, I think that's tricky because you don't have a frame of reference for...

Until then you get to this age, and you're like, "Wait a minute." Yeah. Thing A is not like thing B, and you start to see some of those, like, "This is definitely not what I'm seeing in other people, in other kids in the family." Yeah. So what was your sort of next step once that- that behavior is going on, your kids, your other kids are gonna- It, this is when it gets really ugly.

Like, really hard. We started doing contracts, which now looking back seems so terrible. He would never go to counseling. He'd go to, like, one and done 

[00:13:00] with a few different counselors, or we hired, like, an ADHD coach that was very expensive, like $700 a month, and he'd miss every appointment. Yeah. Or go once in a month and... Anyways, so we... Part of the contract was you couldn't use drugs. You couldn't... It got so bad that at the end we were, we had him on, like, a two-week house arrest. Yeah. He's home, just keep your eye on him, I'll be back soon kind of thing. And there was one time where we left for, I say everyone but he was home for a couple hours, and I came home, the whole house smelled like weed, and I looked on, like, our little tracking app, which we can talk about that in another podcast- Yes. on Make You Crazy. The Make You Crazy- But he, he had walked to just right 

[00:14:00] outside in our driveway, met someone to buy drugs that had, like, driven by, dropped them off for him, and just come in and smoked the heck out of... Like, he had been more secretive, but I think he was just trying to, like, put it in your face.

Yeah. And my husband was out of town, of course. Of course. And the deal was this was it. Like, if this doesn't happen, you're gone. And it was the worst. You know, we live in the Northwest also. It was raining. I told him he couldn't take his car and that he had to leave. And he was so mad, and he packed a few things in a backpack, and he got on his, like, little moped, and he took off in the rain. And I remember just laying on the floor in the entryway, like, on my face. Yeah. Everyone else was at school And I was like, "What just happened?" And

[00:15:00]  he didn't know how to get rid of the tracking yet, so we saw he stayed at some really nice hotel that night- Hmm ... probably with all the money in his bank account, like a lodge hotel. Like, what is going on? Then his best friend's family invited him to stay there for a couple days. Then he moved in with my parents for about a year.

Anyways, but it just never... It didn't get better. It was just this... I thought it was maybe getting better. I was constantly hopeful, but it wasn't. Sure. When did you start thinking potentially that you were seeing some psychotic breaks or psychotic behavior? I think that's what we see in the community, and you're very active, so you see the posts and the questions. Yeah. It- people don't know what they're seeing, right? Yeah. Because if this is your first rodeo, which for most of us it is- It is. Sure ... we have no idea what 

[00:16:00] we're looking at. Yeah. So I'm wondering when you started really kind of stepping back and saying, "Okay. What are we seeing here?" So he went away to college again. He came back home in between. After living with my parents, he came home again. He went away to a different school, kind of following a girl, and then that fell apart. He came home with a broken jaw and, like, a disastrous situation. I flew down, scooped him up, and drove him home- Yeah ... 'cause he was like, he was worried he was gonna get killed.

But it was a situation. Anyways, so- When he got back from being away again, he was ruminating. He would have conversations with himself- Mm-hmm ... like pretty aggressive conversations. He would pace in the backyard. And we have a history of bipolar, a lot of bipolar. My dad is bipolar, 

[00:17:00] some of my, like, first cousins, very familiar. And I had kind of suspected that for a long time, and some of the mania symptoms overlap a lot with psychosis and- Mm ... and I thought maybe, you know, you try to diagnose him yourself, 'cause he wouldn't go see anybody. So I listened to a whole book on borderline personality disorder and all these things overlapped so much.

But that was my first clue that something was different. Yeah. Something was more than what I could handle. For sure. You know? Was he- Way more ... paranoid? Like, was he having- That didn't come till later. The paranoia hit... Okay, so fast-forward, he was homeless for a while, came back home for about six months, and we were sitting side by side on the couch. I mean, it had been a doozy of a six months. He lived in our garage, but I didn't want him on the 

[00:18:00] streets anymore. And we were just sitting side by side. He was high, and I said, "Buddy, we can't do this anymore." Yeah. And he said, "I know. I'll go to treatment." Mm. Just like that. Yeah. And I was like, "Oh, okay." So he's been in treatment now for eight or nine months, since October, and it unfortunately, like, hit the fan after he left one of the treatments and was homeless again there in California.

And I don't know if he... There's all these questions in my mind of what triggered it. I know you can have, like, a little bit of a genetic predisposition for it. Mm. But it also says, like, a high amount of stress can trigger it, a l- long sleepless time. I think he was manic. He was on the streets and awake for about three days straight. I remember talking to him, 

[00:19:00] and that's when I heard it for the first time. He started talking about how he couldn't tell me things over the phone because they were listening, and that became the focus of our conversation over the next few days. He went to another treatment. He was willing to go, and they immediately moved him to a mental health-focused treatment rather than a drug rehab, and he was diagnosed with schizoaffective disorder at that time.

Mm. And again, I know that these are so overlapping, because drugs can essentially induce psychosis while high, and so many practitioners are, like, should be careful diagnosing while they're in active use. But- Yeah ... but it's been long enough that he's had two diagnoses for that, so now we're just trying to figure out what that means.

Hey, friend. If you've ever finished an episode of Hope Stream and thought, "Hmm, but what do I actually do 

[00:20:00] when they come home tonight?" That is what the Stream was built for. The Stream is a private online membership for moms who are navigating all the same difficult things you are, like those nights when your kiddo comes home at 2:00 AM and you don't know what to do, and things are escalating.

It's where knowing about things like CRAFT and the Invitation to Change become real and you start actually using it, and right now you can try it free for two weeks. No credit card required and no long-term commitment. There's nothing to cancel if you decide it isn't for you. What you will have is full access to our special community and the women who have been or are in your exact kitchen situation. They've had those difficult conversations. Even on your busiest, hardest weeks, there is something here that fits for you. You can 

[00:21:00] engage as little or as much as you want, and of course, you get to show up in the way that feels best for you. Go to hopestreamcommunity.org/try to get that free two-week offer, and I will see you inside.

Okay, let's get back to the show What does that mean? So he's currently in a program? Yeah, so he just finished another mental health-focused residential that was, like, full residential and is in a... Is it IOP? I always still mix them up. Mm-hmm. But yeah, he's- he just stepped down, like, a week ago. Yeah. And how has he been with that diagnosis?

Because that's hard, right, to get a diagnosis that says you have this very serious mental health condition. I honestly doesn't think that he knows that we know. Oh. So he moved from... He had signed his release of information at 

[00:22:00] the previous place where he was diagnosed, and then he went to the other place, and he wouldn't sign it. Got it. And the previous place gave us the information, and then the next place, we didn't talk to anyone for weeks. I didn't know why we weren't hearing. But they said he was going there, and I thought, "Well, maybe they just don't communicate. I don't know what's going on." Yeah. But we've had just one counseling session with him.

I've talked to a couple people there, and they pretty much have led on that he's got some stuff he doesn't wanna share yet. Yeah. And I think he's, I think he's embarrassed. I think he's scared. Yeah. I mean, I think he trusts us, but I don't know if he doesn't want us to know yet, honestly. Yeah. I mean, that's a lot, right? Yeah. And so that's a really good... I'm glad you mentioned the release of information because, again, if it's your first rodeo, you have no idea what's going on. And 

[00:23:00] so if you have an adult child who go- meaning they're 18 or over, who goes into treatment, if they will sign that release for you, it's extremely helpful because- Yes, it is it gives you some insight as to- Yeah ... what's going on, whereas now you're a bit in the dark because they- Yeah ... cannot give you, even if they wanted to- Right ... they couldn't tell you what medication he is on or what diagnoses or how he's doing in therapy. So- Yeah ... you know, not all young people will sign that, and there's reasons why that may be a good idea or a bad idea.

But if it is something that you can talk with them about and get them to do, super helpful. Yeah. So what has this been like for you? I mean, obviously, it's hugely emotional and scary and unknown, and sort of for you to process this diagnosis for him and what that might mean for his 

[00:24:00] future. Tell us a little bit about that. I think that you said all the things. It's scary, and I think there's still a ton of unknowns. Part of me has a hope and a wonder if this is a fluid diagnosis, if it has to do more with-- I mean, honestly, I've read enough to know it's probably not. He's probably going to be on antipsychotics or it's his like...

I've listened to a ton about those, and I am actually really hopeful after doing that, that there's a lot of thriving on stable use of antipsychotics. So, so I try to not freak out 'cause he's really far away, and there's not a whole lot I can do about it, and he won't even tell us it's going on yet. So at this point, I'm kinda trying to like gather information and let him just process it and be ready for 

[00:25:00] Dealing with him with it when he's ready, I guess Yeah. It's a lot. I wonder if there's either a skill or a tool or something that you've learned since you've been in the Stream with all the other incredible, courageous- Mm-hmm ... SEAL team moms like you. Has there been something that you have learned that you might wanna pass along to another mom who's out there listening, who's going through this?

Maybe she is seeing some of the things that you saw. What would you tell her? I honestly don't think I was a very good listener. Mm. And I oftentimes would listen with my own agenda, and I think being way more open-minded, just, like, really trying to put myself in his shoes has changed our conversations. It's changed... It's allowed me to let go of 

[00:26:00] control, which I never had in the first place. It's allowed me to be a little bit more at peace and I think find greater, like, love and grace for what he's going through. Listening properly is amazing. Yeah. And I'm still working on it. We all are. We all are. I'm so glad you said that because I think sometimes we hear, "Oh, you know, we just need to be better listeners," but we don't know what that's going to result in.

And so I love that you just shared that the result of that was more compassion, more love, more understanding. It's not just, "Oh, I'm being a better listener." Mm-hmm. There's actually fruit from that labor, right? Because- For sure ... you're able to probably see things that he... and understand things that he was experiencing that you wouldn't have if you were approaching, like you said, with an agenda, like, "Okay, we're gonna sit down and have this conversation, and it's gonna 

[00:27:00] end with this happening." We have to let go of that, right? Yeah. For sure. Yeah. Thank you so much. I know this is really hard to do. I know it's really- Yeah ... makes you feel pretty vulnerable and really emotional, so I just am so grateful and so glad that you're in our community, and we can love on you- Thanks for having me ... all the time.

And we're just right alongside you with this. Yeah. I'm sure grateful for you, for all the ladies, for every... and even the men that you bring on. They are fabulous, and I have, like, also found a lot of peace and, um... What's the right word? I just feel like I can do this because- There's no right way to do it, and I didn't know that before.

And just recognizing that it's okay to just figure it out as you go, 'cause that's all we've got, is- has been a really big blessing to me. And I didn't know that 

[00:28:00] for some reason until I joined the community. So thank you. Thank you. I appreciate it. Thanks, Lynn. I so appreciate your participation in this episode and for sharing what I know is really difficult and painful. Now let's hear from Dr. David Rowe, Director of Neuropsychology at United Assessments. Dr. Rowe is a researcher and a statistician with a BS in psychology, neuroscience, and economics from Trinity College, and an MA and PhD in clinical psychology from Columbia University. He has teaching experience as adjunct professor and deep research experience as principal investigator for the continuation of a 13-year longitudinal study.

Importantly, Dr. Rowe and the team at United Assessments are responsible for neuropsychological testing that helps 

[00:29:00] families and individuals understand their strengths and weaknesses, as well as help diagnose and understand mental health disorders like psychosis, schizoaffective disorder, bipolar disorder, and others.

I tapped into Dr. Rowe's extensive knowledge of mental health and neuropsychological testing to better understand what role evaluation and testing can play in this dynamic. Take a listen. Welcome, Dr. David Rowe. I'm so thrilled to have you here today to talk about a really pertinent and tricky subject, THC-induced psychosis.

I know you're very familiar, so thanks for taking some time out of a very busy schedule to chat with me. Thank you for having me, Brenda. I'm very happy to be here. Yeah. It's-- This episode is long overdue. I've been meaning to do it for a while, but finding the right people and obviously the time and 

[00:30:00] everything is a little tricky. But we have so many members in our community who are... You know, their kids are struggling. They don't know what to do. It's scary as a parent when you're seeing this or when you're hearing about it. So I truly appreciate the time. Why don't you tell us a little bit at first about kind of what you do in general so that we get a good framing for that, and then I'll dive into some specific questions.

Absolutely. So I run a nationwide neuropsychology service. So we do neuropsychological and psychodiagnostic testing all over the country. So people call us when they have questions about what's going on for their children or for themselves. Sometimes there's a level of acuity or complexity, and people are asking, you know, "Is this normal?"

Yeah. And they don't know. They need to get a second opinion. So we're able to do these tests that have been iterated upon for decades. They've been norm referenced on thousands of other people your age or your child's age, so we can get a better sense of, you know, what are your strengths? What are your challenges? What's going on here 

[00:31:00] diagnostically? What's the nature of, of somebody's symptoms? What's primary or secondary or tertiary? What's the severity, the frequency, the duration? So someone can have an actual roadmap moving forward. So we're a part of that process. That sounds amazing because I know from having been through this, you know, as you're living day to day with a young person in particular who has so much going on, right?

It is just a jumble of confusion. It's like, what's driving the bus? Is it the substance use? Is it the mental health? Like, what mental health is it? It is so confusing, and unless you happen to be a neuropsychologist, you don't have a clue how to dive into that. So that is super helpful, and I think, gosh, I have so many questions.

But let's start out with how would somebody know they're observing their, let's call it a 17-year-old, a 23-year-old. You know, we're usually talking to kids that are under 30. How would I 

[00:32:00] even know, is this psychotic behavior versus sort of, you know, maybe substance use induced behavior, but there's no psychosis? Like, help us sort of pick apart what that could look like. Y- yeah, absolutely. I mean, the first thing most parents have to understand is, one, it's been 20 or 30 years since they were teenagers- Yes ... so it's hard to remember what is developmentally normative. Yes. And two, the mental health and the substance use landscape i- is different from a year ago- Right

let alone 10 years ago, let alone 30 years ago. I know it's insipid to say, but, you know, it's not your parents' cannabis anymore. The products available today contain dramatically higher concentrations of THC than what the previous generation encountered, and that changes the risk profile significantly.

And THC is sometimes benign for some brains, but it's not benign for every brain. Most young people who use cannabis aren't gonna develop psychosis. You're gonna see a lot of just kind of substance-induced symptoms. But for some, 

[00:33:00] especially with certain kind of genetic or developmental or mental health vulnerabilities, like, high-potency THC can act as a significant trigger.

But to get to your point, psychosis exists on a spectrum. So most people think psychosis, and they imagine these dramatic hallucinations. It's very cinematic- Right ... and it's been kind of imbued in us by Hollywood because sometimes people get high, and they experience some paranoia, but that's all part of the psychotic spectrum.

So psychosis can include paranoia, suspiciousness, kind of delusional beliefs, believing that other people are watching them, talking about them, feeling more detached from reality, and then obviously kind of the more classic symptoms of things like hearing voices, seeing things that other people don't see, and this kind of disorganized thinking beyond the active intoxication.

Okay, that's good to know because I do think that we think kids, none of them have had this, and so I don't... I have no idea what it looks like, but I do, I think about movies, or I think about some really bizarre, crazy behavior. And so it's good to know about the paranoia because I 

[00:34:00] hear that a lot from our parents, even to the point where, you know, kids are, like, taking weapons that are in the house to protect people in the home, right? Like, "Mom, there's somebody after you. I need to protect you." So that's good to understand that that could be a symptom. Would that be, like, maybe an early warning sign, or how, how should we think about that? Ooh. Certainly. So that kind of falls under... All of these things fall under this idea of being kind of detached from reality.

Okay. Psychosis is a rejection of kind- of your outside world and, like, a strong belief in your internal world, what you're thinking. So if you believe that someone is out to get you, your conviction in that belief is indicative of kind of the severity, that psychotic level of thinking- Yeah ... if that makes sense.

Yeah. So if you're kind of unsure, and you have this kind of sense that people are out to get you, that's one thing. If you're having a full-blown panic attack, and you're collecting weapons in the house so that you can kind of shudder and, you know, protect the family, 

[00:35:00] that would be kind of a full-blown psychotic break, right? And a break is a break from reality. Okay. And is it a medical emergency? Like, what I'm envisioning is people are in their home. They have a kid who's, you know- going through this, and I'm just wondering, like, in the moment, in those hours and days, how do you... Do you just kind of ride it out and try to be agreeable?

And I'm just trying to imagine, like, what- Yeah ... is it a medical thing, or is it more like, "I need to get this psychological evaluation"? Right. So just to be clear, the adolescent brain is always under active construction. Yes. Right? So the systems responsible for judgment and impulse control, emotion regulation, reality testing, are all still developing all the time, and THC interferes with those developing neural pathways. But it is really important to say that, that it can be a medical emergency. Okay. Some parents do just assume they're just high, they're just being 

[00:36:00] dramatic, they're having a panic attack. But if a young person's experiencing hallucinations, severe paranoia to the point of delusion, or a break from reality, that does warrant an immediate medical evaluation.

Now, obviously, you have to ask yourself, you know, are they a danger to themself? Are they a danger to others? But that is a very valuable message to families. This is a serious issue. Right. It's also important to say, and I don't believe in fear-mongering, right? I think that our society learned that Reefer Madness was not an effective tool- Yes.

getting people to not smoke. Yes. But it is important that people know the facts, and the facts are there's a rate of conversion for substances from substance-induced psychosis to primary psychotic disorders. So people who have psychotic episodes as a result of amphetamine use, about 22% of people who have a psychotic episode, who fall over that kind of psychotic cliff edge, never kind of climb their way back up without significant intervention. With hallucinogens, it's 26%, according to the data. Hmm. But with cannabis, it can be anywhere from 34 to 

[00:37:00] 47%. What? So the more- Oh, gosh ... the more you have these psychotic episodes, the more likely you are to remain in active psychosis, and that, that kind of substance induced psychosis will convert to a primary psychotic disorder, like schizophrenia or a bipolar with psychotic symptoms.

And again, that's not to fear-monger- Yeah ... it's so that people know the vulnerability is there and the risk is there. Yeah. I was gonna ask you about that. If in your family you don't necessarily have a history that you know of, that you're aware of, psychosis or mental illness, does that make your young person less maybe prone to this THC induced psychosis, or is it all the same?

Is it like, you know, Russian roulette? Right. And that's a great question, and THC doesn't affect everybody equally. Right. I mean, the important risk factors when considering someone's, the impact of THC on someone's psyche is a family history of psychotic or mood disorders. Obviously, previous psychotic symptoms are 

[00:38:00] a strong prognosticator of future psychotic symptoms. There's neurodevelopmental vulnerabilities, obviously trauma history, the early onset use of cannabis, the frequency of that use, and clearly the potency, the concentrates that people are using of psychosis, 'cause like, of cannabis. Yeah. Cannabis doesn't pull the trigger in every brain, but some brains are kind of loaded with more risk than others.

Now, that all being said, to answer your question kind of very specifically, people often tell me, you know, "I'm surprised I have the disorder. I don't have it in my family." And the unfortunate reality is that, you know, their children and their children's children won't be able to say the same thing. Yeah.

And it has to start somewhere, right? A family history starts with somebody who never had a family history. Yes. I never thought about it that way, but that is very true. Yeah, and I'm glad you made that analogy about the loaded gun, because I hear that a lot from parents, like, "I don't know, we haven't seen this in the family." Or the other thing that sometimes will happen is you have an adopted kid and they don't know the medical history of their biological parents, and so it's 

[00:39:00] super confusing in that as well. So what you're saying, I just want to be clear, 'cause I know every parent is asking this, is if my kid has started having some of these psychotic tendencies or having a break, maybe they're now on medication, do we know, is this going to be forever, or is it potentially, like, is recovery possible that they could potentially not have to be on, like, antipsychotic medications?

I don't know, maybe that's a medical doctor question, but what's your take on that? Well, it, I mean, not to short the question, but it's always gonna be client specific. Yeah. Everyone's brain is wired differently, but I think that hope is especially important for your audience. Mm-hmm. And it's important that people know that hope is based in reality.

Many individuals recover fully from THC induced psychosis, especially when it's recognized early- Okay ... and the use stops. Early intervention is one of the strongest predictors of a positive outcome. Which is to say, like I said, that many people have a psychotic break as a result of 

[00:40:00] their substance use. Some people convert to kind of a primary psychotic illness and are gonna need certain medications in perpetuity, and that's not necessarily a bad thing either. Yeah. Many people are able to take medication, they stabilize the neurochemistry, they're able to live fulfilling, engaged, meaningful, connected lives and achieve all of their goals.

Yeah. It's really no different than kind of stabilizing with insulin for diabetes or glasses for myopia, right? It's about making sure that people have the necessary intervention to achieve stability. Right. But for many, they'll be able to kind of what we call clear, right? They'll recover from the episode, and it's important at that point that people understand the vulnerability and the risk of returning to use.

Okay. So it's important to get tested. So let's say there's a mom listening and she's sitting in the ER right now, because this happens frequently. Kiddo's in the ER, and when I say kid, again, it could be 27, 28, 30. I have kids, I have kids who are 50. Exactly. 

[00:41:00] So they are hearing this and saying, "Okay, so I need to get this psychological evaluation," because that's gonna really give us the clearer picture.

Is that kind of the next step if you've had some of this medical intervention, but you haven't had a psych eval? Is that the next step? I mean, I'm a firm believer in the power of data. Right. I think that a psyche eval is good at any stage. I think the sooner you get it, the sooner you see the ways in which these substance use might be impacting your psyche, both diagnostically and also neurocognitively.

I think it gives us a sense of the nature of the symptoms and what the best next steps are for treatment. I think that there's kind of a misunderstanding that people need to be sober from substances before they get a eval. My next question. How did you know? It's a solid question. I tend to find that if everybody had to be 30 days sober from cannabis, there wouldn't be an eligible teenager for psych testing in the country who needs it, 

[00:42:00] right? The reality is, if people are smoking weed every day for years, obviously, they can't be actively intoxicated during testing, but we're trying to get a sense of what's going on for someone. If they were fine, they'd be fine. They might not even need testing at all. Right. Right. But we're trying to figure out, what are the motivating drivers of their substance use?

How do we help them mitigate that? And more importantly, how has it impacted them, and what do we do about it? Mm-hmm. And how, as a mom of a young person who might be struggling with this, how do I even broach the subject of, "Hey, sweetheart I think it would be a really good idea for you to get, what would I say, psychological testing.

That might sound really intimidating or scary. Sure. How do you suggest parents could, like, lob this over the fence to a kid? Sure. Well, I think that the next best thing to valid, reliable neuropsych testing is maternal intuition. Mm-hmm. And I will say that I pride myself on being a neuropsych expert, but moms are experts in their 

[00:43:00] children, and dads are experts in their children. So it's really, again, it's very person specific. So if your child is someone who really values data and wants to learn about themselves, then you pitch it as an opportunity to get a full inventory of their strengths and challenges- Yeah ... figure out what's working, figure out what's not working, and how to be the best versions of themselves.

If your child is somebody who might not have good insight, whether or not that's because they're experiencing the kind of pathological lack of insight, the anosognosia that comes with psychosis, maybe the frame is, "Okay, you're telling me everything's fine. Take this test and prove it." Mm. Right? Some people are willing to do testing, but not willing to do treatment, or they may not yet be willing to do treatment, but they're willing to do testing, and that could be a foyer.

And then the job of a good psychologist is to be able to leverage the data to help people gain more insight, assessment as intervention. So we can say, "Hey, we have this inextricable, irrefutable data. This shows definitively that you're having these issues across the board," because psychosis doesn't just happen with thought process. It can sit on the brain and really suppress

[00:44:00] things like processing speed- Mm-hmm ... learning, memory, attention, functioning, and be able to show people, you know, you might need more help than you think. Yeah. But again, it's all about speaking with the child and meeting them where they're at. And again, that child could be 14- Right

or 45. 34. Yeah, I like that because I think, you know, getting data is so important, and a lot of times, I think when you actually see something... I had my son tested for ADHD and giftedness, and to actually see that in a report from somebody who spent, I don't know, 35 years going to school, was really helpful for both of us because it showed him, and at the time, he was only in fourth grade, so it wasn't

I'm not talking like apples to apples, but it was still helpful to say, "Hey, buddy, look, like, you are off the charts in this area, and then in this area, there's some other stuff that we could work on." So I'm a huge fan of that. Another question I know is 

[00:45:00] in everybody's mind while I have you is can this be done remotely, or does it have to be done in person? That's a great question. Just to speak for one moment to your experience- Yeah ... it is so wonderful to be able to have some concrete data- Yes ... especially in a world as nebulous as mental health, right? The mind. But psychology doesn't have to be a soft science, right? We are able to bring empirical data back to it, and it happens all the time.

It happens in therapy s- settings where people say, "You know, I really feel like there's something going on here, but I can't put my finger on the pulse of what is." It happens through childhood, as you said. In classrooms, teachers say, "I think that there's something happening here." But neuropsychologists are able to say, "You know, this is depression or anxiety or psychosis," or they're able to say, "This is dyslexia, dyscalculia, dysgraphia.

This is ADHD, and we can show you the way in which that appears in the data." And that really creates some real concrete information for a family to move forward with. Yeah. To answer your question, testing can certainly be done remotely. Okay. There's been voluminous research in the last several years, especially given the necessity of the pandemic, that shows that the validity and 

[00:46:00] reliability of testing is commensurate irrespective of the administration method, which is just to say the results would be the same. Okay. And what we find anecdotally is that people do a better job with remote testing sometimes if they struggle with anxiety, trauma, psychosis, because they're more comfortable on their own home turf. They can eat their own snacks, use their own bathroom, you know, wear their pajamas, and it makes them more confident, which allows us to kinda get better data because they're more open, more honest, more forthright, and it helps to kind of eliminate that garbage in, garbage out phenomenon.

Which is to say the best part about it for us is the test results are the same, and it increases accessibility. And that's really wonderful because in a perfect world, there's not a person, sick or healthy, that wouldn't benefit from testing. Yeah, exactly. So just as a quick summary, 'cause I know these are gonna be the top questions, yes, a psych eval can help diagnose psychosis. No, they don't have to be sober for 30 days before they get their testing. But on the day of testing, you would want them to be substance-free while 

[00:47:00] you're doing the testing, and it can be done remotely 'cause I think those are a lot of the barriers. Like, we sometimes write something off. Like, "Oh, well, I wish I could do that, but I can't because XYZ."

So I just wanna make sure and put that out there. If you had to just give a word of hope to a parent who's been watching this in their family, they're really not knowing what to do, what would your word of wisdom or hope be for them? Yeah, absolutely. I'm a statistician and a diagnostician, and yet I'm still the first person to say that relationships remain one of the most powerful protective factors- Mm-hmm

in a young person's life. Even when you can't control the outcome- Yeah ... you can continue to strengthen connection, and connection creates opportunities for healing, for influence, for hope. Yeah. Well, you're speaking my language there, so I love that. Well, thank you so much for your time. We will make sure and get in the show notes links to you so that parents can reach out if 

[00:48:00] they are interested in this. I think it's a huge step. I love what you said. I think you said evaluation as intervention. Was that right? Did I catch that? Mm-hmm. That's really true, and I think we sometimes forget that. We're only sometimes ever looking at, you know, IOP, PHP, residential. Like, we're looking at some of these things, but until we know what we're dealing with, that might not be the right intervention.

So awesome. Know what you're treating and then treat it. Yes. Thank you for having me. It's been a pleasure. Thank you so much Thank you, Dr. Rowe, for that hugely insightful conversation. I learned a ton, and it's so good to know that there are ways individuals can get definitive data around their mental health and what is driving the bus, especially when there is substance use in the mix.

So thank you for that. Okay, so finally, let's transition to what a treatment provider, a guy with boots on the ground day-to-day, wants parents to 

[00:49:00] know about THC products. For this part of the conversation, I turn to Stefan Bate, partner and co-CEO of Jay Walker Lodge in Carbondale, Colorado. Jay Walker treats men who commonly have experienced multiple treatment programs and are chronic relapsers.

You might recognize Stefan's voice from Hope Stream episode 259, where we talked about recovery capital. It is an amazing episode, so after you're done here, be sure to head to our website, hopestreamcommunity.org, and click on "Podcast," and then you can search for episode 259 or Stefan Bate on that podcast page.

What you'll hear next is really important. I'm gonna say that again, really important, because Stefan is speaking from almost two decades in the field of substance use treatment and is in long-term recovery 

[00:50:00] himself. And he consistently sees families today underestimating the harmful effects of THC products. And by the way, we will talk about why we are using that term versus marijuana or cannabis. We dive into why these products are so dangerous to a developing brain, the signs and symptoms that family members should be looking out for, and most of all, why no one should any longer think that marijuana is no big deal.

It is a big, big deal. And while it may not cause a Russian roulette style overdose threat, like something like fentanyl, it is insidious in its nature because its effects impact neuro and cognitive functions over time, which means your young person could be experiencing full psychotic breaks before you're even aware 

[00:51:00] of how bad things have gotten. This is a hugely important part of the conversation, so let's hear now from Stefan Bate Hey, Stefan. Thanks for coming back and joining me for another Hope Stream episode. This is a doozy. So- Yeah ... I'm glad that we're connected. How are you today? Yeah. Thanks, Brenda. I am really happy to be back. Uh, I'm doing great.

I'm excited to be here, not necessarily a topic that is- I know ... very, very exciting to talk about, but I think really, really important, and I'm grateful that you allowed me to come back on to talk a little bit with you about it. Well, it's-- I was talking to a couple of our moms last week in a coaching call about the fact that even two, two and a half years ago, all of our conversations were about opiates, fentanyl in particular.

It, it was like everyone was freaking out about it. Now, I rarely hear about fentanyl in our community. 

[00:52:00] Not that it's not happening, but so many parents are like, "What am I seeing? This is crazy." And I know we're gonna get into the whole perception of marijuana- Yeah ... all that, and I think that's a real factor in all of this.

I know when my son was struggling, I was like, "Well, I would rather have him doing..." And this was 10 years ago, so even longer than that. But for some reason, I was thinking that, like, marijuana would be safer than alcohol. I don't know where I got that. Right. Yeah. So anyway, thanks for being with us, because you're seeing folks on the treatment side of things.

Like, you're seeing in person, in action what's going on with these young people. So why don't we- Yeah ... start with the perception issue, because I feel like I have talked about this till I'm blue in the face, but apparently the word is not getting out. Talk to me about what 

[00:53:00] you see when families-- You're talking to families. What is their perception of marijuana today? Yeah. Yeah, I so appreciate that you mention that, because that's the same thing that we're seeing in our treatment community is two years ago, five years ago, it was all opioids, and we know that there was a lot of effort and attention and energy on things like fentanyl.

Just the lethality of using that drug was so high. We, you know, the opioid crisis and response to it was in full swing. As we fast-forward today, I don't have that many people in my milieu that really-- opioid use disorder, you know. We still have some, like you said- Mm ... but we have a huge amount of people that are seeking treatment simply for THC, marijuana, cannabis. And it's interesting, because I've been doing this a while. I've been in the field for about 

[00:54:00] 18 years, and if we rewind to when I started in the field- marijuana, when someone was just using marijuana, it was almost like this, "Well, really? You know, what are the consequences? Are they really as bad?" There was sort of a kind of clear delineation between someone who was just using marijuana and the consequences they had, the unmanageability of their life.

It was on average much less than people were using, and I hate this term, Brenda, but, quote unquote, "hard drugs." Right. Exactly. Right. I know. Fast-forward to today, and the consequences and the unmanageability of life for people that are using THC products, I won't even necessarily call it marijuana- Right because that's not really what it is anymore. Nope. What we have are THC products. The consequences are on par, if not often more 

[00:55:00] intense than people that are using other drugs. And your question was, well, what are you hearing from parents? What are you seeing? I think on some level we're still stuck in this, I think it's somewhat cultural, somewhat maybe pop culture, but this impression that marijuana, THC, THC products, it's natural, it's maybe not great, but it's healthier than other drugs, and it's really just not the same thing as heroin, cocaine, methamphetamine.

And of course, it's not the same thing, but that minimization, I think, almost leads people to believe that it's not nearly as harmful- Right ... or nearly as big a deal. Right. Or that you don't need the same level of intervention and treatment for it, and that is just not what we're seeing. So a big reason why I wanted to talk with you today is hopefully to help, like, rapidly bring some awareness up that this is a really big deal. It is 

[00:56:00] very impactful, and the consequences that we're seeing are pretty extreme. Correct. And I don't know if this is true or not, but I'd love to hear your thoughts on it. I almost wonder if we did such a good job on the opiate conversation of like, "Oh, hey, by the way, fentanyl, you know, you get the wrong pill, it could be your first pill, and you could drop dead."

Yeah. Like, I think there was a lot of messaging around that. Obviously, overdoses went way down nationally here in the United States. That had to do with naloxone availability and all of that. I wonder, though, if young people got the message like, "Oh, okay, that's really bad. Let me just go over here to this vape shop where I can get this vape pen that I hold all day long," almost like an- Yeah accessory, and I'm hitting it all day long, whether it's nicotine and THC. Can't remember what that's called, a split or something like 

[00:57:00] that. A spliff, I think. A spliff. Is this... Okay. Yeah. There we go. I wanna have my terminology right. Now we're, now we're hanging with the cool kids, Brenda. Yeah. We can, we can talk the lingo.

Yeah. I'm so not cool. But I wonder if it was more of just a transference to a different substance. You know what I mean? Yeah. Definitely, and I think Well, when we look at drug use, right, we have to look at things like access and frequency and then potency, so dosage. Okay. And I think what we learned from the opioid crisis, right, is on some level, access was coming from pharmaceuticals, right?

That was the way that this epidemic started. There were lots of pain pills that were available and easy to get. Yeah. Well, when that was cracked down on, for very good reasons, then we sort of moved into a synthetic form that could be easily produced and distributed illegally. Yeah. Fentanyl. Yeah. When we look at marijuana, on some level, the same thing has happened. With 

[00:58:00] the legalization of cannabis pretty much nationwide at this point, I think there's only a couple states where it's not legal, what you did is you increased access, but you also gave it some level of legitimacy because now it's an industry. It's a multi-billion dollar industry. So access to marijuana up.

You also commercialized it in a way that it was easy to then do research, development, create different forms of it. Yes. And where we've landed today is that this isn't even the same drug. I think that's the m- if there's anything that I wanna say to parents out there or families that are dealing with loved ones is th- this is not the same drug anymore. We should almost not even call it the same thing. No. It is not marijuana. It is an engineered THC product. Yeah. And there is such high access to it. It's easy to get. It's everywhere now. But on top of that, the delivery systems and 

[00:59:00] the dosage and the potency has gone, it, it has increased so dramatically that, I mean, you think about it, 20 years ago, let's say, oh gosh, not even, unfortunately, 20, 27 years ago, I'm in college, and marijuana's not legal, but I wanna use it.

So I've gotta find somebody who has it. And it's not a gummy or a vape or a wax or a concentrate. You know, it is this skunky smelling, bad looking plant that who knows, I might be smoking oregano, but on average, the THC potency of the marijuana that we could get back then was 3 to 5%. Correct. In the flower form. And you had to smoke it. It smelled bad. You had to sort of hide when you do it. It wasn't necessarily that easy to do. You couldn't do it all day, every day, everywhere. So that's a level of access, frequency, and potency. Fast-forward, you know, as we sit here today, 

[01:00:00] marijuana flower is now 20-plus percent. The THC products that you can get can be upwards to 90% THC. That is a incredible amount of increase in how much drug is in your system. That on top of you can use it all day without anyone knowing. You don't even have to- Exactly ... leave the room. Nobody knows that I'm vaping it. Nobody knows that I'm eating it. Nobody knows that I'm using it in concentrate or wax form.

I can literally be exposed to very high potency THC all day long, every day. Yeah. Combine that with the age in which most people are now starting to use THC, so age of, you know, onset, first use, is combining with a very vulnerable time in human development, typically in that 14 to 20-year-old range where the brain is in critical stages of 

[01:01:00] development, particularly in that prefrontal cortex, that prefrontal lobe, which is really designed to support executive functioning. Yeah. So it is then injuring, and that's where a lot of these cannabinoid receptors live. They live in three primary areas. They live in the prefrontal cortex, so think executive functioning. Yes. My ability to concentrate, my ability to regulate, my ability to get tasks done, to understand information. It's happening in the hippocampus, which is where memory and working memory and processing is happening.

And then it's happening, those cannabinoid receptors are in the amygdala, which is where you've got all of your emotional regulation. All of those are just getting inundated with THC, high potency THC all day long. So the effects that we're seeing are a noticeable drop in working IQ A noticeable drop in 

[01:02:00] concentration, memory, processing speed, and then a real inability to understand what's going on from an emotional level. Yeah. That is also ending up in really high levels of THC-induced psychosis, and that is a piece that I think we're seeing. If we were to talk 15 years ago, I was three years into this field working at Jay Walker Lodge, we might have two to three people in every milieu that had experienced some level of drug-induced psychosis.

And typically, that was coming from high-level stimulants like methamphetamine- Right ... cocaine- Yeah ... crack cocaine. Now, it's almost every client that we're admitting on some level, especially if they're THC users, has experienced or is currently still dealing with, a lot of them currently still dealing with some level of ongoing psychosis. It's shocking. I mean, just that 

[01:03:00] statement, what you just said, is shocking. Yeah. It's, and it's not like this happened over 50 years, right? It is so frequent, and I think what we see, at least in our community and with our parents, is that the young person goes from beginning to use to experiencing these psychotic episodes within maybe six months, you know?

Yeah. If they're using daily, which they are because they've got the vape pen and it's just in their mouth all day long. And so within such a short amount of time, it's like, "Whoa, what is going on?" Um, and you know- Morphic progression ... yeah. You know, we talked with Lynn earlier in the episode about her son and his experience with that, and it was a little different with him because he was away at college, so she wasn't seeing this all the time. But for her to noticeably be like, "What is he 

[01:04:00] talking about?" You know, talking to people that aren't there, paranoia, and all of those things can happen so quickly. Yeah. Yeah. The innovation, I think this is something, too, that maybe parents aren't understanding, is the product innovation that came- Yeah ... out of the legalization is why we are saying it's a different product.

It is not the flower that you were rolling in a piece of paper and smoking. That's right. It is- Yeah ... like any other industry where as soon as it opens up, there is product innovation, and, you know, it's just mind-boggling. And the packaging also that you can't recognize, like it looks like a bag of Cheetos or, you know, the vape pens look like some technology product they, that someone's using. So- Right ... it's just complicated all around because you aren't necessarily seeing 

[01:05:00] it Yeah. Totally. And they don't smell bad. In fact, they taste good. You can have your 90% concentrate strawberry waffle flavored THC pen. Right. It's all about how can I deliver more of it in a more convenient, attractive way?

Correct. And it's all leading to greater access, easibility, easier delivery at a higher potency. Right. And you talked a little bit about the developing brain. So, you know, our community really typically is young people, 13 to mid-20s, late, or sorry, late 20s, early 30s. So if some... And you said most onset use is like 13 to 20-ish, which we see as well.

Mm-hmm. Is this different if somebody, let's say you have a 40-year-old. I don't know why- Yeah ... they would start at 40, but you never know. If a 40-year-old starts using this 

[01:06:00] high potency product, is that different? I know you're not a medical doctor- Yeah ... so I don't wanna put anything out there that you aren't comfortable answering, but I assume that that's different.

I can't imagine it's healthy, but what's the deal with that? Yeah. It's very different for a couple of different reasons. And so we talked about, so what's happening in a developing brain? And the brain, really, they say on average, isn't fully developed by, until age 25. And so what's going on is when a brain's developing in adolescence, it is very, what they call salient.

You know, and the way that I like to think about this is if you drop a little pebble into a pond, it's going to make a little bit of a ripple If you drop a boulder into a pond, it's going to make a huge ripple that's going to cascade out, right? And that's on some level a developing brain is it's very susceptible to 

[01:07:00] new experiences, especially experiences that drive pleasure, dopamine. Mm-hmm. So for someone who's 40, who ingests a substance for the first time, their brain is fully developed, meaning that prefrontal cortex is fully formed. Their brain has pruned down, meaning when a baby is born, it has all of these synaptor connections just sitting there waiting for these little rocks to come in.

Yeah. Well, as we age and as we get older and into our 40s, the brain still can grow and change and still has some level of plasticity, they call it. But for the most part, it is pruned down, it is formed, it is solidified. So when I'm 40 and I do anything that drives a dopamine response, it's like a little pebble dropped from a, you know- In a pond dropped into a pond. Mm-hmm. When I am 13, my prefrontal cortex is not formed, meaning I don't have impulse control, 

[01:08:00] and my brain is incredibly plastic and susceptible to experience. Yeah. So now I'm 14. I have a limbic system that is fully raring to go. My favorite analogy is like I got a Ferrari engine back there.

Yeah. But I've got bicycle brakes- Yeah ... because I don't have this prefrontal cortex. Yeah. And my brain is very susceptible to experience. Now I'm taking a 90% potency THC substance. That is like we are, you know, dropping a boulder from the Empire State Building- Right ... into a pond. Yeah. So it has this huge impact, which then drives, drives addiction.

And then because I have access to it, frequency matters. So now I'm using it more and more and more and more. So rather than a 40-year-old who uses a little bit and gets something out of it, probably has a little bit of pleasure, 

[01:09:00] stress relief, whatever they get from it, but they have a brain that's like, "Oh, that was nice. Maybe I'll do that again in a month." Right. Or, "Oh, that was nice. You know, maybe that was a fun weekend with some friends, and if that ever comes up again, I might do it." Versus a 14-year-old who doesn't say that was nice, says, "That is the best thing that's ever happened- Yeah ... to me in my entire life, and I now cannot live without that, and I need that every minute of every day."

That's basically the big difference there, and I think a lot of times, I also see with parents, too Is this idea that how could I try to ask my loved one to stop doing something if I myself am doing it? Mm-hmm. Let's go there. And my answer to that question, yeah, is, well- What you're asking your loved one is you're looking at the consequences of their life, the impact of their life, what's happening for them. You're not asking, you're not judging them as a moral 

[01:10:00] failure or someone- Right ... who's weak, who has low character, they can't do something. You're looking at somebody who has used to be an incredibly bright, energetic, happy person who now can't remember the paragraph that they just read. Mm-hmm. Is not succeeding in school, is not showing up in critical relationships with friends and family, has a self-esteem that has just dropped through the toilet, and is now dealing with paranoia, delusions, maybe auditory, visual hallucinations.

You're not asking them to do or not do anything. You're talking about their life. Right. And you're not having these consequences in your life. You're not seeing tolerance build. You're not seeing addiction tendencies. And what I would say is, unless you are, and then we should talk too. Yes. Right? This isn't necessarily about marijuana's 

[01:11:00] bad, alcohol's bad. I don't know a lot of people that can smoke crack like a gentleman, but- Right ... you know, it, it isn't about the substance, so to speak. It's about what's going on for a particular individual and what are the consequences and threats to their life. Right. And, and so that's sort of my answer to those parents is my hope is that if you were having these problems and consequences in your life, then you would also be willing to take a look at getting into recovery.

Right, 100%. I, I think that's a really good point. Because of the availability and the legality and all of that, many parents are using THC products, and that does get complicated. It's the same conversation you've probably had with parents and families around alcohol for years, and just now- Yes ... it's shifted to a new one, right? Because if you have a glass of wine a couple times a month with dinner, that is a very different story than drinking three handles of vodka 

[01:12:00] in two days. Like, it's just not apples to apples. Yeah. Yeah, so that is the potency message, folks, and the availability message. Yeah. And the young brain is just so susceptible.

And I think the question that's probably running through the back of a lot of parents' minds is, "Okay, great. I get it. I understand all of this. I know how bad it is, but my young person," whether they're 13 or 30, they're not willing to accept that message, right? Sure. They are like, "No, this isn't making my anxiety worse.

No, this isn't making my depression worse. No, this isn't making my ADHD worse," when we know it is. Like, all- Yeah ... those things happen. What kinds of conversations do the families that you- Yeah ... work with have related to that? I love that you brought that up, 'cause for me it really connects to the first thing that you brought up was two years ago we were talking about fentanyl and now we're talking about THC.

[01:13:00] Mm-hmm. And we are seeing such severe consequences with THC use. When you just look at the psychosis piece alone- Yeah ... it's not just that we're having drug-induced psychosis, but it's sticky. And what I mean by that is when I would get folks that are coming in and their drug of choice is methamphetamine and they go into a methamphetamine psychosis, it's almost-- it's incredibly predictable how quickly they'll come out of that.

Hmm. We have them get some good sleep for a week. We get them some good nutrition. We get them some exercise. That psychosis starts to clear. The THC psychosis, when I say it's sticky, we're helping people and supporting people through this for weeks to months. Yeah. So it is long after the substance has been discontinued, and it is taking a lot of time. I have some clients that have 

[01:14:00] been in the program for six months that are still dealing with some level of paranoia, delusion, or even intermittent hallucinations. Hmm. So that, that's the piece there that I think is so important. So- The question you just asked me was, "Well, how do you talk to parents who say, 'My loved one doesn't want to?'"

And the question that I would ask back is, "What if this was fentanyl-" Right ... and your loved one didn't want to?" Right. And that's the message that I'm trying to give, is that this drug is so potent and so powerful, and is causing such consequences for the clients that we're working with. I'm hoping that parents can start to see this as like a life or death type situation, not just a, "Well, it's marijuana, so if they don't want to, I'm not going to necessarily raise my level of urgency or my willingness to intervene at a level I might- Right if I thought that they 

[01:15:00] were going to die," right? Right. And that's what we saw with parents. The great thing that if there was any silver lining to what was going on when we were treating a lot of people with fentanyl, is because of the lethality of it, we were able to help parents move to a place of understanding that even though their son or their daughter might be mad at them, and it might create some temporary conflict in the relationship, because they were so clear that the next one could kill them, they were willing to set appropriate boundaries and intervene at a high level to help someone get treatment, 'cause they believed that it was literally maybe saving their life.

Right. Right. And so my goal with talking to you about THC and talking to parents is we need to see it more closely to that than it is just this harmless, natural drug that maybe won't actually cause that many problems. So we're

[01:16:00] not going to maybe aggressively intervene or set those higher level boundaries that are needed to motivate someone to go to treatment.

Yes. I think that's a really good way to look at it, because you're right, the fentanyl factor was, it was like the Russian roulette, right? Like, okay- Yeah ... you might take a pill today, and it could be the one that get- has too much fentanyl on the right side of the pill or whatever. There was that sense of Really urgent, urgent terror, I would say.

Yeah. And with, with the THC symptoms, it tends-- Even though I said it happens, like, in six months, six months compared to one day is very long. So the other thing that I think happens is that families, you start to sort of get used to someone's behavior, and you start to-- You don't see... Like, if my kid takes fentanyl and overdoses, that's pretty clear. Yeah. Like, it's like, "Oh no." Right. Versus over a course of six months or 

[01:17:00] a year, and their behavior has changed, but it's changed subtly. Because even we have parents whose kids have had psychotic breaks, but the parents never even knew it, because the kids- Right ... were either not expressing that, it was happening internally, and they weren't...

So, ah, I feel like I'm not explaining this very well but I think we get used to and we normalize behaviors over time that may not be- No, you can explain it ... as extreme as an overdose, right? Where they fall on the ground and they're blue or they, they don't wake up. Yeah. So it can be easier to be less alarmed.

Like you said, like, we should be as alarmed as we are with a fentanyl overdose, but we tend not to be, 'cause it's like, "Well, you know, they're doing okay. I mean, they're still going to school. They're still going to work." Right. "And yeah, he talks about, like, he thinks the FBI is after him or whatever," you know? Like, there's, "I don't know, maybe that's just crazy talk." So it's easier, I think, to write off 

[01:18:00] some of the symptoms of this than of other drugs, if that made sense. That was a really long roundabout way of saying it. I completely followed you and your show right on. Okay. It's, you can explain it away. Yes.

And you can look at, so what are some of the symptoms of this, right? So we start to have anxiety, depression, low self-esteem, executive functioning challenges, right? So we're having a hard time going to school, staying at school, and studying at school. You know, going to work, staying at work, working at work.

We're... So a lot of these things, until we get to a place where we have a full psychotic break that we need inpatient hospitalization, it's hard to know, okay, well, is this because of the marijuana, or is this just- Right ... what's going on for my kiddo right now? Mm-hmm. And they actually say that the only thing that's helping them is using some marijuana, and, you know, I kinda get that 'cause maybe I use a little bit of marijuana every 

[01:19:00] now and again to take the edge off. And so it's not the substance, it's we have these other things happening. So I see a lot of that. It's sort of explaining away, but to be clear, those symptoms are coming from the use of the THC. Right. And we see those symptoms go away. And THC, it's challenging because I think we talk about different levels of replacement and medication-assisted therapies and opioid use disorder primarily. Yeah. Mm-hmm. With THC and cannabis, unfortunately, abstinence really is the only method. Right. Because once those cannabinoid receptors are engaged, once we re-engage them, we will go back to psychosis. We will go... So that's another thing that's sort of like the opioid relapse is terrifying because one relapse could result back into, in an 

[01:20:00] overdose immediately that first one. Hmm. With THC, if someone has experienced psychosis, the greatest predictor of a psychotic episode is that you've had one before. Yeah. And if someone has started to experience some psychosis from THC and they use THC again, they're going to have a psychosis. They're going to have a psychotic episode again.

Mm-hmm. So we've gotta get to that place of abstinence. But what you... And it's so hard 'cause you're a parent and it's breaking my heart, right? Where's my happy, you know, loving to play baseball and the most popular kid in the neighborhood at 12, and now we're 18, and we were in honors programs, and they can't go to class at community college.

You know, what's going on here? And they're depressed, and they're sad, and maybe they're suicidal, and it's... And all we wanna do is help. And all we're seeing is maybe a little bit of marijuana, but whatever level of marijuana you're seeing as a parent, times it by 10. Yes, at least. So if you're seeing a little bit, times it by 10 at least. At least. 

[01:21:00] I so empathize with where they're coming from. Yeah. And this idea of, well, if they were gonna die tomorrow, I'd do anything. Right. Whether they liked it or not. Yeah. Right? Yeah. But because it's marijuana and it can be so confusing, it's hard to make decisions to put in boundaries that are needed to help motivate someone to seek treatment, and I so understand that.

I think that's part of why we're talking today- Mm-hmm ... is to help arm some parents with some information to help them decide. I can never tell any single parent what they should or shouldn't do You know, all I can do is share some facts and some experience, and then some hope of recovery that I've been blessed to be able to see over the last- Mm-hmm

18 years. Yeah. But in the end of the day, every family has to really look themselves in the mirror and decide, "Where are we at and what are we willing to do, and what boundaries are we willing to put into place?" Because ultimately, they're the ones that have to 

[01:22:00] accept whatever happens from that, positive or negative. Yeah. And like Dr. Roe was talking about, it could be that that psychosis does not ever resolve, and they are on medication for life. And a lot of that, this has to do with the family history and, right, all of that. Yes. However, I think the good news that he shared, and that I feel like you probably see as well, is that recovery is possible.

Whether that's an- Yeah ... abstinence situation or whether that's medication or both, that life can resume and be wonderful even after this, you know, these psychotic episodes. And that I think this can be such a scary thing, and parents are thinking, "Oh, my gosh," like, "No, if they go on this medication or if they're having these experiences, that this is gonna be forever."

And we all, I 100% guarantee you, every parent out there is thinking about- Yeah ... that person that you see out on the street that is flapping around and singing songs, and you can tell they're in a fully 

[01:23:00] psychotic state. Yeah. And that's what we think about when we hear that word. And I know he, you know, Dr. Roe's very clear about the fact that that is not that's not their fate. No. You see it, so maybe give us some hope from your seat. Yeah. Well, we thoroughly covered the bad news. Yes, we did. Check. Got that. So here's the good news, is there is a really good blueprint for recovery. And what Dr. Roe's talking about is, and I didn't mention this, but the other thing that's going on is that people in that age group, that's when you have the biggest vulnerability to actually just organic psychosis.

So there's, you know, a percent of our population that is predisposed to having a psychotic episode anyway, whether they never used- Right ... you know, anything ever. So folks that might have a predisposition 

[01:24:00] that are also using THC, that's sort of, you know, the difference between it's just purely drug induced or there might have been an organic vulnerability that has then been triggered.

Right. And those folks might end up having some level of a predisposition to a psychotic episode forever. Here's the good news is there's medication that people can take that they have a, a fully normal life. Yeah. You would not know. They have wonderful lives. They thrive. They have authentic relationships.

They have incredible successful careers. They have hobbies. They have pet- like, they, you know, I would put you in a room full of people and you would have a conversation and you would have no idea that they take a daily antipsychotic because they are the most charming, articulate people that you've ever had a conversation with- Mm and they love their 

[01:25:00] lives. Yeah. Um- That's so, so, so good to hear. Yeah. And just for anyone in general that's using, you know, THC as their drug of choice, we've gotten to that level of psychosis, again, the good news is that- It isn't as lethal of a substance just purely based on I take it and I die from taking it.

Now- Right ... deaths happen from THC, but it's more like because of my level of impairment that I end up, you know. Recovery also happens. Mm-hmm. And there is a real good blueprint for both addiction recovery but also neurocognitive recovery, where over a period of time, given the right interventions and the right environment, and the right amount of time, I s- just said that a second ago, but that is really important is it actually takes longer for the brain to heal 

[01:26:00] from THC than it does from other substances. So there is a timeframe here that's needed. We gotta do it for long enough. But people do recover. They recover well, and they have incredible lives. Awesome. Well, I think that's a great place to wrap it up on a high note- Yeah ... with, with hope. That's right. And with some positivity. And thank you so much. I really appreciate it because you're boots on the ground.

You're seeing this day in and day out in person, and I think it's just really important for parents to have that perspective to say, "This isn't just something that's being talked about i- you know, in academic circles." This is something that you as a treatment provider are dealing with every single day.

And to get the- Yeah ... word out that it's not harmless. It is not natural. It's not a plant anymore. W- what we do is we try to get parents informed and educated on how 

[01:27:00] to start to have a conversation with their kids so that they would call a Jay Walker, and they would talk to you guys and say, "Hey, what would it look like if I was to get some help for this?"

Yeah. Because, and oddly, you know, and maybe it is because it's so scary to have, you know, voices in your head or hallucinations, we are seeing more young people be willing to get treatment, and I don't know if that tracks across the board. Yeah. Um, if you're seeing that, but we are seeing more young people say, "Okay, you know what?

I do need some help. Where can I go?" And so that's good news as well because trying to fight that battle is really tough. Yeah Yeah, you bet. It, and we are seeing that, and I think a huge part of that is young people talk to each other more than we ever did. Mm-hmm. And they are more willing to talk to each other about their emotions and what they're seeing and feeling.

[01:28:00] Plus, they have the internet, so they're constantly sort of sourcing experiences and data and facts, whether they're good data and good information or good- Exactly ... facts or not. You know, if I'm starting to experience some psychotic features and I'm using marijuana, I'm instantly looking to see if other people have dealt with that.

Yeah. And then I'm actually learning that that is something that's more normal and common, not just about me. Okay. So therefore, there's sort of this less stigma around, you know, it being because I am broken and I am wrong versus, oh, this is something that's happened and other, and it's happened for other people, so I could be more willing to get help for it.

100%, yeah. I think, you know, there, like you said, the access to the internet can be good and bad, but for this, it is good for them to be able to go to a Reddit thing and see, okay, wow, this is happening to a lot of people. Here are different people's experiences with it. Think it does tend to take a little bit of that stigma 

[01:29:00] away of like, "Maybe I'm crazy," right? Like, that's- Yeah ... kind of the perception that people can have is, "Oh my gosh, I'm crazy." So that can be really good. And some of the messaging, for parents who are listening, that has, we have seen work to a degree with young people, is this idea that you are being sold a product. People are profiting off of your experience here, and yes, at first maybe it was super fun and it was chill and it made you sleep and it reduced your anxiety, but there's a little bit of that, because it is such a big industry, like the man- Yes

is profiting off of this experience you're having. Have you seen that? Oh, 100%. Well, and- Mm-hmm ... so we talk culture, like you and I are Xers, right? So we were like, you know, The Man was the worst, right? And we are gonna rebel against The Man, and 

[01:30:00] marijuana and, you know, V- Vietnam War coming into, you know, us as latchkey kids. Like- ... we are skeptical of The Man. We are gonna rebel, and marijuana was a part of that in our generation. Marijuana today is the man Yes It is a multi-billion dollar organization owned by hedge funds and private equity groups- Yep ... with a political lobby and power that is beyond what you can possibly imagine.

So marijuana is not the cool counterculture- Flower child You know. That's right. That is not what we're talking about. Nope M- m- marijuana is an industry that is run by billion-dollar corporations and private equity groups, and it is, these are private jet people. These are not rebels fighting for social justice. Right. So if you're having a hard time talking to your kid 

[01:31:00] about this, that might be one area to explore. May have to do a follow-up episode on that, but- Yeah ... thank you, Stephen, so much for joining us. Thank you for treating the men that you do at Jay Walker Lodge, and just keep at it because they really need the help. Yeah. Thank you so much. Oh, thank you, Brenda. I appreciate it. I wanna thank all of my guests today, Lynn, a battle-tested mom, Dr. David Rowe, neuropsychologist, Stephen Bate, the CEO of Jay Walker Lodge, for joining me for such an important conversation. If you go to hopestreamcommunity.org and click on "Podcast," you'll be able to find the show notes for this episode, and in the show notes, there will be a link to a THC resource guide for parents, which goes a little deeper and will be really helpful for you if this has been meaningful and relevant to your family and the situation that you're in right now.

[01:32:00]  We also have a free e-book I wrote. It's called Worried Sick: A Compassionate Guide for Parents Who Have Teens and Young Adults Misusing Substances. It is short and direct, and it will help you start to understand a different way to help your child if they're struggling with their mental health and with substance use.

It's not easy to do, and this approach does not include things like waiting for rock bottom or using tough love. If you would like to grab that e-book, go to hopestreamcommunity.org/worried. And finally, if you're a mom or female caregiver who would like to get tapped into a community of incredible women all going through and navigating their child's substance use together, just go to hopestreamcommunity.org/try, and we will give you two free weeks in the community. No credit card needed, no commitment. Just see if we are the right folks 

[01:33:00] for you. Okay, my friend, that is all I have for this week. Sending all my love and light, and I will meet you right back here next week Okay, my friend, I am so glad that you are here with me today. Do you want the resources from this episode?

If you do, head to hopestreamcommunity.org, click Podcast, and you will find this episode, along with 300 or so others, and every link that we mention. And if you haven't tried it yet, we offer a free two-week trial of our online community for moms, The Stream. No credit card needed, no commitment, just go to hopestreamcommunity.org/try and we can get you set up with a free two-week membership.

And if this is your first time here, or if this whole approach feels new and uncomfortable, that is normal. You can grab a free e-book I wrote called Worried Sick. It will help you start seeing new ways to 

[01:34:00] respond to your child and find new ways to approach this whole situation that feels very confusing. You can find that at hopestreamcommunity.org/worried. You, my friend, are an elite level parent. You are doing an incredible job. You do things most parents never have to do, and I am so honored to be walking this path with you. Take ridiculously good care of yourself, and I will meet you right back here next week