Marijuana in the 21 st Century The reality from Colorado post A64
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
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
Todays Agenda The CURRENT considerations Enforcement Industry Marketing Trends Concentrates Edibles Vape Treatment and Prevention
Please keep in mind National survey on drug use and health - SAMHSA
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 1. 2014 Wayne Hall, Adverse Health Effects of Recreation Cannabis Use 2. Dr. Nora Volkolv s summary of recent research published this year in the NEJM 3. 2014 Rocky Mountain HIDTA report 4. Lancet Journal Feb 2015
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 25-50 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
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., 2004 10
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., 2002 11
Cannabis-Associated Psychosis CANNABIS AND SCHIZOPHRENIA Study of Swedish Conscripts (n=45570) Cases of Sz per 1,000 30 20 10 0 0 1 2 10 <50 >50 No of times cannabis taken Andréasson et al Lancet, 1987. Odds ratio CANNABIS AND SCHIZOPHRENIA-Like Longitudinal prospective Dunedin study (n=1037) 9 Risk 8 of schizophrenia-like psychosis at age 26 years 7 6 5 4 3 2 1 0 4.5 Cannabis users by age 15 years Arseneault et al BMJ 2002 1.6 Cannabis users by age 18 years
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 25 400+ 300 to 399 200 to 299 100 to 199 1 to 99 # of occasions Never using Number of occasions using Cannabis between ages 14-21 Cannabis ages 14-21 Source: Fergusson and Boden. Addiction, 103, pp. 969-976, 2008
14 12 Average THC and CBD Levels in the US: 1960-2011 10 MARIJUANA POTENCY 8 6 4 THC: Psychoactive Ingredient CBD: NON- Psychoactive Ingredient 2 0 196 196 197 197 197 198 198 198 198 198 199 199 199 199 199 199 199 199 200 200 200 200 200 200 200 200 200 200 201 201 0 5 0 4 8 0 3 4 5 6 0 2 3 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 THC 0.2 0.2 0.4 0.5 1 1 1.5 3.3 3.3 3.5 3.5 3.1 3.1 4 4.5 5.2 5 4.7 5.4 6.2 7.3 7.2 8.3 8.1 9.1 10 10 9.9 11 11 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 Mehmedic et al., 2010 15
Potency - last 5 years in CO
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
1000 900 800 700 600 500 400 300 200 100 0 Public Consumption (Denver) Summons for posessions (Aurora) DUID (Weed) 2013 2014 (first 3 quarters)
9000 Chart Title 8000 7000 6000 5000 4000 3000 2000 1000 0 Denver MJ Seizures in LBS 2013 2014
Driving Under the Influence
Colorado hidta report fatalities 2007-2012 Traffic fatalities decreased 14% 2007-2012 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 16.53 percent
90 80 70 60 50 40 30 20 10 0 Fatalities with Operator testing positive for MJ 2006 2007 2008 2009 2010 2011 2012 Fatalities with Operator testing positive for MJ
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
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.
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 email fundraising ask The Weed Lobby $80-100m War chest between the three
Privateer Holdings: The first equity company dedicated to the marijuana industry. Copyright SAM and the Slides' Authors. Use with permission. 29
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
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
Trending Concentrates! Edibles!! Vape!!!
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) https://www.youtube.com/watch?v=jz-1d4gqjws
But it s just a plant (80-90% THC) Concentrates Green Crack wax Ear Wax Butane Hash Oil (BHO) Shatter Budder Hash Oil Capsules
Edibles
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.
10 mg is a legal dose Packaging is not regulated
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Cannabis Candy Store
Why were they GONE?
Vaping Concentrates oils flowers
M-Cigarettes (marijuana vaporizers) Brought to you by Groupon! 89
Increasingly popular and accessible 91
Other stuff
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!
Culture of Recovery Recovery Oriented System of Care Recovery Capital
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 1. 2014 Wayne Hall, Adverse Health Effects of Recreation Cannabis Use 2. Dr. Nora Volkolv s summary of recent research published this year in the NEJM 3. 2014 Rocky Mountain HIDTA report 4. Lancet Journal Feb 2015 5. Journal of Drug and Alcohol Dependence (3/1/15)
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Thank you for listening! www.learnaboutsam.org www.legalizationviolations.com www.cedarcolorado.org