marijuana trends november 13, 2014 mappa members presenter: cynthia shifler, atod prevention...

Marijuana TrendsNovember 13, 2014

MAPPA Members

Presenter: Cynthia Shifler, ATOD Prevention Coordinator, Wicomico County

Health Department

Marijuana Facts• It is addictive

• 1 in 6 teens and 1 in 10 adults who try marijuana become addicted to it.

• The adolescent brain is especially susceptible to marijuana use.

• When kids use, they have a greater chance of addiction since their brains are being primed.

• Source: Anthony, J.C. Warner, L.A., & Kessler,R.C. (1994); Giedd, J. N., 2004

Dependence on or Abuse of Specific Illicit Drugs

• Persons 12 or Older, 2008

• Drugs:

• 126 Sedatives

• 175 Inhalants

• 282 Heroin

• 351 Stimulants

• 358 Hallucinogens

• 451 Tranquilizers

• 1,411 Cocaine

• 1,716 Pain Relievers

• 4,199 Marijuana• Source: Substance Abuse and Mental Health Services Administration. (2009), Office of Applied

Studies, Treatment Episode Data Set (TEDS): 2009 Discharges from Substance Abuse Treatment Services

• Copyright Kevin Sabet and SAM. Use with permission

Increased Potency

• Today’s marijuana is not the marijuana of the 1960’s.

• In the past 15 years, marijuana potency has tripled and since 1960 it’s grown 5 times stronger.

• Source: Mehmedic.et.al., (2010)

• Copyright Kevin Sabet and SAM. Use with permission.

ER Admission Rates Rising

• Cannabis-related emergency hospital admission rates have been rising sharply in the U.S.

•From an estimated 16,251 in 1991 to over 374,000 in 2008

Source: SAMHSA, 2011

Marijuana Facts

• Marijuana is unsafe if you are behind the wheel of a car

• Most common illegal drug involved in auto fatalities

• Found in the blood of around 14% of drivers who die in accidents, often in combination with alcohol and other drugs


• www.drugabuse.gov/

Marijuana Facts• Marijuana affects a number of skills required for safe driving

• Alertness

• Concentration

• Coordination

• Reaction Time

• Hard to judge distances and react to signals and sounds on the road

• Combining with alcohol (even a small amount) greatly increases driving danger

• State law sets 5 nanograms of active THC in the blood as the legal limit for driving.


Marijuana Facts

• Marijuana is linked to school failure

• Negative effects on attention, memory, and learning can last for days and sometimes weeks – especially if you use it often

• Students who smoke marijuana tend to get lower grades and are more likely to drop out of high school

• Linked with unemployment, social welfare dependence

• Lower self-reported quality of life

• Source: Fergusson, D.M. and Boden, J.M., 2008


Marijuana Facts

• It can lower your IQ if you smoke it regularly in your teen years

• Persistent and heavy use among adolescents reduces IQ by 6-8 points

• According to a government survey, youth with poor academic results are more than four times likely to have used marijuana in the past year than youth with an average of higher grades.

• Source: Meier, M.H. et al., 2012; MacLeod, J., et al., 2004.


Marijuana use is linked to low productivity and job

performance• Employee marijuana use is linked with increased:

• Absences

• Tardiness

• Accidents

• Worker’s Compensation Claims

• Job Turnover

• Source: NIDA, 2011


Marijuana Facts• High doses of marijuana can cause psychosis or

panic when you’re high

• Increased risk of mental illness

• Schizophrenia (6 fold)

• Psychosis

• Depression

• Anxiety


• Source: AndreassonS., Allebeck P., Engstrom A., Rydberg U., 1987; Areseneault, L., 2002


http://www.drugabuse.gov/

Health Related Effects• Increased heart rate

• Our heart beats 70 to 80 beats per minute

• May increase by 20-50 beats per minute or may even double in some cases

• Rapid or Irregular heart beat

• Heart Failure

• Some evidence that a person’ s risk of a heart attack during the first hour after smoking marijuana is four times his or her usual risk.

• This is explained by marijuana raising blood pressure and heart rate and reducing the blood’s capacity to carry oxygen

• Source: Tetrault, J.M., 2007


Other Health Related Effects• Chest pain

• Respiratory failure

• Harmful effects on the lungs

• Marijuana smoke is an irritant to the lungs

• Results in greater prevalence of:

•Bronchitis

•Cough

•Phlegym Production

• Nausea

• Abdominal pain

• Strokes

• Source: Tetrault, J.M., 2007


Other Health Related Effects• Seizures

• Headaches

• Cancer

• It contains 50-70 percent more carcinogens and irritants than tobacco smoke

• Evidence linking marijuana and cancer is mixed

• This is due to the way it is smoked which exposes the lungs longer to carcinogenic smoke (over 400 chemicals/with 60 cannabinoides)

• However, marijuana smoke contains an enzyme that converts hydrocarbons into a cancer-causing form.

• Source: Hoffman, D., et al., 1975; Brambilla, C., & Colonna, M., 2008; Bello, D., 2006; Tashkin, D.P., 1999


Smoked/Eaten Marijuana is Medicine

• Marijuana has medical properties, but we don’t need to smoke or eat it!

• We don’t smoke opium to derive the benefits of morphine.

• So we don’t need to smoke marijuana to receive its potential benefits.

• A distinction must be made between raw, crude marijuana and marijuana’s components.


Is Marijuana Medicine?• No: smoked or inhaled raw marijuana is not medicine

• Yes: there are marijuana based pills available and other medications coming soon.

• Research is ongoing.


Marijuana has medicinal properties

• Studies show that components or constituents within marijuana have medical value.

• For instance, dronabinol (also known as Marinol) contains lab-made THC and is widely available at pharmacies as capsules to treat nausea/vomiting from cancer chemotherapy.


Marijuana-based medicines• Sativex is in the process of being studied in the USA.

• THC:CBD = 1.1

• Cannabidiol (CBD) is one of at least 85 active cannabinoids identified in cannabis.[4] It is a major phytocannabinoid, accounting for up to 40% of the plant's extract.[5] CBD is considered to have a wider scope of medical applications than tetrahydrocannabinol (THC).[5] An orally-administered liquid containing CBD has received orphan drug status in the US, for use as a treatment for dravet syndrome, under the brand name Epidiolex.[6]


http://en.wikipedia.org/wiki/Psychoactive_drug

http://en.wikipedia.org/wiki/Cannabinoid

http://en.wikipedia.org/wiki/Cannabis

http://en.wikipedia.org/wiki/Cannabidiol

http://en.wikipedia.org/wiki/Phytocannabinoid


http://en.wikipedia.org/wiki/Tetrahydrocannabinol


http://en.wikipedia.org/wiki/Orphan_drug

http://en.wikipedia.org/wiki/Dravet_syndrome


Marijuana-based medicines

• It is administered via an oral mouth spray

• Already approved in Canada and Europe

• Also, Epidiolex, pure CBD, no THC


Average medical marijuana patients

• Profile:

• 32-year old white male

• History of alcohol and substance abuse

• No history of life-threatening illnesses

• 87.9% had tried marijuana before age 19

• 75% of Caucasian patients had used cocaine and 50% had used methamphetamine in their lifetime.

• Source: O”Connell, T.J. & Bou-Matar, C.B., 2007


Dabbing

• BHO (Butane Hash Oil) is produced by one of two methods: “open” or “closed." The open method involves packing a stainless steel tube with marijuana and "blasting" the tube with butane (an extraction solvent). The resulting extract—a thick, yellow-orange oil—trickles out onto a pan. This method can be dangerous: FEMA reports increasing incidents of explosions across the US caused by clumsy hash oil production attempts.


http://www.usfa.fema.gov/fireservice/emr-isac/infograms/ig2013/6-13.shtm

Dabbing

• The closed system, a safer method, uses a machine called abutane oil extractor—which is also used to perform oil extraction from botanical herbs like lavender and mint to produce aromatics, infusions, and tinctures. Consuming BHO is known as "dabbing," and usually involves the user touching the concentrate onto a heated surface (like a nail) and inhaling its vapors.


http://www.tamisiumextractors.com/how-it-works/?amigosid=6

Dabbing

• Dabbing comes with potential health dangers, including inhalation of "dirty" butane. Another risk is ingesting harmful contaminants that may have been infused into the concentrate during the extraction process, like pesticides, herbicides and fungi.


Vaping Marijuana

Vaping Marijuana

• A way to use marijuana without anyone smelling it

• Some E-Cigarettes can be used for liquid hash oil, etc.

• Dangerous if children obtain access to it

What has occurred to change how society views

Marijuana?

What have been the results?

• Medical Marijuana

• Decriminalization

• Legalization

National Organization for the Reform of Marijuana Laws

• Formation of the National Organization for the Reform of Marijuana Laws (NORML)

• The mission of the NORML Business Network [NBN] is to encourage the development of responsible, sustainable enterprises that seek to serve their community and set a positive example for the growing cannabis industry. The NBN highlights new and growing marijuana-related business partners that have shown a commitment to responsible consumer engagement, environmental protection, and to using their business as a platform for social change.

Marijuana in Colorado

Impact of Legalization

Colorado Youth Marijuana Use

• In 2012, 10.47 percent of youth ages 12 to 17 were considered current marijuana users compared to 7.55 percent nationally. Colorado, ranked 4th in the nation, was 39 percent higher than the national average.

• Drug related suspensions/expulsions increased 32 percent from school years 2008/2009 through 2012/2013. The vast majority were for marijuana violations.


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 25-40% were marijuana alone.

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


Colorado’s Emergency Room Marijuana Admissions

• From 2011 through 2013, there was a 57 percent increase in marijuana related emergency room visits.

• Hospitalizations related to marijuana have increased 82 percent from 2008 to 2013.

• In 2012, the City of Denver rate for marijuana-related emergency visits was 45 percent higher than the rate in Colorado.


Only a small proportion of medical marijuana users report any serious illness

• In Colorado, 2% reported cancer, less than 1% reported HIV/AIDS, and 1% reported glaucoma as their reason for using medical marijuana.

• In Oregon, these numbers are less than 4%, 2% and 1% respectively.

• Source: Colorado Department of Public Health and Environment, 2011; Oregon Public Health Authority, 2011


Chronic Pain• Majority of medical marijuana users report using marijuana

to treat ‘chronic or severe pain.’

• 96% in Colorado

• 91% in Oregon

• 93% in Montana

• Source: Colorado Department of Public Health and Environment, 2011; Oregon Public Health Authority, 2011; Montana Department of Public Health and Human Services, 2011


Medical Marijuana has led to increased use

• Residents of states with medical marijuana laws have abuse/dependence rates almost twice as high as states with no such laws.

• Source: Cerda, M., et al., 2012.


What have we learned from Colorado and Washington

• Increased rates of drugging and driving

• Increased marijuana poisonings of children

• Increased ER visits due to marijuana edibles• Copyright Kevin Sabet and SAM. Use with permission.

Edibles

• Booming business since marijuana has been legalized in Colorado

• Halloween Edibles were found recently in Prince George’s County, Maryland

• Philosophy: get them hooked young and you will have them for life

Edibles

• THC amounts have to be written on the item

• Found that the amounts do not reflect the reality

• Edibles can have up to 99% THC• Copyright Kevin Sabet and SAM. Use with permission.

Edibles

• New York Times Columnist ate candy bar in Colorado and ended up in the ER

• Nothing on item to say that it was supposed to be eaten in 16 pieces

• If she had eaten the entire thing, she probably would have died.


Edibles

• New proposed rules for edibles

• Child Proof Packaging

• Clearly Printed Health Warning Labels

• Strict THC limits for various serving sizes• Copyright Kevin Sabet and SAM. Use with permission.

Edibles

• Many edible shops buy soft or hard candy in bulk

• Then spray it with viscous hash oil

• Once it dries there is no way to tell the difference between candy that is infused and candy that’s not infused

• Best advice to parents: only give candy that comes from a recognized brand like Hershey, Haribo, Mars, etc.


Edibles

• Serving Size of 10 milligrams of THC for marijuana edibles

• A cookie with 65 milligrams is said to contain six and one-half servings


Two Deaths Due to Edibles

• 19 year old Wyoming college student who took a deadly leap off a Denver hotel on March 11 not long after eating edible marijuana.

• There were 7.2 nanograms of active THC per milliliter of blood in the deceased student.

• He consumed a marijuana cookie but no other drugs or alcohol


Two Deaths Due to Edibles

• 44year old Kristine Kirk, allegedly shot dead by her 47 year old husband Richard Kirk while she was reporting his psychotic behavior to a police 911 operator after he consumed marijuana candy.

• Father of three stands accused of murder. He was also on pain killers at the time for his back.


Edibles

More Edibles

marijuana trends november 13, 2014 mappa members presenter: cynthia shifler, atod prevention...

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