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Kevin A. Sabet, Ph.D. Director, Drug Policy Institute, University of Florida
Co-Founder, Project SAM (Smart Approaches to Marijuana) www.learnaboutsam.org
www.kevinsabet.com
1
Marijuana: What the Science Says and
What You Need to Know
2
Why should we care about
marijuana?
3
4
Myth 1:
Marijuana Is Harmless and
Non-addictive
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Cannabinoid Receptors Are Located Throughout the Brain and Regulate:
• Brain Development • Memory and Cognition • Motivational Systems & Reward • Appetite • Immunological Function • Reproduction • Movement Coordination • Pain Regulation & Analgesia
Addiction: About 9% of users may become dependent, 1 in 6 who start in adolescence and 25-50% of daily users
32
159
1711
85
23
05
101520253035
Perc
ent
* Nonmedical Use Source: Anthony JC et al., 1994
Estimated Prevalence of Dependence Among Users
* *
American Psychiatric Association’s Diagnostic Manual (DSM) has included marijuana use disorders since 1980.
DSM-5 added Marijuana Withdrawal as a diagnosis. 2014 Mass. General Hospital study confirms withdrawal syndrome.
1960
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2010
2011
THC 0 0 0 0 1 1 2 3 3 4 4 3 3 4 5 5 5 5 5 6 7 7 8 8 9 10 10 10 11 11 CBD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
0
2
4
6
8
10
12
14
MA
RIJ
UA
NA
PO
TE
NC
Y
CBD: NON-
Psychoactive Ingredient
Average THC and CBD Levels in the US: 1960 - 2011
Mehmedic et al., 2010
THC: Psychoactive
Ingredient
7 Copyright SAM and the Slides' Authors. Use with permission.
High Times 5/7/14
“With dabs your local action news team gets to do a marijuana story that shows crack pipe torches used on sticky heroin-looking goo made from a process that blows up like meth labs.”
Copyright SAM and the Slides' Authors. Use with permission. 8
“But it’s just a plant…” (80-90% THC) Concentrates
“Budder”
“Shatter”
“Ear Wax” “Green Crack” wax
Hash Oil Capsules
Butane Hash Oil (BHO)
Copyright SAM and the Slides' Authors. Use with permission. 9
More Use of Cannabis Associated with Worse Social Outcomes at Age 25 (New Zealand Study)
Source: Fergusson and Boden. Addiction, 103, pp. 969-976, 2008
Number of occasions using Cannabis between ages 14-21
% welfare dependent
(ages 21-25)
% Unemployed (ages 21-25)
mean personal
income at age 25
% gained university
degree by age 25
400+ 300 to 399 200 to 299 100 to 199 1 to 99 Never # of occasions
using Cannabis ages 14-
21
Cannabis-Associated Psychosis
Andréasson et al Lancet, 1987.
0 1 2 10 <50 >50
30
20
10
0
No of times cannabis taken
Cases of Sz per 1,000
4,5
1,6
0 1 2 3 4 5 6 7 8 9
Cannabis users by age 15 years
Cannabis users by age 18 years
Arseneault et al BMJ 2002
Risk of schizophrenia-like psychosis at age 26 years
Odd
s ra
tio
CANNABIS AND SCHIZOPHRENIA Study of Swedish Conscripts (n=45570)
CANNABIS AND SCHIZOPHRENIA-Like Longitudinal prospective Dunedin study (n=1037)
Non-users used 1 Dx
used 2 Dx
used 3 Dx
-8
-6
-4
-2
0
2
Ave
rage
Poi
nt D
iffer
ence
in IQ
sco
re
(IQ a
t age
13
– IQ
at a
ge 3
8)
Persistent Marijuana Users Show A Significant IQ Drop between Childhood and Midlife
Source: Meier MH et al., PNAS Early Edition 2012
Followed 1,037 individuals from birth to age 38. Tested marijuana use at 18, 21, 26, 32 and 38. Tested for IQ at ages 13 and 38
The Gulf Has Never Been Greater Between
The Scientific Understanding of Marijuana’s Harms
and
The Public’s Misunderstanding
Copyright SAM and the Slides' Authors. Use with permission. 13
‘Big marijuana’
Can we trust companies and Big Corporations not to target youth and the vulnerable?
14
Copyright SAM and the Slides' Authors. Use with permission. 15
Privateer Holdings: The first equity company
dedicated to the marijuana industry.
Early Days of Big Tobacco Messaging
17
18
Colorado and
Washington
Nussbaum et al., Am J Psychiatry 168:778-781
2007-8
1st stores
2009
700 stores 3.5% adults have MMJ license
2012
Legalized
2014
Recreational Stores open Medical
Marijuana in Colorado
2001 2005
Denver legalizes possession
Colorado Didn’t Legalize Overnight
20
21
22
Vaporizing industries: Nicotine and Marijuana
Pax by Ploom • Japan Tobacco International (JTI)
is the third largest international tobacco company behind Philip Morris International.
• In 2011, JTI bought a portion of
Ploom – a startup based in Silicon Valley that produces a loose-leaf vaporizer that can be used to inhale heated vapor from marijuana as well as tobacco, called the Pax. 23
24
Marijuana Edible Displays
Copyright SAM and the Slides' Authors. Use with permission. 25
Source of Marijuana* among 12th Graders in 2012 and 2013, by State Policy
0
20
40
60
80
100
Medical Marijuana States Non-Medical Marijuana States
**
**
SOURCE: University of Michigan, 2013 Monitoring the Future Study *Categories not mutually exclusive ** Statistically significant difference
Cerda M et al. Drug and Alcohol Dependence 2012; 120: 22 – 27.
NESARC: National Epidemiologic Survey on Alcohol and Related Conditions
1,81 1,92
1,03
0
0,5
1
1,5
2
2,5
Past Year MJ Abuse/Dependence
Past Year MJ Use Past Year MJ Abuse/Dependence
Among Current Users
Map of States that Legalized Medical Marijuana by 2004
passed laws legalizing medical MJ
Odd
s R
atio
States that Legalized Marijuana Use For Medical
Purposes Have Significantly Higher Rates Of Marijuana Use and of Marijuana Abuse and
Dependence
Pro
port
ion
of M
J Po
siti
ve D
river
s (%
)
Proportion Of Fatal Crash Drivers MJ-Positive In Colorado and
34 States Without Medical MJ, 1994-2011
Salomonsen-Sautel S et al., Drug and Alcohol Dependence 2014.
Year
Date of widespread Medical MJ implementation in Colorado (2009)
Traffic Fatalities + for Marijuana
%
31
Salomonsen-Sautel S, Min SJ Sakai JT, Thurstone C, Hopfer C.Trends in fatal motor vehicle crashes before and after marijuana commercialization in Colorado. Accepted for publication in Drug and Alcohol Dependence
Medical Marijuana Begins, Stays Small
CO youth use at 10-year high Decision to allow
UNLIMITED # of caregivers
Commercialization begins
Projected vs. Actual Tax Revenue
(in millions)
0 50 100 150
January
February
Jan-June
July '14-July '15
Actual Projected
Alcohol & Tobacco: Money Makers or Dollar Drainers?
34
Alcohol Costs
T obacco Costs
$14 billion
Costs
Revenues
$25 billion
$200 billion $185
billion
Revenues
State estimates found at http://www.nytimes.com/2008/08/31/weekinreview/31saul.html?em; Federal estimates found at https://www.policyarchive.org/bitstream/handle/10207/3314/RS20343_20020110.pdf; Also see http://www.tobaccofreekids.org/research/factsheets/pdf/0072.pdf; Campaign for Tobacco Free Kids, see “Smoking-caused costs,” on p.2.
2014 Marijuana Developments
35
• Associated Press: “Two Denver Deaths Linked
to Recreational Marijuana Use”. One includes the under-aged college student who jumped to his death after ingesting marijuana cookie.
• The number of parents calling the poison-
control hotline to report their kids had consumed marijuana has risen significantly in Colorado.
• Marijuana edibles and marijuana vaporizers
have been found in middle and high schools.
Colorado’s underground market
A Colorado drug dealer says that if anything, legalization has helped his business because “it’s over priced, it’s being taxed way too high.”
36
Colorado Springs Lieutenant stated that “[Legalization] has done nothing more
than enhance the opportunity for the black market. If you can get it tax-free
on the corner, you’re going to get it on the corner.”
37
Colorado’s underground market
Overall in CO
• Tax revenue LOWER than expectations • Higher use & car crashes since 2008-
2009 sales began • Edible companies and lobbying groups
on the rise since 2012 passage of legalization
38
2014 Marijuana Vote
• Defeats in AK, OR, DC • Win in FL • Wins in several cities in Colorado, Maine,
California, Michigan • Several anti-marijuana elected officials
Florida – needed 60%
2016
• Looking ahead to California • Maine, Massachusetts, Arizona, Nevada • Gallup Poll 2014: Support for
legalization falls from 58% to 51%
Bipartisan Co-Chairs (Kennedy + Frum)
Launch 2013
Over 50,000 press mentions
Public Health Scientific Advisory Board
24 state-wide affiliates
44
Project SAM 1. To inform public policy with the science of today’s
marijuana. 2. To have honest conversations about reducing the
unintended consequences of current marijuana policies, such as lifelong stigma due to arrest.
3. To prevent the establishment of Big Marijuana that would market marijuana to children — and to prevent Big Tobacco from taking over Big Marijuana. Those are the very likely results of legalization.
4. To promote research of marijuana’s medical properties and produce pharmacy-attainable medications.
45
Thank you – for listening!
[email protected] www.learnaboutsam.org
www.kevinsabet.com www.dpi.psychiatry.ufl.edu [email protected]