Zibby Owens: I’m here today with Alex Berenson, an award-winning novelist, a number-one New York Times best-selling author, and a former New York Times reporter. His latest book, Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence, is his second nonfiction book. His debut novel, The Faithful Spy, based on his time reporting in Iraq, won the Edgar Award for Best First Novel. He’s written a total of twelve novels and two nonfiction books. A Yale graduate, Alex currently lives in the Hudson Valley with his wife and children.

Welcome, Alex. Thanks for coming on “Moms Don’t Have Time to Read Books.”

Alex Berenson: Zibby, thanks for having me.

Zibby: I’m really excited to talk about Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence, which is such an amazing service you’re doing by collecting all this information and research about what us parents should know and what we need to inform our children. It’s super important. Thanks for doing all that work.

Alex: Thank you. I was a reporter for the New York Times. Then I became a spy novelist. Then I had some children — my wife had the children.

Zibby: You can take credit. It’s all right.

Alex: She really got me involved and interested in this topic because she’s a forensic psychiatrist, which means she deals with the criminally mentally ill. So many cases she saw, cannabis use seemed to be a factor in the person’s mental illness. Honestly, I didn’t really believe her at first. As I explain in the book, like everybody else, I had heard about Reefer Madness, the movie. I just assumed that cannabis was pretty harmless. I’d used it a few times growing up and didn’t particularly like it, but didn’t particularly care either way. This went back and forth between us for a couple of years, I’m embarrassed to say, mansplaining things probably, that I knew nothing about. Finally, she got tired of me talking about this. She’s the one who has the fellowship at Columbia. She’s the one who has all the medical training. She’s the one who sees all these people. She said, “You really should look at what the studies say.” I did. I thought to myself, this is a story that is as important as any story I ever worked on at The New York Times. Nobody knows about it. It became Tell Your Children.

Zibby: What should we tell our children? Summarize this intense work of brilliant research into a couple sentences, please.

Alex: Cannabis is not safer than alcohol. For adolescents, it’s less safe. Certainly for adolescents in New York City, it’s less safe. The number one risk of alcohol for adolescents involves driving. If you really want to, you can kill yourself drinking alcohol. There’s no question. You can put yourself into liver failure. Really for adolescents, the risk is drinking and driving, which is obviously not as big a risk in New York. For cannabis, the risks are less physical and more psychiatric. Cannabis is a neurotoxin. THC is a neurotoxin. For vulnerable people, especially if they start using in their teens, it can not just impair memory or motivation or cognition, but it can actually produce a psychosis. Psychosis is the medical term for a break from reality. It’s hallucinations or delusions or severe paranoia. I think we all know that cannabis, or anybody who’s used it knows, that cannabis can cause paranoia. That happens so frequently that in states where it’s legal, people will tell you, “This strain is less likely to make you paranoid.” It, for many people, comes along with the high.

What people don’t realize, because there’s been a really aggressive and very successful marketing, and I would say propaganda, campaign around this is that the paranoia is a symptom of something much more serious, which is psychosis. Not everybody who uses cannabis, and not even a majority of people who use, are going to suffer psychosis, but some people are. The younger you start, the greater your risk. Fourteen is better then twelve. Sixteen is better than fourteen. Eighteen is better than sixteen. Really, this is not a drug people should be using before their twenties if they’re going to use it. The other thing that parents need to know — this is true even if you’re only in your late thirties, but certainly if you’re older than that. It is really true that the cannabis and THC products that are being used today are totally different than what you might have used as an adolescent or in college or in your twenties. It is a different world.

Cannabis in the seventies, most of it was one or two percent THC. It had a measurable amount of CBD. We can talk about what THC is and what CBD is. The short version of that story is CBD is non-psychoactive. It helps counteract the effects of THC. That’s what the science basically says now. These days, if you go into a dispensary and you buy cannabis, it’s likely to be twenty-five percent THC, no CBD. Even worse than that, a lot of people prefer to use what’s called wax or shatter or edibles. This is all just pure THC or near-pure THC that’s been extracted from the plant. Wax and shatter are — it does look like wax. It’s a semi-synthetic gooey product that gets extracted from the plant that you smoke. It’s basically just smoking THC. This is one reason when people say, “This is a natural — it’s a plant. It can’t hurt you,” I say, “Do you know what people are actually using these days?” Edibles are, obviously, edible. They get processed through your liver into a more psychoactive form of the drug.

This is a long background. In two sentences, what I would say to a parent of an adolescent — three sentences. One, don’t think that this is safer than alcohol. It’s not. It’s not a good substitute for alcohol. Two, tell your child to delay using this. Even if you used it, understand that it’s a different drug. Three, with the synthetics and with the edibles, know that the classic signs of the smell, the red eyes, they may not be there. Your child might be using a lot of THC. You’re thinking, I don’t smell any pot in the house. No, you don’t. It doesn’t mean that your child is not really hurting him or herself.

Zibby: Now I’m totally terrified as a mother who has twelve-year-old kids. After doing all this research spanning a hundred and fifty years of history and science, what do you see as the link between marijuana and mental illness? In chapter eleven you say, “The link between marijuana and mental illness is controversial, but the link between marijuana and violence isn’t.” How does violence and this psychosis — explain.

Alex: There’s three issues here. On one, the science is unequivocal. That is cannabis can produce transient psychotic episodes. There’s just no question about it. If you give people THC in a lab, some of them will get psychotic. They won’t stay psychotic forever. B, can cannabis produce permanent psychosis in people, permanent psychotic conditions in people who otherwise wouldn’t have developed those? I think we are pretty close to proving that in a tobacco-y lung cancer way. In other words, we’re never going to prove it through a randomized trial because you couldn’t do that. It’s both illegal and unethical to test a drug to see if it harms people. You have to look at the epidemiology and all this stuff. We’re pretty close on that. There’s a ton of evidence that has accumulated, especially in the last ten years, that people who use, especially if they’re using when they’re younger, especially if they’re using a lot, really increase their risk for schizophrenia. If you do the math, if you say you’re increasing your risk, if your risk goes from one percent to five percent, that means that if a hundred people use, there are going to be four extra cases. To me, increasing risk is the same as causing. We can argue about that. That’s A and B.

C is the most controversial part of the book. That’s really the part that I talk the least about because it is complicated. I don’t want the book to get pinned as reefer madness when there’s so much else that’s important to talk about here. Psychosis causes violence. This is a fact. It has been demonstrated in epidemiological study after epidemiological study. Unfortunately, our prisons, and prisons all over the world, are filled with people with schizophrenia. The best studies show that people who have schizophrenia are about twenty times as likely to commit homicide as healthy people. Just in New York a few days ago, there was a terrible crime in Chinatown where a man who almost certainly was psychotic, based on what the police had been saying about him, beat four people to death with a metal pole.

Zibby: Homeless people.

Alex: Four homeless people, yes. He was homeless. It was random. It was incredibly aggressive. He was ranting and raving, according to the police. That all stinks of psychosis. Psychosis causes violence. Unfortunately, advocates for the mentally ill hate talking about this. What they say is, people with mental illness are not more likely to be violent than people in the general population. That is true if you include people with mild depression and mild anxiety. That’s the half the country. It’s literally half the country. That hides the real risk. The real risk is in people with psychosis. Psychosis is a terrible illness. It makes people do terrible things, unfortunately. Cannabis causes psychosis. It is reasonable to make a link between people becoming psychotic as a result of cannabis use and people becoming violent as a result of psychosis. The link is actually closer than that.

Because the kind of psychosis that cannabis produces is so heavy on paranoia — psychiatrists, they’ve done a lot of work about this issue because it’s so important. If you think about modern society, one of the most important things as a modern society, or as any society, is the prevention of violence. People spend a lot of time studying the causes of violence. They even spend time studying what specific delusions or paranoid ideation makes people violent who have severe mental illness. It’s clear that paranoia is a driver of severe violence. You put all of this together. Then you look at the individual cases, and it becomes harder and harder to argue that, “This is nonsense. I get stoned. I sit around. The only thing I murdered is a bag of Doritos.”

Okay, true. You are not somebody who’s consuming 100mgs of THC a day with an underlying mental illness. You don’t have schizophrenia. You don’t have bipolar disorder with psychosis. The violence is often around those. Unfortunately, it’s around those people. This is a drug that can cause mental illness. It can cause paranoia. It can worsen the kind of mental illness that’s likely to produce violence in people with mental illness. You put all that together, you have a bad combination. The cannabis lobby hates talking about this. They hate it because they know that if people really understood this, it would be bad for efforts to legalize. By the way, you can know this and say, “Okay.” In one case in a thousand or one case in ten thousand, there’s going to be something bad that happens to a regular user. We could debate what the numbers might be.

Zibby: Is that like Richard Kirk?

Alex: Yes, Richard Kirk. That’s a really interesting case because he didn’t really have preexisting mental illness, but he had a vulnerability.

Zibby: This is one of the many stories you tell about specific people that makes this book more narrative, not just a fact-based frenzy, but a very compelling narrative including stories like Richard and his wife Kristine and calling 911.

Alex: Richard Kirk is a guy — it’s a very interesting case. He’s somebody who had a transient episode of cannabis psychosis. I actually met Richard in a prison in Colorado. I talked to him for several hours. It’s interesting to talk to somebody who’s killed another human being, especially for a long conversation. I don’t know what it would have been like to be a lawyer who had to represent one of these people. It’s like, it’s normal, it’s normal, it’s normal, then he says something. It’s like, wait, you killed somebody. You shot your wife in the head with your child there. You’re actually not normal. You’ve done something that almost no one has done. Going back to Richard —

Zibby: — If Richard is normal, and let’s just say anyone else out there who believes themselves to be normal, and you have an episode of psychosis caused by a drug that you take once and you commit horrendous crimes and then you never take the drug again, are you not normal?

Alex: It’s a really good question. He has a family history of psychosis. I believe he has a brother who has schizophrenia. He had used cannabis in the past. It tended to make him paranoid. He has these red flags. He’s a bit of a scammer. He’s an opiate addict, not like he’s shooting heroin. He’s got a problem with pills. He’s got a back problem and a problem with pills. He’s in mild withdrawal. This is all in the book. He goes and he gets himself a cannabis candy, an edible, which is a more dangerous form. Once you eat that candy, you are on the ride. If you’re smoking a joint, you get high, you get too high, maybe you just forget to smoke any more among other things, but you can titrate it, is really the pharmaceutical term. With an edible, you’re on the ride. The joke about edibles is, “Nothing’s happening. Nothing’s happening. I’m going to take another one. Nothing’s happening. Take me to the emergency room.” That’s what happened to Richard Kirk.

Richard Kirk is a guy. He’s got family history of psychosis. He’s had these issues with this drug on the rare occasions when he’s used it. He’s in mild opiate withdrawal. He takes an edible, and he gets extremely psychotic by all accounts. He starts ranting and raving. The world is ending. He jumps out of a window onto his deck. He jumps back into the house. He’s got three kids. He’s got a gun in the house. Does this happen if he doesn’t have a gun in the house? Probably not. Maybe he stabs his wife to death. Who knows? He has a gun in the house. He gets the gun. His wife is calling 911. These are nice, middle-class people in Denver. The cops are not treating it as a priority. Then he walks up to his wife and he shoots her in the head. He just kills her. He destroyed his life. He obviously killed her. He’s never going to see his kids again, most likely. He’s in jail for thirty years.

Why did he do that? If he hadn’t been psychotic, he wouldn’t have done that. Listen, maybe he would’ve been violent in some other way, but he wouldn’t have done that to her that night. Now he’s sane again. Richard, in some ways, he’s both a good example of the dangers of cannabis and a bad example. What he did is kind of a one-off rather than somebody who had long, preexisting mental illness that was worsened. At the same time, if we expose cannabis to millions of people, there’s going to be more Richard Kirks. There are more Richard Kirks out there. It’s in the book. You see these cases. They just pop up. The media doesn’t make a big deal out of it, usually in part because these are not — the Kirk case got a lot of attention because, again, this was a nice, middle-class family. Even in that case, there’s not a lot of mystery. There’s rarely mystery to a psychosis crime. When you’re out of your mind, you don’t usually spend a lot of time trying to escape or hide the crime. Maybe you run away. Often, sometimes people don’t even do that.

The first case, the most terrible case of all the cases in the book is the story that opens the book of Raina Thaiday who is a poor woman in Australia who has lots of stressors in her life. She’s got nine children by six or seven men. I don’t think she’s aboriginal. I don’t think that’s the term. She’s what’s called a Torres Strait Islander, which is a poor community. It’s a marginalized community in Australia. She has all these problems. She’s smoking cannabis every day for more than a decade. She’s slowly losing her mind. In the fall of 2014, she starts to recognize that things are going wrong. She actually stops using. Unfortunately, that probably put her in withdrawal. At this point, her illness — she’s in her mid-thirties. This is not a woman who’s ever been hospitalized before, I don’t think. She’s got depression. She’s got stress. At some point, she became openly psychotic and started behaving in ways that the neighbors recognized was odd. She took all the furniture out of the house. It’s interesting you talk about the narrative in the book. The first draft of this book — my editor, I think correctly, said this was a mistake. I wrote it from her point of view. It’s written from inside her head as she’s losing her mind. My editor was like, “This is just too much. This book is going to be too controversial, too difficult to convince people to take it seriously. You cannot write it this way.”

Zibby: That could be your next novel, though. Not that you need more ideas. You’ve written like fifty-seven novels — twelve.

Alex: Hard to live inside these people’s heads. Raina Thaiday lost her mind. One night, her two oldest kids went out to — it’s Christmastime in Australia. It’s summer. It’s hot. It’s northern Australia. It’s tropical, all these kids living in this little house with these three ducks. Two of the girls go out. They’re going to the mall. It’s Cairns, Australia. It’s a medium-size town in northern Australia. They don’t come home. She freaks out. Finally, they come home. That night, she kills everyone in the house. She kills seven of her children and her niece. She slaughters them. It’s still not clear how she did this with nobody — the neighbors didn’t hear anything. She killed the ducks. Then she killed the kids. Then she went outside. She tried to kill herself, although not very seriously. Then she waited. That was it. Children died. Nobody knows. Nobody knows about this. It’s not just because it’s Australia. It’s because she’s poor. She’s marginalized. We don’t want to deal with it. We just want her to be in a mental hospital for the rest of her life.

Zibby: A lot of your stories and a lot of the research and stuff in the book is somewhat unpopular. It’s going against the tide of, “Pot is the greatest thing ever.” I don’t even call it the right thing, weed, whatever you want to call it.

Alex: Cannabis. Call it cannabis. It’s a drug.

Zibby: “Cannabis is the coolest.” There are all these cute purses coming out, little carrying cases, Apple Store-like dispensaries everywhere. This is the thing. If you not doing it, then you’re left out in a way. Your book is coming out saying, wait, hold on a second. This is not the joyride. This is not just a harmless — well, sugar’s not harmless. You have a bit of an unpopular message.

Alex: More than a bit, yes.

Zibby: How is that affecting even the marketing of this book and how you feel? Do you feel even more compelled to get the message out? Do you feel silenced in part? How do you feel about it?

Alex: I didn’t expect this would become a quest and it would take over my life, but it has. It is partly because of what you were talking about with the marketing. If this drug were being legalized on the basis of, “This is a recreational intoxicant. It’s for adults. It’s got dangers like alcohol,” again, probably worse than alcohol in terms of the psychiatric harms, not as dangerous in terms of the physical harms. “We know it’s going to kill some people. If you use too much and you’re intoxicated on the street, we’re going to arrest you. We know a lot of people are using it and we don’t want to be arresting eight times as many black people as white people for it, so we’re going to legalize it,” I wouldn’t be in favor of that. I don’t think it’s a great idea, but that would be a totally intellectually honest conversation to have.

This drug has been marketed and legalized under basically false pretenses as medicine. It is not medicine. It’s being marketed to exactly the wrong people, to people with anxiety disorders, to people with depression, to people with insomnia. Those are exactly the people who should not be using cannabis regularly. Look, if I gave you an eight ball of cocaine, you’d feel better for a few days. Cocaine’s not an antidepressant. A fifth of vodka might make you feel better for a week, but alcohol’s not an antidepressant either. Using recreational drugs to treat psychiatric conditions is a big mistake. I hate the way this is marketed. I really hate the way it’s marketed to moms. I really hate that. This is one of the things that people hate about the book more than anything else. Raina Thaiday’s not, unfortunately, a unique example.

The statistics show that if you look at child deaths from abuse and neglect in the United States — the United States has terribly high rates of child deaths, more than any other industrialized country by far. If you look at those deaths — it’s the one kind of death that the states actually are supposed to really do a root-cause analysis. Some states are better at this than others. New York is actually not very good at it. Texas is very good at it. Florida’s pretty good at it. Those states show that thirty to forty percent of the deaths of children — these are terrible cases — come at the hands of people who are using cannabis at the time, or who have serious problems with cannabis, or both. That is more than alcohol by far. It’s more than any other drug, including drugs like methamphetamine. Weirdly actually, the opiates, opiates don’t make people hurt their kids. Sometimes they make people die or pass out. Then terrible things happen to their kids when they — you can find cases where people die and then their children die in a crib. It’s horrible. Encouraging moms or dad, but especially moms of young children, to use cannabis is the worst idea in the world.

Here’s what cannabis does to you. It enhances your sensations. That’s why people like it. It makes music sound better. People like to have sex on it because it makes sex more exciting. It makes food taste better. It enhances sensation, but it dulls emotion. In that way, it’s kind of the opposite of alcohol. Alcohol makes you emotional and weepy and happy. Cannabis just puts you in a corner feeling stuff yourself. It dissociates. Again, it’s this classic stoner who doesn’t want to move. It can make you paranoid. It certainly makes you lazy. What do I know as the parent of three young children? Young children are hard. They’re a ton of work. You need to be emotionally connected to them to be aware of what they need. A drug that has the particular aspects of cannabis actually couldn’t be a worse drug for the parents of young children to use. It infuriates me when I read these happy stories about moms using. I’m sorry.

Zibby: I’m not using. Don’t look at me. I promise.

Alex: You’ve got me on my horse about this. I’ve just read too many horrible cases.

Zibby: As parents — you have three kids. I have four kids. They are growing up. What do we tell our kids about — they’re going to want to go try everything. You go to a party, what do you do? Do we say, “Don’t ever try it”? Do we say, “Try it, but here are the risks”? Do we say, “You might go psychotic and murder your entire family. Here’s Alex’s book. This can happen”? What are you going to say your kids? What are you going to say?

Alex: I’m going to say these are things that you probably shouldn’t use. Some of them are so dangerous that you shouldn’t use it even once. I think trying cocaine once is a mistake. There’s just too much risk that you’ll become addicted even if you use it once. Methamphetamine, same thing. The opioids, the opioids have some medical uses if you’re in severe pain. Cannabis is more like alcohol. It’s a dangerous drug. It’s going to eat some people. The risks on a population level are clearly lower than something like cocaine. Please don’t do this until you’re in your twenties. You only have one mind. It’s hard to break, but if you break it, you’re not going to get it back. I made a lot of mistakes growing up. I was lucky I never got arrested. You can’t know. Be careful. Don’t let your friends tell you what to do.

The number one thing about this book is there are people who hate me and tell me I’m not cool. I don’t give a shit. I don’t care whether I’m cool or not. People are dying because of this. We’re going to be honest about it whether you like it or not. I do think that’s a real problem with — the media reception to this book has been very frustrating to me. A lot of places that I feel should’ve written reviews of it didn’t write reviews. You hadn’t heard of this book when I contacted you. You’re in the audience that should’ve heard of this book. This is a book that Simon & Schuster published. I was a reporter for The New York Times for ten years.

People don’t want to take it seriously. In part, that’s because the cannabis lobby has done such a good job with its message. In part, it’s just because there’s all these middle-aged white guys in newsrooms who want to be cool. I’m not going to say who it is, but I heard this interview recently with someone. He was talking about cannabis with somebody who was younger. She said something to him about basically, “Do you use?” She didn’t exactly say it that way. He giggled, “He-he, he-he.” I thought to myself, you are an important person in American journalism. What are you doing? Why are you giggling about this like you’re trying to prove you’re cool to the person who works for you who’s half your age? There’s much too much of that.

Zibby: You feel there’s a peer pressure element to it even as middle-aged people?

Alex: Now that I’m middle aged, I understand. There’s nothing sadder than knowing that —

Zibby: — It doesn’t end?

Alex: That you’re never going to be twenty-two again. You’re not. It’s time to be a grown-up. Sometimes I truly think that there’s three kinds of people in the world, people who have children, who shouldn’t have children whether or not they do, and people who are children. Those of us who are adults need to talk about this. It doesn’t mean we’re going to convince people. You’ve got to try.

Zibby: If anyone was going to convince anyone, it would be with your book. You’re really a brilliant writer, as I mentioned when you got here. You make such a compelling case. It’s hard not to listen to it. I really feel very grateful that you wrote it. I, for one, am taking it super seriously. Everybody should too. It’s really important. It’s especially nice that you’re this very successful novelist and you just took this on as a project. Somehow, that makes it even nicer.

Alex: It’s nice for me. My novels have done pretty well. It turns out, you can actually make a pretty good living if you write one best-selling novel a year. I didn’t need to do this. People said I did this for the money. The truth is, this book has sold less. Even though it’s on its fifth printing and it sold about 40,000 copies, The Faithful Spy, which I hope you do read —

Zibby: — I will. I will read it.

Alex: I’m giving myself a plug here.

Zibby: The Faithful Spy, beautiful read cover, best-selling book.

Alex: That book has sold more than a half million copies. A successful novel, it sells a lot more books, generally, than a piece of nonfiction. I had the opportunity to do this. My wife is successful and makes a good living. I was able to do this. It’s always amusing to me when people say I’m in the pocket of the alcohol — I’ve never taken a dime from an alcohol company or a tobacco company or a cannabis company or an opioid company. I can be independent about this. That feels good.

Zibby: Thank you. Do you have any parting advice? I know we’re out of time. I had a thousand more questions for you. Having gone through all of these novels and this brilliant nonfiction work, advice to aspiring authors?

Alex: Read. I’m sure other people have said that. Read and write stuff that you believe in. There’s very few people out there who can fake it, who can write novels that are just — they’re doing it for money, basically. I can’t do that. I have to believe in the story that I’m telling. I think that’s true of all good novels or good writers, fiction or not. If you’re faking it, it will be obvious to the reader.

Zibby: Next time I need something really well-researched, I’m calling you. I’m going to say, “You do it. You write it up for me.”

Alex: Zibby, I will be here. Thank you for this. This is a real service that you’re doing.

Zibby: Thank you. That’s nice. Thanks, Alex.