Youth Prevention and Education

Denver Marijuana Management Symposium

October 2016

1

DENVER’SHEALTHY LIFESTYLES FOR YOUTH

Findings from Summer 2016

DENVER’S MARIJUANA LANDSCAPE

• Denver residents account for approximately 12%

of the state’s population, however, about 37% of

recreational marijuana stores in the State of

Colorado are located in Denver.

• This high level of exposure may have an

influence on Denver youth’s perceptions and

behavior for using marijuana as a minor.

• For these reasons, the City of Denver has taken a

multi-pronged youth-centered approach.

DENVER’S APPROACH

Denver Marijuana Education

Efforts

Youth Prevention

Youth Diversion

Public Awareness

Data Collection

State Campaigns

31%

9%

30%

30%

2016 Marijuana-Related Expenditures

Education Public Health Regulation Enforcement

5

Marijuana Education Expenditures in

Denver

$7,900

$7,500

$7,500

$1,750

$998

$- $1,000 $2,000 $3,000 $4,000 $5,000 $6,000 $7,000 $8,000

Marijuana Policy

Children's Affairs

Behavioral Health

Denver Health

Parks and Rec

Hundreds

2016 Marijuana Education Expenditures

36%

15%23%

26%

2017 Marijuana-Related Expenditures

Education Public Health Regulation Enforcement

$10,890

$15,000

$7,500

$1,690

$998

$- $2,000 $4,000 $6,000 $8,000 $10,000 $12,000 $14,000

Marijuana Policy

Children's Affairs

Behavioral Health

Denver Health

Parks and Rec

Hundreds

2017 Marijuana Education Expenditures

6

Denver Marijuana Education Efforts-

AFTERSCHOOL RESEARCH

STRATEGIC INVESTMENTS

WHY HEALTHY LIFESTYLES?

Scare tactics

Orthodoxy

Adult-

oriented

ATOD choices

in a vacuum

Fact-driven

Processing

evidence

Youth-

centered

SEL skills

Previous

Prevention

Programs

HEALTHY

LIFESTYLES

FORMULA FOR IMPACT

න𝑯𝑬𝑨𝑳𝑻𝑯𝒀 𝑪𝑯𝑶𝑰𝑪𝑬𝑺𝑴𝑱

𝟔𝑻𝑯

𝟖𝑻𝑯

𝑰𝑵𝑻𝑬𝑮𝑹𝑨𝑻𝑬𝑫 𝑰𝑫𝑬𝑵𝑻𝑰𝑻𝒀𝑺𝑬𝑳 𝒙 𝑲𝑵𝑶𝑾𝑳𝑬𝑫𝑮𝑬𝑴𝑱

Middle school

students make

healthy

choices around

marijuana…

… when they

have skills to

help them

make decisions

consistent with

their identity…

… and

knowledge of

the health and

legal

consequences

of marijuana.

PROGRAM COMPONENTS

DECISION-MAKING

SELF IMAGE

RELATIONSHIPS

MARIJUANA

GOAL-SETTING

YOUTH’S

INTEGRATED

IDENTITY

YOUTH EXPERIENCE

Pot grows

your brain.

Fact.

Marijuana isn’t that bad because it helps people stay calm and in control. That’s why you’re a better driver when you’re high.

Marijuana

can’t hurt

me because

it’s natural

medicine.

EVIDENCE OF IMPACT

10 SUMMER

PROGRAMS

119 MIDDLE

SCHOOL

STUDENTS

W/ FULL

DATA

RESULTS: DECISION-MAKING

4.34 4.38 4.314.55 4.65

4.40

1

2

3

4

5

"I have the abilityto make decisions

about my lifeevery day."

"My future isimpacted by thechoices I make

today."

"When making achoice, I know if Iam making a goodor a bad decision."

Pre-Intervention Post-intervention

Str

ongly

Dis

agre

e

Str

ongly

Agre

e Role in

decision-

making

Sense of

agency

Integrated

identity

RESULTS: MJ KNOWLEDGEPre-

Intervention

Post-

intervention

“Marijuana use can

lead to lower grades

in school.”

“Eating an edible

can be just as

dangerous as

smoking marijuana.”

88%

7%4%

77%

13%

9%

83%

7%9%

74%

18%

8%

Agree/ Strongly Agree

Not sure

Disagree/ Strongly Disagree

RESULTS: MJ MYTHS

57%

33%

68%60%

45%

83%

0%

100%

“Marijuana is a medicine that I

can use whenever I am sick.”

“Marijuana effects kids and

adults in the same ways.”

“Marijuana is natural and so it is harmless and

ok for me to use.”

Pre-Intervention Post- Intervention

% D

isagre

e

RESULTS: LEGAL AGE

9%

79%

3%

9%

34%

51%

3%

12%

0% 20% 40% 60% 80% 100%

<21

21

>21

Unsure

Pre-intervention Post-intervention

“How old do you have to be to legally

use marijuana?”

RECOMMENDATIONS

Strengthen your network

of afterschool providers

Stick to the facts and

knowledge youth want

Build the skills students

need to make healthy

choices

SOCIAL

EMOTIONAL

LEARNING

Connect with other

protective resources in

students’ lives

City and County of

Denver

Office of Behavioral Health Strategies

Requests for Proposal

Youth Opportunity & Behavioral Health Diversion Program (YoBD)

Marijuana Accountability Solutions Project(MASP)

Youth Opportunity and Behavioral Health Diversion funds:

• Alternative consequences for unlawful marijuana use /possession

• Reduce involvement of youth/ young adults in the justice system

• Improve outcomes for youth through coordinated services

• Reduce and address the potential harm of substance use

Facilitate programs/activities to reduce negative consequences of marijuana:

• Public health interventions

• Group and one-on-one interventions

• Treatment and educational programs/activities

38.2%

34.7%

31.8%

28.5%28.8%

24.2%22.1%

19.9%

26.8%

22.0%19.6%

18.4%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

2006-08 2008-10 2010-12 2012-14

Perception of Great Risk of Smoking Marijuana Once a Month

2006-08, 2008-10, 2010-12 and 2012-14: US vs. Colorado vs. DMA

US Colorado DMA

6.0%6.6%

7.0%7.7%

8.6%

11.2%11.7%

14.1%

9.6%

12.2%

13.5%

14.8%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

2006-08 2008-10 2010-12 2012-14

Past Month Marijuana Use 2006-08, 2008-10, 2010-12 and 2012-

14: US vs. Colorado vs. DMA

US Colorado DMA

Youth Opportunity & Behavioral Health Diversion(YoBD) Program Contractors

School based Community based / Alternative

YESS Institute• Leadership

• Emotional intelligence

• Mentoring

Boys and Girls Club• Alternatives to

suspension/expulsion

• Character development

Office of the Independent Monitor (OIM)• Police youth relations

• Youth rights

• Child Development

Youth on Record (YOR)• Alternatives to marijuana use

through engaging in transformative music education

Youth Opportunity & Behavioral Health Diversion(YoBD) Program Contractors

Family Justice

Colorado Non-Profit Development Center-Strengthening Families Program

Youth learn• Refusal skills, Peer pressure,

Goal setting, and managing stress

Parents learn• Clarifying expectations,

Disciplinary practices

• Managing strong emotions regarding their children and Effective communication

Denver Public Safety Youth Programs- HYPE- Day Treatment Program

• Cognitive behavioral groups, character education groups

• Community-based service learning, educational, vocational supports

• Family advocacy, groups that address trauma (SPARCS)

• Substance use, victim empathy

• GED/Credit recovery

24%

72%

4%

21%

2%

60%

17%

0%

10%

20%

30%

40%

50%

60%

70%

80%

YoBD Contractor Core and Secondary Services

Core

Secondary

2.7% 2.1%

14.4%

1.0%

8.6%

2.1%

63.0%

6.2%

YoBD Participants

Race/Ethnicity

American Indian and AlaskaNative

Asian

Black or African American

Native Hawaiian or OtherPacific Islander

White

Other

Hispanic, Latino, or Spanishorigin

Unknown

2

9

14

11

14

26

32

13

0

5

10

15

20

25

30

35

YoBDparticipants

School Grade

5th Grade

6th Grade

7th Grade

8th Grade

9th grade

10th Grade

11th Grade

12th Grade

2 2

67

2122

44

51

32 32

6

13

1 1

0

10

20

30

40

50

60

0 10 11 12 13 14 15 16 17 18 19 20 22 25 29

YoBD participants Age Range

9%

13%

25%

53%

YoBD Contractor DataMarijuana Current Use

1/Month

1/Week

Daily

None

0%

10%

20%

30%

40%

50%

60%

70%

80%

90% 83%

29%

16%

36%

71%

59%

21%

52%59%

Reasons for Using Marijuana

Yes

Marijuana Use Among

Adolescents

Department of Public Health and Environment

Ali.Maffey@state.co.us

Data and Trends: Retail marijuana health

effects, patterns of use, health impacts

Retail Marijuana Education Program

Medical Marijuana Registry

Laboratory testing and assurance

Food safety

Waste disposal

Marijuana Research Grants Program (medical and

retail)

5

1

CDPHE and Marijuana: Roles

4

3

7

2

6

Health Effects

•Neurological and Mental Health

•Effects on Youth

•Unintentional Poisonings

•Marijuana Dose/ Drug Interactions

•Extra-pulmonary Effects

•Injuries

•Respiratory Effects and Lung Cancer

•Marijuana Use During Pregnancy and Breastfeeding

Literature Review Topics

Findings Summary: Marijuana Use and Potential Youth Health Effects

Substantial Moderate Limited Insufficient Mixed

Less high school

graduation

Impaired cognitive

abilities and academic

performance after 28

days abstinence

Less likely to earn

college degree

Lower IQ after brief

abstinence

Lower future IQ scores

Can develop marijuana

addiction‡

Increased MJ use and

addiction‡ after

adolescence

Depression or Anxiety

after adolescence

Treatment for MJ

addiction can reduce MJ

use and dependence

Quitting MJ lowers risk

of cognitive and mental

health effects

Suicidal thoughts or

attempts

Other illicit drug use and

addiction‡ after

adolescence

Alcohol or tobacco use

and addiction‡ after

adolescence

Psychotic symptoms in

adulthood

Psychotic disorder in

adulthood (heavy users)

Public Health Statements

1. Regular marijuana use by adolescents and young adults is

associated with impaired learning, memory, math and reading

achievement, even 28 days after last use.

a. These impairments increase with more frequent marijuana use.

2. Marijuana use by adolescents and young adults is strongly

associated with developing psychotic symptoms such as hallucinations,

paranoia, delusional beliefs, and feeling emotionally unresponsive in

adulthood.

a. This risk is higher among those who start using marijuana at a

younger age.

b. This risk is higher with more frequent marijuana use.

Public Health Statements3. Daily or near daily marijuana use by adolescents and young

adults is associated with developing a psychotic disorder such

as schizophrenia in adulthood.

4. Marijuana use by adolescents and young adults - even

occasional use - is associated with future high-risk use of

alcohol, tobacco, and other drugs like cocaine, ecstasy,

opioids and methamphetamine.

5. Marijuana use by adolescents is strongly associated with

failure to graduate from high school.

Public Health Statements

6. Some marijuana users become addicted to marijuana.

Starting marijuana use during adolescence or young adulthood

is associated with future marijuana addiction.

7. There are treatments for marijuana addiction that can

reduce use and dependence.

Colorado High School

Marijuana Use Rates

Advisory Committee: multi-disciplinary group that includes 40+

school/district staff, local public health, and community partners.

What is the Healthy Kids Colorado Survey?

CO’s only comprehensive survey on the health and

well-being of young people in Colorado.

The purpose of the Healthy Kids Colorado Survey is to

better understand youth health and what factors

support youth to make healthy choices.

Marijuana Use in High School

30-Day Marijuana Use Among

30-Day Marijuana Use Among

Healthy Kids Colorado Survey 2015

Statistically significant change between 2013 and 2015

Campaigns

YOUTH PREVENTION / A TWO-SIDED APPROACH

Youth

Centric

Trusted

Adults

EM

OT

ION

AL R

AT

ION

AL

• Build a platform that is

authentic and relatable

to youth

• Create a message that

has a positive focus

• Engage youth by

allowing them to own

the message/campaign

• Create a message that

can be easily shared

peer-to-peer

• Engage the people that

youth trust in their life

to deliver the laws and

health effects around

marijuana

• Create a program that

supports these trusted

adults

• Build a complimentary

communication plan

between the Trusted

Adult efforts and the

youth campaign

Engage trusted adults (parents, teachers,

coaches, mentors) with the

information they need to start a

conversation about underage retail

marijuana use with youth.

Align with the Protect What’s Next

campaign to support adults in having these

conversations.

Trusted Adult Campaign Objectives

1

2

TV ADS

Youth Prevention

What’s Next Campaign

The #1 deterrent

The most compelling reason not to use marijuana

across all age groups was that it could get in the

way of achieving their goals.

It’s not what we say, it’s how we say it

Youth rejected any language that was preachy or

presented as a scare tactic and were quick to judge

content laced with “someone’s biased point of

view.”

Protect What’s Next

Protect What’s Next

Youth Outreach toolkit

● Pilot with 4 youth group

● Test activities

● Gathered marijuana questions

● Youth facilitator toolkit

● Adult mentor toolkit

● Launch this summer

Prevention through Schools

/ Health Care Providers

TGYS: Fund for youth-serving

organizations

School Health

Professional Grant

Regulations

Licensing

Marijuana

Enforcement

Division (MED)

Drive High get a DUI

Campaign

Surveillance & Data

Education

Food safety

Laboratory testing

Direct Youth Services

• Evidence-based Curricula

• Funding for School Health

Professionals

• Bullying Prevention Grants

• MJ-Free Schools Resources

• Mentoring/After School

Programs

• Substance abuse treatment

Health Care Provider / Education

Resources

• Evidence-based health education curricula

• Pediatric Exposure Prevention Clinical Guidance For

Colorado Health Care Providers For Discussions with

Children and Adolescents Ages 9-20

• Pediatric Exposure Prevention Clinical Guidance For

Colorado Health Care Providers For Discussions with

Parents or Guardians of Children and Adolescents Ages 0-20

• Marijuana Pregnancy and Breastfeeding Guidance For

Colorado Health Care Providers