2013 National Survey on Drug Use and Health, SAMHSA, 2014.

Marijuana is the Most Commonly Used Illicit Drug In the U.S.

Tetrahydrocannabinol (THC) Active Ingredient in Marijuana

• Over 114 million Americans have tried it at least once

• An estimated 2.4 million Americans used it for the first time in 2013

0

10

20

30

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50

60

91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14

Percentage of U.S. 12th Grade Students Reporting Past Month Use of

Cigarettes, Marijuana and Alcohol

SOURCE: University of Michigan, 2014 Monitoring the Future Study.

Cigarettes

Marijuana

Alcohol

Legalization Status

As of November 2016

• 7 states have legalized recreational marijuana

• 28 states legalized marijuana for medical purposes

Marijuana Extracts:

Products and Devices

• Used in Medibles

• Stems, leaves & stalks (sometimes buds) are ground up and placed in a PVC, glass, or aluminum tube

• Butane gas is passed through the tube and strips the resins (nearly pure THC) from the cannabis

• As the butane passes through the tube the THC resin & butane run out the bottom

Marijuana Concentrates/Extracts80-90% THC

“But it’s just a plant…”(80-90% THC) Concentrates

“Budder” “Shatter”

“Ear Wax”“Green Crack” wax

Hash Oil Capsules

Butane Hash Oil (BHO)

Slide Courtesy of Marijuana Impact on Public Health & Safety in Co.

Electronic Delivery Devices (E.D.D’s)

• Allows user to inhale vapor containing nicotine and/or other substances.

• Disposable or rechargeable and/or refillable.

• Contain a cartridge filled with liquid nicotine, flavorings and glycerin or propylene glycol.

• When coil heats, it converts the

contents of the cartridge into vapor.• Devices can easily be

concealed as pens and pencils.

Butane Hash Oil (BHO) Hazards

• Butane is odorless, colorless, and heavier than air

• Butane is a highly flammable gas and the canisters are compressed & pressurized

• If exposed to flame, the canisters are hand sized fire grenades and most scenes have hundreds of cans

• Butane seeps into low lying areas, like basements where there are pilot flames

Butane Hash Oil (BHO)

Michigan State PoliceWestern Wayne Narcotics Case 2013

Myth: No one dies from marijuana useDENVER (AP/CBS 4) April 2, 2014

A Wyoming college student visiting Denver on spring break jumped to his death after eating a marijuana cookie that his friend legally purchased in one of Colorado's recreational pot shops, authorities said Wednesday. An autopsy report lists marijuana intoxication as a "significant contributing factor" in the death of 19-year-old Levi Thamba Pongi, a native of the Republic of Congo who fell from a motel balcony on March 11. Pongi'sfriends told investigators he ate the cookie and "exhibited hostile behavior" that included pulling things off walls and speaking erratically, the report said. Attempts by the three friends to calm Pongi seemed to work until he went outside and jumped over the balcony railing, according to the report. Denver police ruled the death an accident and their investigation remains open. Colorado law bans the sale of recreational marijuana products to people under 21. Possession by people under 21 is also against the law. Authorities said one of Pongi's friends was old enough to buy the cookie from a pot shop. The medical examiner's office had Pongi's body tested for at least 250 different substances, including bath salts and synthetic marijuana, which are known to cause strange behavior. His blood tested positive only for THC, the psychoactive ingredient in marijuana, according to the report. One of Pongi's friends also tried the cookie but stopped after feeling sick, said Michelle Weiss-Samaras, a spokeswoman for the Denver County medical examiner's office. The marijuana concentration in Pongi'sblood was 7.2 nanograms of active THC per milliliter of blood. Colorado law says juries can assume someone is driving while impaired by marijuana if their blood contains more than 5 nanograms per milliliter of the chemical. Officials at Northwest College in Powell, Wyo., say Pongi started taking classes as an exchange student in January. He was studying engineering.

Source: CBS Denver News

Consequences of Marijuana Legalization

and Expanded Availability

The Attractiveness of Provisioning Centers in Michigan

Marijuana Growers Math

72 Plants x 3 Grow Cycles Per Year = 216 Plants per Year PER GROWER1 Lb. of Marijuana per Plant = 216 Lbs. of Marijuana per year PER GROWER

216 Lbs. / 6 Patients = 36 lbs. PER PATIENT

1 Marijuana Cigarette = ½ gram56 Marijuana Cigarettes in 1 oz. (28.35 grams)

896 Marijuana Cigarettes in a Pound (16 ounces)896 Marijuana Cigarettes x 36 lbs. PER PATIENT = 32,256 Marijuana Cigarettes PER PATIENT

THAT’S 88 Marijuana Cigarettes Per Day PER PATIENT

Plant Size

Illicit Drugs vs. Prescription Drugs

• Schedule 1 drugs- No medicinal purposes- illegal substances with high potential for abuse such as Opiates, LSD, ecstasy, MARIJUANA/MARIHUANA

• Schedule 2 drugs- high potential for abuse with currently accepted medical treatment use such as: morphine, oxycodone, fentanyl, etc.

• Schedule 3 drugs- some potential for abuse; stimulants and depressant medications as prescribed by a doctor (sleeping pills, xanax, anti-anxiety medications etc)

• Schedule 4- over the counter drugs such as tylenol and cold medicines

MI Medical Marihuana

• Voted into law for “the sick and dying”

• Less than 12% of card carriers have a terminal diagnosis (2015)

• The Federal government still recognizes this as an illegal substance

talksooner.org

The most common Marijuana myths

Medical Marihuana vs “Regular Marijuana”

• Medical Marihuana is still Marijuana.

• The drug comes from the same grow operations.

• Having a medical card doesn’t mean it can be picked up at a pharmacy like a prescription.

Determine the benefits and risks of the drug

Determine how it may interact with other drugs

Assure standardization of the drug

Determine the appropriate dosage levels

Identify and monitor side effects

Identify safe drugadministration

19

Before the FDA approves a drug as a medicine, testing is done to:

Marijuana bypasses these FDA processes!

Marinol

• Pill containing synthetic THC

• Used for appetite stimulation in AIDS patients and other terminal diagnosis cases.

• Marinol is widely available at pharmacies to treat nausea/vomiting from cancer chemotherapy

• Not to be used in combination with: alcohol, marijuana and other drugs that affect the central nervous system such as diazepam (Valium), or Xanax.

Understanding the Impact of Youth Marijuana Use

Natural and Drug ReinforcersIncrease Dopamine in NAc

VTA/SN

nucleus accumbens

frontalcortex

Drugs of abuse increase DA in the Nucleus Accumbens, which is believed to trigger the

neuroadaptions that result in addiction

150

125

1000 20 40 60 80

MARIJUANA

% o

f B

asa

l R

ele

as

e

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1100

0 1 2 3 4 5 hr

AMPHETAMINE

% o

f B

asa

l R

ele

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e

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% o

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asa

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Empty

Di Chiara et al.

FOOD

Tanda, et al, Science 1997.

Long Term Effects of Marijuana: Addiction

32

15

9

17

118

5

23

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35

Per

cen

t

* Nonmedical Use, Source: Anthony JC et al., 1994

Estimated Prevalence of Dependence Among Users

* *

• About 9% of users may become dependent

• 25-50% of teen daily users become addicted

• 1 in 6 who start use in adolescence become addicted

Mental Health Impact

• The risk of schizophrenia and psychosis increases with frequency of use and potency

• Earlier age of first use increases risk

• Marijuana use increases severity of psychosis in those with schizophrenia

• Brain abnormalities (smaller hippocampus and amygdala volume) seen in heavy long-term users- linked with impaired memory performance

4.5

1.6

0123456789

Cannabis users byage 15 years

Cannabis users byage 18 years

Arseneault et al BMJ 2002

Risk of schizophrenia-likepsychosis at age 26 years

Od

ds

rati

o

Non-usersused 1 Dx

used 2 Dx

used 3 Dx

-8

-6

-4

-2

0

2

Ave

rage

Po

int

Dif

fere

nce

in IQ

sco

re

(IQ

at

age

13

–IQ

at

age

38

)

Persistent Marijuana Users Show A Significant IQ Drop between Childhood and Midlife

Source: Meier MH et al., PNAS Early Edition 2012

Followed 1,037 individuals from birth to age 38. Tested marijuana use at 18, 21, 26, 32 and 38. Tested for IQ at ages 13 and 38

Slide Courtesy of Marijuana Impact on Public Health & Safety in Co.

More Use of Cannabis Associated with Worse Social Outcomes at Age 25 (New Zealand Study)

Source: Fergusson and Boden. Addiction, 103, pp. 969-976, 2008.

Number of occasions using Cannabis between ages 14-21

% welfare dependent

(ages 21-25)

% Unemployed(ages 21-25)

mean personal income

at age 25

% gained university degree

by age 25

400+

300 to 399

200 to 299

100 to 199

1 to 99

Never# of occasions using

Cannabis ages 14-21

Slide Courtesy of Marijuana Impact on Public Health & Safety in Co.

Physical Health Impacts

Lungs and Cardiovascular System

Lungs Cardiovascular System

• Higher heart rate and blood pressure

• Heart attack, stroke, and other adverse events are rare, but have been reported.

• Higher risk of bronchitis

• Higher risk of respiratory infections

• Increased risk of lung cancer in heavy smokers

Lessons Learned from legalization

Lesson #1Colorado Futures Center Tax Estimates

The Plan:15% excise tax will yield $21.7 Million10% special sales tax will yield $90.9 Million 2.9% existing state sales will yield $17.6 Million

Estimated taxes, licenses and fees:

$130.2 Million

Actual Amount Collected in 2014:

$63.4 Million

The Fiscal Impact of Amendment 64 on State RevenuesApril 24, 2013

Prepared by:Charles Brown Phyllis Resnick

Director Lead EconomistColorado Futures Center Colorado Futures Center

www.colostate.edu/coloradofutures

Source: Colorado Department of RevenuePrepared by: Office of Research and Analysis,

dor_ora@state.co.us

The Difference:

-$66.8 Million(That’s more than 50% less than expected!)

Colorado & Washington Past-Year

Statistics Courtesy of SMART Approaches to Marijuana

Alcohol & Tobacco:Money Makers or Dollar Drainers?

32

Alcohol

CostsTobacco

Costs

$14 billion

Costs

Revenues

$25 billion

$200billion

$185billion

Revenues

State estimates found at http://www.nytimes.com/2008/08/31/weekinreview/31saul.html?em; Federal estimates found at https://www.policyarchive.org/bitstream/handle/10207/3314/RS20343_20020110.pdf; Also see http://www.tobaccofreekids.org/research/factsheets/pdf/0072.pdf; Campaign for Tobacco Free Kids, see “Smoking-caused costs,” on p.2.

talksooner.org

Myth: Legalizing Marijuana will create an Economic Stimulus

Will legalizing marijuana create an Economic stimulus? Jobs are created and tax revenue is collected; we won't

deny that. Let's first consider some of the potential “other” costs associated with legalizing marijuana:

1. Increased medical costs such as ER visits2. Increased car crashes3. The cost associated with treating addiction 4. Loss of productivity at work5. Unintentional exposure to children

Lesson #2 Summary

This is not the marijuana that the public and our lawmakers remember from college

• Average THC levels in 1980 were 1.5%• From 1999 to 2011, THC levels increased 144% (4.67% - 11.42%)• The last 4 years in Colorado, THC levels increased 155% to 28%

THC (Return on Investment/Increase market share = a more potent drug)

• There are no studies on marijuana with these THC levels (THC<12%)

• And these THC levels pale in comparison to Medibles….

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2011

THC 0.2 0.2 0.4 0.5 1 1 1.5 3.3 3.3 3.5 3.5 3.1 3.1 4 4.5 5.2 5 4.7 5.4 6.2 7.3 7.2 8.3 8.1 9.1 10 10 9.9 11 11

CBD 0.3 0.3 0.4 0.4 0.3 0.3 0.4 0.4 0.4 0.4 0.5 0.5 0.4 0.5 0.5 0.5 0.5 0.5 0.4

0

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MA

RIJ

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TEN

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CBD:Non-Psychoactive

Ingredient

Average THC and CBD Levels in the US: 1960 – 2011

144% THC increase 1999 – 2011

Mehmedic et al., 2010

201111.42%

1980 1.5%

THC:Psychoactive

Ingredient

35

1999 4.67%

Slide Courtesy of Marijuana Impact on Public Health & Safety in Co.

The Last 4 Years in Colorado

10.96%

Slide Courtesy of Marijuana Impact on Public Health & Safety in Co.

Statistics Courtesy of SMART Approaches to Marijuana

Incarceration Rates

• In total, one tenth of one percent (0.1 percent) of all state prisoners were marijuana-possession offenders with no prior sentences.

• There are very few people in state or federal prison for marijuana-related crimes. It is useful to look at all drug offenses for context. Among sentenced prisoners under state jurisdiction in 2008, 18% were sentenced for drug offenses.

• For federal prisoners, who represent 13% of the total prison population, about half (51%) had a drug offense as the most serious offense in 2009.

• And federal data shows that the vast majority (99.8%) of federal prisoners sentenced for drug offenses were incarcerated for drug trafficking.

• (Sources are in the notes)

Lesson # 3Product Advertising and

Un-Regulated Commercialization

of Marijuana

2014 Colorado Denver

Starbucks

McDonalds

Medical Marijuana Dispensaries

Recreational Marijuana Disp.

As of: Jan 2015

What Will Michigan Look Like with Provisioning Centers?

• 632 Starbucks & McDonald’s Combined in Colorado in 2014• 827 Marijuana Dispensaries in Colorado in 2014

Statistics Courtesy of Colorado HIDTA

Use of Cartoons and Caricatures

Slide Courtesy of Marijuana Impact on Public Health & Safety in Co.

Slide Courtesy of Marijuana Impact on Public Health & Safety in Co.

SO WHEN SHOULD I WORRY?ABUSE

Sudden Changes

in Behavior or

Mood

Drug Paraphernalia

(i.e.: roach clips,

syringes, eye drops,

lighters, rolling

papers)

Unexplained

medical issues such

as nose bleeds,

excessive bronchitis,

red or glassy eyes

Peer Group Drift

Lying

Physical Violence or

Suicidal Ideation

Withdrawal from

family members

Loss of Interest in

normal hobbies,

sports or other

activities

Erratic Sleep

Patterns or Lack

of Energy

Academic Decline

& Absenteeism

Stealing or Sudden

requests for money

without

explanation

Home Truancy

Get mobile with the power of prevention

today by downloading

the TalkSooner App!

Questions?