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Marijuana Trends
November 13, 2014
MAPPA Members
Presenter: Cynthia Shifler, ATOD Prevention
Coordinator, Wicomico County Health Department
Marijuana Facts
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It is addictive
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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
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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
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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
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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
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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
Copyright Kevin Sabet and SAM. Use with permission.
www.drugabuse.gov/
Marijuana Facts
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Marijuana affects a number of skills required for safe driving
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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.
www.drugabuse.gov/
Marijuana Facts
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Marijuana is linked to school failure
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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
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Linked with unemployment, social welfare dependence
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Lower self-reported quality of life
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Source: Fergusson, D.M. and Boden, J.M., 2008
Copyright Kevin Sabet and SAM. Use with permission.
Marijuana Facts
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It can lower your IQ if you smoke it regularly in your teen years
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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.
Copyright Kevin Sabet and SAM. Use with permission.
Marijuana use is linked to low
productivity and job performance
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Employee marijuana use is linked with increased:
• Absences
• Tardiness
• Accidents
• Worker’s Compensation Claims
• Job Turnover
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Source: NIDA, 2011
Copyright Kevin Sabet and SAM. Use with permission.
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Marijuana Facts
High doses of marijuana can cause psychosis or panic when you’re
high
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Increased risk of mental illness
• Schizophrenia (6 fold)
• Psychosis
• Depression
• Anxiety
www.drugabuse.gov/
Source: AndreassonS., Allebeck P., Engstrom A., Rydberg U., 1987; Areseneault, L., 2002
Copyright Kevin Sabet and SAM. Use with permission.
Health Related Effects
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Increased heart rate
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May increase by 20-50 beats per minute or may even double in some
cases
Rapid or Irregular heart beat
Heart Failure
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Our heart beats 70 to 80 beats per minute
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
Copyright Kevin Sabet and SAM. Use with permission
Other Health Related Effects
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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
Copyright Kevin Sabet and SAM. Use with permission
Other Health Related Effects
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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.
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Source: Hoffman, D., et al., 1975; Brambilla, C., & Colonna, M., 2008; Bello, D., 2006; Tashkin, D.P., 1999
Copyright Kevin Sabet and SAM. Use with permission.
Smoked/Eaten Marijuana is
Medicine
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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.
Copyright Kevin Sabet and SAM. Use with permission.
Is Marijuana Medicine?
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No: smoked or inhaled raw marijuana is not medicine
Yes: there are marijuana based pills available and other medications
coming soon.
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Research is ongoing.
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Copyright Kevin Sabet and SAM. Use with permission.
Marijuana has medicinal properties
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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.
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Copyright Kevin Sabet and SAM. Use with permission.
Marijuana-based medicines
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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]
Copyright Kevin Sabet and SAM. Use with permission.
Marijuana-based medicines
• It is administered via an oral mouth spray
• Already approved in Canada and Europe
• Also, Epidiolex, pure CBD, no THC
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Copyright Kevin Sabet and SAM. Use with permission.
Average medical marijuana patients
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Profile:
• 32-year old white male
• History of alcohol and substance abuse
• No history of life-threatening illnesses
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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
Copyright Kevin Sabet and SAM. Use with permission.
Dabbing
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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.
Copyright Kevin Sabet and SAM. Use with permission.
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.
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Copyright Kevin Sabet and SAM. Use with permission.
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.
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Copyright Kevin Sabet and SAM. Use with permission.
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
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Formation of the National Organization for the Reform of
Marijuana Laws (NORML)
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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.
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Copyright Kevin Sabet and SAM. Use with permission.
Impaired Driving in Colorado
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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.
Copyright Kevin Sabet and SAM. Use with permission.
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.
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Copyright Kevin Sabet and SAM. Use with permission.
Only a small proportion of medical
marijuana users report any serious
illness
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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
Copyright Kevin Sabet and SAM. Use with permission.
Chronic Pain
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Majority of medical marijuana users report using marijuana to treat ‘chronic or severe
pain.’
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96% in Colorado
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91% in Oregon
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93% in Montana
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Source: Colorado Department of Public Health and Environment, 2011; Oregon Public Health Authority, 2011; Montana
Department of Public Health and Human Services, 2011
Copyright Kevin Sabet and SAM. Use with permission.
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.
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Source: Cerda, M., et al., 2012.
Copyright Kevin Sabet and SAM. Use with permission.
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
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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
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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.
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Copyright Kevin Sabet and SAM. Use with permission.
Edibles
• New proposed rules for edibles
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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.
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Copyright Kevin Sabet and SAM. Use with permission.
Edibles
• Serving Size of 10 milligrams of THC for marijuana edibles
• A cookie with 65 milligrams is said to contain six and onehalf servings
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Copyright Kevin Sabet and SAM. Use with permission.
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
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Copyright Kevin Sabet and SAM. Use with permission.
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.
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Copyright Kevin Sabet and SAM. Use with permission.
Edibles
More Edibles
More Edibles