Head Inside Mental Health
Todd Weatherly, Therapeutic Consultant and mental health professional hosts #Head-Inside Mental Health featuring conversations about mental health and substance use treatment with experts from across the country sharing their thoughts and insights on the world of behavioral health care.
Head Inside Mental Health
Unraveling Cannabis and Mental Health with Dr. Rocco Marotta
What if the rapidly increasing potency of cannabis is silently fueling a mental health crisis? Join us on Head Inside Mental Health as we sit down with Dr. Rocco Marotta, a distinguished psychiatrist and neurologist with Silver Hill Hospital, to unravel the intricate link between cannabis use and psychosis. Dr. Marotta shares his compelling journey from a liberal perspective on cannabis to a tale of caution, shaped by firsthand experiences in the medical field. Explore the complex divide in cannabis perception—some hail it as a remedy for anxiety and pain management, while others see the potential dangerous consequences, particularly in psychiatric settings.
The conversation takes a critical turn as we examine the skyrocketing THC levels in modern cannabis and the resulting public health challenges. Discover the staggering increase in potency from Woodstock-era levels to today's potent strains, with some products reaching up to 80% THC. This shift places our youth at an unprecedented risk, raising urgent questions about substance use in schools and the role of education in mitigating these risks. The episode amplifies the need for systemic support and informed discussions to address these pressing societal issues.
Hello folks, thanks for joining us on Head Inside Mental Health, featuring conversations about mental health and substance use treatment, with experts from across the country sharing their thoughts, insights and practice perspectives on the world of behavioral health care. Broadcasting on WPVM 1037, the voice of Asheville, independent commercial free radio. I'm Todd Weatherly, your host, therapeutic consultant and behavioral health expert. With me today I have the widely esteemed Dr Rocco Murata, affectionately known as Rocky. I can say that in the world of neuropsychiatric treatment, rocky is a fitting comparative icon.
Speaker 1:Dr Murata is a board-certified psychiatrist and licensed psychologist with fellowship training in neuropsychology. He serves as assistant clinical professor at Yale University and associate clinical professor for psychiatry at New York Medical College. He holds a PhD in psychology and neuroscience from the City University of New York. He completed the National Institute of Health Fellowship in biology, psychology and psychiatry and is a fellow of the American Psychiatric Association.
Speaker 1:For decades now Dr Murata has been the service chief for the adult residential program at Silver Hill Hospital, serving those with complex neuropsychiatric conditions, and the director of their Center for Treatment Study of Neuropsychiatric Disorders. His pedigree of credentials and accolades are these and many more. But I got to be with Dr Murata in Connecticut for a conference hosted by Silver Hill Hospital, where he gave a very insightful presentation on the dangers of cannabinoids and their use, and specifically, as it relates to individuals suffering from psychotic disorders and experiencing psychosis as a result of drug use, and the epidemic that the hospitals are experiencing because of the young adults that are experimenting with drugs and other kinds of things, and especially the high dosages of THC that are in the products that are coming out on the market. First of all, dr Murata, thank you and welcome to the show.
Speaker 2:It's a pleasure. I have family just across the border in South Carolina and in Chapin and Columbia and in Charleston. I'm a secret Charlestonian.
Speaker 1:You're a northerner feeling, the southern draw. I can feel it.
Speaker 2:You come in this way I jokingly say we're of southern Italian extraction, so Charleston is very sympathetic to us.
Speaker 1:Those stoic Italians right.
Speaker 2:Absolutely stoic.
Speaker 1:Well, you know, I tell you I enjoyed your presentation and one of the issues that I think that shows up is that you've got this big segment of the world that feels like weeds Okay, and you know they. There are people out there who are daily users. They experience benefits from it, whether it's reduced anxiety or medical symptomology. You'll even get medical medical doctors saying that cannabinoids are the answer in the medical industry to the opiate epidemic. If they start switching from one to the other for pain management, they're going to get a lot better results.
Speaker 1:But in a psychiatric hospital, watching people come off the street with these high doses of THC and whatever they're taking and having psychotic features or launching latent psychosis, and having psychotic features or launching latent psychosis and you know you gave some numbers and I'm not prepared to cite them, but I mean they are incredible in terms of what the psychiatric hospitals are experiencing. What's the solution Like? How do we bridge the divide between these two kind of interested parts of the society? One says it's okay, one it's definitely not. Where's the middle? Where's the middle ground in your view? What's the solution to that?
Speaker 2:These ideas, these processes are really complex and I don't think I could just say this is what to do. Right, I mean I jokingly, but it's true. I was at Woodstock and I lived in a commune for a while when I was a kid, in college, and so I didn't think of cannabis as being dangerous, but I did see things happen in my dormitory. People had psychotic breaks. We didn't know, but we didn't know what it was. We just thought somebody was weird, you know.
Speaker 2:Right and my changing positions over the years to being opposed to its general availability came out of working in hospitals Now. So I was raised in a very, very liberal progressive. You know left-wing New York environment, politically and socially, and you know my sainted mother-in-law once had tea with me and said you know what's happened to you. You used to be such a Kachotskyist and I actually said to Mr Doug Rester if you're a physician, you see things in the world that people don't normally see. You see the vulnerability, you see the suffering and when you see that, know you have to if you're trained as a scientist. Also, you have to say what is what is really going on around us?
Speaker 2:Right, and it's especially difficult with something like cannabis and psychosis, for example, where it's not everybody, it's not like everybody who's young. There is a vulnerable sub-population and it's another thing about it is that there's a vulnerable period of exposure. And so to try to make sense of what's happened, you could talk about it historically over generations, because you know, in India in the 19th century and over the 20th century it was the suspicion of many physicians that cannabis was dangerous and they even made the connection that it was the potency. You know, a little bit was fine. You could use it in religious ceremony. High potency cannabis was dangerous. Interestingly, this is discussed in Berenson's book on the history of cannabis. You know, in Mexico outlawed cannabis Long before he did Because.
Speaker 1:Isn't that fascinating.
Speaker 2:Yeah, and they outlawed it because when, when cannabis was introduced to that culture, which was late in their history, which was again in the 19th century, they saw a change in behavior.
Speaker 2:this, they saw violence, they saw psychosis, right right and and so on our side of the border we didn didn't. So these things to me are fascinating. So you could see a case of somebody especially say to me it's fascinating because I was trained at Cornell. So Cornell Medical School is in New York City, not in the countryside where the university is, and we were in a very nice neighborhood of Manhattan, but we also I also did research at St Luke's Hospital, which was on the edge of what that at Columbia University was essentially on the campus, but we, we took the patients from the border outlying regions, and so what I was seeing as a young doctor and researcher was the difference in exposure, right, so the difference in the age of starting and the potency of the medicines, so that the degrees of bizarre psychotic behavior uptown were much, much worse than the degrees of behavior on the east side of Manhattan, which in my early time was like they used to call this sort of the silk stocking region. You know it really, you know beautiful townhouses etc.
Speaker 2:It was, and but you didn't know exactly what it was. Was it the family structure? Was it stress? Was it the co-exposure to alcohol and cocaine? And all those things were true, but there was something percolating through that there, which is that kids were using really early in one part of the city and later in the other. But by 1980 or so that was changing. And now you know the estimate is that in New York City roughly a quarter of teenagers high school students use cannabis on a regular basis. Yeah, so that's an amazing number to me. So, but you don't necessarily see change instantaneously if something depends on dose, potency, right and time of exposure and if there's a critical period, and then something will appear, not instantaneously but begin a process that appears over years.
Speaker 2:It'll take you years to clearly see what's going on, right. So so what we began to see in, say, the 70s and 80s, I think only has become clear now as we've changed into a new century. So there's hints of that data all along as being there, and the United States keeps terrible medical records of things compared to Okay so, whereas certain other parts of the world don't, a place where there's incredibly good medical records is Scandinavia, where everybody's in the system as a number. So they're not following you as a person, they're following you as an entity in a mathematical space.
Speaker 1:Well, the health care is freely available. So your participating demographic is everyone and you've got their record from birth, right, you know you even know what medicines they've taken, what the doctor said.
Speaker 2:So you can actually access on the computers enormous piles of data. So I'll try to work through it a little bit. So they've known since for over a hundred and something years to take one terrible illness, schizophrenia, which is a chronic psychotic illness which is often terrible, debilitating. People don't work. They never marry. Not every one of them, large percentages of them. In Western countries roughly 1% of the population exhibits some form of that illness. Right, and so you could see changes in long-term data in scandinavia and it was pretty stable until the last 30 years and it began. The incidence rates began going up a little bit, but you couldn't tell what it was caused by right at the turn of the century, basically yeah, the last century not yeah, yeah, right
Speaker 2:yeah, yeah and and so you get a report from an interesting report of that from Finland. And then you know in Denmark somebody notices something. You know and it kind of has that. You know it's bleeping. But the numbers that have come out in just the last couple of years, especially in the Danish data, which is pretty strong data, is that the rates are accelerating and that the rate may have increased. In other words, that the number of cases that are building up is about a quarter more. So, instead of moving towards an incidence rate higher and a prevalence rate of over one and a quarter, that means that over time take the United States right. So if we have an illness with a 1% rate in the whole country that's like 160,000, 180,000, how you count it cases right, you go up a quarter. You're going up a lot of cases. That's a lot yeah.
Speaker 1:We would call that statistically significant, would we not?
Speaker 2:Yeah, so you have a lot more people to take care of. I mean Lou Berenson in his book on this. You know, goes over it in some detail, you know, and so you have these numbers going up. So those are the chronic cases. Those aren't just kids coming to the ERs having trouble. Those are the cases building up that will be in the system. That will demand enormous time and energy. So you have that going on in one place and then you have the overdose business going on, right.
Speaker 2:Right 120,000 overdose deaths reported, and we begin to get a feel that the younger generation is being exposed to early death from overdose, exposure to violence, with relatively high rates of accidents, and now even this. And so what are the factors? Well, one of the factors seems to be exposure to cannabis. So you take New York City, you have a half a million kids almost in the teenage years. Right, if you say 1% of half a million, right, you know what are we talking. That's 50,000? 50,000. 50,000. Yeah, that's right, out of that cohort, over the next eight years, 50,000.
Speaker 2:And then, if it goes up by you know the percentage, it's another 10, 15,000 cases, minimal, of a chronic debilitating illness. I mean, how do you so? On one hand you could say, well, yeah, sure, 50,000, but the other millions don't have it. But the physician has to deal with and treat the kids who are sick, and this is an illness that not only affects the individual, it affects their families and it affects their families, it affects the culture.
Speaker 2:In the 1960s, in the whole country there was 500 and something thousand beds in hospitals for psychiatric patients, a lot of them in state hospitals and stuff. Now the number is under 50,000, and so it's not strange. If I go downtown in manhattan and I get off the grand central, the main train station, you know that you literally are stepping over people sleeping in that beautiful grand concourse there, which is like a work of art right. And if you go down in the streets it could be raining or pouring and cold and there are poor creatures living in the streets and everywhere. Well, those people should be cared for. They should be in a hospital. They're ill.
Speaker 1:You and I are in a bit of a minority, thinking that everybody should receive care at whatever level they need it. I'm with you there, but we know that it doesn't happen.
Speaker 2:Right. And so, you know, world-class people are walking to dinner at a fancy expensive restaurant and stepping over people in the streets. It's out of a bad, you know movie of the medieval times, right, yeah.
Speaker 1:Well, and you know it begs some of the other questions. I think that you're pointing at some of the desensitization that happens. Right, the most dangerous thing to human life is an automobile, technically speaking. You're riding around and three or four tons worth of metal and people die every day on the highways, et cetera, et cetera, and and and a lot of these statistics.
Speaker 1:I think it got used with the gun argument, it got used with all kinds of other things, but they're used to diminish and minimize, um, the severity of what's happening to people when they interact with this substance. Um, and they did it for years with opiates. And then, you know, we went, however long, and then all of a sudden it's like, wow, these numbers are. They went from the numbers that you're talking about 50,000, and then another half percent, maybe 25 more, or 15 more thousand, and then all of a sudden you're talking about millions, you're talking about a great percentage of the population, and suddenly you've got the epidemic. You know, um, and you know, I still don't believe that it's that you should put people in jail for substance use, regardless of the legal or the illegal or the whatever else, like putting them in jail mainly because that's not a care environment, right, um, and alcohol.
Speaker 1:Of course, you know there's plenty of individuals who suffer from alcoholism. There's plenty of individuals who are in recovery and are able to successfully be around places where you can buy alcohol anywhere and still manage to stay sober. So there's this practice of theirs. But I think that THC is a bit different in its scenario. Now, one thing I think is one thing I think is you know, there's not so much of an alcohol content in alcohol that you can buy. You go to the ABC store. You have to have a license to buy something that's over and above a certain percentage alcohol content, right? We don't have that with thc we have.
Speaker 2:I mean, I live on the um, the border of new york and connecticut. Now, all right, and the laws are different, depending on if you can see this here in my mailbox encouraging me to buy my cannabis products on one side of the border or the other who has the highest potencies come to us because you could buy greater quantities at a time, and so we live in a region where you could go to four different states and purchase, and so they're now fighting over market share right.
Speaker 1:Yeah, that's right.
Speaker 2:What's the thing you know it's about? You know you can buy higher potency from us, and that's the kicker. So at Woodstock the potency of the cannabis there was between one and a half and 2% potency. The potency now of street marijuana is 18-20%. But also they're selling all kinds of products, too, right, gummies and things. That's potencies of 35%, so you're talking about 17-18 times. They're selling products now with potencies of 80%, so that's 40 times the potency in any given hit. I mean right and generally available, which is the other thing. So in the city there are legal marijuana dispensaries. All right, you can go by, you have to be 21 there. But they're also illegal dispensaries and the authorities have real trouble dealing with them. Right, and in fact they've even discussed not even trying to, because it's impossible to enforce the law. Well, where do your teenagers go to? Right?
Speaker 1:to those.
Speaker 2:Where do you go to on the way to school? You know I mean, I grew up in a school system in the city that if you smoked a cigarette you were in jail, you were in punishment. Right Now you have a system where kids go to school intoxicated, where they're smoking marijuana on the way to school, and no one can be searched for anything in the school and they're vaping it, which is hard to find.
Speaker 1:Or they've got gummies which is impossible to detect, and you've got gummies that have got 600 milligrams of THC.
Speaker 2:High potency THC.
Speaker 1:I mean it's insane and literally that's where we're seeing a very significant portion of the population get driven to is psychosis and having the symptoms.
Speaker 2:That's why there's a relationship between potency and toxicity and long-term outcome, and the neurobiology of it's interesting because it's hitting critical parts of the brain. Now I have a hypothesis that we have another problem, especially where I come from, which is everybody's using stimulants yeah this is amphetamines and you know, ritalin is so high and high potency use of those things are toxic too. And if you're going to school and you're smoking, like in colleges I mean college campuses have dealers in the dorms.
Speaker 1:It's a tradition. Right College campuses don't have addictions problems. Dr Murata, don't you know that?
Speaker 2:Well, I've spoken to college professors. The problem is that they can't do anything about it and they can't get any help in dealing with it.
Speaker 1:Well, I think that every time I go to a college campus, they will throw their hands up about responsibility oh, we just can't do anything. It's like I don't believe that, and I think that one of the answers to this problem though it is complicated, is something you stated in your presentation is we've got to educate people about this. It's like, you know, an educated consumer is a far, far more protected you know, buyer beware, protected consumer than a person who's just going in and following these kind of impulses, especially with teenagers and young adults. It's like, well, I have a higher potency, I took a higher potency than you did. It's like, well, I could beat that by. You know, that game, that game can throw you down the. You know, we see young adult programming and adolescent programming popping up all over the place to handle these conditions. They're expensive too.
Speaker 2:The way I try to get people to understand is you know, if I go down to admissions of the residents, of the doctors, and you ask somebody who's been brought into the hospital, you ask do you drink? No, I don't drink, right, you don't drink at all. Well, only on weekends.
Speaker 1:But not much. You say well, how much is not much?
Speaker 2:They say, well, I almost never black out. And I said, well, if you almost never blackout, how often do you blackout? Once every couple of months. Now it's like getting hit on the head with a baseball bat, right from a biological standpoint. But they don't drink because it's only on weekends. But when does the weekend begin? It begins on Thursday.
Speaker 1:Right, right, friday's part of the weekend, right.
Speaker 2:Yeah, and it's the same thing. You use drugs? No, not at all. Just a little cannabis. How often? Well, only to sleep.
Speaker 1:That's every night.
Speaker 1:It's Russian roulette, right? You're loading one bullet into this chamber by engaging in the use of this substance at high levels and high dosages. In the use of this substance at high levels and high dosages, and maybe you and and you know if it's a six bullet chamber five of the five of those individuals in that chamber are not going to experience the the dire consequences of high use and maybe they can go on in life and do whatever they need to do and maybe it doesn't impact them. But that one person and you know one out of six, even one out of ten and millions is still a lot of people and a lot of care that experiences mood disorder or psychosis or a variety of neuropsychiatric conditions that they end up at the hospital for.
Speaker 2:That's right, and it can be in and out of the hospital for the rest of their lives or require lifelong care and not be likely to have a full-time job, you know or and be socially isolated. And those kids are really hard to treat. We use the most complex medication you know algorithms to try to get them better. And we do get lots of them better, but it was. Even. If we get them better and back to school, they've lost three or four years before we get them back.
Speaker 1:Yeah, from the treatment side, you know you're handling them. At the acute care side I see them a lot. On the rest, you know, and if you got a person who went to get your care in the hospital and they're getting ready to come out, I tell parents consistently you're looking at 18 months worth of continuing care. Residential environments, supported living environments, coaching, therapy, continued medication monitoring you know these are, I mean you therapy, continued medication monitoring you know these are. I mean you're talking about intensive care. You're talking about this person now suffers from a medical condition that will require intensive care, long-term intensive care and likely some version of that care for the rest of their lives.
Speaker 2:You got. You touched it exactly, and the government no longer really helps with that right, so the burden is on the family.
Speaker 1:Right.
Speaker 2:And what I say is you know, we, just because of where we are in the world, we live in an incredibly privileged area, where I live right now, you know, and it can impoverish upper middle class families Because you're talking about care that costs not $10,000 a year, tens of thousands of dollars a year at the lowest level, you know and but they do it, but so many families can't. I mean, one of the things that you know, we talk about, we're going to talk about when we have meetings in Charleston in April, is how can you put these things together so that you can deal with some working class families, with poor families? Dead children can get aid too, very difficult. You know, I spoke to Kathleen Radius yesterday. She's the vice chancellor of the medical college in Charleston.
Speaker 1:Abuse, yeah, yeah.
Speaker 2:Yeah, wonderful woman. She went to Florida and that's why we say you know abuse. But you know, I said you know we're spending billions because of the drug epidemic, billions and billions of dollars, and we're having relatively poor outcomes. We can't scale it properly right. We just can't seem to get people to understand and do something. It's education, but it's also education of the people, but not only the families and the possible patients, but the politicians and the educators and the people who get to organize these systems. It's daunting, but to me it's a moral equivalent. It's struggling to save souls here. It's a big, big thing.
Speaker 1:We got to this topic when we were at the conference. But insurance, there's our other. You know, the getting insurance to actually pay for treatment and pay for it long enough for a person to actually recover was a big part of our topic. It's the other half of this equation.
Speaker 2:Well, after we had that meeting right that the assassination of that you know, by that young man from the University of Pennsylvania with a master's degree in computer science and economics.
Speaker 1:Educated guy, you know.
Speaker 2:So he killed. So what it brought out, at least for a while, was some strange numbers. So I may be misremembering it, but four major health insurance companies had combined profits of $600 billion last year. That was after they paid them. The executives paid themselves millions, and you know right. And now to say we got 50,000 more beds for dual diagnosis in the country which was, which would be nothing compared to what we used to have 30 years ago. How many billion would that cost? Maybe 10, 10 or 12.
Speaker 1:Yeah, if that.
Speaker 2:Yeah, if we did it right.
Speaker 1:To bid you high facility and everything else, yeah.
Speaker 2:If we did it right, if we didn't build them in downtown Manhattan, in the countryside or in states without access to regulation, if you want, we could treat 20,000, 30,000 more people well over a year, and that would be what 8% of their excess profit.
Speaker 1:Yeah, barely a scratch.
Speaker 2:Those four companies. I think there's 10 or 12 of them, I don't know. So my guess is that their profit from the insurance industry is in the range of a trillion dollars a year.
Speaker 1:Yeah, and it's not going back to the American public.
Speaker 2:No, it's going into the hedge funds and the rich get richer. Now you know what party I was raised in.
Speaker 1:Well, I think that what you and I are talking about I don't. I'm grateful that I navigated my young years and didn't end up suffering from a condition that caused me lifelong care problems or debilitating issues. I certainly did my share of experimentation, but I also, not unlike you, over a period of time especially when I started in the behavioral health field just witnessed people who were impoverished and could not receive care and were suffering from conditions that needed a lot, including your Medicaid populations, the people who are homeless, the people who are addicted, but they've also got children the whole nine yards, and you know it caused me to be aligned towards. You know I can vote for. I can vote for policies or politicians or party lines that don't necessarily benefit me directly.
Speaker 2:Right.
Speaker 1:I'm not one of these people, but I believe that they need care and I believe that we should have stuff in place that gives them, you know, a path to a better life, a path to care. And you know we're seeing a lot. I think the mentality at the high corporate levels is that, you know, it's a very insulated kind of population of people community, if you will and their aim is that profit, not a community care. And I wonder what's going to make it trip Like. What's the thing? And I think I asked this question and Dr Gerber, the CEO, there at Silver Hill. He had a pretty good response, but I still think it's going to. I still think it's financially beneficial to incentivize care outcomes that are positive. What do you, what is your thought about like? Where do you think the turn is?
Speaker 2:I believe we have a mixed economy. What I've seen in bureaucracies if something is overly bureaucratized, things don't get done. I've been blessed here with an enormous amount of support, but what it allows us to do is to be surrounded by a bunch of saints, people who are so committed to the cause of helping others, and I think that you have to try to have systems that allow those people to grow and do their job. I mean one of our people you know who worked with us, dr Irene Beal. I mean, they said you know, bridgeport is a city in Connecticut which is not in good shape. All right, yeah, and she said, get care to them. She says, well, they raise the money on their own, some from the government, mostly on her own.
Speaker 2:They build a clinic, right, they said, how do you bring in the street people to get help? You know how do you treat the schizophrenics there? Well, you build a clinic to take care of general problems and when the people come in, you're going to get all of them and then, and so you know, they work like that. I mean, one of the other guys you didn't meet was with us at the schizophrenia meetings. You know, chris landry. You know they're in. They're in times square, in the street, going to the people. You know, yeah and so, and that's what you have to do, but you also, you need more to it. You need institutions, some of those people and, right now, large numbers of them, because it hasn't been done for a generation.
Speaker 1:They need containment.
Speaker 2:Yeah, they need to be fed. Yeah, they need to be kept warm. They need to be fed. Yeah, they need to be formed, they need to be cared for. You know, um, and it can't be overly bureaucratized or it won't work, right and so, but how do you get those people? I don't know. But, um, dr doherty, you might have met her. She told me a couple of weeks ago to see a movie called Cabrini.
Speaker 1:Cabrini.
Speaker 2:Cabrini, C-A-B-R-I. Well, if you're a New Yorker, you know that that's Francesca Xavier Cabrini. She was this under five foot tall nun.
Speaker 2:And a force of nature, a force of nature and a force of nature and she founded orphanages, schools, hospitals, first in Italy, because she was born there like one there, and she came to New York with six sisters and she came to New York in her 30s and by her 60s I think they had founded 60 orphanages, hospitals, schools, colleges, and so there's an area in New York that's named for her, you know, but she's part of the mythology of certain parts of New York. She's called Mother.
Speaker 1:Called.
Speaker 2:Mother, yeah, mother, mother, you know, um, and I watched it and I watched that and I said, yes, you, you said a force of nature, she was. You know, this movie tells a story about how she's trying to get the mayor of new york to do something that's right and she power plays him by saying that she's organizing the vote. So if, if he expects to get reelected, he's just working, you know, she's working with the Irish and with the Italians and he says you know, mother, I could, I could talk to you. You know. He says you should have been a man. He says, you know, I'm a woman, the officer, a glass of scotch and she drinks it, and he looks him right in the eye. And she says, no, I'm a woman, can you office her? A glass of scotch, and she drinks it, and she looks him right in the eye and she says do we have a deal?
Speaker 1:Wow, that would have been cool to meet her. Well, I mean, you know you're talking about how you make change, right? That's? Those are the. I think you're doing that, dr Murata. You're doing, you're doing the good work out there and you're passing on the message. I really appreciate the work that you're doing and I really appreciate the fact that, despite all the degrees and credentials and accolades that you have, you're also just a neat and decent guy who wants to care for human beings, and I couldn't be more grateful to know you. I thank you for coming on the show today. This has been Head Inside Mental Health, wpbm 1037, the voice of Asheville, todd Weatherly, your host, dr Murata, thank you so much.
Speaker 2:All right, bye-bye now.
Speaker 1:I feel so lonely and lost in here. I need to find my way home. I feel so lonely and lost in here. I need to find my way home, find my.