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Marijuana The Truth

Joe Burton Prevention Specialist Keystone Substance Abuse Services

Danielle Center, MPH, MCHES Prevention Coordinator Keystone Substance Abuse Services

Marijuana =

-chemical compounds that interact with receptors in the brain cells and repress the release of neurotransmitters in the brain  Delta 9 (THC) –active psychedelic compound  (CBD)- oil extract used to treat seizure disorders  Varieties include Sativa, Indica, and Ruderalis (has the highest prevalence of CBD)

Sativa vs. Indica

Indica Sativa

Sativa Indica Origin Mexico, Thailand, Afghanistan, and certain Turkey, and African countries Morocco Description taller and thinner short and wide plant Height 6 feet (25 feet for 3 feet outdoor plants) Effect/High Greater high; Strongest “energetic” analgesic effect; “couch-locked” Marijuana vs.

 Hemp is a strain of the plant (Cannabis Sativa L)  Hemp producers use the stalk and the seeds to make products for industrial use (ex. Rope. Lotions, Detergents, Papers, etc.)  Marijuana producers use the flowers/buds  Hemp has a low THC content (0.3%-1.5% THC)  Marijuana has a higher THC content (5%-10% and higher)

Marijuana Hash

420 710 Slang terms Marijuana  K  Loud  Pack  Gas

Butane Hash Oil  Honey Oil  Budder  Earwax  Shatter

 Joints, Blunts, Bongs  Vaping  Edibles  Baked Goods  Candy  Drinks  Lotions Ways to Consume Marijuana

 Joints, Blunts, Bongs  Vaping  Edibles  Baked Goods  Candy  Drinks  Lotions Vaping

 E-  mCigs  JuJu Joints  150 hits  Strain of marijuana oil  Does not need to be recharged

Edibles

Ways to Consume Ways to Consume Ways to Consume

 Dabbing  https://www.youtube.com/watch?v=ZqcwF Jp0bZg

South Carolina Marijuana What’s next? Health Risks

 Addiction  Cognitive Impairment  Respiratory Effects  Mental Health Problems  Societal Problems Addiction: “I never knew I was addicted, until I tried to stop.”

14  Estimates from Average THC and CBD Levels in the US: research suggest 1960 - 2011 12 that about 9% of

users become 10 addicted.

8  Increases to about 17% among young 6 CBD: users and 25-50% NON- among daily users. Psychoactive 4 MARIJUANA MARIJUANA POTENCY Ingredient  Today’s marijuana is 4x stronger than 2 in 1960 and as 0 much as 18x

stronger for

1998 2001 2004 2007 1965 1970 1974 1978 1980 1983 1984 1985 1986 1990 1992 1993 1995 1996 1997 1999 2000 2002 2003 2005 2006 2008 2009 2010 2011 1960 marijuana edibles

Mehmedic et Cognitive Impairment

 Memory Ability  Visuomotor Skills  Oculomotor control  Use of Cannabis during neurodevelopmental periods can alter brain structure and function

Source: Shrivastava, Johnson & Tsuang, 2011 The Brain and Marijuana Brain structure Regulates THC Effect of User Amygdala Emotions, fear anxiety Panic/paranoia Basal ganglia Planning/starting a Slowed reaction time movement Brain Stem Information between brain Anti-nausea effects and spinal column Cerebellum Motor coordination, balance Impaired coordination

Hippocampus Learning new information Impaired memory Hypothalamus Eating, sexual behavior Increased appetite Neo Cortex Complex thinking, feeling Altered thinking, and movement judgment and sensation Nucleus Motivation and reward Euphoria (feeling good) Accumbens Spinal cord Transmission of information Altered pain sensitivity between body and brain The brain structures listed above all contain high numbers of CB receptors. Marijuana Use and Educational Outcomes

 Marijuana interferes with:  Attention  Motivation  Memory  Learning

Regular heavy marijuana use by teens can lead to an IQ drop of up to 8 points

Source: National Institute on Drug Abuse Respiratory Effects

Mental Health Problems

 Can worsen symptoms of anxiety, depression, schizophrenia, and paranoia (psychosis)  Including shortness of breath and heart palpitations  Schizophrenia- increased risk of developing illness, including individuals with close family relatives with severe mental disorders  Negative impact- missing more appointments and having more difficulty with medical adherence

Source: National Alliance on Mental Illness. Marijuana and Mental Illness. Retrieved from www.nami.org. 2013. Marijuana Laws

Federal Law

 The federal Controlled Substances Act (CSA) classifies marijuana as a Schedule I drug — one with a high potential for abuse and no currently accepted medical use and criminalizes the acts of prescribing, dispensing, and possessing marijuana for any purpose (Hoffman and Weber, 2010). 5 Steps to Legalization of Marijuana

 Step 1: Legalization of Industrial Hemp  Step 2: Legalization of Cannabidiol (CBD Oil) for Medical Purposes  Step 3: Legalization of Medical Marijuana  Step 4: Decriminalization  Step 5: Legalization of Recreational Use

State “Medical” Marijuana Laws vs. Federal Law

The U.S. Food and Drug Administration (FDA) has not recognized or approved the marijuana plant as medicine (National Institute on Drug Abuse, 2015).

“Medical” Marijuana

 The Institute of Medicine (IOM) has concluded that smoking marijuana is not recommended for any long-term medical use, and a subsequent IOM report declared that, “marijuana is not modern medicine.” Additionally, the American Medical Association, the National Cancer Institute, the American Cancer Society, and the National Multiple Sclerosis Society do not believe that the scientific evidence on therapeutic use of the drug meets the current standard of prescribed medicine.

Source: Office of National Drug Control Policy, www.whitehousedrugpolicy.gov “Medical” Marijuana Uses

 Glaucoma  Nausea  HIV/AIDs (weight gain)  Chronic Pain  Inflammation  Multiple Sclerosis  Epilepsy  Any other condition approved by the state health department Where is SC in the legalization process?

 Step 1: Legalization of Industrial Hemp- passed June 2, 2014

 Step 2: Legalization of Cannabidiol (CBD Oil) for Medical Purposes- passed June 2, 2014

 Step 3: Legalization of Medical Marijuana- stalled in Spring 2015

 Step 4: Decriminalization – stalled in Spring 2015

 Step 5: Legalization of Recreational Use

Legal products in SC

 In Charleston, there  In Greenville, is now e-juice energy drink that being sold contains cannabis. containing CBD. Medical Marijuana in South Carolina?

 Use of low-THC for certain medical conditions  State protect qualifying patients, designated caregivers, and physicians from arrest, prosecution, and certain penalties  To create dispensaries  Allow certain entities to conduct research on cannabidiol and low-THC  DHEC to facilitate proper techniques for handing and testing of marijuana-infused products  A registered patient may only have up to:  2 ounces of a usable form of marijuana  Up to 6 marijuana plants, with three or fewer being mature  Registered patients and caregivers may cultivate marijuana only in an enclosed facility and may acquire marijuana only from registered dispensaries or from one another.

Putting it into Perspective

 How much is one ounce of marijuana?  https://www.youtube.com/watch?v=md- qm5wwBFk&feature=youtu.be&utm_source =July+Eblast+2015+- +Email+Marketing&utm_campaign=E- blast+-+Email+MKT&utm_medium=email

Dispensaries

 The dispensary model of medical marijuana sales is not a safe and appropriate means of conducting business in a manner that preserves public health and should not be used.  Any substance approved for medicinal purpose should be prescribed on a legal doctor script and dispensed through a licensed pharmacy.  Doctor’s cannot prescribe marijuana, as it is not provided by a pharmacy and therefore, a script does not exist.

Do these look like Medical ads? The Pro-Marijuana Movement

*supports the development of a legally controlled market for *“The Drug Policy cannabis."(NORML Alliance is the nation's policy statement on *MPP is the largest leading organization personal use) organization in the U.S. that's focused promoting drug *NORML SC Chapter solely on ending policies that are 2025 Marion St. marijuana prohibition. grounded in science, Columbia, SC compassion, health Source: Marijuana and human rights.” Policy Project; Source: National Organization http://www.mpp.org/ for the Reform of Marijuana Source: Drug Policy Alliance; Laws; http://norml.org http://www.drugpolicy.org/ The Great Social Experiment

Impact on Colorado: Usage Youth College Age Adult 12-17 years old 18-25 years old 26+ years old • National average for • National average for • National average for marijuana use was 7.15%, marijuana use was marijuana use was 5.45%, Colorado’s average was 18.91%, Colorado’s was Colorado’s average was 11.16 %(2013). 29.05%(2013). 10.13%(2013). • In just one year when • In just one year when • In just one year when Colorado legalized Colorado legalized Colorado legalized marijuana, past month marijuana, past month marijuana, past month use among those ages marijuana use among marijuana use among 12-17 years old increased college-age use adults increased 32.8%. 6.6 %. increased 8.4%. • In 2003 the number of • For the 2013-2014 • Ranked 2nd in the nation positive THC urinalyses for academic year, for current marijuana use adults was 3,099 percentage of total among college-age compared to 2014 where expulsions for marijuana adults. the number of positive was 41.9% compared to THC urinalyses was expulsions for alcohol 33,303. which was 2.7%. Impact on Colorado: Impaired Driving

 77 percent of total DUIDs involved marijuana(2014)  41 percent of total DUIDs involved marijuana only(2014)  In 2013, the number of positive THC 2ng/mL or higher was 1,948-compared to the number in 2009 which was only 220.

Source: The Legalization of Marijuana In Colorado: The Impact, Volume 3, Preview 2015, Executive Summary, Rocky Mountain High Intensity Drug Trafficking Area Impact on Colorado: Exposure

 In one year, when marijuana retail businesses began operating, marijuana- only related exposures increased 72%.

 The average percent of marijuana exposures ages 0 to 5 went from 5.95% in 2013 to 17.71% in 2014.

 There was a 400% increase in the number of THC infused edible exposures in children between 2013 (19) and 2014 (95).

Source: The Legalization of Marijuana In Colorado: The Impact, Volume 3, Preview 2015, Executive Summary, Rocky Mountain High Intensity Drug Trafficking Area Impact on Colorado: ER Related Visits

 The highest rates from 2011-2013 of marijuana related ER/hospital visits were among young adults ages 18-25.  Through January 2014 to June 2014, the number of visits where marijuana was likely a causal or strong contributing factor for the reason of the visit was 553,000.  In Denver City and County, there were around 415 per 100,000 marijuana related ER visits between 2011 and 2013.

Source: The Legalization of Marijuana In Colorado: The Impact, Volume 3, Preview 2015, Executive Summary, Rocky Mountain High Intensity Drug Trafficking Area Impact on Colorado: Hospitalization

 Hospitalizations related to marijuana:  2011- 6,305  2012- 6,715  2013- 8,272  2014- 11,439  When retail marijuana businesses began operating, there was an 38% increase in the # of marijuana related hospitalizations in one year. Impact on Colorado: Crime

 Marijuana Related Incidents (Denver)  2012- 223  2013- 239  2014- 272

Source: The Legalization of Marijuana In Colorado: The Impact, Volume 3, Preview 2015, Executive Summary, Rocky Mountain High Intensity Drug Trafficking Area You, Your Child, and Marijuana Is my teen using marijuana?  Declining school work and grades  Abrupt change in friends  Abnormal health issues or sleeping habits  Deteriorating relationships with family  Less openness and honesty

Signs of marijuana use

 Red eyes  Dry mouth  Decreased coordination  Difficulty concentrating or remembering  Slowed reaction time  Paranoid thinking What do I do?

 Be honest if the topic comes up  Listen openly to what they have to say  Be calm and positive  Put yourself in their shoes  Know the facts  Don’t lecture!

Marijuana The Blunt Truth

Joe Burton Prevention Specialist [email protected] 803-324-4118

Danielle Center, MPH, MCHES Prevention Coordinator [email protected] 803-324-4118