Ep. 80 - Wine, Weed and the Next Generation: Dalton Hirsh Confronts Cannabis and Public Health

I am Meredith Hirsch, and this is Working Health Care. Today you're in for a very special treat, because I have my second son here to talk about food, wine, and cannabis. Dalton studies fermentation science at Purdue University, and he is an award-making wine maker. Our conversation spans from the Maha movement and foods that are currently being re-evaluated by healthcare professionals to the health impacts of cannabis consumption in Zoomers and Millennials. I am so thrilled that he had a chance to stop by the podcast studio during his Thanksgiving break for this interview. If you love wine, hate wine, or have any feelings about the cannabis industry, this is a must-listen. It is my favorite podcast interview, or at least my most fun. Enjoy. Dalton Hirsch, welcome to Working Health Care. It's so good to be here. Thanks for having me. Well, it's Thanksgiving and you're home from college, and my listeners really like to hear a little bit more about me. So I said, what better way than to bring in my second child, can't say your middle child, my second child for a podcast episode, because you actually sort of work in healthcare. How do you work in healthcare, Dalton? Wine is medicine. It is medicine, and I love one of your favorite quotes, which is actually from Benjamin Franklin. Wine is a constant proof that God loves us and loves to see us happy. So, hey, right, instead of going to the mental health therapist, drink wine. If you go looking through the canon, there are so many great quotes by so many wise people about how wonderful wine is. And you are studying fermentation science at Purdue University, and you spend your days in viticulture and inology, and you are 22 years old. So you've seen firsthand this massive decrease in alcohol consumption and this massive increase in cannabis consumption. And so part of working healthcare is to really uncover the inner workings of our American healthcare system because we can't fix what we don't understand and I deal personally with challenges with people coming into our clinic asking about cannabis, asking for marijuana. And in the state of Florida, it's not legal, but you're involved in the political sphere and you're also involved as a wine maker. Why did you even decide you wanted to go into wine making? It's funny, so I was in college overlapping with my older brother for a year and he found his way in that last year of college into the whiskey industry through his own different path. I mean, he was an engineer and for him it was about solving problems and finding, like, really falling into an industry that he loved. For me, it's about nature. I mean, as wine starts in the ground, like all of our food does, like everything we put into our bodies. I love nature and when I was a kid, I would spend all of my free time hiking, skiing, you know, whatever it was that I could do to be outside and wine, an opportunity to be creative and productive and also to be in nature and to do something good for the world because wine is absolutely one of the true goods in the world. It is. And you've won wine competitions. Yeah, so I mean, you know, I can brag because that's what this platform is. But when I was a 19 year old sophomore, I entered a wine competition, a prestigious international wine competition and won a silver medal, which is a very serious, very serious indeed. And you also, as a freshman, won the food and science student of the year at Purdue? Yeah, food science student of the year as a freshman, that was fun. And so we're all about the maha movement right now, even if people are not associated with the Republican Party, people are all about healthier food, right? And so this, you deal a lot with what the food and drug administration allows, physicians and those in healthcare are dealing with all of the issues with morbid obesity because obesity is the number one cause really related to death in America right now. And so there are a lot of options for that. But let's go into the food specifically. What are you learning within your studies about the food industry and why do you continue to send me videos that I should never eat Oreo cookies? Well, what you said is true and it doesn't really directly relevant to what we're talking about, the idea that obesity is probably the biggest killer in the world, full stop. Food is not just energy, it is the matter that constitutes our bodies. Everything that we are is the food that we eat, it's not just an aphorism, it is as literal as it sounds. And what I've realized studying food science and agriculture is that we are so divorced from the origin of our food. And we are so isolated from the supply chains that bring food to us. And this is a consequence of a very recent, by recent, I mean, you know, on the historical timelines since really the 1950s and the end of the Second World War developments in how we manufacture and distribute food. Prior to the Second World War, food was made and consumed within really 50 miles of where it was produced. There were small radiuses of food production and consumption. And then with the advent of preservation, refrigeration, large-scale shipping supply chains across interstate highways, food production became increasingly centralized in the heartland and consumption became about eating hyper processed foods with all sorts of deadly ingredients like hyphructose, corn syrup, which is itself just a byproduct of bad agricultural legislation and farm bills that oversubsidize the corn industry. That's why corn is, and that's why corn ethanol is 10% of the petroleum you put in your car. And so when you sent me actually a video about how Oreos are made, yes, I'll never eat another Oreo cookie. I mean glyphosate on all of the crops, soybean oil, which is soybeans that have been crushed and suffused in hexane, which is a deadly petroleum byproduct that we put in so much of our food. No, I mean, it's really a terrifying thing. Is there another way to process soybeans other than putting it in petroleum? Yeah, absolutely on small scales and not to make soybean oil. Soybean oil is about extracting an extremely small, it's about extracting an extremely small quantity of substance from a bunch of really small things and to do that on mass requires the use of industrial solvents like hexane, which ordinarily you would not employ it at home, and which soybean oil isn't something that you would consume at home. The way I like to think about it is what my great, great, great grandfather heavy in this. Someone hundred years ago, heavy in this, soybean oil didn't exist in that way. Even things like corn oil or most of vegetable oils didn't exist. If you wanted a liquid oil, you'd be a liquid fat to cook with, it would be olive oil. If you wanted a solid fat to cook with, it would be larger butter. And that was it. That was all that was available because that's all that existed in natural, easily processable quantities. So, in America, are we processing our food differently than those in Europe? No, so this is a common misconception that Europeans do on average eat healthier, but they're processed foods are just as processed as ours and that's an important distinction to make. Europe still uses trans fats, they still use high fructose corn syrup, they still use invert sugar, they still use all of these different chemicals and industrial byproducts that poison our bodies. The difference is Europeans live with smaller food supply chains. Most of their food is grown within closer proximity to the people who eat it. And as a consequence, it's exposed to less intervention as the supply chain necessitates. Also, Europe has much stricter laws around certain pesticides and industrial herbicides, like glyphosate, which is known famously as roundup. There was a lawsuit about that in America, and yet roundup continues to be used pretty much everywhere, even though the European Union has denounced it as a directly cursinogenic. What do they do in the grape fields, the wine grape fields? Do they use roundup? How do they deal with all of the pests and all of the insects? So it depends on the vineyard, it depends on how big you are. The larger industrial vineyards will absolutely use artificial herbicides. Again, it's all about fighting disease pressure. You know, most of it are culturalists, people whose job it is to manage vineyards. You have to care very much about the specific quality of the end product. Grapes have to be taken care of every step along the way, and so it's not like you're making something in bulk, like grain, which is going to be processed into flour. Grapes individually matter, so you do take these things into consideration. Larger skilled vineyards will absolutely use artificial deadly herbicides to kill weeds, pesticides to deter disease pressure from insects like faloxara, the spotted lantern fly, aphids, which are extremely deadly to great vines that eat the leaves, they grow eggs in the root stock. What about organic wineries? Yeah, so organic wineries are able to use their own host of preventative measures to fight disease pressure, including the use of SO2 spraying, which is the most common. All wineries, if they can, will use the spraying of either sulfur dioxide or copper sulfate, which are naturally derived and are used to fight disease pressure, like Downey and Powdery mildew, which is very common in vineyards across America. And so a lot of my friends will say, "Oh, I can't drink red wine unless it's not American, because European wine I do so much better with, but I get a headache when I drink American wine because of all of the sulfites." Is that actually accurate? Am I allowed to curse on this podcast? Well, you're my child, so I will say please don't, but I actually have a G rating. Okay, so it's all BS, I'll say that, it's all BS. Red wine headaches are an actually caused by sulfur dioxide, and interestingly enough, there are so many foods. I mean, next time someone tells you that, ask them the last time they ate a french fry or a piece of dried mango. You know, a small french fry at a fast food restaurant has way more sulfites than a bottle of wine. Way more, all dried food has sulfites, sulfites are everywhere, and they're naturally occurring. The ancient Egyptians used sulfites in their wine. It isn't sulfites that gives you a headache. Red wine headaches are caused by a molecule called Corsetine, which blocks the secondary via absorption of acetaldehyde, which is a metabolite byproduct of breaking down alcohol in the liver. So it's nothing to do with sulfites, it has to do with the nature of tannins and polyphenols in red wine. And why would America have more of that than European wine? It wouldn't, not necessarily in the style. I mean, if you're an American and you're drinking a big California cab, something that Americans tend to be partial to. You're looking at a wine that's alcoholic, extractive and very tannic. It will have more of these kinds of molecules that prevent your body from cleanly and efficiently metabolizing alcohol. European wines can be as big as American wines. They're huge swathes of Europe that produce hot, big wines. But there's also more variety in consumption, and there are regions that produce wines with less alcohol and less tannin. Okay. Your generation, all of you Zoomers are really drinking much less than predecessors, right? My Gen X or generation is still drinking. We're just getting older so we can't tolerate it as much. And I don't know if people are drinking less because everyone's on a glip one. And so they don't want to drink as much. But regardless, the Zoomers are drinking less. And it seems like the marijuana industry is booming. I hate going to New York now to go visit your brother because everywhere I walk, it's just the rancid, dead skunk smell of marijuana. Why do you think your generation is drinking less and consuming more marijuana? It's interesting. So I think it's a manifold problem. I think first, you have to look at marketing and that's not something you can ignore. You can't think, do not think of this as an organic grassroots trend. Don't think of cannabis consumption. The rise in cannabis consumption among Gen Z and millennials as an accident caused by circumstance. No, it's intentional. From the very powerful lobby behind cannabis, who have influenced recently legislation in the 2018 Farm Bill, legalizing the sale of THC, which is the main psychoactive ingredient in cannabis that's been derived from hemp, which is a part of the cannabis plant, but not traditionally considered to contain the majority of the psychoactive ingredients, like the leaf of the alternative variations of the plant. Why do we care that these tumors are choosing cannabis over alcohol? Well, I care for selfish reasons. Of course, alcohol is my industry. I want to sell my product. And I can have my own personal moralistic reasons about why wine is beautiful and what it does for civilization and for the soul and for community and for family. But no, from a health perspective, we should be very concerned. And this is after all a health care podcast, alcohol is something with which humans have a very old, very long relationship. The oldest evidence of wine production is 10,000 years old, caves in Georgia, vases called them forer. We're found to contain trace amounts of tartaric acid deposits, crystals that form in wine production, proof that humans were making wine in the mountains of Central Asia, modern day Georgia, and Armenia, Azerbaijan, as early as 8,000 BC. Beer is as old, if not older. The ancient Egyptians have stela, stela are our stones, tablets that have been engraved with images and text of rituals where couples and families, people engaging in business relationships will share beer out of a similar vessel with straws. But people will also say that beer was used and made in very low alcohol content because water was in drink to save. Water was not safe to drink and now that we can safely drink water, why do we need beer? But it was brewed in lower quantities and it was also drank more often. And the lower quantity, not lower quantities, lower concentrations of alcohol, it was diluted. It was brewed to it. They got very good at controlling fermentation through environmental factors, like changing the temperature, the amount of nutrition available to yeast, but at the end of the day they would brew their beer to their normal concentrations of alcohol and then they would dilute it with water. And that was again because in cities, like you said, water was unsafe to drink. But also beer, normal concentrations was enjoyed in addition to the sort of water down beer that was kept in homes for regular consumption. And so why should we be concerned? All Americans really, not even those just within the healthcare industry, that your generation is drinking less and using cannabis as an alternative. Right. Well, this goes to what I was saying before, right, alcohol, humans have a long relationship with it and we're very good at metabolizing it. Yes, there are always going to be people who struggle with addiction and people that will not be able to have a healthy relationship with alcohol. The same is true of any vice or any substance that has the properties of alcohol. It makes us, it lowers our inhibitions, it makes us happier, it makes us more sociable. And with, you know, with these things, right, however, the majority of people who over the course of human existence have safely and regularly consumed alcohol have developed a, a, a, almost like an epigenetic adaptation whereby we can metabolize alcohol more cleanly, more efficiently and more safely than any other mammal in the animal kingdom. Well, I wore an aura ring forever and I would sleep with my aura ring and I noticed that the nights that I had more than literally a half a glass of alcohol and I'm talking like a normal glass. Like if I had more than I'd say four ounces of alcohol, I didn't sleep as well and my aura ring increased my heart rate. So would people look at that and say, hey, actually alcohol maybe is not good for consumption? No. So what you're experiencing is, is just a normal facet of alcohol, which is the evidence suggests that if you are interested in getting a good night's sleep, enough REM and deep sleep, you shouldn't consume alcohol within an hour or so of going to bed. That's well known because alcohol, the metabolism of alcohol will raise your heart rate and also alcohol has mood effect of properties. There's nothing wrong with consuming it at meals in the evening, but if you're concerned about sleep, then certainly don't drink in the hour or so before bed. Also, various personal factors, women metabolize alcohol differently than men less efficiently because of just various biological realities. Different people of different backgrounds, different ethnic groups have different natural inclinations toward faster, slower alcohol metabolization. Well, I have a good friend who's married to a man from Singapore and she always says, oh, don't worry, he'll be our designated driver tonight. So it always makes it a little easier because he actually can't drink alcohol and he is of Chinese descent. So was it actually something that was consumed as often in the Orient or in the Asian culture? So it's interesting, actually, the Orient has its own relationship to alcohol that is very different than that of the oxidant, the yeast in the West. They had different ways of making it, literally different ways of producing the necessary monosaccharides for yeast to metabolize. In the West, brewers would molt barley to encourage amylase enzymes to break down complex sugars to allow yeast to perform alcoholic fermentations in the East, in the Orient, they would use Koji, which was a sort of symbiotic relationship between aspergillus or asifungus and this is all very technical. My point is it's interesting. So is alcohol actually good for us? Yes. Alcohol in the basic consensus of science and history is this. Small doses of alcohol, a couple glasses a day for men, a glass for two a day for women, specifically, naturally fermented alcohol. So this excludes distilled beverages. Every time you have a glass of whiskey, you are doing something inherently unhealthy, just like every time you eat an Oreo, every time you have a cigarette, right? You're making an intentional choice. You're saying, "I know this thing is not good for me, but I'm going to weigh the joy that I experience from having that glass of McCallan or having that cigarette or having that whatever and say it's okay in this one moment. Vine is different. Regular wine consumption has been shown in every single serious, and this is where the term "serious" matters because there's a lot of junk science that's come onto the playing field in the past 10 years or so, mostly funded by big cannabis, interestingly enough. But most of the serious science is very clear that moderate alcohol consumption isn't just neutral for your health. It's good for your health. It increases your resistance to stress and lowers your body's production of catocholamine hormones. It improves your happiness and overall health related to happiness and mental health by increasing the value and bonds of community and friendship. No, wine itself contains powerful antioxidants that fight cancer and free radicals. Resveratrol is the main one, which is why red wine has been touted forever as a powerful antioxidant in antichristinogen. So why do you think there's been a lack of consumption as kids are younger? Really, the zoomers, I would say the younger millennials, your brother's girlfriend doesn't drink alcohol, but she doesn't use cannabis either. But there's definitely a more of a sober mentality, even aside from the whole cannabis situation. But there's a sober mentality in your generation. What do you attribute that to? Well, I think we can delineate between sober mentality and methods of intoxication. I think that's a place where we should be clear. I think that young people, listen, at a certain point, you have to understand that it's about the battle of generations. Bourbon is a great example. You know, the James Bond era drinking clear liquor, things like gin and vodka. It was very popular. One who was born watching the James Bond movies wanted to drink a martini. Why? Why was James Bond a martini drinker? Why did he prefer clear liquor? Well, because his predecessor is the GI generation who fought the war. Their cheap drink of choice was dark liquor. It was bourbon. And they wanted to distinguish themselves from what they viewed as their parents' generation. The people who came before them, the old people, were young, were cool. We're not like our parents. We don't drink brown liquor. We drink vodka. In many ways, it can be understood as that, a sort of repudiation of previous generations. Millennials turning to cannabis is a better, cooler, cheaper way of getting high or intoxicated. That's one. Number two, there is a social contagion factor caused by an intentional industrial advertising and lobbying powerhouse, a campaign in public media and in popular culture that's been pretty constant for the last 20 years. I remember no TV show from the, every time from the early 2000s or before, would comfortably show people smoking weed. And if they did, it would always be understood to be in a listed thing, something that was shameful, something that you did privately. Now I mean, go on a TV show, couples are getting high in the evening to wind down before bed. But they're kids. I mean, it's crazy. Which is crazy, because I always tell you and your brothers, it is the stupid drug. Do not use pod, do not use marijuana. But you grew up drinking wine. I allow that. I know you didn't get sloshed, but I didn't make it off limits. And as you smirk and I say you didn't get sloshed, at least under my tutelage and at least under my oversight. But I've been very clear about my dislike of cannabis and I have been more accepting of yes, you can have a glass of wine with dinner if you don't feel like you need to study at night or you're 16 years old and something, everything in moderation, right, except cannabis. Why is cannabis so bad and why are you? Because you're hugely involved in support of the, I don't want to say food and drug administration but the work that you've done in DC for the wine growers and your very anti cannabis usage. What are you seeing as the future with your generation continuing to use cannabis the way that they are? Oh, I totally see a cliff. So, I mean, this is going to be a minute, but let me lay out the playing field. Let me give the exposition. Like I said, alcohol, humans have a very, can have a very healthy relationship with alcohol and more often than not do. We're good at metabolizing it and we've been doing it for a long time. So, cannabis is different. The main psychoactive ingredient in cannabis, the stuff that people are using to get intoxicated get high, THC is a very powerful psychoactive chemical that actually lingers in the fatty tissue deposits of the human body and can be detected in cerebral spinal fluid, literally past the blood brain barrier months, even years after consumption. Wow. You have a drink, the general consensus is that a single serving to find is 15 grams of pure molecular ethanol, so one beer, one glass of wine, one shot is pretty much cleanly gone in a half hour and there's a curve to it that isn't neat. It's not linear. So, the more you drink, the more that changes. But one drink about a half hour for most people, except if you're like your friend with the Pan Asian flush response and can't drink at all, I feel so sorry for him. And designated driver. Yes, the designated driver. Cannabis is not so. The psychoactive ingredient, THC, will literally float around and settle in the fatty deposits of your brain, vital organs and other tissue throughout your body and stay there. Sometimes floating around and causing further damage, as free radicals, causing inflammation for literally years. This is a terrifying thing. I don't think that my generation understands just how dangerous cannabis is and how it's not something that can be regularly safely used like alcohol. I like to, so I've had to make this argument before, not just in front of you, but in front of all of the people I talk to, policymakers, professors, my peers, even. I like to talk about how in the 1920s, everybody smoked cigarettes and everybody thought it was great. I mean, cigarettes were actually often prescribed as medicine. Doctors would have ads in their office saying things like seven out of 10 physicians choose Marlboro as their choice of cigarettes, literally. And then the 50s came around and everybody still smoked, but the literature started to appear and people slowly started to know it was very quiet, but people knew that it was bad. And it was kept hushed by the big cigarette companies and everybody still smoked and nobody really talked about it, but it was starting to become new. And then the 70s came along and the cat kind of got out of the bag and you realized you just killed an entire couple of generations from emphysema and everything else that comes with smoking. You burdened the American healthcare system by trillions of dollars with how many thousands of Americans die from cigarettes and smoking every single day and litigation ensued. Big companies like Philip Morris and Newport were literally litigated out of existence. And now it's the 2020s and nobody smokes. Smoking is uncool. If you smoke you're a pariah, you know, you have to go to that weird, creepy section of the airport and look stupid while you smoke. You know, it's intentional and we're very successful at it. I think that right now with cannabis consumption, we're in the 50s, meaning a lot of people do it and it's very popular, but the body of literature that's coming out proving how dangerous it is is quiet and emerging and growing. And I'm just, I'm just really not looking forward to the period of time generation from now, 20 years from now, when, you know, we're in the 70s, essentially, where now we know really clearly how bad it is and we realize that we really just destroyed. We screwed over an entire generation by letting them believe that this was okay. It rots your brain, like you said, and it should not be treated with the same laissez-faire attitude as more common intoxicants with greater health benefits, like alcohol. What do you think of those who use gummies to sleep, so they need sleeping pills? It's the same thing. Okay, I will say this. Smoking any, ask any of the many physicians who listen to your podcast. Smoking anything is bad. There's a reason why smoking a drug has never, ever been an actual approved means of prescription, like a delivery of a drug. You could inject a drug, you can even snort a drug, but you cannot smoke a drug. Smoking is bad. Every time you light something on fire, you produce carcinogens. That's just the nature of combustion. Smoking is bad. So yes, by eating an edible, you are, you're avoiding that pitfall, which is to say smoking a drug. But you're still ingesting the same active ingredient, THC. And what does that active ingredient do in the long term? And what about those who are my age? So I have a lot of friends who use gummies to sleep every night. I can't tell you how many times I'm offered, and I say the same thing I always say. I don't give them my whole song and dance about the fact that I think it rots your brain. But I do say that it's not something I use, and my body does not react well to it. That's literally all I say. And my friends are cool about it. But oh my god, I have, I know so many people use gummies to sleep. What is their trajectory? It's everywhere. And you know, it's like they say, and I'm not going to age myself awkwardly by saying this, it's not your grandfather's pot. The stuff that's being produced now is not the natural low potency cannabis that was smoked by the hippies in the 60s and 70s. It is much different and much worse. That kind of pot was not nearly as addictive because the intense psychoactive effects weren't nearly as severe. More importantly, it was cultivated as a plant, and there was a unique sort of cultural relationship with the thing. People were, it was counter-cultural. You have to remember that this is the crazy thing, cannabis is still a schedule when substance federally. Like marijuana is on the same legal category as heroin and cocaine. And methamphetamine, according to the federal government, and the same prosecutorial discretion applies. Like, this is not like something that, and yet everyone's doing it, how, how is it? How is it that a drug that, according to the federal government, is scheduled the exact same as methamphetamine and cocaine and heroin is being as openly a lauded and enjoyed by so many people. And that has to do with some very clever legislation, some very clever marketing and some pretty nifty science. And it's really interesting, and I don't know how many people are aware of this, but at least everybody knows in the state of Florida, or at least if you live in the state of Florida, we have medical marijuana which takes your dad off of the in-yang. But we allow for medical marijuana. And it isn't still not legal on the national level, so if a patient comes in, you actually have to separate your two businesses and you cannot bill insurance if you're dispensing medical marijuana, you have to have a whole different business plan. You can't speak about the medical marijuana or recommended or you can't count any of that time in the time involved in an ENM visit or an office visit for a patient. It has to be completely separate. And we're very clear about that when patients come in, do we document that the person uses marijuana? I mean, we document if the person used heroin, right? We document if the person used any of these medications. I wouldn't say. I wouldn't be put heroin is much worse than cannabis. If you have to choose, please, I beg you to choose cannabis. Over heroin. Yes. Okay. But we have to put down everything elicit, everything that is prescription. We do because it helps us best take care of the patient. But what I'm concerned about is how much it's going to cost our healthcare system in the future that we are legalizing this in so many states. Not legalizing. Again, it's a complicated, it's a legal fiction. It's a very complicated system that allows the production, manufacturing, sale and distribution of cannabis to even exist. I will say this, we're already seeing an entire generation of Americans, our generation, my generation, Gen Z appearing in emergency rooms all over the country with extreme psychotic symptoms as a result of cannabis over use. And it happens one of two ways. The first way is you're someone who's been using cannabis in these modern high potency forms for a long time. And over time, it deteriorates your brain and causes severe mental illness. The second thing that happens is you overdose. You happen to take a lot of cannabis in one moment and then you develop these symptoms. Either way, we're already seeing the healthcare strain as physicians in hospitals around the country are struggling to identify a serious cannabis induced psychosis and mental disease in young children. Children, I've read case studies of children as young as three or four who get into their parents' gummies thinking that it's just another snack and end up in the emergency room on life support. That's a terrifying thing. So what are we doing? What can we do? What is the USDA doing? Right. Well, that's a good question. Let's start by identifying how this even exists in the first place because I think we've just made it clear that the Fed's treat this just as much as just as seriously as if it were heroin or cocaine and yet the state efforts don't seem to matter. Every couple of years, the United States government, the agriculture, the agriculture department passes a farm bill through Congress. That's our version of Europe's cap, common agricultural policy. It's an economic policy bill designed to regulate America's massive, massive agriculture industry. I mean, if you think healthcare lobbyists and big scary actors like the PBMs are frightening monsters, I mean, you should see the kinds of people behind the corn lobby or the soybean lobby. They're much scarier and they have much more money. I think that gives a really good visualization to the people who listen to this podcast. It's genuinely terrifying and they've been doing this for so many decades that their entrenched interests are profound. You also have to look at, on a side, no representation, right? Of course, the Senate is equal to a two Senator representation across the country. If you consider that many states in the heartland and around the country rely on agriculture, the kind of influence, you know, if you're representing a district in LA, you don't care about agriculture. But if you're a state setting Senators to Congress, you care about agriculture and agriculture is going to have a huge, the lobby is going to have a huge financial impact when your campaign and your ability to run for office. And so the amount of money poured into to funding Senate campaigns on behalf of big agriculture is truly astounding. Well, I've taught you a different golden rule than I've taught my listeners. Do you know what I call the golden rule? The one with the gold makes the rules. So you know that those who are doing the lobbying efforts and big tobacco and big marijuana and all of these huge industries are out there sharing that it's oh, so great for people. So how do we create change and how does the FDA get involved and what do we do with these farm bills? So I'm going to shock you right now. The FDA has no oversight in the majority of cannabis that's produced and released in the country today legally. The issue which should just astound most people who oversees it, the USDA. So this goes back to that loophole. So the kinds of cannabis that's being consumed now isn't, doesn't come from the actual marijuana plant, the way that a lot of illicit, unless it's in a state that does allow the growing and manufacturing distribution of marijuana plants like California, like California. But that is not, that cannot travel interstate and that doesn't account for the wide accessibility of cannabis. Most cannabis products are what's called Delta 9 or Delta 9 style THC, which is extracted from hemp, which is a similar plant to the marijuana plants that are grown in California, but is, but does not contain large quantities of the psychoactive ingredient THC and is used historically for its fibers to make clothing, chairs, boats, that kind of thing. And from these hemp seeds through a very tedious chemical process, companies can extract THC. So the farm bill that just passed in 2018, our agricultural policy bill that went through Congress in 2018 allowed the extraction of THC and small quantities from hemp seeds. And this is what began the explosive growth of widely available cannabis products, even in states that don't, that highly regulate marijuana. Is there any way to pull it back? I don't think you can pull back the legislation without pulling back the culture first. I don't think this is solvable as a top-down issue, things like this rarely are cigarettes weren't. I don't think this will be either. Well, in Europe, your dad and I love taking photos of the scary cigarette packages of like you have impudence or you have no throw or you are going to give birth to a stillborn baby. I mean, these horrific, horrific visuals on the cigarette boxes if you smoke. We don't even see that in America though. It's amazing, isn't it? So in America, all you need to put on a box of cigarettes, besides all of the terrorist taxation and regulation, is a simple surge in general warning, letting you know that it causes cancer. And there are other things like stores that sell cigarettes are required to post all of the settlements against Newport and Philip Morris, things like cigarette companies intentionally add enough nicotine to keep you addicted and keep you smoking cigarettes. Smoking kills 15,000, you're 1,500 people a day in America. But who reads that? Right. But in Europe, you have every cigarette box by law has these extremely graphic horrifying disgusting pictures that have to cover at least a third of the volume, or the third of the surface area of the box that has decreased the usage of cigarettes. No, so actually Europeans smoke a lot more than Americans. America is the most anti-smoking culture in the West. And it's important to remember that we're kind of the only one. The rest of the world still smokes. The Middle East loves cigarettes. So does Europe, Western Europe. So does China. China consumes an enormous supply of cigarettes, including other countries in the Eastern hemisphere, Central Asia, Russia, cigarettes are a public health concern for the entire planet America is just somehow in a strange way succeeded in creating strong and enduring social stigma and enough oppressive regulation that cigarette companies keep to the background. Do you think it stems from our puritanical upbringing in America? It's interesting. I think a lot of our cultural habits, whether we realize it or not, are a consequence of the puritanical origins of American culture, a country founded by reformed Calvinists. So severe that they make Shiites in the Middle East look like a modern day, you know, dancing, singing hippies. It's a little ridiculous. I mean, look at the witch trials. I mean, that's one of, I mean, you know, they lasted for only a short while and they didn't really end up with many dead witches, but that was the kind of attitude that was common across New England when our, well, not hour were, you know, were Ashkenazi Jews. But when, you know, the founders of this country came to build it. So how are we going to create change because it is going to increase the cost of our American healthcare system? We have a culture around the approval of using THC or cannabis. What's the option for us? So I will say that I am pessimistic on the ability of regulators to, and the influence of regulators to stymie this, this increase in consumption, I think that it will be natural as the consequences become apparent. And I know that's a really tragic thing to say, but I don't really see any other way. It's how it happened with cigarettes. It's how it's, it's even, I mean, you know, the, who knows? I mean, a problem like obesity, right? That was, that was, you know, we look at the wide availability of lip one drugs, which are turning what was once, talk about a puritanical approach to a problem. You know, I would argue that a lot of American culture around obesity and being fat in general was driven by this idea that, you know, if you're fat, you're greedy in gluttonous. And if you're greedy in gluttonous, in order to become thin again, you need to suffer for redemption. You know, this, this sin-suffering redemption arc that's very common in puritanical narratives. You know, you need to die. It needs to be painful, you know, as opposed to, you know, no, my food that I've been eating, my entire life is hijacked, my body. It's not my fault. I have a disease. I take a medicine to cure that disease and protect my body to it, to, to, to, to make my body resistant to the terrible things that we put into it as a consequence of our culture. And look, I'm thin again. So I mean, it could be the kind of thing where we come up with some magical technological problem that's stymies the growth of cannabis or brings us back to a better place. But we have to figure, but we have to figure out within our culture of what makes it a negative. Because what I'm hearing from you is it's acceptable. It's not acceptable to be obese. And while all of these famous people wanted to say everything they wanted to about body positivity, the truth is it wasn't healthy and people did penalize those, right, who were obese. And yes, it was, it is the number one cause of illness in the world. In America, we definitely feel the repercussions of it. But again, what do we do about the cannabis usage? And if wine is healthy, how do we increase that consumption? So yeah, to answer the first thing, you know, the, the fat activists and the social movement around obesity, what existed because rather it, we shouldn't be focusing on why it existed. We should be focusing on why it disappeared. And it disappeared as soon as it was able to disappear. And the thing itself became so painful that is to say the consequences of obesity, that the moment they had a, a drug to cure the problem, Ozonepec, you know, we go over all these lipone drugs, no longer were you obligated to say that it was great to be obese, because you solved the problem technologically. And there was no social reason to want it anymore because it's just so awful for the people, for the people who, who have to endure that. And so with, you know, with this, I really don't, I don't see, unless there's an amazing technological solution, because again, I think that the consequences of cannabis consumption will become even more apparent. Right now they are obvious to anyone who's looking. I mentioned cases of six-year-old sent to the ER, college students across the country, showing up at doctor's offices and therapists, with increasing diagnoses of mental health disease, another kinds of manageable ones, either like ADHD. No, no, no, I'm talking about severe psychotic episodes that require people to be withdrawn from society and their entirety, completely removed, a terrible debilitating mental health disease as a result of consumption, and it will only increase. And when it gets to an unbearable point, society will shift. And in May you graduate, and you're going out to California and you've done three internships, one in, which I always joke, because you laugh at the way I pronounce it and correct me. But should the noof the pulp? It's okay. The French would laugh at you too. Okay. France. And then you did the finger lakes and then you were in Napa already working a harvest. And you're going to go back to California, probably the Napa area. When you graduate, is there a need for, please say there is, is there a need for people with your experience in your degree, or are these wineries closing shot because the production has had to drop because the demand has dropped. So there's less of a supply, less, hence less people they're needing to work. I mean, my goal, Dalton, is that you get off my payroll. That's my goal too. Now, I don't, I don't, first of all, there's always a need for people like me. It is people with passion and people with a, a, a vision and an understanding of why they do what they do. I have a clear understanding of what I value about wine and the industry as a whole and why I care, which matters, regardless of what your industry is. I think that, no, that, that's, that's an unfair misrepresentation. I don't, there's, there is a decrease in consumption, but it's a demographic decrease. Maybe boomers, Gen X are continuing to consume the same amount of wine as before. Millennials are consuming the same amount of wine, but they're drinking cheaper wine. Well, actually, they're drinking middleing range wine, so they're not drinking ultra cheap wine. They're actually scaling back on the Francia and the Barefoot, and they're, they're splurging on the, the 20 to $30 price point is where millennials are really thriving. And the ultra premium stuff, the $100 bottles, the $150 bottles, that stuff is, is delegated to the baby boomers with more disposable income, the, the Gen Xers. Yes, it's only Gen Z and now with recent data, Gen Alpha, that are starting to decline in their consumption of, of alcohol, but it's not wine. I mean, younger drinkers in America have never started with wine. Wine is a statistic, it's beverage. You know, young, young people in America have always started with, with hard liquor and beer. Because it's, it's, it's cheaper. It's less refined. Generally speaking, I'm, you know, of course, that's not fair to all of those great beers and liquors out there. You know, wine is, wine, wine requires always a little bit of age to appreciate it as fullest. But we're actually seeing the Chinese take on a lot of these California wines. Opus 1 is essentially shipped directly to China for their market. Yeah, well, that's, that's also a price point, but Bordeaux has been doing that since the 90s. And that Bordeaux has been, because this becomes so expensive, the greatest states, of which Napa, Opus 1 is essentially just like the sixth greatest state of Bordeaux. In terms of, it's a wine that sells regularly for, you know, hundreds of dollars, you know, to a consistent market demographic. That's been shipped over to the far east for a while now, Singapore, China, Japan, South Korea, because of just different cultural and drinking habits. And the fact that China now has a very large millionaire class because of, you know, various economic policies and their inclusion into the WTO and whatnot. And one of our favorite wineries, Schaefer, was Doug Schaefer did not have his children wanting to go into the wine industry and he didn't have succession planning and he sold to a South Korean company. Again, you have to understand you're looking at the ultra ultra ultra premium category of winery. Most people aren't drinking a bottle of Schaefer, which, you know, hillside select is $350 a bottle. That appeals to people with tremendous amounts of disposable income. People who have already made it, people in the Gen X and baby boomer categories. It, most people are drinking wine between the categories of 20 to $30. And in that vein, production is decreasing, not in wine of average, or what we call premium, premium is anything above 1999 in the American market. Ultra premium is anything above $39.99, which is, yeah, less than you'd think, right? But the threshold is low because most, because before now the market was such that most wine consumption by overall sales was in the cheaper wine, not the more expensive wine. So the expensive wines, wines over $20 are selling and producing just fine. Its company is big conglomerates, like Constellation, which owns dozens of brands across the world, including Madello in America, the beer, or Gallo, which owns Barefoot. These are scaling back, Barefoot is scaling back, Francia is scaling back, because there's not enough demand to meet the supply of millions and millions and millions of cases of very cheap wine a year. But wine is a category above the $20 bottle threshold is doing just fine. So to bring this back into working healthcare and why I had you on this podcast where, listen, Dalton, you're always a wealth of information, and I really love that I got to have this one on one time with you for nearly an hour. Oh good. Did you say me too? Yes. Oh, yay. If you could create one change within the American healthcare system, and I say that because you have a father who's a doctor, a mom who's in healthcare, a grand father who's a doctor, multiple uncles and cousins who are doctors, and you said, mom, I'm going into healthcare too. That's sort of a different sector, so I'm going to say, if you could create one change within our American healthcare system, what would it be? Well, for starters, I would see the aggressive hyper regulation, I mean, even diehard regulators would be offended by the intensity and the veracity of my desire for this kind of regulation. Really, I mean, Europeans would blush, you know, of cannabis and the production. But again, but this also isn't the FDA's purview. The way cannabis is produced legally now is the purview of the USDA. You know, wine and alcohol aren't even regulated by the USDA and FDA, they're regulated by an esoteric old branch of government that's actually a department of the treasury. The treasury has it within the ATF, which regulates firearms tobacco and alcohol, has the TTV, which is responsible for setting regulations for the production and distribution of alcohol. That's why wine labels don't need things like nutrition facts. Have you ever wondered why that is? All food, all beverage, everywhere requires nutrition facts, but not alcohol. That's because it's regulated by the treasury, not by the department of agriculture, different regulations, different requirements. And proof, right? You have to list the proof. Exactly. That's also a treasury regulation, and we could have another podcast on the histories behind that. Right. That's fascinating. Not healthcare, but, you know, it's interesting. Dalton, thank you for joining me on working healthcare. Thank you for having me. This was great. If this conversation hit home, or made you think a little differently, don't keep it to yourself, share the episode, tag a friend, or post about it on social media. Connect with me on LinkedIn to keep the conversation going in between episodes. If you've got a question, an episode idea, or someone you think I should feature, send me a note at MeredithHersh.com. Thank you all for the five star reviews. They help more listeners find the show. New episodes drop every Tuesday. Subscribe so you don't miss what's next. Tune in weekly, as we explore the inner workings of healthcare, because you can't fix what you don't understand.