STATE OF AFFAIRS: COLORADO FOCUSES ON MARIJUANA
#1 Issue in the State Continues to be Alcohol Use DENVER, Colo. – Colorado has been at the center of controversy for nearly 3 years after the state’s legalization of medical and recreational use of marijuana. Since late 2012, scientists have been gathering data on the early effects of the decision, and what it means for other states. Medicinal marijuana has not yet been scientifically proven to be effective in most the diseases it was approved to treat, but statewide studies are in the works through various grants to gather such data to the tune of $8 million. The early medical marijuana era began in Colorado in 2006. By 2009, medical marijuana outlets became commercialized and by 2013, recreational marijuana became legal in the state. According to Rocky Mountain HIDTA, a 30-day prevalence of marijuana use increased 26% among youth ages 12-17, 20% among college-aged students, 36% among adults over the age of 26. ER visits related to marijuana increased 57% between 2011-2013. Young children marijuana-related exposures increased 268% between 2006-2013. Colorado traffic fatalities decreased 14.8% between 2007-2012; however, traffic fatalities involving operators testing positive for marijuana increased 100%. In 2007, Colorado traffic fatalities involving operators testing positive for marijuana represented 7% of total Colorado traffic fatalities. By 2012, the rate increased to 16.5%. An increase of 762% was recorded for marijuana seized from parcels mailed from Colorado to other states between 2010-2013. Contrary to marijuana proponents’ claims that crime decreased, according to Rocky Mountain HIDTA, reported crime in Denver increased 6.7% in one year after retail marijuana stores opened. THC toxicosis in dogs increased 4-fold from 1.5/1000 cases in 2005 to 4.5/1000 cases in 2010. 83% of tax revenue collected through marijuana sales in Colorado supports prevention and treatment, according to the Prevention Alliance of Tennessee. The number of calls to poison centers for young child exposure to marijuana in Colorado is triple the national average (17.81% versus 4.97%). Last month, the Colorado Supreme Court upheld a decision for Dish Network to fire an employee with a medical marijuana card who failed a random drug test because, according to Justice Allison H. Eid, while it is “permitted by state law…it is unlawful under federal law…and not protected by the statute”. [inline_cta_six] On a federal level, the FDA’s drug approval process requires that clinical trials be designed and conducted. THC and cannabidiol do have some therapeutic benefits. The FDA has approved the drugs Dronabinol (Marinol) and Nabilone (Cesamet). The FDA has said to date, there have not been enough clinical trials that show the benefits of the marijuana plant outweigh the risks in patients with the symptoms it is meant to treat; therefore, the FDA has not approved marijuana for medical use. A drug called Sativex, which contains equal parts of THC and cannabidiol, is currently approved in the UK to treat spasticity caused by multiple sclerosis and is now in Phase III clinical trials in the U.S. to establish its effectiveness and safety in treating cancer pain.
“I am very concerned that if we legalize marijuana, we are on a slippery slope,” says Jeff Gray, a 23-year veteran child and youth therapist at Pathways told Tennessee lawmakers in a House study session last month. “I see how drug use destroys families and lives. I am not going to argue the fact that some smoke pot and they do not become a ‘full blown addict’, but I have never seen an addict that does not begin smoking pot, then expands to other drugs due to their disease of addiction. I am asking you as lawmakers not to open up this door, because if you do, in the long run, it will cost the state millions of dollars due to the consequences. Tennessee needs to be the state that stands up.”
The cold hard truth, however, is that only 6% of the studies done on the drug actually analyze its medicinal properties according to CNN. While over 20 states around the country have legalized marijuana, the jury, for the most part, is still out. So, what are some positive things we know that come from marijuana legalization? We know that for some it has decreased opioid and benzodiazepine use. We talked with one Tennessee lawmaker who told us of a relative, who, in their last days, was addicted to prescription painkillers. According to him, marijuana might have allowed his relatives to be more present, and not in the grips of an addiction in their last days. Another person we spoke with claimed that while Xanax made him want to sleep all day, marijuana helped him function, and treated his anxiety in what he called a more manageable way. We know that it can help treat and prevent Glaucoma by decreasing the pressure behind the eye, according to the National Eye Institute. According to the American Medical Association, it can reverse the effects of carcinogens and aid in lung capacity. A study conducted by Virginia Commonwealth University claims it can help prevent epileptic seizures. We know one family claims it decreases the amount of symptoms of Dravet syndrome. The California Pacific Medical Center claims it can help stop cancer from spreading. We also know that it disturbs sleep cycles, and can impair someone’s function, much like alcohol. Not everyone who smokes marijuana is an addict, and not everyone who drinks alcohol is an alcoholic. And there are large amounts of tests on both sides of the fence to support their argument. But most advocates on either side will agree that more data needs to be collected on the topic. Colorado is at the forefront of such research. Most recently, award-winning and well-renowned Doctors Robert and Barbara Schrier established an endowment to study the effects of drugs on infants. Dr. Robert Schrier says he was invited to give the Commencement speech at Marshall University’s Joan C. Edwards School of Medicine when he and his wife began to see West Virginia’s problem with infants born addicted.
“One third of pregnant women are addicted to narcotics in the state,” says Dr. Schrier, a kidney disease specialist. “I think getting in the research arena and identifying addicted women early and letting them know the dangers to their newborns is key.”
The clinical study is aimed at reducing the effects of addiction on newborns. Meanwhile in Colorado, the state’s Certified Prevention Specialists is a statewide trade association for executive directors in intervention, treatment and recovery that is doing what it can to educate 30 providers working throughout the state.
“The number one issue continues to be alcohol,” says Executive Director Matt Sundeen. “A lot of the focus has been on marijuana in our state since we’ve legalized it medically and recreationally. However, regarding admissions, alcohol continues to be the number one issue.”
Colorado is seeing its biggest boost in admissions with heroin, and the largest challenge is for people working with adolescents. The group says it’s seen a 6-7 fold increase in admissions for heroin addiction, closely connected to prescription drug use. While alcohol is the drug of choice for Colorado, there is a growing concern about the increased use of heroin. CCPS advocates for their members in the state legislature and state agencies.
“We advocate for increased support for programs that we feel are effective in helping with these issues,” says Sundeen. “We’ve had a lot of discussion about substance use since marijuana has been legalized in the state.”
Sundeen looks at services that might be able to address substance use in the primary care environment. The discussion in the legislature right now is how to allocate marijuana revenue toward treatment and prevention programs. Sundeen says to the best of his knowledge, there’s not enough evidence to support marijuana curbing the prescription painkiller epidemic in the state.
“We are fairly new with it,” says Sundeen. “There’s not a lot of data supporting that.”
[middle-callout] There has, however, been a fair amount of legislation related to substance use and marijuana, taking into consideration all of the components involved. But not a lot has been passed specifically targeting drug use. Most of the regulation is to businesses operating in the state. Colorado did pass a bill related to Naloxone during the last legislative session, making the heroin overdose antidote more accessible to first responders.
“We certainly are supportive of addressing addiction as a health condition rather than a criminal issue,” says Sundeen. “I think when you are making people criminals and not actually treating addiction, you’re not addressing the underlying problems.”
Sundeen says addiction cuts across every demographic in Colorado. When we start taking people out of their communities and throwing them in jail, we’re only worsening the problem. He says whatever we can do collectively to address it as a health issue rather than a criminal issue, the better off we are. We’ve seen significant growth in heroin addiction, not just in his state, but across the country. While the state does have needle exchange programs, they’ve also had a lot of synthetic marijuana and issues with that. There was a discussion recently about powdered alcohol, but Sundeen is not sure those are what’s creating the problems. “I think it’s gonna take a collective recognition of the significance of the problem,” says Sundeen. “We have, as a result of the Affordable Care Act, expanded Medicaid and set up a state health insurance exchange. More people than ever before have access to health insurance. We’ve had some significant discussions about improving healthcare. What we need as part of that discussion is to recognize that substance use is the number one health issue in our state and the nation. It is the most costly and most prevalent, yet we spend the least amount of money on it. We’re not really tackling the problem. When we have discussions on the topic, the substance use disorder issue is at the bottom of the ladder when it comes to where people want to look. There’s very little talk about investing in the treatment of marijuana addiction. To get on top of the issue we need to treat it as the most prevalent issue in our country.” If you or someone you know is struggling with marijuana and would like to receive help call Vertava Health today at 844-470-0410. Indeed, it is.