Marijuana in the 21 st Century. The reality from Colorado post A64

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1 Marijuana in the 21 st Century The reality from Colorado post A64

2 CeDAR Residential, Outpatient and Extended Care for adult CD patients at the University of Colorado Hospital Specialize in the treatment of co-occurring disorders Nationally recognized as a thought leader in the field

3 Project SAM 1. To inform public policy with the science of today s marijuana. 2. To have honest conversations about reducing the unintended consequences of current marijuana policies, such as lifelong stigma due to arrest. 3. To prevent the establishment of Big Marijuana that would market marijuana to children and to prevent Big Tobacco from taking over Big Marijuana. Those are the very likely results of legalization. 4. To promote research of marijuana s medical properties and produce pharmacy-attainable medications. 3

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5 Todays Agenda The CURRENT considerations Enforcement Industry Marketing Trends Concentrates Edibles Vape Treatment and Prevention

6 Please keep in mind National survey on drug use and health - SAMHSA

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8 Real Science There is nothing subjective about scientific findings, when it is real science. Demand peer reviewed and published studies. Keep in mind that these do not happen overnight Wayne Hall, Adverse Health Effects of Recreation Cannabis Use 2. Dr. Nora Volkolv s summary of recent research published this year in the NEJM Rocky Mountain HIDTA report 4. Lancet Journal Feb 2015

9 Marijuana IS Addictive Contrary to common belief, marijuana is addictive. Estimates from research suggest that about 9 percent of users become addicted to marijuana; this number increases among those who start young (to about 17 percent, or 1 in 6) and among people who use marijuana daily (to percent). NIDA The DSM 5 clearly spells out the OBJECTIVE criteria for addiction and for the first time Cannabis Withdraw is listed as a diagnosis

10 1 in 6 teens become addicted Keeping in mind that this is based on THC content <12% 1 in 10 adults and 1 in 6 adolescents who try marijuana will become addicted to it. The adolescent brain is especially susceptible to marijuana use. When kids use, they have a greater chance of developing addiction. Wagner, F.A. & Anthony, J.C., 2002; Giedd. J. N.,

11 Harmful effects on mental health Increased risk of mental illness Schizophrenia Psychosis Depression Anxiety Contraindicated for almost all mental health conditions Andréasson S, Allebeck P, Engström A, Rydberg U., 1987; Arseneault, L.,

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13 Cannabis-Associated Psychosis CANNABIS AND SCHIZOPHRENIA Study of Swedish Conscripts (n=45570) Cases of Sz per 1, <50 >50 No of times cannabis taken Andréasson et al Lancet, Odds ratio CANNABIS AND SCHIZOPHRENIA-Like Longitudinal prospective Dunedin study (n=1037) 9 Risk 8 of schizophrenia-like psychosis at age 26 years Cannabis users by age 15 years Arseneault et al BMJ Cannabis users by age 18 years

14 More Use of Cannabis Associated with Worse Social Outcomes at Age 25 (New Zealand Study) % welfare dependent (ages 21-25) % Unemployed (ages 21-25) mean personal income at age 25 % gained university degree by age to to to to 99 # of occasions Never using Number of occasions using Cannabis between ages Cannabis ages Source: Fergusson and Boden. Addiction, 103, pp , 2008

15 14 12 Average THC and CBD Levels in the US: MARIJUANA POTENCY THC: Psychoactive Ingredient CBD: NON- Psychoactive Ingredient THC CBD Mehmedic et al.,

16 Potency - last 5 years in CO

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19 Lancet Study of High Potency Weed Daily use sees an increase in psychosis of 5x Weekend use sees an increase 3x 24% of psychosis cases in the study group caused by weed alone

20 Public Consumption (Denver) Summons for posessions (Aurora) DUID (Weed) (first 3 quarters)

21 9000 Chart Title Denver MJ Seizures in LBS

22 Driving Under the Influence

23 Colorado hidta report fatalities Traffic fatalities decreased 14% Traffic fatalities involving drivers testing positive for marijuana increased 100% In 2007, Colorado traffic fatalities involving operators testing positive for marijuana represented 7.04 percent of the total traffic fatalities. By 2012, that number more than doubled to percent

24 Fatalities with Operator testing positive for MJ Fatalities with Operator testing positive for MJ

25 Teen drivers Liberty Mutual/SADD survey 19% admitted to driving after smoking marijuana 36% - marijuana smoking no distraction while driving 34% who admitted to smoking while high said it made them a better driver

26 We see the inevitability of large, well-run companies to sell cannabis, that train left the station a long time ago. - Brendan Kennedy CEO of Privateer Holding Beer, wine and tobacco people I ve met with them all, said Allen St. Pierre, the executive director of NORML, St. Pierre hopes to create a Dionysus lobby, built on the shared interests of alcohol, tobacco and pot. All three industries want low taxes, the right to advertise freely, and the ability to make convenient sales, he said.

27 MPP is a Machine, whereby you insert money in one end and policy change comes out the other end Rob Kampia/ED of MPP in his 2014 end of year fundraising ask The Weed Lobby $80-100m War chest between the three

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29 Privateer Holdings: The first equity company dedicated to the marijuana industry. Copyright SAM and the Slides' Authors. Use with permission. 29

30 The Yale MBAs Are Here "We have 250 high net-worth accredited investors, which places us in the top ten for all angel investor groups not just cannabis, Troy Dayton -Founder Arcview 30

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34 I really see the future of the marijuana industry being way more like wine than like beer -Amanda Reiman CA Director for the Drug Policy Alliance

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60 Trending Concentrates! Edibles!! Vape!!!

61 Potency Concentrates : 710 is the new 420 Butane-extracted hash oil (BHO) Not your granddad s weed Not your dad s weed Not even my weed A chunk of the stuff the size of a Tic Tac can be the equivalent of hoovering up an entire joint in one massive toke. Even for hardcore smokers, the experience which fans call dabbing can be like getting high for the very first time. Your head spins, your eyes get fluttery, a few beads of sweat surface on your forehead and, suddenly, you're cosmically baked. (Rolling Stone Magazine, 6/20/2013)

62 But it s just a plant (80-90% THC) Concentrates Green Crack wax Ear Wax Butane Hash Oil (BHO) Shatter Budder Hash Oil Capsules

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71 Edibles

72 In a report published in the Journal of the American Medical Association last month, Andrew Monte, MD; Richard Zane, MD; and Kennon Heard, MD, pointed to edible marijuana as the culprit behind the most troubling cases arriving at the UCH and Children s Hospital Colorado emergency departments, including severe burns and cycling vomiting syndrome.

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74 10 mg is a legal dose Packaging is not regulated

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83 Cannabis Candy Store

84 Why were they GONE?

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88 Vaping Concentrates oils flowers

89 M-Cigarettes (marijuana vaporizers) Brought to you by Groupon! 89

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91 Increasingly popular and accessible 91

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97 Other stuff

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107 Treatment/Prevention The best treatment is still prevention Normalizing sobriety is key Pushing back in a way that will resonate with the culture they are in Family and social groups MUST BE RELEVANT!

108 Culture of Recovery Recovery Oriented System of Care Recovery Capital

109 Real Science There is nothing subjective about scientific findings, when it is real science. Demand peer reviewed and published studies. Keep in mind that these do not happen overnight Wayne Hall, Adverse Health Effects of Recreation Cannabis Use 2. Dr. Nora Volkolv s summary of recent research published this year in the NEJM Rocky Mountain HIDTA report 4. Lancet Journal Feb Journal of Drug and Alcohol Dependence (3/1/15)

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111 Thank you for listening!