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This document provides a summary of a presentation on the risks of medical marijuana and marijuana legalization. It begins with disclosures from the presenters and outlines six learning objectives. It then discusses concerns that marijuana is addictive, especially for those who start using it early, and impacts adolescent brain development. The document notes the lack of evidence that marijuana is effective for the conditions it is claimed to treat. It also discusses the risks of increased diversion of marijuana to youth and greater social acceptance of marijuana use negatively impacting public health. The document concludes with messages on how to discuss these issues with the public.

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The Naked Truth about Medical Marijuana Presenters: • Susan R. Thau, MCRP, Public Policy Consultant, Community Anti-Drug Coalitions of America • Thomas J. Gorman, Director, Rocky Mountain High Intensity Drug Trafficking Area Advocacy Track Moderator: Nancy Hale, MA, President and CEO, Operation UNITE
Disclosures Thomas J. Gorman; Susan R. Thau, MCRP; and Nancy Hale, MA, have disclosed no relevant, real, or apparent personal or professional financial relationships with proprietary entities that produce healthcare goods and services.
Disclosures • All planners/managers hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months. • The following planners/managers have the following to disclose: – John J. Dreyzehner, MD, MPH, FACOEM – Ownership interest: Starfish Health (spouse) – Robert DuPont – Employment: Bensinger, DuPont & Associates-Prescription Drug Research Center
Learning Objectives 1. Identify concerns related to marijuana, medical marijuana and legalization. 2. Evaluate the impact of marijuana legalization in Colorado. 3. Describe the impact of marijuana use on the adolescent brain. 4. Explain how to track the impact of medical marijuana and marijuana legalization on public health and safety. 5. Prepare attendees to deliver science-based messages that resonate with the general public. 6. Provide accurate and appropriate counsel as part of the treatment team.
Marijuana 101: Science-Based Marijuana Messages That Matter Sue Thau Public Policy Consultant CADCA 5
6 Much of the content presented today has been created and then formatted into a presentation by CADCA’s Public Policy department. Thus, this presentation is property of said organization and cannot be presented by anyone else. Please contact CADCA for more information. The data and other information that does not belong to CADCA has been cited or is available in the public domain. It may be used elsewhere depending upon the requirements of the original source.
“THE NAKED TRUTH IS ALWAYS BETTER THAN THE BEST-DRESSED LIE.” – ANN LANDERS 7
THE NAKED TRUTH ABOUT MARIJUANA 8
Marijuana is Addictive • Long-term marijuana use can lead to addiction. Approximately 9 percent of users will become addicted to marijuana. • This number increases to 17 percent among those who start young. 9 Budney AJ, Vandrey RG, Hughes JR, Thostenson JD, Bursac Z. 2008. “Comparison of cannabis and tobacco withdrawal: Severity and contribution to relapse.” J Subst Abuse Treat, e-publication ahead of print.
Marijuana is Addictive 10 who start using marijuana in adolescence become addicted National Institutes of Health, National Institute on Drug Abuse. 2011. Topics in Brief: Marijuana. Available: http://www.drugabuse.gov/publications/topics-in-brief/marijuana
11 52.42% 25.36% 7.96% 0% 10% 20% 30% 40% 50% 60% A L C O H O L T O B A C C O M A R I J U A N A PAST MONTH USE OF SELECT SUBSTANCES, AGES 12 AND OLDER, 2013 NSDUH Source: 2014 National Survey on Drug Use and Health, http://www.samhsa.gov/data/sites/default/files/NSDUHsaeShortTermCHG2014/NSDUHsaeShortTermCHG2014.pdf
Alcohol and Tobacco: A Model? • Use levels for alcohol and tobacco are much higher than marijuana (7x and 2x respectively) • Industries promote use and target kids and lower socio-economic status individuals 12Schiller JS, Lucas JW, Peregoy JA. Summary health statistics for U.S. adults: National Health Interview Survey, 2011. National Center for Health Statistics. Vital Health Stat 10(256). 2012. Centers for Disease Control and +. Vital Signs: Current Cigarette Smoking Among Adults Aged ≥ 18 Years—United States, 2005–2010. Morbidity and Mortality Weekly Report 2011;60(33):1207–12
Alcohol and Tobacco: A Model? • In Colorado, adult marijuana use is now HIGHEST in the country – 13.6% of adults in CO are regular users, with rates of 18.5% in Denver • Just like tobacco and alcohol, a report prepared for the Colorado Department of Revenue showed that “the vast majority of marijuana demand” in that state “emanates from the regular users” – those who consume daily or near daily – In CO, the top 21.8% of users make up almost 67% of demand for marijuana in the state 13 1 https://www.colorado.gov/cdphe/marijuanause 1 2 2 https://www.colorado.gov/pacific/sites/default/files/Market%20Size%20and%20Demand%20Study,%20July%209,%202014%5B1%5D.pdf
Alcohol and Tobacco: A Model? • The negative social and health effects of marijuana legalization will fall on those least able to bear the burdens of cost and health • EXAMPLE: Legal marijuana businesses in Denver are already concentrated in lower income and minority neighborhoods http://www.washingtonpost.com/blogs/wonkblog/wp/2015/03/12/the-stereotype-of-the-college-educated-pot-smoker-is-wrong/?tid=sm_fb1 1 2 2http://www.thecannabist.co/2016/01/04/unbalanced-denver-marijuana-landscape-regulation-concerns/45849/
According to the 2015 Monitoring the Future Survey, perceptions about the risks of marijuana are going down among 12th graders. 15
Diversion To Youth
Increased Use Among Teens • Pacula et al found that two features of medical marijuana – home cultivation and dispensaries – are positively associated with youth marijuana use and “have important implications for states considering legalization of marijuana.” • An Emory University study found an 8.3% increase in the baseline prevalence rate caused by having retail dispensaries, as well as a 5% increase in youth initiation rates for marijuana related to medical marijuana laws 17 Wall, M., et al., 2011; Johnston, L.D., et al., 2011. and Pacula et al 2013 Wen, Hefei. Hockenberry, Jason M. Cummings, Janet R. The effect of medical marijuana laws on adolescent and adult use of marijuana, alcohol, and other substances. 22 May 2014. Journal of Health Economics. 1 2 1 2
A Recent Australian Study on Individuals Prescribed Opioid Painkillers That Also Used “Medical Marijuana” (1 in 6 participants) found that they: • Were more likely to take opioids in ways not recommended by their doctor • Were over twice as likely to have an alcohol use disorder and four times as likely to have a heroin use disorder • Were over 50 percent more likely to be taking anti-anxiety medications (benzodiazepines), which when combined with opioids are particularly likely to cause an overdose Degenhardt, Louisa. ,Humphreys, Keith. Medical Marijuana and the Risk of Painkiller Overdose. Scope, Published by Stanford Medicine. January 13, 2015. Experience of adjunctive cannabis use for chronic non-cancer pain: Findings from the Pain and Opioids IN Treatment (POINT) study. Drug Alcohol Depend. 2015 Feb . http://www.ncbi.nlm.nih.gov/pubmed/25533893 18
FACTS on Medical Marijuana –Is not even good for conditions it is touted for –Could exacerbate symptoms (American Glaucoma Society) 19 1American Glaucoma Foundation. Available: http://www.glaucomafoundation.org/UserFiles/File/TGF_Summer_10_Web.pdf 1
Marijuana as “medicine” to treat veterans suffering from PTSD • Medical marijuana can exacerbate symptoms. Researchers found that veterans using marijuana were associated with having HIGHER levels of PTSD symptoms, including PTSD avoidance/numbing and hyper arousal symptoms. • Research shows the Marijuana use can cause increased paranoia, anxiety, and psychosis in some people Bonn-Miller, M.O., Boden, M.T., Vujanovic, A.A., & Drecher, K.D. (2011, December 19). “Prospective Investigation of the Impact of Cannabis Use Disorders on Posttraumatic Stress Disorder Symptoms Among Veterans in Residential Treatment.” Psychological Trauma: Theory, Research, Practice, and Policy. This study was done with the National Center for PTSD and Center for Health Care Evaluation at the Palo Alto VA Health Care Center. 20
FACTS on Medical Marijuana • Less than 3% of state “medical marijuana” users have cancer, HIV, or glaucoma. • Vast majority are white males in 30s and 40s with self-diagnosed pain. • Most cancer doctors and other physicians do not recommend smoking or ingesting marijuana. 21 California average medical marijuana patient statistics, found at: O'Connell, T and Bou-Matar , C.B. (2007). Long term cannabis users seeking medical cannabis in California (2001–2007): demographics, social characteristics, patterns of cannabis and other drug use of 4117 applicants. Harm Reduction Journal,
Using “Marijuana as Medicine” a “Permission Structure” was built about the safety and acceptability of marijuana use with the general public.
23
Marijuana on Front Page of Business Journal in WA
YOUTH REGUARLY RECEIVE PRO-MARIJUANA TWEETS • A STUDY OF 2,285 MARIJUANA TWEETS DURING AN EIGHT- MONTH PERIOD SHOW THAT 82% OF THE TWEETS WERE POSITIVE ABOUT MARIJUANA. • INVESTIGATORS FOUND THAT OF THOSE RECEIVING THE TWEETS 73% WERE UNDER THE AGE OF 19
Changes in Social Norms Increase Use • As social norms around the acceptability of marijuana use change, use and abuse have gone up • NIH released a report in October 2015 that showed from 2001/2002 – 2012/2013 past year marijuana use among adults increased from 4.1% to 9.5% nationally – The increase in marijuana use disorder during the same time frame was almost as large 26 http://www.nih.gov/news-events/news-releases/prevalence-marijuana-use-among-us-adults-doubles-over-past-decade
27 How to Frame Marijuana Messages for the Public
Volkow, Nora M.D., Baler, Ruben D. Ph.D., Compton, Wilson M. M.D., Weiss, Susan Ph.D. Adverse Health Effects of Marijuana Use. The New England Journal of Medicine. June 5, 2014. NIDA Scientific Evidence Marijuana Effects on Health and Well-Being. Overall Level of Confidence* Addiction to marijuana and High other substances Diminished lifetime achievement High Motor vehicle accidents High Symptoms of chronic bronchitis High
Based on the Science We need to give people an “A Ha! I got it!” message. It’s going to actually affect ME Best Example: Second Hand Smoke 29
30 • If you care about academic achievement: • You need to care about increased marijuana use.
Marijuana & Adolescence Use by age 15= 1.) 3.6 times less likely to graduate from high school 2.) 2.3 times less likely to enroll in college 3.) 3.7 times less likely to get college degree. Thurstone, Christian, Dr. Marijuana Use & Pregnancy. May 14, 2014. Available at http://drthurstone.com/?s=pregnancy&x=0&y=0. 31
32 Because Marijuana Use Lowers IQ1 • A recent study found that those who used marijuana heavily in their teens and continued through adulthood showed a permanent drop in IQ of 8 points. • A loss of 8 IQ points could drop a person of average intelligence into the lowest third of the intelligence range. 1M.H. Meier, Avshalom Caspi, et al. 2012. “Persistent cannabis users show neuropsychological decline from childhood to midlife.” Proceedings of the National Academy of Sciences Why?
33 Take Away Message for Parents: • Marijuana use will hurt YOUR child’s IQ, grades, and ability to graduate from high school !!
34 Take Away Message For Teachers/School Systems: Increased marijuana use will result in reduced academic achievement for which teachers/school system will be blamed
If you care about college completion: You need to care about increased marijuana use. 35
36 • College students with high levels (17 days/month) of marijuana use were twice as likely as those with minimal use (less than 1 day/month) to have an enrollment gap while in college.1 • (e.g. dropout and not graduate on time) 1 Amelia M. Arria , MD. Drug Use Patterns and Continuous Enrollment in College: Results From a Longitudinal Study. January 2013. Vol 24 Issue 1. Available: http://www.jsad.com/jsad/article/Drug_Use_Patterns_and_Continuous_Enrollment_in_College_Results_From_a_Long/4775.html Why?
Increased Use Among College Students 37 http://www.monitoringthefuture.org/pressreleases/15collegepr.pdf?utm_source=Legislators+List&utm_campaign=e543cbde3f- September_2_2015_TMR_LEGS9_2_2015&utm_medium=email&utm_term=0_ce2346c3fe-e543cbde3f-334806865 Credit to themarijuanareport.org September 2, 2015. Data is from:
Average cost of college in 4 years is: $89,044 Average cost of college in 6 years is: $133,566 Source: National Association for College Admission Counseling 2012-2013. 38
39 Take Away Message for Parents: • Your child’s marijuana use could derail their college career and be very costly to you!!
If you care about mental health You need to care about increased marijuana use 40
Cannabis Use and Risk of Psychiatric Disorders • Study published Feb. 16th, 2016 that examined prospective associations between cannabis use and risk of mental health and substance use disorders in the general adult population. • In conclusion authors suggested “caution in the implementation of policies related to legalization of cannabis for recreational use, as it may lead to greater availability and acceptance of cannabis, reduced perception of risk of use, and increased risk of adverse mental health outcomes, such as substance use disorders.” Rasic D, Weerasinghe S, Asbridge M, Langille DB. Longitudinal associations of cannabis and illicit drug use with depression, suicidal ideation and suicidal attempts among Nova Scotia high school students . Drug Alcohol Depend. 2013;129(1-2):49-53. Authors: Carlos Blanco, MD, PhD1; Deborah S. Hasin, PhD2; Melanie M. Wall, PhD2; Ludwing Flórez-Salamanca, MD3,4; Nicolas Hoertel, MD, MPH2,3,4,5; Shuai Wang, PhD2; Bradley T. Kerridge, PhD, PhD2; Mark Olfson, MD, MPH2
42 Because: • Regular marijuana use by adolescents and young adults is strongly associated with developing psychotic symptoms and disorders such as schizophrenia in adulthood for those people with an underlying genetic vulnerability to developing this disease • This risk is higher among those who start using marijuana at a younger age • This risk is higher with more frequent marijuana use • Volkow, Nora D. Baler, Ruben D. Compton, Wilson M. 2014 June 5. Adverse Health Effects of Marijuana Use. The New England Journal of Medicine
Take Away Message for the Public and Decision Makers: Early persistent marijuana use is associated, in vulnerable individuals, with the early onset and some exacerbated symptoms of schizophrenia. This is a debilitating mental illness that is costly to individuals, families and society.
If you care about the environment, you need to care about increased marijuana use. 44
Why? Because • Marijuana grow sites are already having major adverse environmental impacts including: • Vastly increasing fish kills from fertilizer runoff that creates toxic aquatic conditions; and • Poisoning watersheds with arsenic and acaracide, used to keep rodents away from the marijuana plants. 45 1 Allen, Hezekiah, Mattole Resoration Council and Scott Greacen, Friends of the Eel River. The Ugly, the Bad and (Maybe) the Good? (April 17, 2012). Available; www.treesfoundation/org/publications/article-486
Because: • An average marijuana grow site of 1,000 plants uses 5,000 gallons of water a day • Question: Where does all this water come from? • Answer: Your local streams and rivers 46 http://www.think-mag.com/your-world/high-dry/
Because: • 45% of the increased demand in Denver for electric power is coming from legal marijuana growers • This is putting upward pressure on carbon emissions from coal-burning power plants http://www.denverpost.com/environment/ci_28417456/pot-boom-spikes-denver-electric-demand- challenges-clean
Take Away Message: • Increased marijuana grows will further degrade our environment and exacerbate water and energy shortages 48
49 If you care about employment: You need to care about increased marijuana use.
According to the American Council for Drug Education in New York, employees who abuse drugs are: • 10 times more likely to miss work Because: Why?
• 3.6 times more likely to be involved in on- the-job incidents
52 • 5 times more likely to file a workers’ compensation claim.
53 Many big companies, industries, and professions nationwide conduct drug testing • Target • Walmart • McDonalds • Police/Fire Departments • Military • Transportation
54 These students are virtually unemployable
55 Take Away Message For Job Seekers: • Marijuana use can RUIN your chances of employment!
56 Take Away Message For Business: • Increased marijuana use is BAD for your business and your bottom line
57 If you care about highway safety: You need to care about increased marijuana use.
58 Why? • Because marijuana use impairs driving ability1 1For a comprehensive review, see DuPont, R. et al. 2010. “Drugged Driving Research: A White Paper.” Prepared for the National Institute on Drug Abuse. Available at http://stopdruggeddriving.org/pdfs/DruggedDrivingAWhitePaper.pdf
Because Cannabis use impairs driving as much as alcohol A new NIDA study found: –Marijuana's active chemical THC affects weaving within a road lane in a similar way to a blood alcohol level of .08, the legal limit in many states. –Marilyn Huestis of NIDA: “One of the things we know happens with cannabis is that it reduces your field of vision and you get tunnel vision, so you're unable to react as quickly.” http://www.dailymail.co.uk/news/article-3137943/Marijuana-DOES-impair-driving-kind-comprehensive-government-study-reveals-cannabis-use-affect-motor-skills-three-drinks.html
60 • Marijuana is the most prevalent illegal drug detected in impaired drivers, fatally injured drivers, and motor vehicle crash victims. 1 1 National Highway Traffic Safety Administration. Drug Involvement of Fatally Injured Drivers. U.S. Department of Transportation Report No. DOT HS 811 415. Washington, DC: National Highway Traffic Safety Administration, 2010. Because:
61 • Driving under the influence of marijuana is associated with a 92% increased risk of vehicular crashes. 1 • Such driving is associated with a 110% increase in fatal crashes. 2 1 Asbridge, M., Hayden, JA, Cartwirght, JL. Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta- analysis. British Medical Journal, 2012; 344 (ePub): e536. PMID: 22323502. 2 Ibid. Because:
62 Because: • Researchers at the University of Massachusetts, Amherst, found 44 % of college men said they drove after smoking marijuana in the previous month, compared with 12% who said they drove after drinking. • Jennifer M. Whitehill, PhD; Frederick P. Rivara, MD, MPH; Megan A. Moreno, MD, MSEd, MPH; Marijuana-Using Drivers, Alcohol-Using Drivers, and Their Passengers. AMA Pediatr. Published online May 12, 2014. doi:10.1001/jamapediatrics.2013.5300
Because: • A new study conducted by the National Cannabis Prevention and Information Centre, found nearly 70% of recent cannabis users had driven while under the influence of the drug. • 16% of users said they had driven on a daily basis less five hours after using • Many users were oblivious to the impact cannabis had on driving skills http://www.abc.net.au/news/2015-06-10/cannabis-users-report-driving-under-influence/6534368
64 Take Away Message: • Increased marijuana use will increase car crashes and fatalities
65 If you care about your tax burden, you need to care about increased marijuana use
66 Why? Because Because the total overall costs of substance abuse in the U.S., including productivity, health and crime-related costs, exceed $600 billion annually.1 This includes approximately: • $235 billion for alcohol • $193 billion for tobacco • $181 billion for illicit drugs 1 Office of National Drug Control Policy. The Economic Costs of Drug Abuse in the United States, Executive Office of the President (Publication No. 207303). 2004. Available at www.ncjrs.gov/ondcppubs/publication/pdf.economic_costs.pdf
67 Because • Federal and state alcohol taxes raise $14.5 billion, covering only about 6% of alcohol’s total cost to society.1 • Federal and state tobacco taxes raise $25 billion, covering only about 13% of tobacco’s total cost to society.2 1 Dupont, Robert M.D., Director of the National Institute on Drug Abuse (1973-1978), “Why We Should Not Legalize Marijuana.” April 2010. Available: www.cnbc.com/id/36267223/Why_We_Should_Not_Legalize_Marijuana 2 Ibid
Legal corporations work hard to keep prices low and consumption high! 68 • Alcohol taxes are now 1/5 of what they were during the Korean War (adjusted for inflation). Cook, P. J. (2007). Paying the tab: The economics of alcohol policy. Princeton, NJ: Princeton University Press.
Take Away Message: • Increased marijuana use will COST tax payers much more money than it can possibly bring in.
Thomas J. Gorman, Director Rocky Mountain High Intensity Drug Trafficking Area www.rmhidta.org 2016
www.rmhidta.org click on “Reports”
Has the “War” on Drugs Been a Failure?
Background • Purpose of Drug Policy • Limit the number of people using drugs • Victimless Crime? • Four classes of victim: 1. User 2. Family/Friends 3. Victim of Crime 4. Taxpayers
Background • Factors Affecting Rate of Drug Use • Four primary factors: 1. Price 2. Availability 3. Perception of Risk 4. Public Attitude
The Issue Drug “War” a Failure Question… What would it take for you to consider our drug policy successful?
The Issue 2013 National Survey on Drug Use • Americans age 12 and older (past month):  9% used any illegal drug  26% used tobacco  52% used alcohol
The Issue 91% of Americans do NOT use illegal drugs Source: 2013 National Survey on Drug Use
The Issue Alcohol and Tobacco Heroin, Meth, Crack, Hallucinogens, Cocaine, Tranquilizers, Pain Relievers and Marijuana
Licensed Marijuana Businesses Medical Marijuana (January 1, 2015) Recreational Marijuana (January 1, 2015) • 497 licensed centers • 748 marijuana cultivation facilities • 163 infused products (edibles) businesses • 369 licensed marijuana retail stores • 397 licensed marijuana cultivation facilities • 98 licenses for infused product (edibles) businesses
Perspective • Colorado Business Profile, January 2015 2014 Colorado Starbucks 405 McDonalds 227 Medical Marijuana Centers 505 Recreational Marijuana Shops 322
Denver: The Mile HIGH City
Denver: The Mile HIGH City
“Legal pot blamed for some of influx of homeless in Denver this summer” The Denver Post, July 25, 2014 • Haven of Hope: 500% rise over normal in homeless in summer 2014 (50 to 300) • “They have an attitude” • Salvation Army: 33% rise since 2014 compared to 2013 • “30% relocated for pot”
“Legal pot blamed for some of influx of homeless in Denver this summer” The Denver Post, July 25, 2014 • Urban Peak: 152% increase • “Majority of new kids here because of weed.” • St. Francis: 50 more people a day • “Marijuana only trails looking for work as reason.”
Marijuana and Public Consumption “Citations for using pot in public rising” Denver police say they’re not purposely trying to nab users since marijuana was legalized. The Denver Post Sunday, December 28, 2014 2012 = 8 citations 2013 = 184 citations 2014 = 770 citations
Marijuana Edibles
Marijuana Edibles Deaths Levy Thamba Pongi and Kristine Kirk (Denver, CO) Luke Goodman (Keystone, CO)
www.rmhidta.org click on “Reports”
Forecast What Does the Data and Trends Show?
0 500 1,000 1,500 2,000 2,500 2009 2010 2011 2012 2013 2014 220 619 1,152 1,264 1,583 1,903 398 NumberofScreenswithActiveTHC Number of Positive Cannabinoid Screens with Active THC 1ng/mL 2ng/mL SOURCE: ChemaTox Laboratory and Rocky Mountain HIDTA
Marijuana and Traffic Fatalities 37 39 43 47 49 63 78 71 94 0 10 20 30 40 50 60 70 80 90 100 2006 2007 2008 2009 2010 2011 2012 2013 2014 NumberofFatalities Traffic Deaths Related to Marijuana * *Number of Fatalities Involving Operators Testing Positive for Marijuana Commercialization Legalization * Number of Fatalities Involving Operators Testing Positive for Marijuana SOURCE: National Highway Transportation Safety Administration, Fatality Analysis Reporting System (FARS), 2006-2013 and CDOT/RMHIDTA 2014. NOTE: Cannot confirm 100% reporting prior to 2012.
Marijuana and Traffic Fatalities * Number of Fatalities Involving Operators Testing Positive for Marijuana SOURCE: National Highway Transportation Safety Administration, Fatality Analysis Reporting System (FARS), 2006-2013 and CDOT/RMHIDTA 2014. NOTE: Cannot confirm 100% reporting prior to 2012. 6.92% 7.04% 7.85% 10.10% 10.89% 14.09% 16.53% 14.76% 19.26% 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 2006 2007 2008 2009 2010 2011 2012 2013 2014 PercentofDeaths Percent of All Traffic Deaths That Were Marijuana Related* *Percent of All Fatalities Where the Operators Tested Positive for Marijuana Commercialization Legalization * Percent of All Fatalities Where the Operators Tested Positive for Marijuana
Operators Positive for Marijuana * Number of Fatalities Involving Operators Testing Positive for Marijuana Marijuana ONLY 33% Marijuana and Other Drugs (No Alcohol) 15% Marijuana and Alcohol 37% Marijuana, Other Drugs and Alcohol 15% SOURCE: Colorado Department of Transportation/RMHIDTA 2014
Teens and Marijuana “Since legalization, reports of pot in middle and high schools soar.”
Marijuana Use in Youth Youth (ages 12 to 17 years) Current Marijuana Use 2013/2014  National average for youth was 7.22 percent  Colorado average for youth was 12.56 percent  Colorado was ranked 1st in the nation for current marijuana use among youth (74 percent higher than the national average)  2013/2014 Colorado youth use increased 20 percent compared to pre-legalization years 2011/2012.  Nationally a decline of 5 percent.
Marijuana Use in Youth 0.00 5.00 10.00 15.00 05/06 06/07 07/08 08/09 09/10 10/11 11/12 12/13 13/14 National Average 6.74 6.67 6.67 7.03 7.38 7.64 7.55 7.15 7.22 Colorado Average 7.60 8.15 9.13 10.17 9.91 10.72 10.47 11.16 12.56 Percentof ages12-17Years Annual Averages of Data Collection Youth Ages 12 to 17 Years Old Past Month Marijuana Use National vs. Colorado Commercialization Legalization SOURCE: SAMHSA.gov, National Survey on Drug Use and Health, 2013 and 2014
Marijuana Use in Youth 0.00% 2.00% 4.00% 6.00% 8.00% 10.00% 12.00% 2006-2008 (Pre-Commercialization) 2009-2012 (Post-Commercialization) 2013/2014 (Legalization) 8.64% 10.37% 12.56% AveragePercent Colorado Average Past Month Use of Marijuana Ages 12 to 17 Years-Old (20% Increase) (21% Increase) SOURCE: National Survey on Drug Use and Health, 2013 and 2014
Student Marijuana Sources SOURCE: Colorado School Counselor Association (CSCA) and Rocky Mountain HIDTA, 2015
High School Discipline SOURCE: Colorado Department of Education, 10-Year Trend Data: State Suspension and Expulsion Incident Rates and Reasons
High School Discipline SOURCE: Colorado Department of Education, 10-Year Trend Data: State Suspension and Expulsion Incident Rates and Reasons
College-Age Marijuana Use College-Age Adults (ages 18 to 25 years) Current Marijuana Use 2013/2014  National average = 19.32 percent  Colorado average = 31.24 percent  Colorado was ranked 1st in the nation for current marijuana use among college-age adults (62 percent higher than the national average)  2013/2014 college age use increased 17 percent compared to pre legalization years 2011/2012. Nationally a 2 percent increase
College-Age Marijuana Use SOURCE: SAMHSA.gov, National Survey on Drug Use and Health 2013 and 2014
College-Age Marijuana Use SOURCE: SAMHSA.gov, National Survey on Drug Use and Health 2013 and 2014
Adult Marijuana Use Adults (ages 26+ years) Current Marijuana Use 2013/2014  National average = 6.11 percent  Colorado average = 12.45 percent  Colorado was ranked 1st in the nation for current marijuana use among adults (104 percent higher than the national average)  2013/2014 adult use increased 63 percent compared to pre-legalization years 2011/2012. Nationally an increase of 21 percent.
Adult Marijuana Use SOURCE: National Survey on Drug Use and Health, 2006-2014
Colorado Emergency Department Rates Likely Related to Marijuana SOURCE: Colorado Department of Public Health and Environment
Colorado Hospitalization Rates Likely Related to Marijuana SOURCE: Colorado Department of Public Health and Environment
Rocky Mountain Poison Center SOURCE: Colorado Department of Public Health and Environment/RMPDC
Marijuana Diversion
States to Which Marijuana Was Destined (2014)
Diversion – By Motor Vehicles SOURCE: El Paso Intelligence Center (EPIC), National Seizure System
Diversion – By U.S. Postal Service Packages SOURCE: United States Postal Inspection Service – Prohibited Mailing of Narcotics
All Reported Crime in Denver 2013 2014 55,115 reported crimes 60,788 reported crimes 5,391 reported crimes increase from 2013 to 2014 (10 percent increase) Reported offenses using the National Incident Based Reporting System (NIBRS) definitions in the City and County of Denver, January 9, 2015
Alcohol Consumption SOURCE: Colorado Department of Revenue
Colorado General Fund Colorado's Total General Fund Revenue, FY 2015* Marijuana Tax Revenue (Medical and Recreational) = 0.7% * Preliminary Numbers Based on June 2015 Forecast
FY 2015 Tax Revenue
A Snapshot in Colorado 2014 Marijuana-Related DUIDs Marijuana-Related Traffic Deaths Youth Marijuana Use College Marijuana Use Adult Marijuana Use Marijuana-Related Emergency Room Admissions Marijuana-Related Hospitalizations Marijuana-Related Exposures Marijuana-Related Treatment Marijuana Diversion THC Extraction Labs
Local Response to Medical and Recreational Marijuana in Colorado Of 321 total local jurisdictions:  228 (71 percent) prohibit any medical or recreational marijuana businesses  67 (21 percent) allow any medical and recreational marijuana businesses  26 (8 percent) allow either medical or recreational marijuana businesses, not both
 Important to Remember with Statistics… Why We Do This
Thank you for what you do. Remember:
The Naked Truth about Medical Marijuana Presenters: • Susan R. Thau, MCRP, Public Policy Consultant, Community Anti-Drug Coalitions of America • Thomas J. Gorman, Director, Rocky Mountain High Intensity Drug Trafficking Area Advocacy Track Moderator: Nancy Hale, MA, President and CEO, Operation UNITE

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Rx16 adv wed_1230_1_thau_2gorman

  • 1.
    The Naked Truthabout Medical Marijuana Presenters: • Susan R. Thau, MCRP, Public Policy Consultant, Community Anti-Drug Coalitions of America • Thomas J. Gorman, Director, Rocky Mountain High Intensity Drug Trafficking Area Advocacy Track Moderator: Nancy Hale, MA, President and CEO, Operation UNITE
  • 2.
    Disclosures Thomas J. Gorman;Susan R. Thau, MCRP; and Nancy Hale, MA, have disclosed no relevant, real, or apparent personal or professional financial relationships with proprietary entities that produce healthcare goods and services.
  • 3.
    Disclosures • All planners/managershereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months. • The following planners/managers have the following to disclose: – John J. Dreyzehner, MD, MPH, FACOEM – Ownership interest: Starfish Health (spouse) – Robert DuPont – Employment: Bensinger, DuPont & Associates-Prescription Drug Research Center
  • 4.
    Learning Objectives 1. Identifyconcerns related to marijuana, medical marijuana and legalization. 2. Evaluate the impact of marijuana legalization in Colorado. 3. Describe the impact of marijuana use on the adolescent brain. 4. Explain how to track the impact of medical marijuana and marijuana legalization on public health and safety. 5. Prepare attendees to deliver science-based messages that resonate with the general public. 6. Provide accurate and appropriate counsel as part of the treatment team.
  • 5.
    Marijuana 101: Science-Based MarijuanaMessages That Matter Sue Thau Public Policy Consultant CADCA 5
  • 6.
    6 Much of thecontent presented today has been created and then formatted into a presentation by CADCA’s Public Policy department. Thus, this presentation is property of said organization and cannot be presented by anyone else. Please contact CADCA for more information. The data and other information that does not belong to CADCA has been cited or is available in the public domain. It may be used elsewhere depending upon the requirements of the original source.
  • 7.
    “THE NAKED TRUTHIS ALWAYS BETTER THAN THE BEST-DRESSED LIE.” – ANN LANDERS 7
  • 8.
    THE NAKED TRUTHABOUT MARIJUANA 8
  • 9.
    Marijuana is Addictive •Long-term marijuana use can lead to addiction. Approximately 9 percent of users will become addicted to marijuana. • This number increases to 17 percent among those who start young. 9 Budney AJ, Vandrey RG, Hughes JR, Thostenson JD, Bursac Z. 2008. “Comparison of cannabis and tobacco withdrawal: Severity and contribution to relapse.” J Subst Abuse Treat, e-publication ahead of print.
  • 10.
    Marijuana is Addictive 10 whostart using marijuana in adolescence become addicted National Institutes of Health, National Institute on Drug Abuse. 2011. Topics in Brief: Marijuana. Available: http://www.drugabuse.gov/publications/topics-in-brief/marijuana
  • 11.
    11 52.42% 25.36% 7.96% 0% 10% 20% 30% 40% 50% 60% A L CO H O L T O B A C C O M A R I J U A N A PAST MONTH USE OF SELECT SUBSTANCES, AGES 12 AND OLDER, 2013 NSDUH Source: 2014 National Survey on Drug Use and Health, http://www.samhsa.gov/data/sites/default/files/NSDUHsaeShortTermCHG2014/NSDUHsaeShortTermCHG2014.pdf
  • 12.
    Alcohol and Tobacco:A Model? • Use levels for alcohol and tobacco are much higher than marijuana (7x and 2x respectively) • Industries promote use and target kids and lower socio-economic status individuals 12Schiller JS, Lucas JW, Peregoy JA. Summary health statistics for U.S. adults: National Health Interview Survey, 2011. National Center for Health Statistics. Vital Health Stat 10(256). 2012. Centers for Disease Control and +. Vital Signs: Current Cigarette Smoking Among Adults Aged ≥ 18 Years—United States, 2005–2010. Morbidity and Mortality Weekly Report 2011;60(33):1207–12
  • 13.
    Alcohol and Tobacco:A Model? • In Colorado, adult marijuana use is now HIGHEST in the country – 13.6% of adults in CO are regular users, with rates of 18.5% in Denver • Just like tobacco and alcohol, a report prepared for the Colorado Department of Revenue showed that “the vast majority of marijuana demand” in that state “emanates from the regular users” – those who consume daily or near daily – In CO, the top 21.8% of users make up almost 67% of demand for marijuana in the state 13 1 https://www.colorado.gov/cdphe/marijuanause 1 2 2 https://www.colorado.gov/pacific/sites/default/files/Market%20Size%20and%20Demand%20Study,%20July%209,%202014%5B1%5D.pdf
  • 14.
    Alcohol and Tobacco:A Model? • The negative social and health effects of marijuana legalization will fall on those least able to bear the burdens of cost and health • EXAMPLE: Legal marijuana businesses in Denver are already concentrated in lower income and minority neighborhoods http://www.washingtonpost.com/blogs/wonkblog/wp/2015/03/12/the-stereotype-of-the-college-educated-pot-smoker-is-wrong/?tid=sm_fb1 1 2 2http://www.thecannabist.co/2016/01/04/unbalanced-denver-marijuana-landscape-regulation-concerns/45849/
  • 15.
    According to the2015 Monitoring the Future Survey, perceptions about the risks of marijuana are going down among 12th graders. 15
  • 16.
  • 17.
    Increased Use AmongTeens • Pacula et al found that two features of medical marijuana – home cultivation and dispensaries – are positively associated with youth marijuana use and “have important implications for states considering legalization of marijuana.” • An Emory University study found an 8.3% increase in the baseline prevalence rate caused by having retail dispensaries, as well as a 5% increase in youth initiation rates for marijuana related to medical marijuana laws 17 Wall, M., et al., 2011; Johnston, L.D., et al., 2011. and Pacula et al 2013 Wen, Hefei. Hockenberry, Jason M. Cummings, Janet R. The effect of medical marijuana laws on adolescent and adult use of marijuana, alcohol, and other substances. 22 May 2014. Journal of Health Economics. 1 2 1 2
  • 18.
    A Recent AustralianStudy on Individuals Prescribed Opioid Painkillers That Also Used “Medical Marijuana” (1 in 6 participants) found that they: • Were more likely to take opioids in ways not recommended by their doctor • Were over twice as likely to have an alcohol use disorder and four times as likely to have a heroin use disorder • Were over 50 percent more likely to be taking anti-anxiety medications (benzodiazepines), which when combined with opioids are particularly likely to cause an overdose Degenhardt, Louisa. ,Humphreys, Keith. Medical Marijuana and the Risk of Painkiller Overdose. Scope, Published by Stanford Medicine. January 13, 2015. Experience of adjunctive cannabis use for chronic non-cancer pain: Findings from the Pain and Opioids IN Treatment (POINT) study. Drug Alcohol Depend. 2015 Feb . http://www.ncbi.nlm.nih.gov/pubmed/25533893 18
  • 19.
    FACTS on MedicalMarijuana –Is not even good for conditions it is touted for –Could exacerbate symptoms (American Glaucoma Society) 19 1American Glaucoma Foundation. Available: http://www.glaucomafoundation.org/UserFiles/File/TGF_Summer_10_Web.pdf 1
  • 20.
    Marijuana as “medicine”to treat veterans suffering from PTSD • Medical marijuana can exacerbate symptoms. Researchers found that veterans using marijuana were associated with having HIGHER levels of PTSD symptoms, including PTSD avoidance/numbing and hyper arousal symptoms. • Research shows the Marijuana use can cause increased paranoia, anxiety, and psychosis in some people Bonn-Miller, M.O., Boden, M.T., Vujanovic, A.A., & Drecher, K.D. (2011, December 19). “Prospective Investigation of the Impact of Cannabis Use Disorders on Posttraumatic Stress Disorder Symptoms Among Veterans in Residential Treatment.” Psychological Trauma: Theory, Research, Practice, and Policy. This study was done with the National Center for PTSD and Center for Health Care Evaluation at the Palo Alto VA Health Care Center. 20
  • 21.
    FACTS on MedicalMarijuana • Less than 3% of state “medical marijuana” users have cancer, HIV, or glaucoma. • Vast majority are white males in 30s and 40s with self-diagnosed pain. • Most cancer doctors and other physicians do not recommend smoking or ingesting marijuana. 21 California average medical marijuana patient statistics, found at: O'Connell, T and Bou-Matar , C.B. (2007). Long term cannabis users seeking medical cannabis in California (2001–2007): demographics, social characteristics, patterns of cannabis and other drug use of 4117 applicants. Harm Reduction Journal,
  • 22.
    Using “Marijuana asMedicine” a “Permission Structure” was built about the safety and acceptability of marijuana use with the general public.
  • 23.
  • 24.
    Marijuana on FrontPage of Business Journal in WA
  • 25.
    YOUTH REGUARLY RECEIVEPRO-MARIJUANA TWEETS • A STUDY OF 2,285 MARIJUANA TWEETS DURING AN EIGHT- MONTH PERIOD SHOW THAT 82% OF THE TWEETS WERE POSITIVE ABOUT MARIJUANA. • INVESTIGATORS FOUND THAT OF THOSE RECEIVING THE TWEETS 73% WERE UNDER THE AGE OF 19
  • 26.
    Changes in SocialNorms Increase Use • As social norms around the acceptability of marijuana use change, use and abuse have gone up • NIH released a report in October 2015 that showed from 2001/2002 – 2012/2013 past year marijuana use among adults increased from 4.1% to 9.5% nationally – The increase in marijuana use disorder during the same time frame was almost as large 26 http://www.nih.gov/news-events/news-releases/prevalence-marijuana-use-among-us-adults-doubles-over-past-decade
  • 27.
    27 How to FrameMarijuana Messages for the Public
  • 28.
    Volkow, Nora M.D.,Baler, Ruben D. Ph.D., Compton, Wilson M. M.D., Weiss, Susan Ph.D. Adverse Health Effects of Marijuana Use. The New England Journal of Medicine. June 5, 2014. NIDA Scientific Evidence Marijuana Effects on Health and Well-Being. Overall Level of Confidence* Addiction to marijuana and High other substances Diminished lifetime achievement High Motor vehicle accidents High Symptoms of chronic bronchitis High
  • 29.
    Based on theScience We need to give people an “A Ha! I got it!” message. It’s going to actually affect ME Best Example: Second Hand Smoke 29
  • 30.
    30 • If youcare about academic achievement: • You need to care about increased marijuana use.
  • 31.
    Marijuana & Adolescence Useby age 15= 1.) 3.6 times less likely to graduate from high school 2.) 2.3 times less likely to enroll in college 3.) 3.7 times less likely to get college degree. Thurstone, Christian, Dr. Marijuana Use & Pregnancy. May 14, 2014. Available at http://drthurstone.com/?s=pregnancy&x=0&y=0. 31
  • 32.
    32 Because Marijuana UseLowers IQ1 • A recent study found that those who used marijuana heavily in their teens and continued through adulthood showed a permanent drop in IQ of 8 points. • A loss of 8 IQ points could drop a person of average intelligence into the lowest third of the intelligence range. 1M.H. Meier, Avshalom Caspi, et al. 2012. “Persistent cannabis users show neuropsychological decline from childhood to midlife.” Proceedings of the National Academy of Sciences Why?
  • 33.
    33 Take Away Messagefor Parents: • Marijuana use will hurt YOUR child’s IQ, grades, and ability to graduate from high school !!
  • 34.
    34 Take Away MessageFor Teachers/School Systems: Increased marijuana use will result in reduced academic achievement for which teachers/school system will be blamed
  • 35.
    If you careabout college completion: You need to care about increased marijuana use. 35
  • 36.
    36 • College studentswith high levels (17 days/month) of marijuana use were twice as likely as those with minimal use (less than 1 day/month) to have an enrollment gap while in college.1 • (e.g. dropout and not graduate on time) 1 Amelia M. Arria , MD. Drug Use Patterns and Continuous Enrollment in College: Results From a Longitudinal Study. January 2013. Vol 24 Issue 1. Available: http://www.jsad.com/jsad/article/Drug_Use_Patterns_and_Continuous_Enrollment_in_College_Results_From_a_Long/4775.html Why?
  • 37.
    Increased Use AmongCollege Students 37 http://www.monitoringthefuture.org/pressreleases/15collegepr.pdf?utm_source=Legislators+List&utm_campaign=e543cbde3f- September_2_2015_TMR_LEGS9_2_2015&utm_medium=email&utm_term=0_ce2346c3fe-e543cbde3f-334806865 Credit to themarijuanareport.org September 2, 2015. Data is from:
  • 38.
    Average cost ofcollege in 4 years is: $89,044 Average cost of college in 6 years is: $133,566 Source: National Association for College Admission Counseling 2012-2013. 38
  • 39.
    39 Take Away Messagefor Parents: • Your child’s marijuana use could derail their college career and be very costly to you!!
  • 40.
    If you careabout mental health You need to care about increased marijuana use 40
  • 41.
    Cannabis Use andRisk of Psychiatric Disorders • Study published Feb. 16th, 2016 that examined prospective associations between cannabis use and risk of mental health and substance use disorders in the general adult population. • In conclusion authors suggested “caution in the implementation of policies related to legalization of cannabis for recreational use, as it may lead to greater availability and acceptance of cannabis, reduced perception of risk of use, and increased risk of adverse mental health outcomes, such as substance use disorders.” Rasic D, Weerasinghe S, Asbridge M, Langille DB. Longitudinal associations of cannabis and illicit drug use with depression, suicidal ideation and suicidal attempts among Nova Scotia high school students . Drug Alcohol Depend. 2013;129(1-2):49-53. Authors: Carlos Blanco, MD, PhD1; Deborah S. Hasin, PhD2; Melanie M. Wall, PhD2; Ludwing Flórez-Salamanca, MD3,4; Nicolas Hoertel, MD, MPH2,3,4,5; Shuai Wang, PhD2; Bradley T. Kerridge, PhD, PhD2; Mark Olfson, MD, MPH2
  • 42.
    42 Because: • Regular marijuanause by adolescents and young adults is strongly associated with developing psychotic symptoms and disorders such as schizophrenia in adulthood for those people with an underlying genetic vulnerability to developing this disease • This risk is higher among those who start using marijuana at a younger age • This risk is higher with more frequent marijuana use • Volkow, Nora D. Baler, Ruben D. Compton, Wilson M. 2014 June 5. Adverse Health Effects of Marijuana Use. The New England Journal of Medicine
  • 43.
    Take Away Messagefor the Public and Decision Makers: Early persistent marijuana use is associated, in vulnerable individuals, with the early onset and some exacerbated symptoms of schizophrenia. This is a debilitating mental illness that is costly to individuals, families and society.
  • 44.
    If you careabout the environment, you need to care about increased marijuana use. 44
  • 45.
    Why? Because • Marijuana growsites are already having major adverse environmental impacts including: • Vastly increasing fish kills from fertilizer runoff that creates toxic aquatic conditions; and • Poisoning watersheds with arsenic and acaracide, used to keep rodents away from the marijuana plants. 45 1 Allen, Hezekiah, Mattole Resoration Council and Scott Greacen, Friends of the Eel River. The Ugly, the Bad and (Maybe) the Good? (April 17, 2012). Available; www.treesfoundation/org/publications/article-486
  • 46.
    Because: • An averagemarijuana grow site of 1,000 plants uses 5,000 gallons of water a day • Question: Where does all this water come from? • Answer: Your local streams and rivers 46 http://www.think-mag.com/your-world/high-dry/
  • 47.
    Because: • 45% ofthe increased demand in Denver for electric power is coming from legal marijuana growers • This is putting upward pressure on carbon emissions from coal-burning power plants http://www.denverpost.com/environment/ci_28417456/pot-boom-spikes-denver-electric-demand- challenges-clean
  • 48.
    Take Away Message: •Increased marijuana grows will further degrade our environment and exacerbate water and energy shortages 48
  • 49.
    49 If you careabout employment: You need to care about increased marijuana use.
  • 50.
    According to theAmerican Council for Drug Education in New York, employees who abuse drugs are: • 10 times more likely to miss work Because: Why?
  • 51.
    • 3.6 timesmore likely to be involved in on- the-job incidents
  • 52.
    52 • 5 timesmore likely to file a workers’ compensation claim.
  • 53.
    53 Many big companies, industries,and professions nationwide conduct drug testing • Target • Walmart • McDonalds • Police/Fire Departments • Military • Transportation
  • 54.
    54 These students arevirtually unemployable
  • 55.
    55 Take Away MessageFor Job Seekers: • Marijuana use can RUIN your chances of employment!
  • 56.
    56 Take Away MessageFor Business: • Increased marijuana use is BAD for your business and your bottom line
  • 57.
    57 If you careabout highway safety: You need to care about increased marijuana use.
  • 58.
    58 Why? • Because marijuanause impairs driving ability1 1For a comprehensive review, see DuPont, R. et al. 2010. “Drugged Driving Research: A White Paper.” Prepared for the National Institute on Drug Abuse. Available at http://stopdruggeddriving.org/pdfs/DruggedDrivingAWhitePaper.pdf
  • 59.
    Because Cannabis useimpairs driving as much as alcohol A new NIDA study found: –Marijuana's active chemical THC affects weaving within a road lane in a similar way to a blood alcohol level of .08, the legal limit in many states. –Marilyn Huestis of NIDA: “One of the things we know happens with cannabis is that it reduces your field of vision and you get tunnel vision, so you're unable to react as quickly.” http://www.dailymail.co.uk/news/article-3137943/Marijuana-DOES-impair-driving-kind-comprehensive-government-study-reveals-cannabis-use-affect-motor-skills-three-drinks.html
  • 60.
    60 • Marijuana isthe most prevalent illegal drug detected in impaired drivers, fatally injured drivers, and motor vehicle crash victims. 1 1 National Highway Traffic Safety Administration. Drug Involvement of Fatally Injured Drivers. U.S. Department of Transportation Report No. DOT HS 811 415. Washington, DC: National Highway Traffic Safety Administration, 2010. Because:
  • 61.
    61 • Driving underthe influence of marijuana is associated with a 92% increased risk of vehicular crashes. 1 • Such driving is associated with a 110% increase in fatal crashes. 2 1 Asbridge, M., Hayden, JA, Cartwirght, JL. Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta- analysis. British Medical Journal, 2012; 344 (ePub): e536. PMID: 22323502. 2 Ibid. Because:
  • 62.
    62 Because: • Researchers atthe University of Massachusetts, Amherst, found 44 % of college men said they drove after smoking marijuana in the previous month, compared with 12% who said they drove after drinking. • Jennifer M. Whitehill, PhD; Frederick P. Rivara, MD, MPH; Megan A. Moreno, MD, MSEd, MPH; Marijuana-Using Drivers, Alcohol-Using Drivers, and Their Passengers. AMA Pediatr. Published online May 12, 2014. doi:10.1001/jamapediatrics.2013.5300
  • 63.
    Because: • A newstudy conducted by the National Cannabis Prevention and Information Centre, found nearly 70% of recent cannabis users had driven while under the influence of the drug. • 16% of users said they had driven on a daily basis less five hours after using • Many users were oblivious to the impact cannabis had on driving skills http://www.abc.net.au/news/2015-06-10/cannabis-users-report-driving-under-influence/6534368
  • 64.
    64 Take Away Message: •Increased marijuana use will increase car crashes and fatalities
  • 65.
    65 If you careabout your tax burden, you need to care about increased marijuana use
  • 66.
    66 Why? Because Because the totaloverall costs of substance abuse in the U.S., including productivity, health and crime-related costs, exceed $600 billion annually.1 This includes approximately: • $235 billion for alcohol • $193 billion for tobacco • $181 billion for illicit drugs 1 Office of National Drug Control Policy. The Economic Costs of Drug Abuse in the United States, Executive Office of the President (Publication No. 207303). 2004. Available at www.ncjrs.gov/ondcppubs/publication/pdf.economic_costs.pdf
  • 67.
    67 Because • Federal andstate alcohol taxes raise $14.5 billion, covering only about 6% of alcohol’s total cost to society.1 • Federal and state tobacco taxes raise $25 billion, covering only about 13% of tobacco’s total cost to society.2 1 Dupont, Robert M.D., Director of the National Institute on Drug Abuse (1973-1978), “Why We Should Not Legalize Marijuana.” April 2010. Available: www.cnbc.com/id/36267223/Why_We_Should_Not_Legalize_Marijuana 2 Ibid
  • 68.
    Legal corporations workhard to keep prices low and consumption high! 68 • Alcohol taxes are now 1/5 of what they were during the Korean War (adjusted for inflation). Cook, P. J. (2007). Paying the tab: The economics of alcohol policy. Princeton, NJ: Princeton University Press.
  • 69.
    Take Away Message: •Increased marijuana use will COST tax payers much more money than it can possibly bring in.
  • 70.
    Thomas J. Gorman,Director Rocky Mountain High Intensity Drug Trafficking Area www.rmhidta.org 2016
  • 71.
  • 72.
    Has the “War” onDrugs Been a Failure?
  • 73.
    Background • Purpose ofDrug Policy • Limit the number of people using drugs • Victimless Crime? • Four classes of victim: 1. User 2. Family/Friends 3. Victim of Crime 4. Taxpayers
  • 74.
    Background • Factors AffectingRate of Drug Use • Four primary factors: 1. Price 2. Availability 3. Perception of Risk 4. Public Attitude
  • 75.
    The Issue Drug “War”a Failure Question… What would it take for you to consider our drug policy successful?
  • 76.
    The Issue 2013 NationalSurvey on Drug Use • Americans age 12 and older (past month):  9% used any illegal drug  26% used tobacco  52% used alcohol
  • 77.
    The Issue 91% ofAmericans do NOT use illegal drugs Source: 2013 National Survey on Drug Use
  • 78.
    The Issue Alcohol andTobacco Heroin, Meth, Crack, Hallucinogens, Cocaine, Tranquilizers, Pain Relievers and Marijuana
  • 80.
    Licensed Marijuana Businesses MedicalMarijuana (January 1, 2015) Recreational Marijuana (January 1, 2015) • 497 licensed centers • 748 marijuana cultivation facilities • 163 infused products (edibles) businesses • 369 licensed marijuana retail stores • 397 licensed marijuana cultivation facilities • 98 licenses for infused product (edibles) businesses
  • 81.
    Perspective • Colorado BusinessProfile, January 2015 2014 Colorado Starbucks 405 McDonalds 227 Medical Marijuana Centers 505 Recreational Marijuana Shops 322
  • 82.
  • 83.
  • 85.
    “Legal pot blamedfor some of influx of homeless in Denver this summer” The Denver Post, July 25, 2014 • Haven of Hope: 500% rise over normal in homeless in summer 2014 (50 to 300) • “They have an attitude” • Salvation Army: 33% rise since 2014 compared to 2013 • “30% relocated for pot”
  • 86.
    “Legal pot blamedfor some of influx of homeless in Denver this summer” The Denver Post, July 25, 2014 • Urban Peak: 152% increase • “Majority of new kids here because of weed.” • St. Francis: 50 more people a day • “Marijuana only trails looking for work as reason.”
  • 87.
    Marijuana and PublicConsumption “Citations for using pot in public rising” Denver police say they’re not purposely trying to nab users since marijuana was legalized. The Denver Post Sunday, December 28, 2014 2012 = 8 citations 2013 = 184 citations 2014 = 770 citations
  • 88.
  • 89.
    Marijuana Edibles Deaths LevyThamba Pongi and Kristine Kirk (Denver, CO) Luke Goodman (Keystone, CO)
  • 90.
  • 91.
    Forecast What Does theData and Trends Show?
  • 92.
    0 500 1,000 1,500 2,000 2,500 2009 2010 20112012 2013 2014 220 619 1,152 1,264 1,583 1,903 398 NumberofScreenswithActiveTHC Number of Positive Cannabinoid Screens with Active THC 1ng/mL 2ng/mL SOURCE: ChemaTox Laboratory and Rocky Mountain HIDTA
  • 93.
    Marijuana and TrafficFatalities 37 39 43 47 49 63 78 71 94 0 10 20 30 40 50 60 70 80 90 100 2006 2007 2008 2009 2010 2011 2012 2013 2014 NumberofFatalities Traffic Deaths Related to Marijuana * *Number of Fatalities Involving Operators Testing Positive for Marijuana Commercialization Legalization * Number of Fatalities Involving Operators Testing Positive for Marijuana SOURCE: National Highway Transportation Safety Administration, Fatality Analysis Reporting System (FARS), 2006-2013 and CDOT/RMHIDTA 2014. NOTE: Cannot confirm 100% reporting prior to 2012.
  • 94.
    Marijuana and TrafficFatalities * Number of Fatalities Involving Operators Testing Positive for Marijuana SOURCE: National Highway Transportation Safety Administration, Fatality Analysis Reporting System (FARS), 2006-2013 and CDOT/RMHIDTA 2014. NOTE: Cannot confirm 100% reporting prior to 2012. 6.92% 7.04% 7.85% 10.10% 10.89% 14.09% 16.53% 14.76% 19.26% 0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 2006 2007 2008 2009 2010 2011 2012 2013 2014 PercentofDeaths Percent of All Traffic Deaths That Were Marijuana Related* *Percent of All Fatalities Where the Operators Tested Positive for Marijuana Commercialization Legalization * Percent of All Fatalities Where the Operators Tested Positive for Marijuana
  • 95.
    Operators Positive forMarijuana * Number of Fatalities Involving Operators Testing Positive for Marijuana Marijuana ONLY 33% Marijuana and Other Drugs (No Alcohol) 15% Marijuana and Alcohol 37% Marijuana, Other Drugs and Alcohol 15% SOURCE: Colorado Department of Transportation/RMHIDTA 2014
  • 96.
    Teens and Marijuana “Sincelegalization, reports of pot in middle and high schools soar.”
  • 97.
    Marijuana Use inYouth Youth (ages 12 to 17 years) Current Marijuana Use 2013/2014  National average for youth was 7.22 percent  Colorado average for youth was 12.56 percent  Colorado was ranked 1st in the nation for current marijuana use among youth (74 percent higher than the national average)  2013/2014 Colorado youth use increased 20 percent compared to pre-legalization years 2011/2012.  Nationally a decline of 5 percent.
  • 98.
    Marijuana Use inYouth 0.00 5.00 10.00 15.00 05/06 06/07 07/08 08/09 09/10 10/11 11/12 12/13 13/14 National Average 6.74 6.67 6.67 7.03 7.38 7.64 7.55 7.15 7.22 Colorado Average 7.60 8.15 9.13 10.17 9.91 10.72 10.47 11.16 12.56 Percentof ages12-17Years Annual Averages of Data Collection Youth Ages 12 to 17 Years Old Past Month Marijuana Use National vs. Colorado Commercialization Legalization SOURCE: SAMHSA.gov, National Survey on Drug Use and Health, 2013 and 2014
  • 99.
    Marijuana Use inYouth 0.00% 2.00% 4.00% 6.00% 8.00% 10.00% 12.00% 2006-2008 (Pre-Commercialization) 2009-2012 (Post-Commercialization) 2013/2014 (Legalization) 8.64% 10.37% 12.56% AveragePercent Colorado Average Past Month Use of Marijuana Ages 12 to 17 Years-Old (20% Increase) (21% Increase) SOURCE: National Survey on Drug Use and Health, 2013 and 2014
  • 100.
    Student Marijuana Sources SOURCE:Colorado School Counselor Association (CSCA) and Rocky Mountain HIDTA, 2015
  • 101.
    High School Discipline SOURCE:Colorado Department of Education, 10-Year Trend Data: State Suspension and Expulsion Incident Rates and Reasons
  • 102.
    High School Discipline SOURCE:Colorado Department of Education, 10-Year Trend Data: State Suspension and Expulsion Incident Rates and Reasons
  • 103.
    College-Age Marijuana Use College-AgeAdults (ages 18 to 25 years) Current Marijuana Use 2013/2014  National average = 19.32 percent  Colorado average = 31.24 percent  Colorado was ranked 1st in the nation for current marijuana use among college-age adults (62 percent higher than the national average)  2013/2014 college age use increased 17 percent compared to pre legalization years 2011/2012. Nationally a 2 percent increase
  • 104.
    College-Age Marijuana Use SOURCE:SAMHSA.gov, National Survey on Drug Use and Health 2013 and 2014
  • 105.
    College-Age Marijuana Use SOURCE:SAMHSA.gov, National Survey on Drug Use and Health 2013 and 2014
  • 106.
    Adult Marijuana Use Adults(ages 26+ years) Current Marijuana Use 2013/2014  National average = 6.11 percent  Colorado average = 12.45 percent  Colorado was ranked 1st in the nation for current marijuana use among adults (104 percent higher than the national average)  2013/2014 adult use increased 63 percent compared to pre-legalization years 2011/2012. Nationally an increase of 21 percent.
  • 107.
    Adult Marijuana Use SOURCE:National Survey on Drug Use and Health, 2006-2014
  • 108.
    Colorado Emergency DepartmentRates Likely Related to Marijuana SOURCE: Colorado Department of Public Health and Environment
  • 109.
    Colorado Hospitalization RatesLikely Related to Marijuana SOURCE: Colorado Department of Public Health and Environment
  • 110.
    Rocky Mountain PoisonCenter SOURCE: Colorado Department of Public Health and Environment/RMPDC
  • 111.
  • 112.
    States to WhichMarijuana Was Destined (2014)
  • 113.
    Diversion – ByMotor Vehicles SOURCE: El Paso Intelligence Center (EPIC), National Seizure System
  • 114.
    Diversion – ByU.S. Postal Service Packages SOURCE: United States Postal Inspection Service – Prohibited Mailing of Narcotics
  • 115.
    All Reported Crimein Denver 2013 2014 55,115 reported crimes 60,788 reported crimes 5,391 reported crimes increase from 2013 to 2014 (10 percent increase) Reported offenses using the National Incident Based Reporting System (NIBRS) definitions in the City and County of Denver, January 9, 2015
  • 116.
  • 117.
    Colorado General Fund Colorado'sTotal General Fund Revenue, FY 2015* Marijuana Tax Revenue (Medical and Recreational) = 0.7% * Preliminary Numbers Based on June 2015 Forecast
  • 118.
    FY 2015 TaxRevenue
  • 119.
    A Snapshot inColorado 2014 Marijuana-Related DUIDs Marijuana-Related Traffic Deaths Youth Marijuana Use College Marijuana Use Adult Marijuana Use Marijuana-Related Emergency Room Admissions Marijuana-Related Hospitalizations Marijuana-Related Exposures Marijuana-Related Treatment Marijuana Diversion THC Extraction Labs
  • 120.
    Local Response toMedical and Recreational Marijuana in Colorado Of 321 total local jurisdictions:  228 (71 percent) prohibit any medical or recreational marijuana businesses  67 (21 percent) allow any medical and recreational marijuana businesses  26 (8 percent) allow either medical or recreational marijuana businesses, not both
  • 121.
     Important toRemember with Statistics… Why We Do This
  • 122.
    Thank you forwhat you do. Remember:
  • 123.
    The Naked Truthabout Medical Marijuana Presenters: • Susan R. Thau, MCRP, Public Policy Consultant, Community Anti-Drug Coalitions of America • Thomas J. Gorman, Director, Rocky Mountain High Intensity Drug Trafficking Area Advocacy Track Moderator: Nancy Hale, MA, President and CEO, Operation UNITE