November 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 ID: 254848
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Slide1
Marijuana Trends
November 13, 2014
MAPPA Members
Presenter: Cynthia Shifler, ATOD Prevention Coordinator, Wicomico County Health Department Slide2
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., 2004Slide3
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 permissionSlide4
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.Slide5
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, 2011Slide6
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
Copyright Kevin
Sabet
and SAM. Use with permission.
www.drugabuse.gov/Slide7
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.www.drugabuse.gov/Slide8
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
Copyright Kevin Sabet and SAM. Use with permission.Slide9
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.
Copyright Kevin Sabet and SAM. Use with permission.Slide10
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
Copyright Kevin Sabet and SAM. Use with permission.Slide11
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
www.drugabuse.gov/
Source: AndreassonS., Allebeck P., Engstrom A., Rydberg U., 1987; Areseneault, L., 2002
Copyright Kevin Sabet and SAM. Use with permission.Slide12
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
Copyright Kevin
Sabet
and SAM. Use with permissionSlide13
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 ProductionNauseaAbdominal painStrokes
Source: Tetrault, J.M., 2007
Copyright Kevin Sabet and SAM. Use with permissionSlide14
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
Copyright Kevin Sabet and SAM. Use with permission.Slide15
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.
Copyright Kevin Sabet and SAM. Use with permission.Slide16
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.
Copyright Kevin Sabet and SAM. Use with permission.Slide17
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.
Copyright Kevin Sabet and SAM. Use with permission.Slide18
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]
Copyright Kevin Sabet and SAM. Use with permission.Slide19
Marijuana-based medicines
It
is
administered via an oral mouth spray
Already approved in Canada and Europe
Also, Epidiolex, pure CBD, no
THC
Copyright Kevin
Sabet
and SAM. Use with permission.Slide20
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
Copyright Kevin Sabet and SAM. Use with permission.Slide21
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.
Copyright Kevin
Sabet
and SAM. Use with permission.Slide22
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.
Copyright Kevin
Sabet
and SAM. Use with permission.Slide23
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.
Copyright Kevin
Sabet
and SAM. Use with permission.Slide24
Vaping MarijuanaSlide25
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 itSlide26
What has occurred to change how society views Marijuana?Slide27
What have been the results?
Medical Marijuana
Decriminalization
LegalizationSlide28
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.Slide29
Marijuana in Colorado
Impact of LegalizationSlide30
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 4
th
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.
Copyright Kevin
Sabet
and SAM. Use with permission.Slide31
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.
Copyright Kevin
Sabet
and SAM. Use with permission.Slide32
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.
Copyright Kevin
Sabet
and SAM. Use with permission.Slide33
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
Copyright Kevin Sabet and SAM. Use with permission.Slide34
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
Copyright Kevin Sabet and SAM. Use with permission.Slide35
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.
Copyright Kevin Sabet and SAM. Use with permission.Slide36
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.Slide37
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 lifeSlide38
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.Slide39
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.
Copyright Kevin
Sabet
and SAM. Use with permission.Slide40
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.Slide41
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.
Copyright Kevin
Sabet
and SAM. Use with permission.Slide42
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
Copyright Kevin
Sabet
and SAM. Use with permission.Slide43
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
Copyright Kevin
Sabet
and SAM. Use with permission.Slide44
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.
Copyright Kevin
Sabet
and SAM. Use with permission.Slide45
EdiblesSlide46
More EdiblesSlide47
More Edibles