High5 with Dr. Igor Grant, MD

In this special episode of High5, CMCR Co-Director Dr. Tom Marcotte moderates a panel featuring Ricky Williams, Anna Simmons, Riley Cote, Greta Gaines, and Ross Rebagliati from CMCR’s 2026 Cannabis and Sports symposium. Drawing on their experiences in football, rugby, hockey, and snowboarding, the athletes describe how they have used cannabis to manage pain, anxiety, sleep, and the physical and psychological demands of recovery. They discuss how their use evolved over time, often alongside practices such as yoga, meditation, and greater attention to their bodies. The conversation explores stigma, drug testing, and differing interpretations of performance enhancement, including the distinction between supporting recovery and directly improving competitive performance. Panelists also reflect on circumstances in which cannabis use became problematic or required adjustment. A central message is the need for research informed by athletes’ experiences, including questions about mental health, women’s health, and differences across sports and individuals.

In this episode, former NFL running back and Heisman Trophy winner Ricky Williams discusses his experiences with cannabis, social anxiety, and recovery during his football career. He describes how therapy and self-reflection while using cannabis helped him understand his anxiety, and how cannabis became part of a broader approach to recovery that included yoga, stretching, and meditation. He also reflects on the psychological burden of injuries when an athlete’s livelihood depends on physical performance. The conversation explores his experiences with the NFL’s drug-testing program, the shift he sees toward a wellness-focused approach to cannabis, and barriers to research involving athletes. Drawing on his forthcoming memoir, The Long Run, Williams discusses finding meaning beyond others’ expectations. A central message is his call for researchers to listen to people who use cannabis and approach their experiences with curiosity when developing research questions.

Chapters:

00:56 Introduction to Ricky Williams and Medicinal Cannabis

02:14 Ricky's Journey with Anxiety and Cannabis

04:15 The Role of Cannabis in Pain Management

06:49 NFL's Changing Perspective on Cannabis

09:29 The Impact of Injuries on Mental Health

12:09 Research and Understanding of Cannabis Use

14:56 Ricky's Upcoming Memoir and Life Lessons

17:16 Stigma and the Future of Cannabis Research

20:26 Stigma and the Future of Cannabis Research

20:26 Outro

In this episode, Dr. Nicholas DiPatrizio discusses how the endocannabinoid system helps regulate appetite, nutrient sensing, metabolism, and communication between the gut and brain. He describes findings from mouse studies showing how cannabinoid signaling in the intestinal lining may promote preferences for foods high in fat and sugar and interfere with signals that normally tell the brain when to stop eating. He also explores the “cannabis paradox,” in which cannabis can stimulate appetite while chronic users tend to have lower body weight and a reduced likelihood of type 2 diabetes. The conversation examines research comparing pure delta-9 THC with whole-cannabis extract, including evidence in obese mice that both reduced body weight but only the whole extract reversed diabetes-like metabolic dysfunction. A central message is that therapies targeting cannabinoid receptors specifically in the gut may one day improve metabolic health while limiting unwanted effects on the brain.

In this episode, Dr. Kent Hutchison discusses how his research on cannabis grew from a background in alcohol and nicotine studies into a broader effort to understand both the risks and potential benefits of cannabis use. He describes findings from large brain-imaging datasets suggesting that lifetime cannabis use was associated with larger regional brain volumes and better performance on some cognitive tests in older adults.

He also discusses why cannabis may affect adolescents and older adults differently, including age-related changes in the endocannabinoid system. The conversation explores possible neuroprotective effects of cannabinoids, the use of cannabis among older adults for pain, sleep, and anxiety, and emerging research on cannabis and exercise. A central message is that cannabis effects depend on the product, dose, route of administration, age, health status, and reason for use.

Chapters

00:54 Introduction to Cannabis Research and Personal Journey

04:04 Exploring Cannabis and Brain Function

09:14 Adolescent Cannabis Use and Cognitive Effects

12:31 Neuroprotective Effects of Cannabinoids

14:25 Understanding the Endocannabinoid System

16:23 Cannabinoids in Older Adults

19:03 Cannabis Use in Relation to Other Medications

20:01 Cannabis and Exercise: Subjective Experiences

24:24 Future Research Directions and Closing Thoughts

Summary

In this episode of High5 with Dr. Igor Grant, Dr. Matt Springer explains how inhaling smoke from combusted products such as tobacco and cannabis, as well as inhaling aerosol from e-cigarettes and cannabis vaping devices, may impair endothelial function, an early marker of cardiovascular risk. Drawing on rodent and human studies, he reports that chronic tobacco smokers, e-cigarette users, and cannabis smokers all show reduced vascular function.

He also discusses evidence that chronic THC edible users may have impaired vascular function through a different mechanism than inhaled products. A central message is that “cannabis use” is too imprecise a term, because smoking cannabis and ingesting THC are very different exposures. His public health takeaway is simple: be aware of cardiovascular risks, practice moderation, and avoid exposing others to secondhand smoke.

Key Topics

• Endothelial function and its role in cardiovascular health
• Effects of tobacco, cannabis, and e-cigarette smoke on blood vessels
• Mechanisms of smoke-induced vascular impairment
• Differences between inhaled and ingested cannabis effects
• Public health implications of secondhand smoke exposure

Chapters

00:00 Preview

01:24 Dr. Springer's Background

03:43 Exploring Cardiovascular Effects of Cannabis

03:43 Personal Anecdote - Paul McCartney Concert

05:13 Understanding Endothelial Function

09:33 The Role of Endothelial Cells in Cardiovascular Health

09:58 Understanding Vascular Health and Flow Mediated Dilation

12:03 Translating Rodent Studies to Human Health

14:20 The Impact of Cannabis and Tobacco Smoke on Vascular Function

16:53 Chronic Use: Comparing Cannabis, Tobacco, and E-Cigarettes

20:15 The Science Behind Smoke and Its Effects

24:48 Distinguishing Cannabis Use from Smoking Effects

29:08 Moderation and Public Health Messaging

34:31 Secondhand Smoke: Risks and Recommendations

Summary:

In this episode, Nathaniel Schuster, MD, Professor and Medical Director of the Center for Pain Management at UC San Diego Health, explores the potential role of cannabinoid therapy in migraine care. Join us as Dr. Schuster shares insights into the benefits, limitations, and practical considerations of this approach, and discusses his latest research on vaporized cannabis for acute migraine treatment, including clinical trial findings and future directions.

Key Topics:

Overview of the first placebo-controlled trial of vaporized cannabis for migraineThe scientific rationale behind using THC and CBD in migraine treatmentStudy design: crossover methodology, dosages, and use of research-grade cannabisPrimary and secondary outcomes: pain relief, pain freedom, and bothersome symptomsSurprising findings on nausea, photophobia, and sound sensitivity improvementsSide effects, safety profile, and optimal dosing strategiesPractical considerations: vaporized vs. oral formulations and patient preferencesRecommendations for patients with refractory migraines considering cannabinoid therapyFuture research directions: preventive treatments and guidelines incorporation

Timestamps:

00:03 - Introduction to Cannabis Study

00:56 - Welcome Dr. Nathaniel Schuster

01:41 - Dr. Schuster's Background

02:29 - Understanding Migraine

03:18 - Current Migraine Treatments

04:14 - Defining Migraine

05:11 - Genetic Factors in Migraine

06:01 - Cannabis as a Treatment Option

07:54 - Study Hypothesis and Design

10:45 - Study Design Details

13:41 - Crossover Study Explanation

16:51 - Study Findings

20:36 - Most Bothersome Symptom Freedom

23:01 - Side Effects and Safety

26:40 - Participant Demographics

28:34 - Future Research Directions

30:00 - Practical Considerations

32:09 - Advice for Migraine Patients

33:50 - Safety Considerations

34:03 - Closing Remarks

⁠Read Dr. Schusters's study.

Bio:

Dr. Nathaniel Schuster is a pain and headache neurologist and is Professor and Medical Director at the UC San Diego Center for Pain Management. He has served as Treasurer of the American Academy of Pain Medicine, Senior Vice President of the World Headache Society, and as Vice Chair of the Guidelines Committee for the International Pain and Spine Intervention Society. He has received the American Academy of Pain Medicine’s Rollin “Mac” Gallagher Award, the American Academy of Pain Medicine’s Distinguished Service Award, the American Headache Society’s Harold G. Wolff Award, the International Pain and Spine Intervention Society’s Outstanding Volunteer Award, and the Migraine Research Foundation’s Impact Award. He is section editor for the Neuropathic Pain section for the journal Pain Medicine. He graduated from University of Michigan Medical School and completed a neurology residency at UCLA, headache fellowship at Montefiore Headache Center, and pain fellowship at Massachusetts General Hospital. He conducted the first placebo-controlled trial of cannabinoids for acute migraine and his ongoing research includes clinical trials studying treatments for migraine and neuropathic pain.

In this episode, Catherine M. Cahill, PhD, Professor of Psychiatry at the UCLA Brain Research Institute, delves into the fascinating world of terpenes—natural aromatic compounds found in cannabis and other plants—and their potential therapeutic effects, especially for pain relief. Join us as Dr. Cahill shares her expertise on the mechanisms, research findings, and regulatory status of these promising molecules.es.

Key Topics Covered:

• The basic chemistry and role of terpenes andterpenoids in plants
• How terpenes differ from cannabinoids like THCand CBD
• The most studied terpenes in pain relief:myrcene and beta-caryophyllene
• Preclinical evidence for terpene analgesiceffects in nerve and inflammatory pain
• The endogenous cannabinoid system and howterpenes may modulate it
• Evidence for sex differences in terpene responseand receptor distribution
• The regulatory status of terpenes as foodadditives and their availability
• Emerging research on terpene interactions withother cannabinoids
• Potential for opioid-sparing effects andreducing adverse outcomes

Timestamps:

00:00 - Introduction to cannabisterpenes and their therapeutic promise

02:30 - Basic chemistry: what areterpenes and terpenoids?

06:00 - The role of terpenes inattracting pollinators and plant defense

09:30 - Key terpenes studied:myrcene and beta-caryophyllene

13:00 - How terpenes influence theendogenous cannabinoid system

15:45 - Differences betweenterpenes and cannabinoids

17:30 - Conditions potentiallybenefitting from terpene treatment and current research

21:00 - Preclinical findings:analgesic effects in nerve and inflammatory pain models

26:00 - Modulation of emotionalaspects of pain through the cannabinoid system

27:30 - The entourage effect: doterpenes enhance THC and CBD efficacy?

31:00 - Regulatory status andsafety of terpenes

34:00 - Sex differences andhormonal influences on terpene receptor expression

36:00 - Future directions:combination therapies and opioid-sparing potentials

38:00 - Final thoughts

In this episode, Dr. Deepak D'Souza, a renowned psychiatrist from Yale University, discusses the complex relationship between cannabis and psychosis. He explores the potential causal links, the role of environmental factors, and the implications of cannabis-induced psychosis as a precursor to schizophrenia. The conversation delves into the evolving landscape of cannabis potency and its impact on mental health, drawing parallels with historical public health challenges like smoking and lung cancer.

Takeaways

• Cannabis can induce transient psychotic symptoms during intoxication.

• Cannabis-induced psychosis may be a precursor to schizophrenia.

• Environmental factors, like cannabis use, can impact schizophrenia risk.

• Cannabis potency has increased, affecting psychosis rates.

• Cannabis is a modifiable risk factor for mental health disorders.

• Not everyone who uses cannabis develops psychosis.

• Cannabis use during adolescence may increase schizophrenia risk.

• Genetic predisposition plays a role in cannabis-related psychosis.

• Cannabis and schizophrenia have a complex, multifactorial relationship.

• Preventing cannabis use in youth could reduce schizophrenia cases.

Chapters

00:00 - Intro

01:19 - Professional Background - Deepak Cyril D'Souza

02:29 - Understanding Psychosis and Cannabis

03:15 - Background on Schizophrenia

05:06 - Symptoms of Psychosis vs. Psychotic Disorders, Causality

10:31 - Cannabis Induced Psychosis

12:28 - Causality: Cannabis and Schizophrenia | The Bradford Hill Criteria for Causality

23:20 - The Role of Genetics and Environment

29:30 - Risk Factors Associated with Schizophrenia

32:29 - Advice for Healthcare Providers and Families

Summary

In this conversation, Dr. Igor Grant and Dr. Eric Leas delve into the complexities surrounding Delta-8-THC, exploring its differences from Delta-9-THC, consumer demand, regulatory challenges, and safety concerns. They discuss the implications of state regulations on the market, the need for compliance in cannabis research, and the future of Delta-8-THC regulation. The conversation also touches on the broader landscape of cannabinoids and psychoactive substances, highlighting the ongoing evolution of cannabis regulation and public health considerations.

Takeaways

• Delta-8-THC is structurally similar to Delta-9-THC but less psychotropic effect.
• Consumer demand for Delta-8 is driven by its legal status as a hemp product in states without medical or recreational cannabis use regulations.
• Regulatory challenges exist due to the lack of standardized safety measures.
• States with legal cannabis markets are concerned about competition from Delta-8 products.
• Research on Delta-8 is limited, necessitating further studies on its effects.
• The market for Delta-8 is largely unregulated, raising safety concerns.
• There is a growing interest in other cannabinoids and psychoactive substances.

• Compliance checks in cannabis retail are complicated by federal laws.
• The patchwork of state regulations creates confusion for consumers and manufacturers.

Chapters:

00:00 Introduction to Delta-8 THC

02:51 Understanding Delta-8 THC: Differences and Similarities

05:15 Consumer Demand: Supply and Demand Dynamics

09:48 Regulatory Challenges and Safety Concerns

17:01 Research Background and Interest in Delta-8 THC

19:33 Compliance and Regulation in Cannabis Sales

21:50 Redesigning State and Federal Cannabis Policy

24:24 The Future of Delta-8 THC Regulation

27:39 Exploring Other Cannabinoids and Their Implications

32:25 The Broader Landscape of Psychoactive Substances

In this conversation, Dr. Igor Grant and Dr. Alison Moore discuss the increasing prevalence of cannabis use among older adults, the reasons behind this trend, and the medical applications of cannabis. She highlights the complexities of cannabis use, including its association with comorbid conditions and the challenges in educating both healthcare providers and patients about its safe use. The conversation emphasizes the need for more research and better education in the field of geriatric care regarding cannabis.

Takeaways

• Alison Moore is the Chief of Geriatrics at UC San Diego.

• Cannabis use among older adults is increasing.

• Reasons for cannabis use include pain, sleep issues, and anxiety.

• Older adults often use cannabis for medical purposes.

• The prevalence of cannabis use in older adults varies by survey.

• Long-term users tend to prefer smoking, while newer users prefer edibles.

• Cannabis use is linked to comorbid conditions like diabetes and heart disease.

• Education on cannabis use is lacking among healthcare providers.

• Patients often receive cannabis information from non-medical sources.

• There is a need for more research on cannabis effects in older adults.

Chapters

00:00 Intro

02:00 Prevalence and Reasons for Cannabis Use

03:56 Medical Applications and User Experiences

06:41 What Types of Products Are Older Adults Using?

08:32 Cannabinoids and Behaviors in Older Adults

11:40 Cannabis as a Treatment for Dementia Symptoms

13:54 Risk/Benefit for Clinicians Recommending Cannabis

14:38 Different Risks for Different Methods of Use

16:14 Pharmacokinetics of Different Methods of Use

16:45 Sources of Products for Older Adults

19:37 The Stigma of Cannabis Disclosure

20:48 Complexities of Cannabis and Alcohol Use

25:08 Educating Physicians on Cannabis

26:57 Advice for Patients Considering Cannabis

29:58 Understanding Cannabis Use Disorder

32:07 Inhalation vs. Oral Cannabis Use

33:31 Final Thoughts on Cannabis Education

36:16 Outro

Bio

Alison A. Moore, MD, MPH, FACP, AGSF, is a Professor and Chief of the Division of Geriatrics, Gerontology and Palliative Care, and Director of the Sam and Rose Stein Institute for Research on Aging and the Center for Healthy Aging. She holds the Larry L. Hillblom Chair in Geriatric Medicine. She is a geriatrician who provides primary and consultative care to older adults and a public health researcher whose work focuses principally on older adults with unhealthy substance use. She also has interests in healthy aging, gerontechnology, health equity, and aging and HIV. Dr. Moore has a passion for health equity; she was the inaugural Vice Chair for Justice, Equity, Diversity and Inclusion in the Department of Medicine. She is equally passionate about mentorship; in 2019, she was awarded the UC San Diego Health Sciences Faculty Excellence in Mentoring Award. She is MPI of an NIA-funded Alzheimer’s Disease Resource Center for Minority Aging Research (P30AG059299) and has been the recipient of a K24 Midcareer Award in Patient-Oriented Research from NIAAA (K24AA15957). She is an elected member of the Board of Directors of the American Geriatrics Society and is currently its President-elect.