Building Safe, Healthy, and Drug Free Communities The Naked Truth About Marijuana 1 Sweden Against Drugs Gävle, Sweden – September 7-8, 2016 Sue Thau, Public Policy Consultant CADCA

2 “THE NAKED TRUTH IS ALWAYS BETTER THAN THE BEST-DRESSED LIE.” – ANN LANDERS

3 Marijuana is Addictive Long-term marijuana use can lead to addiction. Approximately 9 percent of users will become addicted to marijuana. This number increases to 17 percent among those who start young. Budney AJ, Vandrey RG, Hughes JR, Thostenson JD, Bursac Z “Comparison of cannabis and tobacco withdrawal: Severity and contribution to relapse.” J Subst Abuse Treat, e-publication ahead of print.

4 Marijuana is Addictive who start using marijuana in adolescence become addicted National Institutes of Health, National Institute on Drug Abuse Topics in Brief: Marijuana. Available:

5 Source: 2014 National Survey on Drug Use and Health, Past Month Use

6 Alcohol and Tobacco: A Model? Use levels for alcohol and tobacco are much higher than marijuana (7x and 2x respectively) Industries promote use and target kids and lower socio-economic status individuals Schiller JS, Lucas JW, Peregoy JA. Summary health statistics for U.S. adults: National Health Interview Survey, National Center for Health Statistics. Vital Health Stat 10(256) Centers for Disease Control and +. Vital Signs: Current Cigarette Smoking Among Adults Aged ≥ 18 Years—United States, 2005–2010. Morbidity and Mortality Weekly Report 2011;60(33):1207–12Vital Signs: Current Cigarette Smoking Among Adults Aged ≥ 18 Years—United States, 2005–2010

7 Alcohol and Tobacco: A Model? In Colorado, adult marijuana use is now HIGHEST in the country – 13.6% of adults in CO are regular users, with rates of 18.5% in Denver Just like tobacco and alcohol, a report prepared for the Colorado Department of Revenue showed that “the vast majority of marijuana demand” in that state “emanates from the regular users” – those who consume daily or near daily – In CO, the top 21.8% of users make up almost 67% of demand for marijuana in the state

8 Alcohol and Tobacco: A Model? The negative social and health effects of marijuana legalization will fall on those least able to bear the burdens of cost and health EXAMPLE: Legal marijuana businesses in Denver are already concentrated in lower income and minority neighborhoods

9 SOURCE:Colorado Department of Revenue, Colorado Liquor Excise Tax Alcohol Consumption

10 FACTS on Medical Marijuana – Is not even good for conditions it is touted for – Could exacerbate symptoms (American Glaucoma Society) 1 American Glaucoma Foundation. Available: 1

11 FACTS on Medical Marijuana Less than 3% of state “medical marijuana” users have cancer, HIV, or glaucoma. Vast majority are white males in 30s and 40s with self-diagnosed pain. Most cancer doctors and other physicians do not recommend smoking or ingesting marijuana. California average medical marijuana patient statistics, found at: O'Connell, T and Bou-Matar, C.B. (2007). Long term cannabis users seeking medical cannabis in California (2001–2007): demographics, social characteristics, patterns of cannabis and other drug use of 4117 applicants. Harm Reduction Journal,

12 Changes in Social Norms Increase Use As social norms around the acceptability of marijuana use change, use and abuse have gone up NIH released a report in October 2015 that showed from 2001/2002 – 2012/2013 past year marijuana use among adults increased from 4.1% to 9.5% nationally – The increase in marijuana use disorder during the same time frame was almost as large

13 The Naked Truth about Marijuana Legalization in Colorado

14 Marijuana Use by State Policy Source: 2016 Rocky Mountain HIDTA Report on Legalization of Marijuana in Colorado:

15 Source: 2016 Rocky Mountain HIDTA Report on Legalization of Marijuana in Colorado: Impact of Marijuana Legalization in Colorado

16 Youth (ages 12 to 17 years) Current Marijuana Use 2013/2014  Colorado ranked 1 st in the nation for current marijuana use among youth Ranked 3 rd in 2012/2013 Ranked 3 rd in 2012/2013 Ranked 14 th in 2006/2007 Ranked 14 th in 2006/2007  Colorado youth use is 74 percent higher than the national average  2013/2014 Colorado youth use increased 20 percent compared to pre-legalization years 2011/2012. Nationally a decline of 5 percent.

17 Source: 2016 Rocky Mountain HIDTA Report on Legalization of Marijuana in Colorado: Impact of Marijuana Legalization in Colorado

18 College-Age Adults (ages 18 to 25 years) Current Marijuana Use 2013/2014  Colorado ranked 1 st in the nation for current marijuana use among college-age adults Ranked 2 nd in 2012/2013 Ranked 2 nd in 2012/2013 Ranked 8 th in 2006/2007 Ranked 8 th in 2006/2007  Colorado college-age use is 62 percent higher than the national average  2013/2014 college-age use increased 17 percent compared to pre-legalization years 2011/2012. Nationally a 2 percent increase.

19 Source: 2016 Rocky Mountain HIDTA Report on Legalization of Marijuana in Colorado: Impact of Marijuana Legalization in Colorado

20 Adults (ages 26+ years) Current Marijuana Use 2013/2014  Colorado ranked 1 st in the nation for current marijuana use among adults Ranked 5th in 2012/2013 Ranked 5th in 2012/2013 Ranked 8 th in 2006/2007 Ranked 8 th in 2006/2007  Colorado adult use is 104 percent higher than the national average  2013/2014 adult use increased 63 percent compared to pre-legalization years 2011/2012. Nationally an increase of 21 percent.

21 Hospitalizations: Impact of Marijuana Legalization in Colorado Source: 2016 Rocky Mountain HIDTA Report on Legalization of Marijuana in Colorado: (graph from

22 Marijuana and Traffic Fatalities SOURCE:National Highway Transportation Safety Administration, Fatality Analysis Reporting System (FARS), and CDOT/RMHIDTA NOTE: Cannot confirm 100% reporting prior to 2012.

23 Operators Positive for Marijuana SOURCE:Colorado Department of Transportation/RMHIDTA 2014

24 Poisonings: Impact of Marijuana Legalization in Colorado Graph from Marijuana-Related Poisonings in Colorado Surged after Legalization

25 Teen Treatment Admissions: Impact of Marijuana Legalization in Colorado Graph from Youth Treatment Admissions for Marijuana Use in Colorado Increased after Legalization

26 Advertising in Colorado

27 Full-Page Ads in Colorado

28 Edibles for Sale in Colorado

29 Edibles for Sale in Colorado

30 Types of Marijuana 30

31 Perspective Colorado Business Profile, January 2016 Colorado Business Profile, January 2016

32 Denver: The Mile HIGH City 210 Licensed Medical Marijuana Centers 108 Pharmacies

33 “Legal pot blamed for some of influx of homeless in Denver this summer” The Denver Post, July 25, 2014 Haven of Hope 500% rise over normal in homeless in summer 2014 (50 to 300) Haven of Hope: 500% rise over normal in homeless in summer 2014 (50 to 300) o “They have an attitude.” Salvation Army 33% rise since 2014 compared to 2013 Salvation Army: 33% rise since 2014 compared to 2013 o “30% relocated for pot.”

34 Marijuana and Public Consumption “Citations for using pot in public rising” Denver police say they’re not purposely trying to nab users since marijuana was legalized. The Denver Post Sunday, December 28, = 8 citations 2013 = 184 citations 2014 = 770 citations 2015 = 752 citations

35 Colorado General Fund

36 FY 2015 Tax Revenue

37 A Snapshot in Colorado 2014 Marijuana-Related DUIDs Marijuana-Related Traffic Deaths Youth Marijuana Use College Marijuana Use Adult Marijuana Use Marijuana-Related Emergency Room Admissions Marijuana-Related Hospitalizations Marijuana-Related Exposures Marijuana-Related Treatment Marijuana Diversion THC Extraction Labs SOURCE:Rocky Mountain HIDTA