Trending Topics Track

The Naked Truth About “Medical” Marijuana: Translating the Science

into Messages that Matter

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 (HIDTA)

Moderator: Nancy Hale, President and CEO, Operation UNITE

Disclosures

Susan R. Thau, MCRP; Thomas J. Gorman; and Nancy Hale 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:– Kelly Clark – Employment: Publicis Touchpoint Solutions;

Consultant: Grunenthal US– Robert DuPont – Employment: Bensinger, DuPont &

Associates-Prescription Drug Research Center– Carla Saunders – Speaker’s bureau: Abbott Nutrition

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.

The Naked Truth About “Medical” Marijuana:

Translating the Science into Messages that Matter

Sue Thau, Public Policy Consultant, Community Anti-Drug Coalitions of

America

5

Sue Thau, Public Policy Consultant, Community Anti-Drug Coalitions of America, has disclosed no relevant,

real or apparent personal or professional financial relationships

with proprietary entities that produce health care goods and services.

6

Goals

• Understand the latest science about marijuana use

• Understand how CADCA has framed marijuana prevention messages from the science

• Understand how to employ these prevention messages locally to educate residents and key community leaders

7

“The naked truth is always better than the

best-dressed lie.” – Ann Landers

8

Marijuana is Addictive

9

• 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.

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.

who start using marijuana in adolescence become addicted.

So…1 in 6 Young People

National Institutes of Health, National Institute on Drug Abuse. 2011. Topics in Brief: Marijuana. Available: http://www.drugabuse.gov/publications/topics-in-brief/marijuana

10

According to the 2014 Monitoring the Future Survey, perceptions about the risks of marijuana

are going down among 12th graders.

11

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.

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,

12

FACTS on Medical Marijuana

–Is not even good for conditions it is touted for

–Could exacerbate symptoms (American Glaucoma Society)

1American Glaucoma Foundation. Available: http://www.glaucomafoundation.org/UserFiles/File/TGF_Summer_10_Web.pdf

1

13

Medical Marijuana Is Easily Diverted To Youth

• Teens who know somebody with a medical marijuana license are more like than those who don’t to report ‘fairly’ or ‘very’ easy access to marijuana

• 74% of Denver-area teens in treatment said they used somebody else’s medical marijuana an average of 50 times

Thurstone, 2013; Salomonsen-Sautel et al., 2012

14

Diversion To Youth

15

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.”

Wall, M., et al., 2011; Johnston, L.D., et al., 2011. and Pacula et al 2013

Pacula slide 16

17

A Recent Australian Study on Individuals Prescribed Opioid Painkillers That Also

Used “Medical Marijuana” (1 in 6 participants)

• 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

• Medical marijuana users 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

20

Play #1

•Pass “medical” marijuana initiatives

21

Using “Marijuana as Medicine”a “Permission Structure” was built

about the safety and acceptability of marijuana use with the general

public.

23

24

25

Play #2

• Open “medical” marijuana dispensaries

26

Play #3•Full legalization of marijuana

27

The Ultimate Play?

•Full legalization of all drugs

28

“I’m always telling my marijuana reform allies, when they say we need to legalize marijuana and get tougher on the other drugs, ‘shut the hell up’”

The whole, of course, is safe and legal access to all drugs. Cocaine. Heroin. Hash. Ecstasy.

“Legalize all drugs? The man behind loosening pot laws in US eyes new goal” Available: http://usnews.nbcnews.com/_news/2013/11/27/21578665-legalize-all-drugs-the-man-behind-loosening-pot-laws-in-us-eyes-new-goal

Ethan Nadelmann – Head of Drug Policy Alliance

29

HOW TO FRAME OUR MESSAGES TO WIN BACK THE PUBLIC

30

Using Science with High Evidence from NIDA to Change the Frame:

From negative to positive

From “old” to “new”

From complicated to simple

31

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

33

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

If you care about academic achievement:

You need to care about increased marijuana use.

34

Because: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.

35

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

36

37

The more a student uses marijuana, the lower their grade point average is likely to be and the more likely they are to drop out of school.1

1 Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E.. University of Michigan, 2011. Monitoring the Future Study

Because:

• Marijuana use negatively effects motivation, memory, AND learning.1

1 National Institute on Drug Abuse, “Marijuana: Facts Parents Need to Know.” 2011. Available: www.nida.nih.gov/marijbroch/parents/001.php

Because:

38

Take Away Message for Parents:

Marijuana use will hurt

YOUR child’s IQ, grades, and

ability to graduate from high school!

39

Take Away Message ForTeachers/School Systems:

40

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.

41

• 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

Because:

42

Because:Daily marijuana use among college students is the

highest it's been in more than three decades.

A MTF study found:

• In 2013, 1 in every 20 college students is smoking pot on a daily basis, including 1 in every 11 males and 1 in every 34 females

• In 1990, 1 in 50 college students used marijuana that frequently

• This is the highest rate of daily use observed among college students since 1981

http://www.mlive.com/news/ann-arbor/index.ssf/2014/09/regular_marijuana_use_among_co.html 43

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.

44

Take Away Message for Parents:

Your child’s marijuana use could derail their college career and be very costly to you!!

45

IF YOU CARE ABOUT HIGHWAY SAFETY:

YOU NEED TO CARE ABOUT INCREASED MARIJUANA USE.

46

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

47

• Between 1999 and 2010, the prevalence of drugs other than alcohol in fatally injured drivers increased significantly.

• While the prevalence of alcohol remained stable at 39%, the prevalence of other drugs increased from 16.6% in 1999 to 28.3% in 2010.

• The greatest increase was for marijuana, which tripled, from 4.2% in 1999 to 12.2% in 2010.

Because: Marijuana Most Prevalent Drug Detected in Fatally Injured

Drivers

Source: Adapted by CESAR from Brady, J.E. and Li, G., “Trends in Alcohol and Other Drugs Detected in Fatally Injured Drivers in the United States, 1999-2010,”

American Journal of Epidemiology, Advance Access, 1/29/2014. For more information, contact Dr. Guohua Li at gl2240@columbia.edu.

48

Impaired Driving in Colorado:

• Traffic fatalities involving operators testing positive for marijuana have increased 100% from 2007 to 2012.

• The majority of driving-under-the-influence-of-drugs arrests involve marijuana and 25 to 40% were marijuana alone.

• Toxicology reports with positive marijuana results for driving under the influence have increased 16% from 2011 to 2013.

49

http://www.rmhidta.org/html/August%202014%20Legalization%20of%20MJ%20in%20Colorado%20the%20Impact.pdf

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

50

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:

Because:

• According to the 2012 Monitoring the Future Study, three times as many high school seniors reported driving after smoking marijuana than drinking alcohol (8.6% to 2.9%)

51

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

52

IF YOU CARE ABOUT

EMPLOYMENT:

YOU NEED TO CARE ABOUT

INCREASED MARIJUANA USE.

53

According to the American Council for Drug Education in New York, employees who abuse drugs are:

• 10 times more likely to miss work

Why? Because:

54

Because:

3.6 times more likely to be involved in

on-the-job incidents.

55

Because:5 times more likely to file a workers’

compensation claim.

And since regular users can’t pass drug tests, this hurts employability!

56

Many big companies, industries and professions nationwide

conduct drug testing

• Big Retailers (Target, Walmart)

• Food Services

• Police/Fire Departments

• Military

• Transportation

• Banking

• Real Estate

57

These students are virtually unemployable.

58

TAKE AWAY MESSAGEFOR JOB SEEKERS:

Marijuana use can RUIN

your chances of employment!

59

TAKE AWAY MESSAGEFOR BUSINESS:

Increased marijuana use is BAD for your business and

your bottom line.

60

IF YOU CARE ABOUT YOUR TAX BURDEN,

YOU NEED TO CARE ABOUT INCREASED MARIJUANA USE

61

Why? BecauseBecause 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

62

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

63

TAKE AWAY MESSAGE:

Increased marijuana use will COST

tax payers much more money

than it can possibly bring in.

64

BEWARE: Our Nations Future Could Look Like This

65

Instead of This!

66

Thomas J. Gorman, DirectorRocky Mountain High Intensity Drug Trafficking Areawww.rmhidta.org2015

DRUG POLICY 101

WHAT’S HAPPENING IN COLORADO

THE LEGALIZATION OF MARIJUANA IN COLORADO: THE

COLORADO: THE IMPACT

Disclosure Statement

Director Tom Gorman has disclosed no

relevant, real or apparent personal and

professional financial relationships with

proprietary entities that produce health care

goods and services.

Learning Objectives

• Identify concerns related to marijuana, medical

marijuana and legalization

• Evaluate the impact of marijuana legalization in

Colorado

• Describe the impact of marijuana use on the

adolescent brain

• Explain how to track the impact of medical marijuana

and marijuana legalization on public health and safety

• Prepare attendees to deliver science-based messages

that resonate with the general public

www.rmhidta.org

click on

“Reports”

The War on Drugs

Has Been a FailureQuestion:

Why do you and/or others feel our drug policy has been a failure?

Questions

What is the purpose of

drug policy?

Isn’t drug use a

victimless crime?

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

Question

What are the factors that

affect the rate of drug use?

Background

• Factors Affecting Rate of Drug Use

• Four primary factors:

1. Price

2. Availability

3. Perception of Risk

4. Public Attitude

Some Common Issues

• Alcohol Prohibition Didn’t Work

• Legalization Experiments in Other

Countries

• Everyone Uses and, if Legalized,

Marijuana Wouldn’t Increase Much

Some Common Issues• Marijuana is Safe

– No, it’s more harmful than most think

• Intoxication

• Physical and health effects

• Addiction

• Psychological or mental health impact

• Brain development and deterioration

• Impaired driving

• Impact specifically on youth

• Employment issues

Some Common Issues

• Drug Laws Invade Privacy

and Freedom

• Drug Laws Don’t Deter Use

or Limit Availability

Some Common Issues

• Marijuana Arrests and Prison

• Drug Laws are Racist

Some Common Issues

• Mexican Cartels and Profits

• Tax Revenue from

Legalization

• Federal vs. State Law

The Issue

Drug “War” a Failure

Question…

What would it take for you to

consider our drug policy successful?

The IssueAlcohol and Tobacco

Heroin, Meth, Crack,

Hallucinogens,

Cocaine, Tranquilizers,

Pain Relievers and

Marijuana

The Issue

SOURCE: 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

Licensed Marijuana Businesses

Medical Marijuana(January 1, 2015)

Recreational Marijuana (January 1, 2015)

• 497 licensed

dispensaries

• 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…

Medical Marijuana Centers = 497

Recreational Marijuana Stores = 369

Starbucks Coffee = 405

McDonalds = 227

Denver: The Mile HIGH City

Denver: The Mile HIGH City

Full-page ad

WestwordFebruary 6 –

12, 2014 issue

“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)

• Salvation Army: 33% rise since 2014

compared to 2013

• Salvation Army: Survey 25% increase

related to marijuana

Marijuana and Public Consumption

“Boulder

[Colorado]

pot smoking

tickets up

nearly 4

times”

Boulder Daily CameraDecember 23, 2013

www.rmhidta.org

click on

“Reports”

Forecast

What Does the Data and

Trends Show?

Impact

Comparison Dates

2007 – 2008: Early Medical Marijuana Era

1,000 – 4,800 cardholders and 0 known

dispensaries

2009 – 2012: Medical Marijuana Commercialization

and Expansion Era

108,000 cardholders and 532 licensed dispensaries

2013 – Present: Medical Marijuana

Commercialization and Recreational Marijuana

Era

DUID – Colorado State Patrol

0

200

400

600

800

1000

Total Number ofDUIDs

Positive forMarijuana with

Alcohol or OtherDrugs

Positive forMarijuana Only

874

674

354

Year 2014 Totals

SOURCE: Colorado State Patrol, 2014

100% 77% 40%

Marijuana and Impaired Driving

SOURCE: Colorado Department of Transportation Fatality Analysis Reporting System (FARS)

2006 – 2011 and Rocky Mountain HIDTA

- 200 400 600 800

1,000 1,200 1,400 1,600 1,800

2009 2010 2011 2012 2013

Chematox 79 190 1,076

CDPHE 223 650 1,322 1,342 596

DUID Blood Tests Confirmed THC

Marijuana and Traffic Fatalities

Driving Fatalities Data Involving Marijuana

2007 – 2012• Colorado fatalities with operators testing

positive for marijuana increased by 100 percent

Marijuana and Traffic Fatalities

SOURCE: National Highway Transportation Safety Administration, Fatality Analysis Reporting System

(FARS), 2006-20011 and RMHIDTA 2012

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

18.00%

20.00%

2006 2007 2008 2009 2010 2011 2012

6.92% 7.04%7.85%

10.10%10.89%

14.09%

16.53%

Pe

rce

nt

of

Tota

l Fat

alit

ies

Percent of All Fatalities With Operators Testing Positive for Marijuana

Marijuana Use in Youth and Adults

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

National average for youth was 7.15 percent

Colorado average for youth was 11.16 percent

Colorado was ranked 3rd in the nation for current

marijuana use among youth (56.08 percent higher

than the national average)

Marijuana Use in Youth

SOURCE: National Survey on Drug Use and Health, 2012 and 2013

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

2006-2008(Pre-Commercialization)

2009-2012(Post-Commercialization)

2013 (Legalization)

8.29%

10.32%11.16%

Ave

rage

Pe

rce

nt

Colorado Average Past Month Use of MarijuanaAges 12 to 17 Years

(25% Increase) (8% Increase)

SOURCE: SAMHSA.gov National Survey on Drug Use and Health 2012 and 2013

Past Month Usage by 12 to 17-Year-Olds in Medical Marijuana States, 2013

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

AL KS MS OK WV NJ AR WY TN NE IL MN MO GA OH FL NY NV MT MA DE ME OR WA VT

Ave

rage

Pe

rce

nta

ge

As of 2013:

Legalized Recreational/Medical Marijuana State

Legalized Medical Marijuana State

Non-Legalized Medical Marijuana State

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

Non-Medical MarijuanaStates

Medical MarijuanaStates

Recreational/MedicalMarijuana States

6.1%

8.9%

10.5%

Ave

rage

Pe

rce

nta

ge

Average Past Month Use by 12 to 17-Year-Olds, 2013

SOURCE: National Survey on Drug Use and Health, 2012 and 2013

Marijuana Use in Youth

0

1,000

2,000

3,000

4,000

5,000

6,000

2004-2005to

2008-2009

2009-2010to

2013-2014

3,864

5,167

Ave

rage

Nu

mb

er

of

Susp

en

sio

ns/

Exp

uls

ion

s

Academic Years

Average Drug-Related Suspensions/Expulsions

34% Increase

SOURCE: Colorado Department of Education, 10-Year Trend Date: State Suspension and

Expulsion Incident Rates and Reasons

High School Discipline

High School Discipline

SOURCE: Colorado Department of Education, 10-Year Trend Data: State Suspension and

Expulsion Incident Rates and Reasons

3.2 3.2 3.0 3.1 3.1

4.45.0 5.1

5.4

6.4

1.2 1.3 1.1 1.0 1.0 1.0 1.0 1.0 0.9 0.9

0

1

2

3

4

5

6

7

Pe

rce

nta

ge o

f To

tal S

usp

en

sio

ns

Percentage of Total Suspensions in Colorado from 2004 - 2014 School Years

Drug Violations

Alcohol Violations

Commercialization

Legalization

College-Age Marijuana Use

College-Age Adults (ages 18 to 25 years)

Current Marijuana Use 2013

National average = 18.91 percent

Colorado average = 29.05 percent

Colorado was ranked 2nd in the nation for current

marijuana use among college-age adults (53.62

percent higher than the national average)

College-Age Marijuana Use

SOURCE: National Survey on Drug Use and Health, 2012 and 2013

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

2006-2008Pre-Commercialization

2009-2012Post-Commercialization

2013 Legalization

22.36%

26.18%29.05%

Ave

rage

Pe

rce

nt

Average Past Month Use of Marijuana College Age (18 to 25 Years Old)

(17% Increase) (11% Increase)

Adult Marijuana Use

Adults (ages 26+ years)

Current Marijuana Use 2013

National average = 5.45 percent

Colorado average = 10.13 percent

Colorado was ranked 5th in the nation for current

marijuana use among adults (85.87 percent higher

than the national average)

Adult Marijuana Use

SOURCE: National Survey on Drug Use and Health, 2012 and 2013

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

2006-2008Pre-Commercialization

2009-2012Post-Commercialization

2013 Legalization

6.03%

7.98%

10.13%

Ave

rage

Pe

rce

nt

Average Past Month Use of Marijuana Adults (Age 26+)

(32% Increase) (27% Increase)

Marijuana and Emergency RoomVisits

SOURCE: Proceedings of the Denver Epidemiology Work Group (DEWG), Denver Office of Drug

Strategy/The Denver Drug Strategy Commission, October 29, 2014

0.00

50.00

100.00

150.00

200.00

250.00

300.00

350.00

400.00

450.00

2011 2012 2013

Colorado 147.80 179.00 248.32

Denver City and County 315.34 331.22 415.46

Rat

es

Pe

r 1

00

,00

0

Emergency Department Rates Per 100,000 Marijuana-Related, 2011-2013

Legalization

SOURCE: Colorado Department of Public Health and Environment, Monitoring Health Concerns

Related to Marijuana in Colorado: 2014

0

200

400

600

800

1000

1200

2011 2012 2013 Jan-Jun2014

618701

873

1,105

Rat

es

Pe

r 1

00

,00

0

Data Not Available Pre-2011

Rates of Emergency Department (ED) Visits with Possible Marijuana Exposures, Diagnoses, or Billing

Codes per 100,000 ED Visits by Year in Colorado

Jan-Jun2014

Legalization

SOURCE: Colorado Department of Public Health and Environment, Monitoring Health Concerns

Related to Marijuana in Colorado: 2014

0

500

1000

1500

2000

2500

2006 2007 2008 2009 2010 2011 2012 2013 Jan-Jun2014

810 818911 963

1,260 1,3131,417

1,779

2,277

Rat

es

Pe

r 1

00

,00

0Rates of Hospitalization (HD) Visits with Possible Marijuana Exposures, Diagnoses, or Billing Codes

per 100,000 HD Visits by Year in Colorado

Jan-Jun2014

Commercialization

Legalization

Marijuana and Poison Control Cases

Rocky Mountain Poison Center

SOURCE: Rocky Mountain Poison Center and American Association of Poison Control Centers

0

5

10

15

20

2006 - 2009 2010-2013

3.76 4.97

9.74

17.81

Average Percent of Children Ages 0 to 5 Years forReported Marijuana Exposure Cases

National

Colorado

Rocky Mountain Poison Center

SOURCE: Colorado Department of Public Health and Environment/RMPDC

0

20

40

60

80

100

120

140

160

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

28 29 27 2534

2532 37

18

5340

61

88

151

Nu

mb

er

of

Exp

osu

res

Re

po

rte

d

RMPDC Marijuana Exposure Calls Through December 31, 2014

Commercialization

Legalization

THC Extraction Lab Explosion

THC Extraction Labs

SOURCE: Rocky Mountain HIDTA Investigative Support Center

0

5

10

15

20

25

30

35

20 0 0

12

32

Nu

mb

er

of

Exp

losi

on

s

Explosions

0

5

10

15

20

25

30

35

30 0 0

18

30

Nu

mb

er

of

Inju

rie

s

Injuries

Marijuana Diversion

Diversion of Marijuana fromColorado

Diversion – By Motor Vehicles

SOURCE: El Paso Intelligence Center (EPIC), National Seizure System

5441

57 5892

281

321

274288

360

0

50

100

150

200

250

300

350

400

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Colorado Marijuana Interdication Seizures

Diversion – By Motor Vehicles

SOURCE: El Paso Intelligence Center, National Seizure System

0

1,000

2,000

3,000

4,000

2005-2008 2009-2014

2,763

3,667

Average Pounds of Colorado Marijuana fromInterdiction Seizures

Diversion – By U.S. Postal Service Packages

SOURCE: United States Postal Inspection Service

** Preliminary data

0

50

100

150

200

250

300

350

2009 2010 2011 2012 2013 2014

0 1536

158

207

320**

Par

cels

Parcels Containing Marijuana Mailed from Coloradoto Another State

Diversion – By U.S. Postal Service Packages

SOURCE: United States Postal Inspection Service

** Preliminary data

0

100

200

300

400

500

2009 2010 2011 2012 2013 2014

057.20 68.20

262.00

493.05469.91**

Po

un

ds

Pounds of Colorado Marijuana Seized by theU.S. Postal Inspection Service

All Reported Crime in Denver

2012 2013 2014

43,867

reported

crimes

48,147

reported

crimes

49,258

reported

crimes

5,391 reported

crimes increase

from 2012

through 2014

(+12.3 percent)

Reported offenses using the National Incident Based Reporting System (NIBRS) definitions

in the City and County of Denver, January 9, 2015

Alcohol Consumption

SOURCE: National Institute on Alcohol Abuse and Alcoholism

2.72

2.72

2.78

2.77

2.70

2.71

2.73

2.76

2.33

2.28

2.31

2.31

2.23

2.27

2.28

2.33

0.00 0.50 1.00 1.50 2.00 2.50 3.00

2005

2006

2007

2008

2009

2010

2011

2012

Gallons

Year

s

Alcohol Consumption Per Personin Gallons by Year

National

Colorado

John Aguilar, The Denver Post, Saturday, February 7, 2015

County Responses to A-64

As of November 5, 2014 related to recreational

marijuana businesses:

36 counties prohibited

8 counties have a moratorium or temporary

ban

5 counties prohibited new businesses but

allowed medical to migrate to recreational

15 counties have allowed (23 percent)

City Responses to A-64

As of November 5, 2014 related to recreational

marijuana businesses:

179 cities prohibited

40 cities have a moratorium

6 cities prohibited new businesses but

allowed medical to migrate to recreational

41 cities have allowed (15 percent)

PollingNovember 2012 A64 Election Results

54% in Favor 46% Opposed

Sept. 2014 Suffolk University/USA Today Poll

Colorado

46% continue to

support A64

50.2% do not agree

with A64 decision

Polling

October 2014 Gallup Poll

Favor

Legalized

Oppose

LegalizedUnsure

2013 58% 39% 3%

2014 51% 47% 2%

Polling

October 2014 Pew Research Center Poll

Favor

Legalized

Oppose

LegalizedUnsure

Feb. 2014 54% 42% 3%

Oct. 2014 52% 45% 3%

Thank you for what you do.

Remember:

Trending Topics Track

The Naked Truth About “Medical” Marijuana: Translating the Science

into Messages that Matter

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 (HIDTA)

Moderator: Nancy Hale, President and CEO, Operation UNITE