Cannabis and Driving with Dr. Denise Valenti

0:00This isn't a running ad for Mariii because it's mostly walking and occasionally flying It's hitting your favorite trail with your favorite people who showed up for the same on hinge reason And it's not just about fast snowing times, but finding the funnest times Because this isn't running it's trail running Get your gear for the trail in store or at REI dot com Well, this is a topic that I think the listeners are going to care about a lot in general I think the public cares about a lot because we're really used to you know drunk driving and testing for that It's been a part of a society, but everyone has this question about like what about cannabis and driving is there a way to test for a cute intoxication

1:06So welcome to the show dr. Denise Valente I think you are probably the leading expert that I know on this topic and you've been studying it for a really long time So I'm really excited to pick your brain a little bit and have you educate us about this topic and Just a note to the listeners. I'm sorry if I sound a little different today my microphone broke So I am microphoneless on this episode Welcome to the show Denise and can you give a little bit more background about who you are and when you got into studying cannabis and driving? Well, let's start with driving in general I chose not to go to medical school because I wasn't confident. I could be a good surgeon I wasn't confident that I would be happy with some of the interactions with patients. I started my career before there was such a thing as Implants for cataract surgery. I started my career one there really was a legitimate reason to use cannabis for glaucoma because there were no surgeries and there were no drugs to treat it so people went blind

2:11I started my career when people went blind from diabetes So again, there were sad episodes if you were involved in eye care I chose the route of optometry because I wanted to go into the field of rehabilitation Once they lost vision Getting them to where they can be a little higher performing. I do have to say Some of my knowledge regarding cannabis came during one of my internships There was a young man that went totally blind because of an accident and he was at the commission for the blind I did not tell on him although I felt I should I never did it was in Oregon in the 70s and he had planted several several marijuana bushes in the grounds and he proceeded to show them to me So one of the things I was curious about and I challenged him on it because I felt he should rip them out

3:12If he'd him rip them out I might get in trouble, but I said Who did it? I missed your Marijuana he goes I could do it. I'm just fine. I'm like, I don't think so So he demonstrated to me by harvesting it and this was all unofficial not sanctioned by anybody and yes He should have been turned in but I did not and he did a remarkable job because there was mostly plant you know the bud And then I was Challenging him. Yeah, but I know you can't roll a joint And he's like Yes, I can for so well I wasn't good at rolling them. That's why I was challenging him and he proceeded to show me and he had a remarkable skill In both harvesting the plant and rolling a joint now I have mentioned and nobody really likes paying attention to me about it that we can create part-time jobs Within the industry for many types of disabilities so far I've not seen that happen, but that is one thing that I think is an exciting Opportunity because many people with significant disabilities don't want full-time jobs

4:17That might interfere with their health insurance it might interfere with a lot going on So again, that's one thing I've been talking about within my own community well, I Went into apt-amitary school. I specialized in vision loss, but I emphasized When you've lost vision and you can't pass the state registry Can we really rehabilitate you to teach you skills that allow you to be a safe driver now often when there's a vision loss It's more common among older adults. Yeah, so you have the intersection of cognitive loss Aging and vision loss so I became an expert very early on in a sensory impairment and driving I was a consultant for General Motors and I served early on on the National Highway Traffic Safety Research Group Fast forward a little bit. I had severe health issues. I have a gene that is considered the most deadly of cardiac arrhythmias I had already lost a 19 year old sister a 17 year old sister

5:21My 15 year old nephew. I was able to keep my own heart However, I couldn't practice anymore. So I transitioned into research. I started researching retina Imaging and Alzheimer's. I also did that with Parkinson's disease and post-traumatic stress disorder Starting around 2012. I started developing a research protocol to treat Alzheimer's with marijuana not because I think it's so good But because the drugs out there really don't work and I developed a hypothesis that there is a particular cell category In the retina that is impaired by Alzheimer's but can be modulated I'm sorry to interrupt but is it very common for people with Alzheimer's to lose vision? They don't lose vision. They lose some perceptual processing. They're two different things. I say okay Now I also research Parkinson's and what can happen if they don't have their dopamine medication

6:26they can lose And it's hard to actually articulate and describe because they're acuity How well they see tiny letters stays the same but their ability to process depth Speed Contraist and other functions are severely reduced if they're not taking dopamine now That's how we started to understand the deficits when you don't have dopamine in your retina marijuana takes the dopamine out of your retina So you temporarily have visual deficits that as soon as the marijuana wears off You will actually have a return of those functions now there can be real subtle Losses that are permanent if you started marijuana use before age 16 chronic use that's a very different subject I never believed when I started in this industry I would say absolutely no marijuana use For under 21 I now say unless there's a strong medical indication which is don't know enough and there is

7:31Re-routing Changing of axons and cells in the brain now. I hypothesize the very thing that's causing a problem with development It's actually a good thing with degeneration uh normal aging Parkinson's Alzheimer's Post-traumatic stress disorder those are the things we really need to research We're starting to understand sadly the negatives just because they're showing up But without controlled studies we're not gonna actually understand the positives Yes Um once I realized the dopamine piece I took a test that I had been using Hoping it was an early diagnosis of Parkinson's or Alzheimer's it was not And started developing it so we can see if it would work to digi-thermen impairment to drive with marijuana used So we had opportunity to see our first set of data in Colorado The government was teaching police officers to better detect marijuana impairment

8:33So they were selectively allowing people to get high And I was able to capitalize on that we got enough data to write and get grants So we have been demonstrating our initial hypothesis is accurate Slowly and methodically So the dilemma with what we do is We don't have controlled studies Opportunistic dosing is working for us again You can't use that type of protocol if you're trying to develop a treatment for Alzheimer's and those kind of things You have to know what they're using and as we're learning When groups choose to investigate the labels on these products aren't accurate anyway Yeah, we just saw something come out about that in Massachusetts like today something was just released about Yeah, what happened to us our first study though we asked no CBD We're trying to control as many variables as possible totally

9:34The label said no CBD and their data were really strange But when their blood came back they had more CBD in their system than they had THC It was early on and what I'm guessing happened is the Dispensary ran out of product Just put in that baggy whatever they had on the shelf god. I hope not that's crazy. It was it was within the first month Yeah, okay, so yeah, they knew there were gonna not be any lab checks They also knew that many of these customers wouldn't know the difference Yeah, totally can you just for some background talk about like the challenges of testing for THC impairment cannabis impairment while driving compared to something like alcohol that we have a breathalyzer Like we can just do that on the scene. Why can't we do that for cannabis? Well our data is clearly showing this but the amount of product in your system Does not match your impairment? We have had people

10:36Barely any identifiable THC in their system and they're impaired on the other hand We've had chronic daily users and There's not a change In their data from baseline and we know what baseline they had no THC But when we measure them now the drawback of that is right now. We're comparing change from baseline chronic heavy users If we start to compare them to a large population base normative database for our instrument Are going to be slightly impaired even at baseline now The drawback of measuring one sensory function That is only one sensory function the advantage of measuring peripheral vision We already know reductions in your peripheral vision are tightly correlated to ability to drive

11:37There's plenty of research out there unrelated to cannabis We also know reductions in contrast Which our stripes are changes in contrast is tightly correlated to safe and the ability to drive So we don't expect Even though we know it's related to driving All products To show the same amount of impairment we think terpenes in the ratna And other sensory systems are probably contributing differently depending on the terpene Now you may have one terpene that's great To lessen balance impairment But it worsens vision impairment so we do think That roadside Using AI and combining accurate good tests And we don't think tests of actual cognitive performance

12:41are consistent enough And directly related to driving enough to be good for marijuana detection So this is like the touch your nose walking a straight line No, no, no, there are Okay, that's the print Those are sensory tests Okay, those are sensory The cognitive I test I'm talking about our tests that are administered to Alzheimer's already Okay, they're transferring them to using cannabis They're good tests But they're not appropriate for decisions about driving Again, just because you don't know what aspect exactly of driving their measuring And there have been several Products out there on the other hand those type of tests Might be excellent in consumption cafes Because what many of them do is they require your own baseline

13:42And then your impairment is related to your own baseline Right the change from the baseline So I think we should mandate Because a bud server Well, first of all, if you're having a product in a consumption cafe The goal is to be impaired Yeah, that's why you're there for sure So again, we need tools to protect Both the customer but decrease the liability of whoever's serving them So I think that type of product Is not good for roadside But it's excellent again, those are more cognitive based tests Our tests we think Combined with other eye tests For example, there's a technology out there also in a vera goggle That looks closely at eye movement Well, the drawback of an eye movement test will by itself You have very bad eye movement

14:42And still be just fine for driving So it's an indicator that you used marijuana By itself with nothing else. It's not really an indicator that you're impaired You need other tests to go with it And just uh, sorry to interrupt again But just when you're talking about like this VR and eye movement Is this again from baseline or is it you're wearing this no VR? No, that particular one has normative database It's an excellent test But it again When you have these tests They're not useful if they're not accepted in the courtroom And the first customers for all forensics technology Is the judge in the courtroom that says Oh, this is directly related to driving You have science and non peer-reviewed publications For me to say I am comfortable convicting somebody I am comfortable putting them away For a good person of their life So they need to accept it to a certain level science

15:45And we have been working towards that and Other products Started in immediately hired marketing people And sales people with no science Classic We've survived despite all the horrible things that have happened to us Including our colleague's death And we've just started publishing some of our data We have data we're sitting on That's much more powerful than what we've published But we don't have because my colleague died that was his job So we'll be there Yeah, we'll get it out there The next way was We do think combining tests in one technology We will for our final product Have our retina test That measures dopamine That is directly related to driving We will add in an iMovent test We will be adding in a pupil test Marijuana impacts your pupils in a very specific way

16:46And we just published on this When officers presented this test in the courtroom It could be so inconsistent roadside That it did not get accepted in the courtroom We uncovered why it's inconsistent What happens with marijuana if you shine a light in the eye While the light is still shining in your eye The pupil will have constricted But it will dilated again That's unique to marijuana What we discovered and we published on this is the reason the findings are inconsistent Is if you're using a medical grade light Meaning all white You don't find it You have to have blue in your light And some officers carry light with more blue Because you can better highlight body fluids if you go You can find it if you have red in your light So we published on that So there's science behind it And we know which cells it is And this is the cell we had hypothesized all along that's impacted by marijuana

17:50The intrinsically photosensitive retinal ganglion cell So while we're not moving along as fast with our VR goggle and retina test Because of my colleagues' death, we are slowly moving forward with science Dr. Janice, this is amazing that you're talking about this I had no idea about the people changes and that's incredibly unique So just like for people to picture It's kind of the goal that you have somebody who's driving a little bit erratically A police officer pulls them over And then you need a field sobriety test So they would carry with them these VR-their type goggles They put the goggles on them The goggles are going to do multiple redundant things that you're talking about here We plan on four tests Okay, cool Our test An eye movement test A pupil test and a test of sway Okay In the geriatric literature

18:53Again, I study driving impairment and elderly In balance and gate changes, walking changes are related to impairment to drive in older adults So that literature is pretty strong Kind of this Impairs your ability to main balance and sway So while not as easy for a jury to understand If you have abnormalities in sway and balance That is directly related to driving impairment Okay You know, a jury is going to say Yeah, maybe I don't believe you But then again Right now the only tests are the observations And those observations have scientific validity In a lot of the literature So they're not bad tests It's just the system to assure that it's equitably applied

19:53That the stops are equitably applied And there is a little flawed Yeah, it is And you know, that was a question I was going to ask Because I think we need better testing For a non-discriminatory way to tell if somebody's too impaired to drive Despite what they're on Maybe they're on a little bit of opioids A little bit of alcohol, a little bit of cannabis Is there a way to just say Okay, you're too messed up to drive I have to say Our retina test is only for marijuana Okay However, the deaths associated with impaired driving 40% of them were marijuana related In a study in the Midwest And with beverages Which, nanol and muslimification of the beverages They're hitting your system pretty quickly Very fast That rate's going to increase So again And now 40% is that just people had cannabis in their system

20:53Like that's the data we had Yes, and when they're dead, you have no way of knowing if they're impaired Yes And unfortunately with some of this data, you also don't know what the other driver was going on Right Now, data out of the state of Washington And they did an amazing collection of data early on They hired companies and they set it up nicely They have found in their data from that era 85% of drivers that had marijuana in their system In a fatal crash They themselves survived They killed somebody Where is with alcohol the opposite is true That alcohol impaired drivers tend to die themselves As well as other people So it's kind of the type of crashes and the type of deaths are very different

21:54And again, once you start adding the two, it's not linear, it's exponentially more deadly I was just going to say the same thing We have a lot of data showing that too from our nonprofit Looking at the combination of alcohol and cannabis And how it's so unpredictable and so much worse than either of them in isolation Now one of the things that never gets discussed Right now in some countries there's a discussion, I think New South Wales About basically letting drivers that have a medical use drive And not really have repercussions And Germany, that's the case if you have a medical priority Well you do the drawback of that is think about many of the Reasons for using cannabis I'm not looking at pain, I'm not looking at cancer, I'm not looking at those MS Parkinson's Alzheimer's, they are impaired They have dysfunctions for driving When they're not on any medications So again at baseline

22:55That doesn't mean they are too impaired to drive But they have dysfunctions Yeah, they say they don't And must will say, well I focus better And that Parkinson's will say I have less tremors Well you had dysfunction at baseline based on your disease So if you start even adding the smallest amount of THC They may be deadly So these are things that We have to understand the intersection of all factors Including the alcohol but the disease So it's one of those things Let's back off and again we all know somebody with cognitive impairment that's still driving and shouldn't be Yeah quite a few actually is super super scary So you mentioned changes in balance For people who are impaired with cannabis Their ability to perceive contrast differently Their peripheral lenses kind of change Or their ability to detect in the periphery What about reaction time?

23:56Do you have any data on cannabis consumer? We have data within our system on movement reaction But we don't really follow that Let me talk a little bit about the peripheral vision When we're doing the type studies We do not know timestamped Again because we don't have control over the dosing Our data accumulative over several projects Show that immediately after inhaling With not done edible yet You have very constricted vision Which is tunneling almost We don't know how long that lasts It probably doesn't last more than five to ten minutes On the other hand that's why we support The ability to use burnt marijuana order To pull somebody over and do an assessment If there's burnt marijuana order in the car That's indicative that whatever reason you pulled them over They were probably pretty impaired And within ten minutes They're not going to be as impaired

24:56There still might be impaired So we have data sets that look at Within ten minutes Another one that's about twenty They're impaired there But starting at our data set We have some that are at 40 minutes At 40 minutes For what we measure Which means they may be really impaired But people are not as impaired So if I had to say how long is the impairment Overall impacting your safe abilities to drive With inhalation and hour On the other hand we've never measured Edibles and then you throw in the nano and Mulsification It's like I don't know For routine driving though They have found in studies of pilots For more extreme use of perceptual reaction And abilities They are impaired up to twenty-five hours later So if you have somebody that wants to use

25:59marijuana And is in the industry And operating one of those large crane Things That is more precise than lending an airplane So that is type of job You would want to say Zero tolerance Yeah And I'm glad you answered that We actually had a few community questions That were that exact topic Like for instance Jackson O'Hare said What evidence-based advice can clinicians Or cannabis educators give medical patients About how long to wait before driving Is there any reasonable rule of thumb When impairment varies by dose, consumption method, tolerance And the individual No there isn't really Yeah On the other hand if you're using it for pain management Or cancer You already can Pretty much assume you probably don't have baseline problems That would interfere So your safe time Before you can drive this very different You have somebody that has

27:01A young adult With intact cognition That has motor problems Their time to safe maybe even Much longer You also have the factor Of chronic heavy use Yeah Some medicinal users are really heavy users You know when they're doing some of the First of all Dabbing There is an animal study Out of Africa that shows dabbing The high dose THC concentrate Is killing the brain cells That control eye movement Now that's an animal study What happens in humans I don't know But anybody that's been around people that dab With very high concentrates You will notice There's a jiggle eye movement Wow interesting I have not noticed that Yeah and I hang around There are no high concentrates I was these I hang around some pretty heavy dabbers

28:01But maybe I'm just not looking in their eyes Enough that's something that I'll certainly Pay attention to now What that probably is If it's happening Is the cells dying And that's just like a dose problem Yeah you're thinking that's just dose related Like if you put enough cannabinoids On the cells Yeah Was excellent Because they looked at several regions related to vision And they found no damage in other regions So again that tells me This wasn't a group looking for harm They were just looking for information And again it's only one paper So we don't know much But Ethically and more likely You would not dose a human being on purpose Just to see if it's there If they're choosing to use it And end up with those tremors So researching it's going to be interesting That is very I can't wait to read that paper after this Yeah What One of those obscure ones I just happened to find I love finding those

29:01I always find them at like 11 p.m. too And I'm like oh my gosh I need to go to bed But can I ask you Go ahead Seeing all me and I'll send it to you Cool Awesome I wanted to ask one other question from the community While we're kind of on the topic here Of Cody S in Denise's experience Do standard roadside sobriety tests Have any value when it comes to cannabis use And driving impairment What does research currently indicate As best practice for someone who microdoses cannabis Before driving In terms of length of time before getting behind the wheel Or judging personal impairment Empowerment levels themselves Don't okay There are these nice little apps you can buy And measure your baseline But I wouldn't use them Because We don't know what it all means But if you're trying to make decisions And trying to be responsible And you're microdosing I'm gonna still say don't Because we don't know any different

30:03Yeah, I thought it'd Read a paper a couple years ago That talked about cannabis consumers Versa alcohol consumers That cannabis consumers were more likely To be kind of more in tune with their body And able to tell if Like if they shouldn't drive based on dose Compared to alcohol being a little more like Giving you more confidence I seem to know because it affects the same regions as does alzheimer's Okay Alzheimer's can't perceive how cognitively impaired they are So again, everybody's different So that's a conversation First of all, I always suggest And they're hard to find, I know that If you're treating for a medical disease Try to find a good clinician that knows what they're doing For example, post-traumatic stress disorder In the veteran system In the past, I haven't looked this up recently The suicide rate among marijuana users Was higher than normal Within the system However, post-traumatic stress disorder In general, particularly if there was an injury associated with it

31:04Is a sleep pathology And then the next question Is it a sleep pathology With it Is a sleep pathology If you have these diseases Frequently you have abnormal sleep All right Marijuana during the day Disrupts your sleep And your normal circadian rhythms We're slowly proving this So if you're treating a disease That's very different than some of the diseases You gotta remember that If you're disrupting sleep Further, you're actually causing Lessor healing Or lesser treatment for that disease So when you have a sleep pathology Post-traumatic stress disorder Parkinson's Alzheimer's We hypothesize That if you're dosing With circadian rhythms Before bed, an hour or so

32:04You have more potential to actually treat the disease Now what happens though Think of Alzheimer's When it's a pro-ferral Alzheimer's It's generally a pro-ferral agitation Which means daytime use All right That poor person's gonna go home Have worse sleep than normal The people in the house Are gonna have worse sleep than normal So everybody's gonna be miserable Except for the people at the day system That was administering them And they had a more sedated Less agitated person So those are the kind of things We think it's really important to understand and study Yeah and again, when you're asking questions about dosing You need a clinician to start guiding Because of all these other factors When it comes to driving Many people can self-perceive However, again That's not a good thing to go by Because of the brain regions that are impacted You can't self-perceive

33:04And I totally see where you're coming from From just how many medical patients Are listening to this podcast Or within my community I just I have trouble thinking about the concept of anyone Who does consume cannabis during the day Essentially telling him You gotta stay home You can't drive anywhere at any time For that type of person And it's essential for their health Yeah When I was in the system where people were not supposed to be driving They had a driving assessment With their impairment Meaning the visually impaired people They didn't get to drive They didn't get a driver's license Until they actually had a formal assessment So if people really think they're safe And want to protect themselves Because frequently it's not you that caused the accident It could be somebody else But you're the one that Was tested positive Yeah So those are the kind of things

34:05You know again If I was in that situation I would have a formal assessment Yeah Okay And that's totally fair And then again Those are the kind of things to protect yourself When Data And again, data is really hard to come by But there were bicycle deaths That increased With cannabis When cannabis became legal Well in the straight of Colorado There was a year where It wasn't the driver that was positive It was bicyclists Yet Oh okay That driver May or may not have been on cannabis If they were They might not have been impaired But they're the one in trouble When it was actually the bicyclist So there was the kind of things That get difficult Now the other thing That's a very difficult topic Go ahead There's no good answers I'm sorry No I know there's no good answers And that's why this podcast is really important To talk about this topic There's a ton of nuance And frankly People are doing it

35:06Already Every day And people won't answer And what's your question though In states with drug recognition experts Pretty much that particular process Started in the 70s Ungot refined And so it's been in use In many states since the 70s Particularly Oregon, Washington, Colorado The process itself The subtests When it comes to detecting marijuana Are quite good There is science Behind subtests However, a lot of the science is very old Because it was done in the 70s and 80s So It needs to be further validated The drawback of its use Is Every state Defines how it's used when it's used There needs to be national standards To make sure everybody's talking the same language And using the same type of tests

36:08Now the expert opinion On DRE Is not allowed in the court in Massachusetts Oh Right New Jersey there was strong push With a lot of inaccurate information To try to have the same thing happen There are cases that come forward Now there was an effort to get it Added in Massachusetts The bill was named after a police officer That was hit by somebody that was clearly impaired Had just purchased the joints and smoked a couple of them Going 85 miles in L.A. Father of six However, the bill named after him All it was doing was matching other states It wasn't doing anything particularly special Got defeated Because of a very strong effort on the power To the marijuana advocates On the other hand Using DREs was actually written into the law

37:08In Rhode Island and Connecticut So that there was a means Flood as it is To actually have a way to pull people off the road People attend to call others Because of you know impairment It's not the first time they drove In fact Yeah, so again Removing offenders from the road While protecting People that really aren't impaired Yeah, it's important But that's good though There's a technology under development They tend to beat us out for NIH money Oh no They also have Parts of this group of test fight against police officers Saying their technology is better The technology is inaccurate And 37% of pigmented people Black and Hispanic No Oh we cannot have that With how much discrimination has already happened With this community And people believe them When they say it's more accurate Than the police officers Because it's

38:08Harvard And they actually had a paper published Without discussing How inaccurate it is In blacks It's a type of technology That the inaccuracy With pigmented skin came out Because it's infrared technology And that's just a little more inconsistent In when you have pigment And that technology is used in oxygen Detection And during COVID Because of the inaccuracy It affected treatment Of people of color To the point there were deaths Wow So So that's measuring Brainwaves What it does in white From your infrared to measure brainwaves Okay Okay Until the problem of accurate Reading the sensors to not be impacted by pigment The other interesting thing There's another brainwave technology That's on the scalp That's inaccurate If you have highly textured hair

39:11So again the black and brown communities Are the right ones right? We're trying to make sure Our technology has no racial bias We do what's called a Frederic's test Where we actually have a scale Eye color, hair color, etc We do firmly believe That if there is a bias And we're not finding any yet Because the back of eye has more pigment The more pigment that you are That it'll actually underestimate The impairment Because you have less internal glare And bouncing off of the retina When you have pigment Interesting Actually you just mentioned glare And this is a question I had for you Because you just taught me that That cannabis consumers Pupils are changing after they consume But something I've always wondered Is why after we consume cannabis Our eyes get really glossy Some people don't get Necessarily like the red pigmented eyes But their eyes just get really glossed over

40:11We don't know why but we have a real strong theory about that Cool I'd love to know Okay First of all, we've done other studies of sensory We did a smell study And a tear study Smell is fascinating In that our limited data Shows you actually Smell better and quicker But you can't differentiate Similar smells And we've got very little data It was more pronounced lemon lime and orange They could say immediately And better that it was citrus So they detected it right away But they couldn't tell which one it was We find that fascinating As people develop products For example, whenever I see a product That's key lime I'm like they can't even tell if it's lemon lime or orange When they're high, let alone Key lime So for marketing and understanding But having changes in your smell

41:11In the manner we're finding Makes sense Evolution In that you could detect food in that I was thinking it's related to the munchies The fact that people's like Like hungry entries We've never studied that We thought there was an interesting opportunity To study that Were you aware of hostess Snack cakes and their munchy mobile Yeah, I'm very familiar with hostess But not the munchy mobile Not this year but last year during 420 They had a munchy mobile where they were giving out free products Their host I believe is to capture a junk food population Because they're selling fewer and fewer of their products Yeah, I would have thought it would be fascinating to find out Which went better Twinkies or holes Chocolate or vanilla Because in our lab people tend to go for the chocolate I don't know if that's just because we give out a lot of munchies afterwards

42:14All right, enough about smell Tears Yeah We did a study on tears And we found that THC is dense in your tears It's actually in your tears With more abundance than breath or saliva Because your tears are viscous and oily I was just gonna say that blows my mind Because it's like a fat soluble In a water soluble But I didn't know tears were more oily compared to like They are because there's different natures of oil and mucin To make sure they stay on your eye Now You make plenty of tears when you're high Volume is never a product actually safely collecting them is Yeah You know people were trying their best But you know, it's a natural reaction to fight when something's coming towards your eye So it'll never really be a practical test

43:15We're gonna need a little more detail of what you are doing to try to collect tears What were you like? Everybody got paid Like We're like maybe just make them laugh really hard Will that make tears? Volume was never a problem Okay It was a research lab So what I was doing is inserting these sponges Now the sponges are designed for up-thalmic surgery to totally dry out the cornea They do not hurt but they sting A sponge on the eyeball Yeah, it was only on there for like three seconds But That's a long time Yeah Because even when you've not touched the eye It's normal to fight And for some reason I don't do this on purpose I tried real hard not to do it We are an old man One of them was a contact lens wearer Who was easy to do? Because he used to that The others were horrible What I did is I put

44:15We have squeeze balls for when they have their blood drawn I put one in each hand So I put their hands on their lap and I said If you squeeze these in rhythm You actually make more tears and this will go quicker So they're sitting there squeezing them in rhythm And that was not at all true I was lying I was just trying to occupy their hands So their hands weren't grabbing at me So it worked fine I do say part of A problem we had My fault It was during COVID And I had never worked with the eyes with gloves Oh god I was a little slower Than I normally would have been But if any of these people The sign up for round two of your experiments Yeah they wanted First of all once the sponge came out of your eye You couldn't tell it had been done Yeah You didn't do anything Oh they were happy They were students They were happy to do

45:16They did the smell test too though And Anyway so what the back to the question Literature on animals And you cannot compare the cannabinoid system Directly across species and to humans So but what information we do have Is that Cannabis Causes the water part The lacrimal gland to secret less So you're getting less Water going into your tears We hypothesize because we're getting a nice volume of tears The cannabis stimulates the patruction of the musin Unlippids Now we've never done any study on that But once we had our project in looking at people's eyes It's called a roomy appearance that'll that glassy I'm pretty convinced it's an increased production of the musin

46:21That's good to know because I feel like my eyes When I consume cannabis never get read But everyone knows because it looks like I have fake eyeballs And they're so shiny What happens with that layer Is it kind of magnifies the redness 100 it's so obvious and it's like even if I like look in the mirror I'm like oh my gosh Because I look at people and I'm like the eyes aren't really red Exactly It's so clearly glazed and shiny it's so different So again with not study on that it's more Observation If we had our due grants we would have formally studied all that And I hope you still get a chance too I mean even with the tear drop thing could that ever be reasonably implemented in With the analysis Not roadside But in the workplace In the workplace where there are frequently nurses you know Dees and technicians so we do think it's not a bad thing from the workplace

47:23We do think a real Important part of roadside testing are saliva and oral fluid Wrath cannot pick up edible use So oral fluid saliva and that doesn't quantify it though It just tells the officer what drug It's important to rule out Certain drugs It's important to know some of the drugs where the Driver may be violent And again, it's important to do the first step Let's just sort out what drugs there are If they're not on marijuana they would just skip our test Now that doesn't mean they might use the other test Thy movement and all that but again it's a decision Process now the drug recognition expert Testing has changed over the years as they learned more The process again started in the Northwest I can tell you the time we got pulled over times With an ass

48:23With an ass It was already What do you want to know about growing in a closet anyway That's okay Wait real quick while you're mentioning these other drugs If you were to just look at the data from a very just objective standpoint Is alcohol the most harmful drug to have in your system when you're driving Or can you rank the top 30? They are two different things It depends on where you're driving It depends on what you're doing When you say where you're driving do you mean like what state or like back roads versus highway Back roads versus highway For example, we're finding Dead spots where stoplight is So we're guessing That means that T-bone lean a car Hitting a pedestrian is more likely to happen if you're on cannabis Versus alcohol on the other hand You know alcohol we got to stop saying comparing them. They're two different drugs

49:23two different side effects And the one comparison that can continue is you don't only take with a little bit of alcohol in your system You're okay What is a little bit of cannabis You know when are you okay? Are you ever okay? Right Ignancy you're never okay Alcohol you're never okay during pregnancy. Oh, you know again. How do we do that? Yeah, I think that's totally fair I think it's really easy to compare them because that's where most of our data is and that's what people We know yeah, and people want like you were talking about baseline like people want to be able to put these on a linear scale And be like okay, well like this is my baseline. Where am I with alcohol? Where am I with cannabis and it probably is very individualized There's lesser driving with alcohol during the day So there's actually more opportunity to harm somebody else With cannabis just because there's more people around and again that does contribute

50:26Their behavior contributes to The injuries and we have a dispensary in my city That I talk to them about it has four stoplights around it So no matter what we say there's going to be somebody that comes there high there's going to be somebody that leaves their high So designing that road a little better by just adding one more light Not another place where there's lights but put it in it because it's just here So if we added it another one here those kind of things Yeah, that's our harm reduction of understanding like people are doing this anyway How can we make the roads safer for the people who are already doing it? It makes it roads safer anyway. Yeah, yeah, so those are the kind of things that it's important to start Thinking about because it's not going to go away No, I like that Despite tidal aid that vote for Massachusetts

51:26I was gonna tell you one of the tests that were eliminated from DRU when I was a young person That part of the test was they put coins on your back bumpa So you had to go back there stand and pick them up and put them in your palm And a dime is really hard to pick up Yeah, and then you had to tell them how much money there was That has obviously been eliminated Wow budget cuts they probably couldn't afford the coins anymore No, it probably didn't add that much to it Yeah, I'm just getting it to do somebody didn't like it But I can remember twice that test And I haven't even made the connection until I heard a lecture and they were talking about that test some like Oh, I feel like wow, that's bringing back a memory. That's so funny I have a couple friends that very openly very regularly use cannabis and drive and One of the reasons they say that it helps them is road rage and preventing road rage They say they're more dangerous on the road if they're not consuming cannabis because they're just like all riled up

52:29You're like no data doesn't support that at all. I would say no that that's true of drinking Yeah, and what do you agree what's causing the rage? I think people somebody who just got some rage deep down, but I mean I kind of I see it, but like again, that's probably a dozing thing too If you can take a little microdose before driving first like Smoking to drive without it. That's a crutch That's okay And again When I used to work with people with sensory impairment to begin with Nice excuse, but you're not supposed to have been doing that, you know again There are times you're safe. There are times you are less safe. Yeah So again, I mean like just from a futuristic standpoint I feel like most of the cars in the next 10 years maybe 20 years are going to be driverless cars Anyway, right? Well, I think a penalty for a DUI should be you have to have a driverless car

53:33That's an interesting kind of why but if you did damage Yeah, just like no you have to have well many states require all cars to have alcohol breath systems But you know, you have to the future technology like mine won't be needed You know, and again, but that's but even like riding bikes and stuff like you kind of think that would be translatable to Operating any sort of motorized or even like movable device. Yeah Okay, interesting now you mentioned grants a few times and I think that's how we'll kind of wrap up this episode is talking about You know, I've seen a ton of grants that have been flown for this exact issue because every state is struggling with it It's something that is so needed How has it been getting grants for this topic? Massachusetts does not have any funds for research and grants From now I've tried So you have to reside in the states that are offering them or your business has to be there So we've got nothing other than federal the reason we were successful in getting federal is we had some science to be in with

54:39We had a team that matched what a reviewer would say okay, they're they're reasonable and I understood the process I had gone through it with Alzheimer's and I also had sat on review sections That awarded grants you have to be very thick skinned because frequently you get a no eight times Yeah, and you have to be able to Understand what you can't change and just Not get angry For example my colleague as good as he was was from UMass Boston That's not as competitive as Harvard or Yale I'm an optometrist we get grants back that say you're not qualified to do this You don't have the background to do this you can't do this work You're only a medical professional That's crazy. Yes, but that's what you know who's reviewing it you have to kind of know and

55:39Again, thick skin we At the time we got Our first award timing They were giving out grants specific For marijuana impairment technology We were all supposed to get a second grant that was one million All four of us COVID hit Impaired driving's not a disease So all the money disappeared So money specific to impaired driving is at the state level Okay, you know when I submit something I'm competing with everything Cancer, you know, so And up until schedule three change recently the National Science Foundation couldn't fund anything with cannabis Because it was schedule one so We now are not Probably gonna get grants because of my Change on the other hand timing wise may be a time where we can get a family

56:46Investment from interested in us. Yeah, we are committed To making the road safer if that somebody else's product We'll back down Right now it's us I got into this industry When I realized I had technology That could demonstrate impairment I got into this industry because when I was mourning the loss of my son I'd already met parents who Children died in a DUI But they had the additional grief and anguish of no repercussions. Yes for their child's murderer So we need to make sure that doesn't happen if they're guilty Jail sentences if they're not guilty which can happen You know and again make sure that doesn't happen and I believe in the law enforcement process. I know that's not popular

57:47Ha not for a lot of cannabis consumers, but that's okay. I mean I think we should aim for a just system and Case the experience with law enforcement varies from city to city I'm sure I've been Portland Oregon And which was considered a beautiful wonderful place. I spent a lot of time in Detroit running a clinic for the indigent And it was fascinating last summer when I visited both Portland Detroit though was beautiful. They had a very friendly visible police force all over the place you felt safe You felt welcome. They were friendly. So I think we have to understand Everybody's goal is to make sure the public is safe Yeah, the industry is safe. I think though what we really need is the ability to do control placebo We'll find those controls Yeah, and definitely one thing though about me though. We will never have marijuana in our labs Marijuana. I have a baseline cardiomyopathy

58:49And it sets off a nasty arrhythmia So again when I see older adults and it's an inherited disease They're with me and manifested itself as the products got higher percentage indoors So again, I don't know how much it takes now that I'm older with less reserves I don't expose myself to any inhaled products Including the harvesting I don't blame you at all when you first mentioned that on this episode I was like Unfortunately like that is the group of people that is very impacted by cannabis on the heart is people with these like predisposition and our predispositions with these like they just came out with a study that talks about without predispositions normal healthy It actually decreases the amount of premature a fib So again, we don't know much about it If you have a underlying disease line though Even if your cardiologist or health care provider knows nothing one find somebody else or

59:52He had work on it Which is kind of funny because my primary care who is now retired When I would see him much of our visits were discussing the latest Just because of how limited people are in where they can get their information Much better now there are some really nice organizations There's really nicely developed curriculum now. So again, you can learn much like you get You know, we are there education to keep up Yeah, and the cannabis nurses are doing a fantastic job too You know, I immediately and thea care comes to mind where they offer like free consulting and all of them are trained nurses like with backgrounds and cannabis and they are so educated on the topic And they know how to communicate as well Our circadian function hypothesis based on nurses that have been treating Alzheimer's with cannabis for several A decade So that's one where like, oh, this is really interesting. This is why and this is what

1:00:52Yeah, that's really cool and before we wrap up just one last just statement about impaired driving is just it could be impaired Even if you're distracted and I'm someone who is actually very scared of the road I think everybody is distracted nobody's paying attention So stay off your phone and if you're driving your job is to be driving that is all That you should be doing on the road. So If you're in range Calm down learn to do meditation. It's tough or one of these great things This is my little calm down. I think it's a little urban haller and it's just like menthol and these other herbs And it smells so relaxing and so good. Do you use lavender too? Oh, yeah, I use them all I mean, I'm not like a very tense angry person baseline. I'm pretty chill Calm my arrhythmia a little bit As linole the therapy. I don't know if it's like the logical, but yeah, you call it just in lavender There's studies on lavender just the aroma of lavender relaxing you so I believe it. I think that's wonderful, but

1:01:56Dr. Denise thank you for coming on the show. I feel like I learned so much. Yeah, I do care a lot. Yeah And I don't even talk about sports yet Do you want to talk about that now or later? It's up to you. Don't be going to ask me later because I've got some good opinions Okay, great. We'll talk about Okay, sports and cannabis you have some positive opinions and some negative but positive Okay, well, we'll have you back on for the topic of sports in the future But I learned a lot and I think what you're doing is really important for harm reduction and education So thank you for doing the work and I hope that you continue to get grants and get continued funding so you can keep doing more research Me too, so if you know a billionaire send him my way Yeah, also send him my way awesome. All right mad love everyone. We will catch you in a couple weeks

1:03:02This podcast is distributed by the women in media podcast network Find out more at women in media. Network