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Ep. 367: Dr. Nehama Lewis, University of Haifa

Cannabis Economy Podcast
Ep. 367: Dr. Nehama Lewis, University of Haifa

Ep. 367: Dr. Nehama Lewis, University of Haifa

Dr. Nehama Lewis joins us and reflects on how the media effects cannabis perception: “I would teach these classes on anti-drug campaigns and they would cover anti-marijuana campaigns and it never made sense to me why there wasn’t a distinction made.We collected data in several projects now. The questions I always ask is how does exposure to media coverage of cannabis specifically say medical cannabis affect the way we think about cannabis more broadly and support for legalization? What interests me is the extent to which the public are being asked to make a distinction between medical cannabis that is being sold more heavily as a treatment and is being framed by the media as something good with an emphasis on the health benefits. There is a really good growing evidence base for that.”

Transcript:

Dr. N. Lewis: Dr. Nehama Lewis. My job title is senior lecturer, which is unique to Israel. It's basically the equivalent of associated prof. They jus make us do an extra job.

Seth Adler: Gotcha. It's more for them.

Dr. N. Lewis: It's based on the British system.

Seth Adler: Oh, okay. All right.

Dr. N. Lewis: Yeah.

Seth Adler: We've got wedding photos happening with the mother of the bride I think, it might be the mother of the groom. They just set up shop as we were setting up shop. It's really who owns this territory and the answer's no one. It's a national park. We're sitting in Caesarea. Is that how you pronounce it?

Dr. N. Lewis: Yes. Caesarea.

Seth Adler: Caesarea.

Dr. N. Lewis: Yep.

Seth Adler: Caesarea.

Dr. N. Lewis: In the ancient bay, which has a long, long history.

Seth Adler: Right. It's the Mediterranean Sea. This is-

Dr. N. Lewis: Yes.

Seth Adler: -the ancient bay of Caesarea. I say Caesarea because it's for Caesar it was named.

Dr. N. Lewis: Yeah, it's Caesarea in English, but Caesarea in Hebrew.

Seth Adler: It sounds so much better when you say it that way. It's just ... give us a little something on the bay if you ... Because we've now referenced it. There was a treasure found at least not that long ago.

Dr. N. Lewis: Here?

Seth Adler: Oh yeah, sure. You can read about it right in there.

Dr. N. Lewis: Oh. [crosstalk 00:03:09]

Seth Adler: There was thousands of ... Well I've just done some tourism. Thank you so much for inviting me here. I would have never come here because it's kind of between Haifa and Tel Aviv is where we are.

Dr. N. Lewis: Yes. Yes. It's about half an hour south of Haifa.

Seth Adler: Yeah, so just like everywhere else in Israel, little ... some Greek, some Romans, some Ottoman influence here in Caesarea, right?

Dr. N. Lewis: It's basically been a port forever and it was built and destroyed, and built and destroyed. Now it's just a really nice tourist spot.

Seth Adler: If you've got a city in Israel, I've got a place that was built and destroyed, built and destroyed, and built and destroyed. Okay.

Dr. N. Lewis: Yes.

Seth Adler: Now let's kind of get down to, with all of the people finding us. Somehow we walked away from everyone and then they came and found us.

Dr. N. Lewis: Then they found us. Unfortunately.

Seth Adler: Somehow.

Dr. N. Lewis: Yes.

Seth Adler: Let's get down to how you found cannabis as something that is interesting to you. Before we do that, we need to understand, you know, what you profess about.

Dr. N. Lewis: Okay. I'm in the Department of Communication at the University of Haifa and my PhD is in communication.

Seth Adler: Yeah.

Dr. N. Lewis: Specializing in health communication from the University of Pennsylvania. My MA is in political communication, which I'm no longer interested in.

Seth Adler: Okay.

Dr. N. Lewis: My postdoc is in intervention research, which actually was anti-drug intervention research. Over time I became quite familiar with ... I teach anti-drug campaigns.

Seth Adler: Interesting.

Dr. N. Lewis: It always confused me. I always found certain campaigns, you know, anti-heroin campaigns you stand, you teach a class, and it makes sense to you that there's this paradigm that it's not a good behavior for different reasons, and you cite the evidence, and the health evidence.

Seth Adler: Oh, to do heroin?

Dr. N. Lewis: Yeah.

Seth Adler: Heroin is bad for you.

Dr. N. Lewis: Drugs are bad basically.

Seth Adler: No, I chose my words specifically.

Dr. N. Lewis: Exactly. The saying in South Buck would be drugs are bad. Obviously, there are distinctions and some of it is socially constructed and it's on the basis of politics, and different lobby interests in the 1950s, and whatnot. I would teach these classes on anti-drug campaigns and they would cover anti-marijuana campaigns and it never made sense to me when I was teaching them why there wasn't a distinction made. Then at the same time in ... I'm friendly with another colleague, Dr. Sharon [inaudible 00:05:49]. She was researching medical cannabis.

Dr. N. Lewis: Dr. Nehama Lewis. My job title is senior lecturer, which is unique to Israel. It's basically the equivalent of associated prof. They jus make us do an extra job.

Seth Adler: Gotcha. It's more for them.

Dr. N. Lewis: It's based on the British system.

Seth Adler: Oh, okay. All right.

Dr. N. Lewis: Yeah.

Seth Adler: We've got wedding photos happening with the mother of the bride I think, it might be the mother of the groom. They just set up shop as we were setting up shop. It's really who owns this territory and the answer's no one. It's a national park. We're sitting in Caesarea. Is that how you pronounce it?

Dr. N. Lewis: Yes. Caesarea.

Seth Adler: Caesarea.

Dr. N. Lewis: Yep.

Seth Adler: Caesarea.

Dr. N. Lewis: In the ancient bay, which has a long, long history.

Seth Adler: Right. It's the Mediterranean Sea. This is-

Dr. N. Lewis: Yes.

Seth Adler: -the ancient bay of Caesarea. I say Caesarea because it's for Caesar it was named.

Dr. N. Lewis: Yeah, it's Caesarea in English, but Caesarea in Hebrew.

Seth Adler: It sounds so much better when you say it that way. It's just ... give us a little something on the bay if you ... Because we've now referenced it. There was a treasure found at least not that long ago.

Dr. N. Lewis: Here?

Seth Adler: Oh yeah, sure. You can read about it right in there.

Dr. N. Lewis: Oh. [crosstalk 00:03:09]

Seth Adler: There was thousands of ... Well I've just done some tourism. Thank you so much for inviting me here. I would have never come here because it's kind of between Haifa and Tel Aviv is where we are.

Dr. N. Lewis: Yes. Yes. It's about half an hour south of Haifa.

Seth Adler: Yeah, so just like everywhere else in Israel, little ... some Greek, some Romans, some Ottoman influence here in Caesarea, right?

Dr. N. Lewis: It's basically been a port forever and it was built and destroyed, and built and destroyed. Now it's just a really nice tourist spot.

Seth Adler: If you've got a city in Israel, I've got a place that was built and destroyed, built and destroyed, and built and destroyed. Okay.

Dr. N. Lewis: Yes.

Seth Adler: Now let's kind of get down to, with all of the people finding us. Somehow we walked away from everyone and then they came and found us.

Dr. N. Lewis: Then they found us. Unfortunately.

Seth Adler: Somehow.

Dr. N. Lewis: Yes.

Seth Adler: Let's get down to how you found cannabis as something that is interesting to you. Before we do that, we need to understand, you know, what you profess about.

Dr. N. Lewis: Okay. I'm in the Department of Communication at the University of Haifa and my PhD is in communication.

Seth Adler: Yeah.

Dr. N. Lewis: Specializing in health communication from the University of Pennsylvania. My MA is in political communication, which I'm no longer interested in.

Seth Adler: Okay.

Dr. N. Lewis: My postdoc is in intervention research, which actually was anti-drug intervention research. Over time I became quite familiar with ... I teach anti-drug campaigns.

Seth Adler: Interesting.

Dr. N. Lewis: It always confused me. I always found certain campaigns, you know, anti-heroin campaigns you stand, you teach a class, and it makes sense to you that there's this paradigm that it's not a good behavior for different reasons, and you cite the evidence, and the health evidence.

Seth Adler: Oh, to do heroin?

Dr. N. Lewis: Yeah.

Seth Adler: Heroin is bad for you.

Dr. N. Lewis: Drugs are bad basically.

Seth Adler: No, I chose my words specifically.

Dr. N. Lewis: Exactly. The saying in South Buck would be drugs are bad. Obviously, there are distinctions and some of it is socially constructed and it's on the basis of politics, and different lobby interests in the 1950s, and whatnot. I would teach these classes on anti-drug campaigns and they would cover anti-marijuana campaigns and it never made sense to me when I was teaching them why there wasn't a distinction made. Then at the same time in ... I'm friendly with another colleague, Dr. Sharon [inaudible 00:05:49]. She was researching medical cannabis.

Seth Adler: Right.

Dr. N. Lewis: We talked about doing a project together and my interest is in how the media affects the way we think about things.

Seth Adler: Okay.

Dr. N. Lewis: She is more from a classic public health background in sociology. We collected data in several projects now. We've had a bunch of projects, we do qualitative work, but we do experimental work and survey work. The questions I always ask is how does exposure to media coverage of cannabis specifically say medical cannabis affect the way we think about cannabis more broadly and support for legalization? What interests me is the extent to which the public are being asked to make a distinction between medical cannabis that is being sold more heavily as a treatment and is being framed by the media as something good with an emphasis on the health benefits. There is a really good growing evidence base for that.

Seth Adler: Right.

Dr. N. Lewis: On the other hand, the federal government is clinging to this paradigm-

Seth Adler: We'll just say the US federal government because we're in Israel.

Dr. N. Lewis: Yes, the US federal government, but also here. You can't light up a joint, you know, in public here.

Seth Adler: Oh, as far as adult use? Certainly.

Dr. N. Lewis: Yeah, I mean, that's actually recently changed. You can, I think if the police find you with a small amount, they won't do anything. They'll give you a warning.

Seth Adler: Here in Israel, right.

Dr. N. Lewis: That was a recent change. The public of being asked to form an attitude that's intrinsically dissonant. It's the same substance and they're being told by the media, the same media that is both a drug and medicine, and those two things don't work together. What I'm interested in as a researcher because again, part of what I do is work out the cognitive and psychological processes that go on in our heads as individuals exposed to media. Do people make that distinction and because I don't think they do, and how are the media confusing that distinction?

Seth Adler: Right.

Dr. N. Lewis: We found that there actually are, I'm going to be presenting at the conference, but there's spillover effects. If you are exposed to media messages about medical cannabis, a lot of those messages are quite persuasive. For example, patient testimonials, which were tested in a separate study. If you hear a patient explain how they were suffering and how they use conventional treatment, and it didn't help, and then they found medical cannabis and it really helped them with cancer, or symptoms, or HIV symptoms or whatever. I mean, it's used in a lot of different contexts, and you're exposed to that narrative, that narrative is very persuasive. Then the effect of that is to spill over into your general ideas about cannabis and then you become more supportive of legalization.

Seth Adler: Okay. If I hear from the patient him or herself.

Dr. N. Lewis: Yeah. The more you're exposed to the message that cannabis has medical benefits, the harder it is to sell you on the case that-

Seth Adler: It's bad.

Dr. N. Lewis: -cannabis is a drug because it just ... it's too very dissonant cognitions and they don't work together.

Seth Adler: Let's get to your former life as drugs are bad. I would imagine you mean just studying those or ...

Dr. N. Lewis: No. Yeah, no. I teach health campaigns, so I teach the science of designing health campaigns and also the history of evaluation of health campaigns. For example-

Seth Adler: You're not coming from a perspective when you teach them, you're just saying here's what has happened?

Dr. N. Lewis: No, what's interesting is ... yeah, I don't have an agenda. The students will sometimes, they try to pin me down, they tried to get me to ... They say, "Well did you use it?" I'm like, "I'm not here to answer that question. That's not a professional question anyway."

Seth Adler: Right.

Dr. N. Lewis: I'm here to teach you about what kind of campaigns there are. What has empirically been shown to change behavior and attitudes-

Seth Adler: Whether we're talking about heroin, cocaine, or it kind of just doesn't matter.

Dr. N. Lewis: Yeah, I mean, I let them make their own conclusions of course and I definitely wouldn't ask anybody. I don't judge students for ... it's, you know, they have a freedom to conclude whatever they like. I'm teaching the science of campaign design.

Seth Adler: Sure. The science of campaign design, let's get back to where did this all start? As I remember it was Harry Anslinger and his folks in the US who said, "Hey, we don't necessarily want this marijuana, which the Mexican farmers are using to be in the hands of the well, white people, so we're gonna kinda make some rules here."

Dr. N. Lewis: Exactly. Then they started the whole gateway theory, which was rubbish afterwards. This gateway theory was sold very heavily and I show clips in my class. It was ... it looks ridiculous to us now, but people really bought this idea that if a teenager in the 50s or 60s will start smoking pot, in six months they'll be on harder drugs or whatnot and it'll be the beginning of the end, like the whole moral panic associated with it.

Seth Adler: The reefer madness.

Dr. N. Lewis: Exactly, but also I think part of it was probably the smoking and the alcohol lobby, who wanted to make it very clear that cannabis is not okay, but by our products. We're good. People want to relax at the end of the day and cannabis is a major threat to existing lobbies.

Seth Adler: Interesting.

Dr. N. Lewis: Again, I can't prove any of this.

Seth Adler: No, but that's what you've heard.

Dr. N. Lewis: These are ideas that, you know-

Seth Adler: I've heard of if you go way back far enough and you look at kind of DuPont, and Carnegie, and all those folks who wanted to make products out of plastic and realized that hemp could be an alternative for that. That's where some of that came from as well. Have you heard those theories as well?

Dr. N. Lewis: I have not.

Seth Adler: You have not heard those theories. Okay.

Dr. N. Lewis: No, no.

Seth Adler: All right, so how did you get into wanting this to be your career, to talk about anti-

Dr. N. Lewis: I'm, in general, interested in, well health communication is its own field and drug campaigns or health campaigns in general are one part of it. Basically the big questions that I ask is how do people change behavior and change their attitude? The behavior can be different. I've looked at fruit and vegetable consumption, and I've looked at sun protection, and no vaccines. I use the same psychological models to predict attitude and behavior change. Here I'm looking at it in the context of medical cannabis.

Seth Adler: Yeah, let's draw that parallel. Let's take a couple of those examples because sun protection, I've noticed in my lifetime we went from making sure that you had 15 SPF to 100 SPF. Who's winning there and why?

Dr. N. Lewis: That's a whole ... Yeah. The whole issue actually empirical studies on whether or not sunscreen prevents cancer are their own ... like in anything in public health once you like open the topic of is this health behavior good? It leads to a whole bunch of other debates. I mean growing up in Australia, I also, I grew up at a time where ... I'm very, very pale, but it was considered cool to be tan and so people would go out and they would sunbathe, and then that quickly changed because the ozone layer ... disappearing. Then the government had to shift the paradigm from, it's cool to be tan to everybody seat cover, you know? Wear lots of clothes. They did these really effective campaigns which became gold standard campaigns afterwards and they changed behavior on a massive level. I mean, the media has a lot of power to slowly change social norms, and sometimes quickly, but usually slowly. That's what I'm interested in. I've always been interested in ... you could do what I do and sell products, but I'm not interested in selling products. I'm interested in examining behavior and health behavior.

Seth Adler: All right, well good. I like it your way. Let's talk about fruits and vegetables.

Dr. N. Lewis: Okay. In grad school we collected data from the general US population. When I say we, I mean my thesis advisor, Professor Robert [inaudible 00:14:08], who got a huge NCI grant to collect data and I was lucky enough to be on the research team and I had access to that data and so we try to understand whether or not seeking health information about a specific behavior will change the likelihood of you doing that behavior say six months or a year later. These were really complex statistical models where you compare people over time when the only difference is did they seek information from their doctor, from the internet and then you try and make a case that seeking information is a predictor of behavior change. I looked at fruit and vegetable consumption for example, and it works.

Seth Adler: Just give us an example of-

Dr. N. Lewis: People who were diagnosed with cancer, we looked at a whole bunch of different outcomes, but one of them was, did they do something to get more healthy?

Seth Adler: Yeah.

Dr. N. Lewis: One of the recommendations is change your diet and one of the best ways to change your diet is, you know, meeting the recommendations for fruit and vegetable consumption. What we found is that people who, once they got the diagnosis reported that they sought information about how to eat better and whatnot. They were more likely to consume additional portions afterwards. This is less related to the medical cannabis-

Seth Adler: Isn't that from their doctor though? Doesn't change things?

Dr. N. Lewis: No, it's separate from doctor.

Seth Adler: You're talking about from doctor, media ingestion so to speak.

Dr. N. Lewis: Mostly media. Yeah. Did you seek from the media?

Seth Adler: Okay, let's talk about how media and social media are either the same or different.

Dr. N. Lewis: Okay. So this is exactly where I'm literally like running data at the moment and the ... when it comes to medical cannabis, what I think is interesting is that you ... the powers that be can regulate mass media and advertising for dispensary's, and blogs, as in the kind of pro cannabis information that's out there. They have a tighter leash when it comes to broadcast and mass media. It's completely out of their hands on the internet with social media and that kind of thing. What the argument and what we find in our data in a study that we're working on right now is that there is an impact of seeking information about cannabis from social media that we don't see from mass media on attitudes, and that that makes a lot of sense.

Seth Adler: It does.

Dr. N. Lewis: That I think is driving the difference in social norms, especially among like the Pew study, the 2017 data. Millennials are massively in favor of legalizing everything, like 70 ... 90% of millennials I think and 61% of the population in general, and that's coming from just a mass of pro cannabis information.

Seth Adler: Interesting. When it comes to that generation.

Dr. N. Lewis: Well, that's one factor. The media is only one small part of the puzzle.

Seth Adler: Of course, but when it comes to that generation, I think that they seek to find other information than the other generations that have come before them.

Dr. N. Lewis: There's just more. It's not a clean experiment.

Seth Adler: Yeah.

Dr. N. Lewis: I mean people who grew up with three channels and no internet, you can't compare them.

Seth Adler: Yeah. That's me. Yeah. Not you though. You're much younger than me.

Dr. N. Lewis: I'm on the border there.

Seth Adler: You're generation Y. You were born between '80 and '85 is my guess.

Dr. N. Lewis: No, you're wrong.

Seth Adler: Oh, wow.

Dr. N. Lewis: I won't correct you.

Seth Adler: Okay. Fair enough.

Dr. N. Lewis: No, I'm definitely an X and a proud X.

Seth Adler: Good. Exactly. Now let's talk about these generations, right? You and me, generation X, we've got the millennials who are just kind of getting information in a different way. Quite literally.

Dr. N. Lewis: Yes. Even though I think a lot of X's are not that different in terms of their media use patterns. They may not all be like on Instagram and Snapchat, but it doesn't mean that ... I think I'm at least as internet savvy as my students and my students are Y.

Seth Adler: I think that your relationship with media is different than theirs is-

Dr. N. Lewis: Could be, it could be.

Seth Adler: -is my point.

Dr. N. Lewis: Yeah. Again, I can't as a scientist, that's wrong to, you know, extrapolate from a sample of one.

Seth Adler: There we go. You being that sample of one.

Dr. N. Lewis: Yeah. Exactly.

Seth Adler: Let's bring it in the baby boomers. Right? I've got my dad who has ... well, let's just say at least one medical issue as a 72 year old.

Dr. N. Lewis: Yes.

Seth Adler: Okay. I feel like that's fair to say.

Dr. N. Lewis: Yes, that's reasonable.

Seth Adler: It's something that possibly could be treated with cannabis. There's enough information out there on the internet, not on television commercials.

Dr. N. Lewis: Exactly.

Seth Adler: Not in magazine ads.

Dr. N. Lewis: You have to go look for it.

Seth Adler: But on the internet, which showcases, hey, you know, if you ask your doctor about these uses, maybe this will help your one ailment so to speak. Your condition.

Park Attendee: Microphone.

Seth Adler: He doesn't see the microphone right here. Also he's a child, so what does he ... but that's okay.

Dr. N. Lewis: You can edit that out.

Seth Adler: Yeah, well, maybe we will. Maybe we won't.

Seth Adler: My point here is I had a tough time-

Dr. N. Lewis: Yeah, getting him to look for information.

Seth Adler: No, no. Getting him to read the information that I had given to him because it was from the internet. I also had a tough time convincing him to show it to his doctor.

Dr. N. Lewis: Ah, okay.

Seth Adler: His doctor, we had asked beforehand, what are your thoughts on medical cannabis? She said, "Well, I don't know."

Dr. N. Lewis: Really?

Seth Adler: Well she's not taught about the endo-cannabinoid system in medical school. No one is.

Dr. N. Lewis: In Israel, the doctors are getting much more demand. A huge demand.

Seth Adler: Here's the distinction. Here's the distinction between Israel, and the United States, and elsewhere.

Dr. N. Lewis: That's inevitably gonna happen there too.

Seth Adler: First things first, let's talk about baby boomer, versus gen X, versus millennials as far as that media consumption and what, and that case study that I just brought to you.

Dr. N. Lewis: Yeah, well I completely agree with you. I think that a lot of the good information and the updated information out there is not available in the mass media for obvious reasons. You're not going to get patient testimonials. I mean, in our study we looked at patient testimonials in news media, so these were part of the accepted media coverage, but we found also a lot of negative information out there. On social media you can get just such a huge amount of even academic publications and research and yeah, I mean if I was a patient I would definitely want to explore that and I would insist and be disappointed if my doctor didn't know what was going on.

Seth Adler: Let's now, because you've been in Israel for how long?

Dr. N. Lewis: A long time.

Seth Adler: Right.

Dr. N. Lewis: Twenty two years.

Seth Adler: Okay, so you understand this country.

Dr. N. Lewis: Yes.

Seth Adler: Explain from your perspective and your work with Sharon, how Israel is looking at cannabis, and from a physician standpoint versus maybe other countries.

Dr. N. Lewis: Well, actually, Sharon could help you a bit more with this. We did it the very beginning of our project in 2014 because we ... as scientists again, it's important not to make assumptions before you go in and we wanted to work out who are the different stakeholders, what do they think about medical cannabis, what do they think about legalization, who is it helping? We interviewed a leading doctor in charge of the cannabis system at the time and this is when it was much smaller. He had a particular perspective and then we interviewed patients which was fascinating because they just described how it completely changed their quality of life. When you interview a patient one to one and you get that information it's very convincing evidence.

Seth Adler: Some might call it enlightening.

Dr. N. Lewis: It's enlightening. However, I also interviewed two doctors in a major health system here. Now I got some information that again, from a scientific perspective, it's important to try and remain with the facts and keep your mind open instead, I don't want to go in looking for a particular hypothesis and trying to find it supported. You go in, you let the data speak to you.

Seth Adler: Right.

Dr. N. Lewis: I interviewed, a man, a doctor who was in charge of general practice in Haifa, and he was quite positive. Then his friend, a psychiatrist came in the room and the psychiatrist began to tell me how he had an influx of patients in their 20s with cannabis induced psychosis, and how he was seeing schizophrenia beginning at like decades before it was supposed to, as far as what he was used to. His argument was that cannabis can be great for most people, but if you have some kind of tendency toward psychosis or schizophrenia from his psychiatric perspective, it's not a good thing.

Seth Adler: I see.

Dr. N. Lewis: That you don't know until you try it. It's something that it's quite difficult to treat afterwards. Again, I'm not a psychiatrist, but it was the first time that I stopped and I'm like, I went home and I Googled cannabis induced psychosis because I didn't obviously know much about it.

Seth Adler: Well, there is when I speak about the side effects of cannabis it's a very long list of zero things.

Dr. N. Lewis: Yes.

Seth Adler: No, but there is ... paranoia is on the list. You might get a little hungry that's on the list, but that paranoia thing-

Dr. N. Lewis: It's beyond paranoia.

Seth Adler: I guess, it's beyond paranoia is what this-

Dr. N. Lewis: For certain people.

Seth Adler: -this scientist was saying for certain people. If you have an issue there-

Dr. N. Lewis: That's the thing, a lot of people don't necessarily know that they have genes that predispose them to schizophrenia.

Seth Adler: That's why THC, you might want to leave that out of-

Dr. N. Lewis: That's the things, so a little bit more research needs to be done. That's why I'm not ... if anyone for any topic is like a 100% convinced, I always-

Seth Adler: Forget about it.

Dr. N. Lewis: Yeah, so I think that there needs to be some kind of a medical debate as well about who is it good for? When is it better than other options? Who is it maybe not good for? Is there a way to screen for people who may be potentially either not benefit or be potentially harmed by it? Even though I don't think it's a large amount of people. I think on the whole, if you're looking at an aggregate public good, it's a great treatment from what I understand from the research.

Seth Adler: Well yeah, and worst case scenario, you can't die.

Dr. N. Lewis: You can't die, but if it brings on schizophrenia by three decades you may not-

Seth Adler: Yeah, that's an issue.

Dr. N. Lewis: -be thrilled about that.

Seth Adler: That's something to look into. Can you put me in touch with your person who said that to you?

Dr. N. Lewis: The psychiatrist?

Seth Adler: Yeah. I'd love to-

Dr. N. Lewis: I can try. I'd have to look back at my research notes.

Seth Adler: Yeah. If you could though, in all seriousness-

Dr. N. Lewis: Yeah, no.

Seth Adler: If that has come up then I'd like to talk about it.

Dr. N. Lewis: I can also send you links to research. I mean what he's saying is not inconsistent with some research findings out there.

Seth Adler: Sure.

Dr. N. Lewis: There are a few studies again that make that case and I cite them in my own research just as part of the discussion about the debate.

Seth Adler: Right.

Dr. N. Lewis: There is that-

Seth Adler: There is that, and again though that is only THC we are talking about.

Dr. N. Lewis: Yes.

Seth Adler: That is only one little particular component of the plant. You can remove that and have CBD rich-

Dr. N. Lewis: You can, you can and it's also difficult to prove cause and effect here because. Again, I don't know if he's done a randomized control trial. You can't bring in people who are similar for risk of schizophrenia and tell some of them to smoke and some of them not smoke, so there's a lot of other possibly confounding factors there.

Seth Adler: Can you just give me, just unpack that slightly. What do you mean by that? Scientifically, what are you saying?

Dr. N. Lewis: I'm saying a psychiatrist who has a particular clientele of patients or a patient population and the psychiatrist sees correlation between schizophrenic symptoms at age 20 something and smoking cannabis. It could be that the cannabis was a kind of unrelated, that there might be something else, like a spurious third factor that explains both.

Seth Adler: Oh, wow. Yeah, I'm a strong believer-

Dr. N. Lewis: Again, it's not a clean test.

Seth Adler: -in the fact that it is the person and if it's the cannabis that metastasizes it, okay.

Dr. N. Lewis: I don't ... the cannabis could be-

Seth Adler: It could and it could not is your point.

Dr. N. Lewis: Yeah, and again, I would need-

Seth Adler: Who knows?

Dr. N. Lewis: -to see a randomized control trial. That's not the kind of thing that you can do a randomized control trial because people aren't just gonna, you can't tell people to start smoking cannabis and tell other people not to and then test who gets schizophrenia. That's not cool.

Seth Adler: Well, sure you can. It just depends on the country you're in. You can't do it in Israel or the United States. Yet.

Dr. N. Lewis: Not in this country. No.

Seth Adler: Anyway, did you see how I almost went somewhere and then I didn't, yeah, purposely. Again, you and I spoke before this. You've obviously from Australia. We can hear that. Where in Australia?

Dr. N. Lewis: From Melbourne.

Seth Adler: Okay. I went to Melbourne. You know that there's those little gold ... there's the walk that you can take, a self guided tour with the little gold-

Dr. N. Lewis: No. I haven't lived there for a while.

Seth Adler: -almost circles in the ground.

Dr. N. Lewis: I go back and forth, but no.

Seth Adler: Yeah. It always rains there is what they say.

Dr. N. Lewis: They've actually had a seven year drought, so it rains sometimes but not often.

Seth Adler: It used to always rain there.

Dr. N. Lewis: Yes.

Seth Adler: All right. South of Sydney?

Dr. N. Lewis: Yeah, it's ...

Seth Adler: Right, but not even that far. Right.?

Dr. N. Lewis: It's 13 hours by car, but one hour by-

Seth Adler: Plane.

Dr. N. Lewis: Yeah.

Seth Adler: Thirteen hours, well, that doesn't add up.

Dr. N. Lewis: Yes.

Seth Adler: Really?

Dr. N. Lewis: Yes. Having done that trip a couple of times.

Seth Adler: That's one hour by plane is 13 hours by car. That's just feels like it would be ... but that is why I thought it was so close. I flew there.

Dr. N. Lewis: Yes. It feels close when you're doing it by plane.

Seth Adler: Right. Yeah. Indeed. Then how do we like it here in Israel?

Dr. N. Lewis: It's good. I won't get into the politics because I'm not a huge fan of the government.

Seth Adler: Right.

Dr. N. Lewis: As a country I like it and I work with really smart people.

Seth Adler: Yeah.

Dr. N. Lewis: I like that.

Seth Adler: Yeah. It's good to surround yourself with very smart.

Dr. N. Lewis: Yeah, and I think there's so much good research here on medical cannabis and there's just really interesting perspectives. I'm quite happy that I'm studying this particular topic.

Seth Adler: Yeah. You mentioned the conference, it's [inaudible 00:28:17], which is being put on by the Ministry of Health from the government itself?

Dr. N. Lewis: Yes. The government is very involved. Israel is actually at the forefront as far as the medical cannabis program. They really got-

Seth Adler: Leading.

Dr. N. Lewis: -got organized quite quickly and we've been following that, Sean and I, and over the years. What's interesting is it's a small country and there's no degrees of separation and something like, there's estimates of between 23,000 and 40,000 people who have had or do have licenses.

Seth Adler: Right.

Dr. N. Lewis: I mean, even if you're not exposed to information, the media, you know somebody or you know, somebody who knows somebody who has a license and so word gets around. In the case of your dad, he may not have, if he was living here he would eventually hear from somebody who's being treated.

Seth Adler: Right.

Dr. N. Lewis: Work of mouth is everything.

Seth Adler: And a physician who's treated him.

Dr. N. Lewis: Exactly. It's a very interesting experimental case in that respect. Especially when you have ... Israelis are a bit competitive like that. If they hear that somebody else has got a treatment, and it works, and they're not getting that treatment, so then they'll go and they'll demand it quite aggressively. That's how it works.

Seth Adler: All right, so basically what you're saying is a soon enough as far as cannabis is concerned, does that relate back to essentially what the truth is in quotation marks with your research on say no to drugs, and antidrug campaigns, and basically if you give it long enough the truth prevails? Is that not necessarily the conclusion that you've come to?

Dr. N. Lewis: Well, that's what I find fascinating specifically about cannabis, that it's a strange test case for a topic about which the public are changing their mind quicker than the policy's changing.

Seth Adler: Right.

Dr. N. Lewis: The policy has to catch up and so we're going to look back in the same way as smoking was considered cool in the 40s and 50s and now we look back at ads for smoking and it looks ridiculous. I think with anti-cannabis interventions and a lot of money has been put into that. I mean billions of dollars and I do not exaggerate, into convincing the public not to smoke cannabis. We're going to look back and think that that was a colossal waste of money. We're exactly in that interesting point now that the public opinion is shifting. Sean and I study what causes public opinion change as far as the media, for example. The media is one part, but I mean there are other factors.

Seth Adler: Policy.

Dr. N. Lewis: Yes, policy and just, again, word of mouth, and science.

Seth Adler: Is media the largest part?

Dr. N. Lewis: I don't know. I think it depends on the person.

Seth Adler: It depends on who is evaluating the information?

Dr. N. Lewis: It depends on what your habits are, how much you tend to look for information in general about health in the media. Do you trust that information? I think social norms are not just about media. I think if your friends start smoking, that's going to be a much bigger influence.

Seth Adler: Media, government, word of mouth, i.e., your social network and by that I mean physical or offline, but then also online and any other components there?

Dr. N. Lewis: I think enforcement in the sense that you can have, like in Israel there's ... people know that you shouldn't sit in front of a police officer and smoke a joint, but if the police officer is more likely over time to ignore that kind of behavior, then the public gets the message. It's like with parents and children, there's no enforcement. Then they understand the social norms simply because the enforcement rules have changed. It's no longer a law enforcement priority to pull you over and look for cannabis in your car, which again, I think it's a huge waste of money and they should be doing other things.

Seth Adler: Sure, sure.

Dr. N. Lewis: That in itself sends a message.

Seth Adler: What else is on that list?

Dr. N. Lewis: What list?

Seth Adler: We've got media, we've got government, we've got word of mouth, we've got-

Dr. N. Lewis: Money, money. It's an industry, it's a very huge industry and it's growing, and it's going to be massive. The Israeli [inaudible 00:32:36] world wants in.

Seth Adler: Yeah.

Dr. N. Lewis: If they're cool with it, then that also sends a message to the business community that this is a good thing, this is a product. The public should have it. How do we find an app or an oil or some kind of way. I mean, and you see that happening now with telegram and you know it's ... so there's the business side of things. I mean money talks. If you invest in a cannabis startup and they make money for you, then you'd probably think it's a good thing.

Seth Adler: You probably do. All right, and so it does all come back to the money, doesn't it? The money wins. Is that fair? That's fair.

Dr. N. Lewis: Money is its own language.

Seth Adler: Yeah. Money is its own language. That's a quotable quote. All right. I'll ask you the three final questions. I'll tell you what they are and I'll ask you them in order.

Dr. N. Lewis: Okay.

Seth Adler: What's most surprised you in cannabis? What's most surprised you in life? On the soundtrack of your life, one track, one song that's got to be on there. Just a-

Dr. N. Lewis: I don't know if I can answer that.

Seth Adler: Oh, we'll find a way. We'll find a way. You've been studying this and the hope is I was going to sit down with Sharon today and hopefully I can later.

Dr. N. Lewis: She'll give you-

Seth Adler: I like to call her Sharon because it feels easier on my face, but it is Sharon, right?

Dr. N. Lewis: Yes and no. She'd be good with Sharon.

Seth Adler: She'd be fine either way?

Dr. N. Lewis: Yeah, yeah.

Seth Adler: Along your travails, what's most surprised you in cannabis?

Dr. N. Lewis: What surprises me is that it's still federally classed as a drug given that nine states have already okay'd legalization-

Seth Adler: And we're back to talking about the United States.

Dr. N. Lewis: In the US, yeah. I find that a very strange legal situation that you can, for example, smoke up in Denver, get on the plane and then ... and you can't take it with you in the air, but you can land and at somewhere where you can potentially go to jail for the same thing. To me that seems ... it's not a situation that can hold long term.

Seth Adler: We have to ... Well, we have to follow the money, right? Where is the money? That'll let us know if it'll hold.

Dr. N. Lewis: I think it'll hold for sure. I mean, look at California. Everyone wants in on the money and nobody wants to be the last hold out state.

Seth Adler: Sure.

Dr. N. Lewis: It's like with prohibition. You can't have some states allowing and some states not allowing because people travel all the time. It's just ... it becomes ridiculous and it also raises the question of, well, if it's okay for my neighbor who lives in the next town across the border, why can't I do it? With Canada now, I mean, the question is not if it's when.

Seth Adler: I hope that you are correct. We started the conversation with certain industries having a hand in making cannabis illegal in the first place.

Dr. N. Lewis: I think they've lost the battle.

Seth Adler: Have they?

Dr. N. Lewis: I think the balance of power is against them.

Seth Adler: I think, well, alcohol, forget about it because their Constellation brands, one of the beer manufacturers, alcohol manufacturers as now invested in a cannabis company in Canada. They're going to come with.

Dr. N. Lewis: Yes.

Seth Adler: I think there might be other industries which might be reticent for cannabis to be a medicine.

Dr. N. Lewis: I think, yeah. Pharma, for example.

Seth Adler: Oh, that's your ... those are your words, not mine.

Dr. N. Lewis: Yes. I made it. My hypothesis would be they may not be thrilled about it. That's a strong lobby. I didn't know. Again, it's the borders of my knowledge.

Seth Adler: I gotcha.

Dr. N. Lewis: What I will say is that that's what surprises me is that we're in this strange state of legal limbo. I keep waiting for there has to be a tipping point in the debate and the point of no return, and I want to see when that happens.

Seth Adler: What is that, because your whole thing is public opinion and how that is-

Dr. N. Lewis: Yes, you can't-

Dr. N. Lewis: Once people, yeah-

Seth Adler: We're telling two things that are inverse.

Dr. N. Lewis: Completely dissonant. You can at the same time think that cannabis has excellent benefits and it's a medicine, and then be told that it's terrible and it's a drug. Those two cognitions can't exist at the same time. According to psych theory of cognitive dissonance, you're going to necessarily lean to one or the other and the policy will shift eventually too.

Seth Adler: Accordingly.

Dr. N. Lewis: The public are moving to cannabis is a medical treatment-

Seth Adler: There we go.

Dr. N. Lewis: -and it's not that harmful.

Seth Adler: Yeah, what's most surprised you in life?

Dr. N. Lewis: I don't know.

Seth Adler: Did you live in Israel and you're from Australia, and those places are somehow kind of similar ... in the way that society runs in each place? Meaning they're kind of beach loving, kind of happy direct people?

Dr. N. Lewis: Yeah, but I'm not often surprised in general.

Seth Adler: Oh, okay. Well then that's fine.

Dr. N. Lewis: I tend to ...

Seth Adler: I think that's your role as you know, right? If you're studying, you've got to take your hypothesis. You've got to-

Dr. N. Lewis: Exactly.

Seth Adler: The whole point is that you're not surprised.

Dr. N. Lewis: I'm not surprised ... if you open yourself up to different possibilities, it's not that something surprises ... you may not have expected certain things, but it shouldn't be a surprise.

Seth Adler: That's very well put.

Dr. N. Lewis: What surprises me actually-

Seth Adler: Oh, the after all? You just gave us a great example, or a good reasoning for why we wouldn't-

Dr. N. Lewis: No, what surprises me ... I don't want to get too much into politics, but I'm amazed that the government is still in power.

Seth Adler: Yeah, so and here's what I'll say to that.

Dr. N. Lewis: Yeah.

Seth Adler: If you're able to identify them, right? Then your rhetoric is against them and then you have enough of us, then you stay in power. This is, we're here in Caesarea, or what is it? How do you pronounce it again?

Dr. N. Lewis: Caesarea.

Seth Adler: Caesarea, and it was happening then, you know?

Dr. N. Lewis: I guess. I guess.

Seth Adler: Over 2000 years ago, all we got to do is separate us from them and then whoever does the separating remains in power. It just is the way that it is.

Dr. N. Lewis: Unfortunately, yeah. Unfortunately [crosstalk 00:38:26].

Seth Adler: If we allow that as a society, it will continue.

Dr. N. Lewis: Well, we've seen that in the US too.

Seth Adler: All over the world. Absolutely.

Dr. N. Lewis: Yeah. That's surprising/disappointing I suppose.

Seth Adler: Yeah. All right. Then let's end differently.

Dr. N. Lewis: But you can edit that out.

Seth Adler: No, no, no. We want to keep that. Let's end differently as far as the soundtrack, on the soundtrack of your life. One track one song that's got to be on there. Wouldn't it be Men at Work, She Comes From a Land Down Under?

Dr. N. Lewis: No. No.

Seth Adler: Okay.

Dr. N. Lewis: No.

Seth Adler: She does.

Dr. N. Lewis: I do, I do. Unfortunately I don't have an Australian song.

Seth Adler: Okay.

Dr. N. Lewis: I think Requiem, I just love Requiem.

Seth Adler: The M word song?

Dr. N. Lewis: Mozart's Requiem.

Seth Adler: Oh, great. Okay. Fair enough.

Dr. N. Lewis: Yeah.

Seth Adler: Yeah. We'll go with that.

Dr. N. Lewis: Yeah.

Seth Adler: All right. I can't beat you there if you, once you pull Mozart you win.

Dr. N. Lewis: Sorry, well, it's kind of old school.

Seth Adler: Yeah, kind of. Very much appreciated. An interview that has spanned the history of time. Thank you so much for your time.

Dr. N. Lewis: My pleasure. Thank you.

Seth Adler: And there you have to have Nehama Lewis, very much appreciate her time. Very much. Appreciate your time. Stay tuned.

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Cannabis Economy is a real-time history of legal cannabis. We chronicle how personal and industry histories have combined to provide our current reality.