Cannabis and ADHD: Dr Bryce Joynson from Innovative Medicine (Altmed Ep.75)
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- čas přidán 11. 09. 2024
- In this week's podcast we speak with Dr Bryce Joynson from Innovative Medicine about:
- ADHD and cannabis
- THC and CBD thresholds in treatment
- Cannabis use disorders
Innovative Medicine:
www.innovative...
AltMed:
altmed.com.au/
Thank you for this podcast and I appreciate that we can have a discussion about ADHD and medicinal cannabis. I am a neurodivergent psychologist who uses medicinal cannabis. I find this topic really interesting and one that I am very curious about. Personally, medicinal cannabis helps me with sleep as it calms the internal hyperactivity in my head after my medication has worn off. I sense in the discussions that there is a lot of complexity with prescribing medicinal cannabis for those with ADHD and getting the right dosage is key. I really appreciate Dr. Bryce Joynson’s approach to individualised treatment that considers the person’s lived experience. It's so important to empower individuals by understanding their experience rather than fitting them into a treatment model. I appreciate the effort that has been put into this podcast, however, I would like to clarify some things in relation to Autism, ADHD, and Neurodiversity as there have been a lot of misunderstandings and I would like to shine a light on the current research as well as promote the social model of disability. My thoughts and opinions are based on my readings of the current literature, my clinical experience, and my own lived experience:
• Firstly, the first line of treatment for adults with ADHD is medication (This is in the NICE guidelines and is well supported by research). Dr. Barkley likens it to the treatment of Diabetes. "It’s like a diabetic choosing not to use insulin but instead trying to deal with the diabetes strictly through diet and more exercise. Maybe that will work, but it’s less likely to do so and will result in far less control of the disorder than using medication to manage it. Why would you deny yourself the equivalent of insulin for a diabetic” (Barkely, 2022 p. 118). A multimodal approach to ADHD treatment is important so exercise and a healthy diet is necessary. For most people with ADHD, they need the medication to be able to help them with the exercise and diet.
• Assessment and diagnosis require a clinical interview and a collection of other data that assesses a variety of complex daily tasks at different times and settings. According to Dr. Thomas Brown, no Imaging studies such as Positron Emission Tomography and FMRI can determine whether someone has the condition, though this can be helpful to investigate the brain activity in those already diagnosed with the condition (Brown, 2017).
• Those with ADHD have been shown to be deficient in norepinephrine (not adrenalin) and dopamine which are neurotransmitters. Neurotransmitters are chemical messengers in the body which transmit nerve cells to target cells and are essential in regulating the body's functions. There are suggestions that other neurochemicals are involved but I have not heard of adrenalin. If you can point me to some studies, I am happy to update my belief system around this.
• Stimulant medications increase dopamine and to some degree norepinephrine. Non-stimulant ADHD medication such as Straterra mainly prevents norepinephrine reuptake which some research suggests can increase dopamine. These medications help with easing ADHD symptoms because it regulates the brain deficits in the executive functioning system. This means that while the medication is active in the body it helps reduce executive functioning problems such as distractibility, and impulsivity. It also improves attention, emotional regulation, motor timing, and coordination. This is just a brief and simplified description of ADHD medication, and it’s important to consider that it is more complex than this. Whilst there is anecdotal evidence (reports from users) that medicinal cannabis can aid in ADHD symptoms, there is very limited evidence to suggest that it is effective for the treatment of ADHD. Whilst there is some evidence that THC can enhance dopamine, there are also studies that suggest that it can dull it in the long term.
• Neurodiversity is a term that proposes that people experience and interact with the world in a multitude of ways and there is no “right” or “normal” way of thinking, feeling, learning, or behaving. As such ADHD and Autism are considered a ‘neurotype.’ The difficulties mainly stem from navigating a world that is not designed for minority groups and the stigma in society around these neurotypes. It is not something that needs to be ‘fixed.' For example, I am born Asian, and if I come to you for anxiety and executive functioning difficulties, you are not going to treat my ‘Asian-ness’ but rather the anxiety and the executive functioning issues. Autism and ADHD often co-occur together, and whilst there are difficulties, there are also many strengths. Dr. Ned Hallowell (Psychiatrist) commonly states that people with ADHD don't have a deficit in attention, they have too much attention and are hyperaware of their environment, thoughts, and feelings. ADHDrs have an interest-based nervous system, can hyperfocus on the things that interest them, are typically out-of-the-box thinkers, spontaneous, great problem solvers (as long as it is an interesting problem), determined, intuitive, and respond well in a crisis. To be clear, Autistic people are not deficient in empathy or social skills. Damian Milton talks about this in terms of the 'double empathy problem.’ It is a double problem because autistic people and non-autistic people have a difficult time understanding each other. As such the idea that autistic people have a ‘social deficit’ does not consider that perspective-taking, theory of mind and empathy are two-way processes. There is a recent study that suggests that autistic people do not have problems communicating with each other and have a good rapport. When autistic and non-autistic people interact there seems to be lower rapport and ability to communicate. There is a misconception that Autists are unable to read emotions but this is more about alexithymia rather than autism. This article is helpful in understanding this better www.scientificamerican.com/article/people-with-autism-can-read-emotions-feel-empathy1/#:~:text=We%20found%20that%20individuals%20with,of%20empathy%2C%20but%20alexithymia%20is.
Dr. Joynson talks about homeostasis however I just wanted some clarity as to how THC is "the perfect drug to treat ADHD” because it increases "dopamine and adrenalin" but then it turns off the brain’s ability to make its own. This seems counterintuitive to homeostasis and given that people report that it is helpful to them there seems to be something else going on that we don’t quite understand yet.
References
Barkley, R. & Benton, C. (2022) Taking Charge of Adult ADHD: Proven Strategies to Succeed At Work, At Home, and in Relationships. The Guilford Press.
Brown. (2017). Outside the Box: A Practical Guide. American Psychiatric Publishing.
Brewer, R. & Murphy, J. (2016) People with Autism Can Read Emotions, Feel Empathy: There is a fine line between autism and alexithymia-feeling emotions but being unable to identify them. Scientific American.
www.scientificamerican.com/article/people-with-autism-can-read-emotions-feel-empathy1/#:~:text=We%20found%20that%20individuals%20with,of%20empathy%2C%20but%20alexithymia%20is.
Crompton, Ropar, D., Evans-Williams, C. V., Flynn, E. G., & Fletcher-Watson, S. (2020). Autistic peer-to-peer information transfer is highly effective. Autism: the International Journal of Research and Practice, 24(7), 1704-1712. doi.org/10.1177/1362361320919286
Devita-Raeburn, E. (2016, August 10). The controversy over autism’s most common therapy. Spectrum News. www.spectrumnews.org/features/deep-dive/controversyautismscommon-therapy/
Hallowell N., & Ratey J. (2021). ADHD 2.0 New Science and Essential Strategies For Thriving with Distraction from Childhood through Adulthood. Ballantine Books Trade.
Milton, D. (2012). On the ontological status of autism: the “double empathy problem.” Disability & Society, 27(6), 883-887. doi.org/10.1080/09687599.2012.710008
Milton, D.E.M., Heasman, B., Sheppard, E. (2021). Double Empathy. In: Volkmar, F.R. (eds) Encyclopedia of Autism Spectrum Disorders. Springer, Cham. doi-org.ezproxy.library.sydney.edu.au/10.1007/978-3-319-91280-6_102273
Silberman, S. (2015) NeuroTribes: the legacy of autism and the future of neurodiversity. Penguin.
Great comment Mary! Thankyou
If only more people put this much effort into their youtube comments. Just fantastic and is almost identical to what I would have said if in a particular state of hyperfocus. Awesome
MC has been an amazing help for my ADHD (Yes co-morbidity). But I am ever aware that it can make things worse, I have very low doses of THC and as much CBD as I can afford to get into my system along with regular THC breaks.
Helps with sleep and back pain as well
So true about sugar trying to get that high...regulate emotion...blood flow to brain.... yes..yes
This was really great. As someone with ADHD who is using medical cann to medicate, this really hits hard at times. I use a strong indica but only very small amounts but more regularly than I would like. What I find is when I vape a very little amount, like half of what it would take to feel high. I get a very noticeable improvement in ADHD symptoms. But what happens is I try and repeat this 2/3 hours later but I find it makes my ADHD symptoms worse but still improves other things like anxiety etc. I feel like inhaling is part of the problem. As a ROA, inhaling is great at instant relief, but it hits too hard. For example, dexamphetamine is a very effective treatment for ADHD. But if you were to vape it, even in a medical setting. I dont think its going to be an effective treatment anymore. I personally dont like stimulants because i struggle to control my use and they fuel my anxiety. I find cannabis much less taxing on the body despite being less effective. Its just inhaling is just so dam cool and fun. One thing is for sure, all us ADHD folk need to get out and run each morning.
Our pleasure
Have U tried sativa? I use really weak edibles along with other things like l- phenylalanine and find it helpful. The key IMHO is to get the dose right. My theory is that THC enhances focus outside the mind (good) in small doses but begins to enhance focus inside the mind as dose increases (bad).
Packed a bong and this popped up... hmmmmmmmmmm the algorithm is trying to nudge me 100% 😂
Ive been feeling guilty hooked on weed and living with adhd and cptsd
I got the strong impression that Dr Bryce increased dopamine levels with his fellow interviewers and one in more so than the other was a stoner? Haha strongly agree with 95% of what was said. He certainly had his statistic and %%% down to a tee. Im ADHD and getting told to smoke green by my doctor in small amounts and it does help also have back and nerve injuries so helps with that too need more doctors like yourself much respect...
Thank you for this interesting podcast and for your honesty, its refreshing💚
Thank you so much Dr. He was so informative and unbiased. I have so much respect and gratitude for him.
I have ADHD and the wierd thing bout weed is it does the opposite effect on me. I get more of a coma high and being trapped in my head making my brain race 10x fast, not eating and just paranoid. I get the shorter end of the stick
You’re not alone
Outstanding explained and informative, very useful talk. Thank you for producing this content 🙏
Our pleasure
Like most all of healing as they are based well on the attribute called time spent. Given healing is much better by under standing the individual. a dr prescribed ridilin medicine was what drs teacher parents for helping the hyperactity in a child. If a person does get a personal understanding of thier medicine the treatment becomes supported by the patient. And followed by better results as needed...m
I almost came here looking for an excuse to keep smoking even though im certain i have undiagnosed ADHD because its a marijuana channel lol. Ive been clean for about 4 months now after a 3 month binge after 1 year sober so obviously ive had my issues and always assumed the weed helped but its very clear now it didnt all that much. Thank you guys this is a great conversation.
I found that impulsivity has two sides...one my own , mostly others that push you into doing that ....
So... if you are in a room with 100 people and you only see 9 adhd... then you make 10. 😂
Standard deviation for iq test is point 15. all less (like 8 points) isnt significant!
Can you please use the correct pronunciation of ' H' - it is Aitch not Haitch :)