MARIJUANA MARIJUANA TRENDS, SCIENCE AND TRENDS, SCIENCE AND

UPDATESUPDATES2015 2015

CCTT Resource Sharing CCTT Resource Sharing MeetingMeeting

September 1, 2015September 1, 2015

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TODAY’S TODAY’S

PRESENTATIONPRESENTATION::

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Use Rates, Trends & Perceptions Science of Marijuana Marijuana 101 Harms & New Findings Marijuana & Potency Legalization Vs. Decriminalization Data: Colorado Since 2012

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TTUSD

18%2014

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TTUSD STUDENTS REPORTING PAST 30 DAY MARIJUANA USE

TTUSD TTUSD2010

TTUSD2012

TTUSD2014

State2011-13

NJUH2013

RJUH2013

7th Grade 3% 4% 5% (-2)

7% NA NA

9th Grade 8% 21% 23% (+8)

15% 15% 8%

11th Grade

7% 31% 26% (+2)

24% 26% 18%NJUH-Nevada Joint Union High School (1700 students)RJUH-Roseville Jt. Union High District (5500 students)

*TTUSD CHKS Main Report Secondary (2013-2014)

TTUSD Student Perception of Harm & Availability*Smoke MJ occasionally... 7th 9th 11th Slight to No HARM 34% (35%) 53% (39%) 71% (61%)*Smoke MJ 1-2 Times (Week) 7th 9th 11th Slight to No HARM 27% (34%) 37% (36%) 58% (41%)*How difficult for students in your grade to get MJ

7th 9th 11th Fairly Easy/ to Very Easy 44% (26%) 67% (54%) 78% (73%)

MARIJUANA USE AMONG YOUTH IS RISING AS

PERCEPTION OF RISK DECREASES

*TTUSD CHKS Main Report Secondary (2013-2014)

TTUSD Students Perception of Parental Disapproval of Your AOD Use*How wrong do your parents feel it would be for you to smoke MJ?

9th 11th Very WRONG/WRONG 83% 73%

TTUSD Students Perception of Peer Disapproval of Your AOD Use*How wrong do your peers feel it would be for you to smoke MJ?

9th 11th A little Bit WRONG/NOT at all WRONG 52% 65%

SCIENCE OF SCIENCE OF MARIJUANA:MARIJUANA:

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Is it Is it Addictive?Addictive?

* Nonmedical Use Source: Anthony et al. Exp. Clin. Psychopharmacol. 2(3), pp.244-268 (1994)

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% o

f use

rs w

hoB

eco

me

ad

dic

ted Comparative Prevalence of

Dependence Among Different Drug Users

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5

10

15

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25

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Tobacco Alcohol Cannabis Cocaine Stimulant Analgesics Pshychedelics Heroin

Addiction: About 9% of Marijuana users may become dependent , 1 in 6 (17%) who start use in adolescence,

25-50% of daily users

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The earlier people begin using The earlier people begin using marijuana, the more likely they are to marijuana, the more likely they are to become dependentbecome dependent

Wintersa, Ken C, * and Chih-Yuan S. Leea Likelihood of developing an alcohol and cannabis use disorder during youth: Association with recent use and age Drug Alcohol Depend. 2008 January 1; 92(1-3): 239–247. doi:10.1016/j.drugalcdep.2007.08.005.

#1 DRUG #1 DRUG THAT TEENS THAT TEENS

SEEK SEEK TREATMENT TREATMENT

FORFOR

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2014: 2014: 68 Teens Were in Placer 68 Teens Were in Placer County Drug Treatment County Drug Treatment (Does not include private treatment)(Does not include private treatment)

Their drug of choice was:61% Marijuana61% Marijuana

14% Alcohol13% Methamphetamine

3% Herion3% Oxycotin (Pills)

1.5% other

12*2014 Treatment Admissions Substance Use, (Ca. Outcomes Measurement System), Placer

MARIJUANA IS 2ND MOST COMMONLY ABUSED MARIJUANA IS 2ND MOST COMMONLY ABUSED DRUG THAT PEOPLE SEEK TREATMENT FOR DRUG THAT PEOPLE SEEK TREATMENT FOR

TREATMENT ADMISSIONS BY DRUG, 2007

Source: Treatment Episode Data Set, US Health and Human Services, 1993 & 2007.13

MARIJUANA DETOXWithdrawal Symptoms Reported •Depression•Anxiety, Irritability, Anger •Insomnia•Appetite disturbance•Craving

Begin within 24 hours peak at 4-6 days, most subside by 3 weeks but can last up to 3 months – Impacts attempts to quit and motivation to seek other drugs for relief. DSM-5 added Marijuana Withdrawal as a diagnosis. 2014 Mass General Hospital study confirms withdrawal syndrome.*Hall, W. and Degenhardt, L. (2009) *Hall, W. and Degenhardt, L. (2009) Adverse health effects of non-Adverse health effects of non-

medical cannabis use medical cannabis use The Lancet (374) 1383-1391 The Lancet (374) 1383-139114

Marijuana 101Marijuana 101(What We Know):

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MARIJUANA MARIJUANA CONTAINS 421 CONTAINS 421 CHEMICALSCHEMICALS

4 THAT ARE PSYCHOACTIVE(IMPACT THE BRAIN)

1 THAT IS RESPONSIBLE FOR GETTING A PERSON HIGH= THC(DELTA -9-TETRAHYDROCANNABINOL)

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ENDOCANNABINOID ENDOCANNABINOID SYSTEM (ECS)SYSTEM (ECS)

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Regulation of neuronal activity:

Activates or supresses neurotransmitters

Effects those involved in neuronal growth

System most active: adolescence

MARIJUANA IS A CHEMICAL IMPOSTER MARIJUANA IS A CHEMICAL IMPOSTER (THC MIMICS A NATURAL BRAIN CHEMICAL) (THC MIMICS A NATURAL BRAIN CHEMICAL)

Drug

THC

Brain’s Chemical

Anandamide

Role is to quiet the brain18

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Not under Not under influenceinfluence

StonedStoned

Scan of Brain ActivityScan of Brain Activity

WHERE THC CONCENTRATES IN THE BRAIN (BINDING SITES)

HYPOTHALAMUS Controls appetite , hormonal levels and sexual behavior

HIPPOCAMPUSImportant for memory and the learning of facts, sequences and places

CEREBELLUM Center for motor control and coordination

NEOCORTEXResponsible for higher cognitive functions and the integration of sensory information

BASAL GANGLIA Involved in motor control and planning as well as the initiation and termination of action

VENTRAL STRIATUM Involved in the prediction and feeling of reward

BRAIN AND SPINAL CORD Important in the vomiting reflex and the sensation of pain

AMYGDALA Responsible for anxiety, emotion and fear

http://www.drugabuse.gov/publications/research-reports/marijuana/how-does-marijuana-produce-its-effects

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HIPPOCAMPUS= CONTROLS LEARNING AND MEMORYHIPPOCAMPUS= CONTROLS LEARNING AND MEMORY

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Marijuana is Marijuana is Neurotoxic to Neurotoxic to

Adolescent Brain Adolescent Brain DevelopementDevelopement

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MOST SERIOUS MOST SERIOUS HARMS ARE HARMS ARE RELATED TORELATED TO

DAILY OR REGULAR USE THAT DAILY OR REGULAR USE THAT BEGAN IN TEEN YEARS BEGAN IN TEEN YEARS

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HEAVY ADOLESCENT MARIJUANA USE AND COGNITIVE IMPAIRMENT

25 Year Study followed 1,037 People( from Ages 13-38)

•People who started as teens and smoked the most Marijuana saw an 8 point IQ Drop (LEAD=6 points)•The more they used, and the younger they started, the more intelligence they lost•People who did not use Marijuana did not see any IQ drop.

251M.H. Meier, Avshalom Caspi, et al. 2012. “Persistent cannabis users show neuropsychological decline from childhood to midlife.” Proceedings of the National Academy of Sciences

Image Above: Source: Cannabis and schizophrenia. A longitudinal study of Swedish conscripts, Lancet, 1987)

50,000 army recruits Age 18

•If used Marijuana more than 50 times by age 18 they were 2 x more likely to develop Schizophrenia within 15 years

Heavy Adolescent Marijuana Use and Schizophrenia Heavy Adolescent Marijuana Use and Schizophrenia Diagnosis Diagnosis

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Marijuana use before driving Marijuana use before driving doubles the risk of car crashdoubles the risk of car crash

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*Hall, W.. (2014) What has research over the past two decades revealed *Hall, W.. (2014) What has research over the past two decades revealed about the about the adverse health effects of recreational cannabis use adverse health effects of recreational cannabis use Addiction, Addiction,

(110) 19-35(110) 19-35

Chronic Marijuana Use Chronic Marijuana Use is Associated with is Associated with

Lower Life Satisfaction Lower Life Satisfaction and Achievmentand Achievment

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Fergusson and Boden. Addiction, 103, pp. 969-976, 2008 and Fergusson, D. M., L. J. Horwood, et al. (2003). "Cannabis and educational achievement." Addiction 98(12): 1681-92..

Marijuana Use and Later Life Outcomes are Dose Dependent (25 year study of birth cohort)

(Association)

Source: Fergusson and Boden. Addiction, 103, pp. 969-976, 2008.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 incomeIn thousands of NZ dollars

at age 25

% gained university degreeby age 25

400+

300 to 399

200 to 299

100 to 199

1 to 99

NeverNumber of occasions using

Cannabis ages 14-21

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Cardiovascular Disease (Chronic)4.8x Heart Attack Risk 4.8x Heart Attack Risk Irregular Heart BeatsIrregular Heart BeatsMinistrokeMinistrokeWeakend Heart Muscles Weakend Heart Muscles (young adults w/o other risk (young adults w/o other risk factors related to smoking factors related to smoking marijuana)marijuana)

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*Hall, W.. (2014) What has research over the past two decades revealed about the adverse health effects of recreational cannabis use Addiction, (110) 19-35

Hormonal Effects (Chronic):Decreased TestosteroneDecreased TestosteroneTesticular ShrinkageTesticular ShrinkageGynecomastia (Man Boobs)Gynecomastia (Man Boobs)Loss of Interest in SexLoss of Interest in Sex2-3x Testicular Cancer2-3x Testicular Cancer

Other Chronic:2x Chronic Bronchitis 2x Chronic Bronchitis Low Birthweight BabiesLow Birthweight BabiesMore Likely to Use Other DrugsMore Likely to Use Other DrugsCannabinoid Hypermesis Cannabinoid Hypermesis Syndrome: Severe Nausea, Syndrome: Severe Nausea, Vomiting, DehydrationVomiting, Dehydration

*Cannabinoid Hyperemesis: A Case Series of 98 PatientsSimonetto, Douglas A. et al. Mayo Clinic Proceedings , Volume 87 , Issue 2 , 114 - 119

MORE KNOWN HARMS OF MARIJUANA USE

Acute: Increased Heart Rate (20-100%)Increased Heart Rate (20-100%)Anxiety & Panic (naive users) Anxiety & Panic (naive users) Psychosis (in large doses)Psychosis (in large doses)Impaired Decision MakingImpaired Decision MakingCognitive ImpairmentCognitive ImpairmentMotor Impairment (Accidents)Motor Impairment (Accidents)

Marijuana is Marijuana is DifferentDifferent

High PotencyHigh Potency

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MARIJUANA IS 500% (5X) MARIJUANA IS 500% (5X) STRONGER THAN 1970’SSTRONGER THAN 1970’SINCREASED THC CONTENT IN SEIZED MARIJUANA,

1983-2009

Sources: The University of Mississippi Potency Monitoring Project

Year

2015- AVG. % OF THC

•16% WASHINGTON

•18% COLORADO

•2015 BOULDER CO. LOCAL DISPENSARIES DID NOT CARRY

ANY LOWER THAN 25%

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Legalization Legalization Vs.Vs.

DecriminalizationDecriminalizationWhat’s the Difference?What’s the Difference?

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2015 LEGALIZATION LANDSCAPE2015 LEGALIZATION LANDSCAPE

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*23 States have some form of legalized Medical Marijuana

Marijuana Legalization Vs. Marijuana Legalization Vs. DecriminalizationDecriminalization::

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Decriminalization•Marijuana remains illegal but punishment for possession and use are reduced to non-criminal offenses. (CA $100 fine for < 1 oz.)

•IntentIntent: To discourage To discourage use, prohibit use, prohibit distribution.distribution.

Legalization•Marijuana becomes a legal product that adults can buy and use and companies can market and sell

•IntentIntent: To eliminate To eliminate the black market, the black market, regulate sales, and regulate sales, and collect taxes.collect taxes.

Marijuana Legalization Marijuana Legalization ::

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3 Inevitable 3 Inevitable Consequences Consequences

1)1)Product Innovation Product Innovation

2)2)Marketing Innovation Marketing Innovation

3) Lobbying3) Lobbying

1) Product Innovation: make them more appealing, addictive, and easier to use. ,

LEGALIZATION:LEGALIZATION:

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VAPING MARIJUANA OIL: VAPING MARIJUANA OIL:

LESS HARSH, LESS LESS HARSH, LESS SMELL, MORE POTENT, SMELL, MORE POTENT,

EASY TO CONCEALEASY TO CONCEAL

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EDIBLES:EDIBLES:EASY TO EASY TO

CONSUME, CONSUME, DISCRETE, HARD DISCRETE, HARD TO TASTE THCTO TASTE THC

2) Marketing Innovations: to increase the use of product, and the number of users. Expansion

LEGALIZATIONLEGALIZATION: MARKETING: MARKETING

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https://youtu.be/7H8Cz9woC2A

NORMS AND MARKETING:COMMUNITY EVENTS IN COLORADO

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June 6thPuff Pass and Paint 420- Friendly painting class 7-9 pm $50

June 7th

Get Fit, Stay Lit YogaOne hour yoga class followed by an educational talk on vaporizers. Hosted by Healthy Honey. 1-3 pm $25

June 10th-13th

Mixed Bag: Marijuana in the Highlands Marijuana Culture and commerce photo exhibit Colorado Photographic Arts Center.

June 11-13th

CannaCon Consumer expo with optional education seminars $15-$125 10-5 pm Colorado Convention Center,

June 13th CORE: Marijuana & Health Symposium: Medical symposium covering scientific evidence, risks and side effects associated with cannabis use $10 8 am-noon. National Jewish Health

June 18thWomen Weed and Wellness Ladies night at Healthy Honeys. Learn about stress relieving, blemish- and wrinkle reducing cannabis strains and products for women. Snacks, Chakra Balancing. 10 min massage and Tarot card readings. $42-50. 7 pm-11 pm.

June 21stSushi and Joint Rolling- Learn two skills-the art of rolling sushi and making perfect joints. $65 4-6 pm

2) Marketing Innovations: to increase the use of product, the number of users (Expand)

LEGALIZATIONLEGALIZATION::

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Stocks

Legal investors

Shareholders,

3) Lobbying: so they can change their product in any way and can be protected from meaningful public health efforts to reduce harm.

LEGALIZATIONLEGALIZATION: LOBBYING: LOBBYING

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CHANGING SOCIAL CHANGING SOCIAL NORMS IN COLORADONORMS IN COLORADO

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COLORADO DATACOLORADO DATA

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http://www.rmhidta.org/default.aspx/MenuItemID/687/MenuGroup/RMHIDTAHome.htm

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WHAT’S THE WHAT’S THE GOOD NEWS?GOOD NEWS?

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POLL: SUPPORT FOR MARIJUANA LEGALIZATION IN COLORADO FALLING (A 64)

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Law does not do a good job:•51% would oppose•preventing marijuana-impaired driving •workplace accidents•preventing child poisonings from candies, •preventing increase among youth.  (8/25/15, Firm Smith Johnson Research)

http://myemail.constantcontact.com/POLL--SUPPORT-FOR-MARIJUANA-LEGALIZATION-IN-COLORADO-FALLING-.html?soid=1112224482685&aid=xXVELVhdEcU

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WE HAVE THE POWER WE HAVE THE POWER TO CHANGE SOCIAL TO CHANGE SOCIAL

NORMSNORMS

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Thank You!61

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June 2014Table: “Clinical Conditions with

Symptoms that May be Relieved by Treatment with Marijuana or

Other Cannabinoids”

http://coleman-pediatrics.com/marijuana_article.pdfhttp://www.nejm.org/doi/full/10.1056/nejmra1402309

Dr. Kevin Sabet :What worksDr. Kevin Sabet :What worksHow to talk about it:How to talk about it:

1)Do you want to see “Big Marijuana” 2)Marijuana is different (emphasize this)3)Personalize it: Are you relationships better off when people use more?, Does it make your neighborhood better? Does it make people better parents, employees, kids, drivers when there is more recreational use?4)Do you want retail stores in your neighborhood? Recreational home grows next to your home? 5)Criminal Justice System should be reformed 6)Don’t preach to the choir: speak to new groups, people.

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Dr. Kevin SabetDr. Kevin SabetKey Messages People are Key Messages People are

Responding to:Responding to:

1)Annoyance-how it affects them2) Pot shop in your neighborhood

3)Impact on Schools4)The Colorado Experience5)Driving and impairment

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