2013 National Survey on Drug Use and Health, SAMHSA, … · 2013 National Survey on Drug Use and...
Transcript of 2013 National Survey on Drug Use and Health, SAMHSA, … · 2013 National Survey on Drug Use and...
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
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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
• 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)
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
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
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
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
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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.
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
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Di Chiara et al.
FOOD
Tanda, et al, Science 1997.
Long Term Effects of Marijuana: Addiction
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* Nonmedical Use, Source: Anthony JC et al., 1994
Estimated Prevalence of Dependence Among Users
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• 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
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Cannabis users byage 15 years
Cannabis users byage 18 years
Arseneault et al BMJ 2002
Risk of schizophrenia-likepsychosis at age 26 years
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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
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300 to 399
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Never# of occasions using
Cannabis ages 14-21
Slide Courtesy of Marijuana Impact on Public Health & Safety in Co.
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
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,
The Difference:
-$66.8 Million(That’s more than 50% less than expected!)
Alcohol & Tobacco:Money Makers or Dollar Drainers?
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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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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
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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
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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.
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)
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
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