S6 E6: Hot Topics in Addiction Medicine: CannabisS6 E6: Hot Topics in Addiction Medicine: Cannabis
Addiction Medicine Podcast
The conversation focuses on how high-potency THC and hemp products in North Carolina affect addiction medicine practice and patient care. Dr Larry Greenblatt shares three key messages for clinicians about availability, potency, regulation gaps and practical changes they might consider in their day-to-day work.
18:13•21 Sept 2026
Cannabis, THC and Clinical Practice: Hot Topics for North Carolina Clinicians
Episode Overview
- Intoxicating THC products are widely available in North Carolina with virtually no state-level regulation on dosing, packaging or testing.
- Modern cannabis and hemp-derived products contain much higher THC levels than in past decades, increasing the risk of cannabis use disorder and other harms.
- Clinicians are urged to treat positive THC screens as a prompt for detailed discussion about frequency, form of use and impact on patients’ lives.
- There is currently no proven pharmacological treatment for cannabis use disorder, making behavioural approaches and motivation crucial.
- Federal law will soon limit hemp THC content, but state and local enforcement will remain unchanged, leaving retail availability largely intact.
“"Don't do what I did, which was to ignore when THC shows up on the urine drug testing, but rather use that as an opportunity to have a conversation."”
In this eye-opening episode, you'll learn about how rapidly changing cannabis and hemp laws are reshaping clinical practice in North Carolina. Aimed squarely at healthcare professionals working with substance use disorders, the conversation walks through what clinicians need to know right now about intoxicating THC products. Co-hosts Pauline Williamson and Mel Ramage chat with Dr Larry Greenblatt, State Health Director and Chief Medical Officer for North Carolina DHHS, who brings his experience from the state’s Advisory Council on Cannabis.
As he puts it, "It's kind of the wild, wild west out there of THC." The episode breaks down three main messages for clinicians: intoxicating THC is widely available and essentially unregulated at the state level; today’s products are far stronger than "your dad’s marijuana" and are driving more cases of cannabis use disorder, psychosis in young people, and cannabis hyperemesis syndrome; and upcoming federal changes in November will make intoxicating hemp illegal federally, while remaining largely untouched at the state enforcement level.
He explains how the 2018 federal farm bill unintentionally opened the door to high-potency THC products marketed as hemp, now sold as gummies, drinks and candies across the state. Style-wise, the chat stays practical and conversational, with a clear focus on what you can do on your next clinic day.
You’ll hear Dr Greenblatt urge clinicians to stop shrugging off a positive THC on urine drug screens and instead use it as a starting point for a proper history: how often patients use, in what forms, and whether it’s causing harm. There’s frank acknowledgement that treatments for cannabis use disorder are behavioural only, and often tough, but the message is that curiosity, better questions and clearer safety conversations can make a real difference.
If you’re a clinician juggling limited time but big concerns about cannabis, this episode might help you sharpen your questions and rethink what "harmless" THC use really looks like today.
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