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Getting In The Weeds

Getting In The Weeds. Marijuana’s Impact on Society. Marijuana Status (Medicinal) - 23 States and DC. California – 1996 Alaska – 1998 Oregon – 1998 Washington – 1998 Maine – 1999 Colorado – 2000 Hawaii - 2000 Nevada – 2000 Montana – 2004 Vermont – 2004 Rhode Island – 2006

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Getting In The Weeds

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  1. Getting In The Weeds Marijuana’s Impact on Society

  2. Marijuana Status (Medicinal)- 23 States and DC • California – 1996 • Alaska – 1998 • Oregon – 1998 • Washington – 1998 • Maine – 1999 • Colorado – 2000 • Hawaii - 2000 • Nevada – 2000 • Montana – 2004 • Vermont – 2004 • Rhode Island – 2006 • New Mexico - 2007 • Michigan– 2008 • Arizona – 2010 • DC – 2010 • New Jersey – 2010 • Delaware – 2011 • Connecticut – 2012 • Massachusetts - 2012 • Illinois – 2013 • New Hampshire – 2013 • Maryland – 2014 • Minnesota – 2014 • New York - 2014

  3. Marijuana Legalization Medicinal Use Recreational Use 23 States and DC 11 – Voter Initiative 10 – General Assembly Limits Alaska – 1 oz. & 6 plants Oregon – 24 oz. & 24 plants Taxes 4 states – no tax 8.1% tax – Nevada Fees cover the program Colorado and Washington Limits vary by state

  4. Marijuana Status (CBD) - 10 States Alabama Florida Iowa Kentucky Mississippi Missouri South Carolina Tennessee Utah Wisconsin

  5. Cannabidiol Medications • Children with Seizure Issues • Charlotte’s Web (Charlotte Figi) • Epidiolex (GW Pharmaceuticals) • Mixed Success with Epidiolex • Scant results with Charlotte’s Web • Epilepsy Foundation – Need for more testing

  6. Georgia and CBD • HB885 – Haleigh’s Hope Act (Rep. Allen Peake) • Haleigh Cox – severe form of epilepsy • Moved through House but defeated in Senate • Moved forward with medical marijuana study • GW Pharmaceuticals and Georgia Regents • Allows for a study of cannabis on children with seizure disorders

  7. Marijuana Status (Recreational) • Colorado • Washington

  8. Policy Moral Issue vs. Policy Issue Moral Individually based Effective – based on personal level • Public safety • Public health • Society focus

  9. The Art of Persuasion The Communicator • Credibility – Is the communicator credible? • Broken bone – Dr. has qualifications and background. • Knowledgeable – Does the communicator understand the subject? • Leaky refrigerator – Do you go to your Dr.? • Similar – Do the communicator and I share experiences, cultural background, lifestyle, etc.? • Politicians going door to door with the sleeves rolled up.

  10. Top Communicators of 2012 Michelle Obama Marco Rubio • Uses personal stories • Confident and authentic • Uses humor in messages • Uses personal stories • Exposes vulnerability • Remains clear and confident in her message

  11. Worst communicators of 2012 Francesco Schettino Todd Akin Was silent and evasive Frantic and disheveled Lied about the situation • Legitimate rape comments – insensitive and no basis • Failure to admit miscue • Polarizing comments

  12. The Art of Persuasion The Message • How does this effect me? • Cincinnati Reds fan • Is it based on emotional or a rational argument? • Which story carries more “umph?” • Is the message repeated? • The more times a message is repeated, the more believable it becomes. • Messages are best when using emotion first and then backing it up with stats • Who else endorses this belief? • What do other people I admire/respect think?

  13. The Art of Persuasion The Audience Identify high involvement vs. low involvement audiences Your audience might not just be the person sitting in front of you Listen to the audience and not just prepare for your next point Meet them where they are at

  14. High Involvement vs. low involvement High involvement Low involvement High involvement product – cars and shampoo Bought into the position The argument really matters to them on a personal level Possible large financial or time commitment involved Low involvement product – gum and tissues Does not regularly think about the subject Does not think it affects them personally Little to no reason to buy in

  15. High involvement vs. low involvement About 20-30% are high involvement That means 70-80% are low involvement Low involvement tend to go with the crowd Emotion is strong influencer Brand recognition or the number of times something is heard Stories or stories plus stats are the best way to persuade

  16. Marijuana Lobbying Groups Marijuana Policy Project Increase public support for non-punitive, non-coercive marijuana policies. Identify and activate supporters of non-punitive, non-coercive marijuana policies. Change state laws to reduce or eliminate penalties for the medical and non-medical use of marijuana. Gain influence in Congress. National Organization to Reform Marijuana Laws (NORML) NORML's mission is to move public opinion sufficiently to legalize the responsible use of marijuana by adults, and to serve as an advocate for consumers to assure they have access to high quality marijuana that is safe, convenient and affordable.

  17. Marijuana Messaging • Marketing • Natural – It grows from the ground. • Medicinal – Shrinks tumors and treats migraines. There are actual health benefits. • Doctors would love to have the ability to prescribe it. • No one has ever died of an overdose.

  18. Is History Being Repeated? • In the late 19th and early 20th Century, tobacco marketers used these tactics. • Natural – Tobacco was a natural product. It was from the ground. • Medicinal – Health benefits of smoking included asthma, head colds and all diseases of the throat. • Doctors Use it. The product must be ok. • No one has ever died of an overdose.

  19. Safer Than Peanuts Ohio Marijuana Marketing God Approves

  20. Is Marijuana Medicine? Components of marijuana have promise... Marinol - able to be prescribed Sativex - final stages of FDA process Epidiolex – Orphan Drug Law designation DEA – Over 400 studies about marijuana

  21. What is Medicine? No one chews willow bark for aspirin... Smoking opium not used for pain relief... Compound in viper venom used for blood pressure…

  22. Who Is Impacted? • Addiction Services – Maintain Healthy Lifestyle (Prevention, Treatment and Recovery) • Business – Bottom line • Children’s Services agencies – Parent readiness and safety of child • Colleges – Financial aid and retention • Education – Student testing requirements • Healthcare Professionals – Marijuana safety and efficacy • Law Enforcement – Public safety and officer/employee issues • Legislators – Budget/jobs and then “election-time” issues

  23. Marijuana Policy Project Model Language Section 4. Protections for the Medical Use of Marijuana. A registered qualifying patient shall not be subject to arrest, prosecution, or denial of any right or privilege, including but not limited to civil penalty or disciplinary action by a court or occupational or professional licensing board or bureau, for the medical use of marijuana pursuant to this chapter, if the registered qualifying patient does not possess more than: Six ounces of usable marijuana; and (2) 12 mature marijuana plants and 12 seedlings, if the qualifying patient has not specified that a designated caregiver will be allowed under state law to cultivate marijuana for the qualifying patient.

  24. Marijuana Policy Project Model Language • Section 4A and 1B – Issues • What is a “qualifying patient”? • Definition of “qualifying patient” in Section 3(m) - "Qualifying patient" means a person who has been diagnosed by a practitioner as having a debilitating medical condition. • Will children be allowed to be a “qualifying patient”?

  25. Six ounces of marijuana – 6 ounces X 54 joints = 324 joints • Normal high is 4-6 hours (420 Magazine) • Continuous high for 54 days • 12 plants per patient • 2-5 pounds per plant (420 Magazine) • Potentially – 20,736 joints • 3,456 days of continuous high = Almost 9 ½ years of high! How Much Pot?

  26. Youth Perception of Marijuana • "It is harmless and natural, it is only an herb, and it won't affect me long-term" • "It is not addictive" • "It doesn't hurt me as much as smoking tobacco" • "It makes me feel calm" • "It doesn't affect my thinking or my grades" • "It's safe because it is used as medicine for cancer and other diseases“ • “Marijuana is safer than sugar.”

  27. Realities of Marijuana – Brain Function New Zealand Study • Loss of 8 IQ Points – Irreversible • Peer Reviewed

  28. Northwestern University Northwestern Medicine at Northwestern University 1. December, 2013 – Brain Abnormalities with Chronic Use • “The younger drug abuse starts, the more abnormal the brain.” • Of schizophrenia patients surveyed, 90% used before schizophrenia set in 2. April, 2016 – Casual Marijuana Use Linked to Brain Abnormalities • Changed the volume, shape and density of gray matter in brain – effects on decision making • “I’ve developed a severe worry about whether we should be allowing anybody under age 30 to use pot unless they have a terminal illness and need it for pain.”

  29. Marijuana Addiction • Is Marijuana Addictive? • 1 in 11 adults become addicted • 1 in 6 children become addicted (if start under the age of 15) • Nationally – 4 million people addicted to drugs and alcohol • 1.2 million addicted to marijuana alone • Psychological addiction • Short term effects of heavy marijuana use include: memory and learning problems, distorted perception, poor problem solving ability, loss of motor skills, etc. • Long term effects of heavy marijuana use include permanent physical changes to the brain and its functions. • Anxious and irritable

  30. Grades and Retention Maryland School of Public Health (June, 2013) • Study followed 1200 college students over 10 years • College students skipped more classes, earned lower grades and dropped out more often • Unemployment rates higher after college • 15 times or more per month – twice as likely to have experienced “discontinuous enrollment”

  31. What Can Colleges Do? Communication strong on campus policies Student Life and Residence Life Student Health Center Can students use off campus? Task Force to Look at Marijuana Policies Students joining the workforce – DF Workplace

  32. Marijuana Policy Project Model Language • Section 3f – Designated Caregiver • (f) "Designated caregiver" means a person who: • (1) is at least 21 years of age; • (2) has agreed to assist with a patient's medical use of marijuana; • (3) has not been convicted of a disqualifying felony offense; and • (4) assists no more than five qualifying patients with their medical use of marijuana. • If my math is right… • 5 patients who can have 12 plants = 60 plants • 2-5 pounds per plant (420 Magazine) • 120 pounds of pot • Potentially – 103,680 joints

  33. Marijuana Policy Project Model Language • Section 3d(1-3) and Section 7 • (1) cancer, glaucoma, positive status for human immunodeficiency virus, acquired immune deficiency syndrome, hepatitis C, amyotrophic lateral sclerosis, Crohn's disease, agitation of Alzheimer's disease, post-traumatic stress disorder, or the treatment of these conditions; • (2) a chronic or debilitating disease or medical condition or its treatment that produces one or more of the following: cachexia or wasting syndrome; severe, debilitating pain; severe nausea; seizures; or severe and persistent muscle spasms, including but not limited to those characteristic of multiple sclerosis; or • (3) any other medical condition or its treatment added by the department, as provided for in section 7. • Section 7. Addition of Debilitating Medical Conditions. • Any citizen may petition the department to add conditions or treatments to the list of debilitating medical conditions listed in section 3(d). The department shall consider petitions in the manner required by department regulation, including public notice and hearing. The department shall approve or deny a petition within 180 days of its submission. The approval or denial of any petition is a final decision of the department subject to judicial review. Jurisdiction and venue are vested in the _____ Court.

  34. Marijuana Policy Project Model Language • Section 3d(1-3) and Section 7 – Issues • Is it easier to delve into what isn’t eligible? • What issues does this play into reacting with other medicines? • Is the pain masking a greater disease? • What dose is good for which ailment? • Who is on the committee to decide what other ailments are eligible?

  35. Study didn’t consider: • Opioid treatment admissions • Implementation of Naloxone programs • Policies to reduce opiate overdoses? Marijuana and Rx Drug Overdose Deaths AMA Journal Study showed that mm states had 25% lower death rate from opioids Direct Link?

  36. HIV? Who are the Patients? Cancer?

  37. Who are the Patients? • Other States • Michigan – 128,441 patients and 26,875 caregivers. • Arizona – 37,598 patients and 46% of all marijuana patients have been certified by 10 physicians. • California – 3% of state population are cardholders. • Approximately 1,000,000 people • 67% reported daily use

  38. Who Are the Cardholders? • Less than 5% of all patients have the life threatening issues • 90-95% use for chronic pain – Not about the 5% • Average cardholder - 32 year old white male with no history of chronic illness and a history of substance abuse

  39. Marijuana Policy Project Model Language Section 6 – Discrimination Prohibited (a) Except as provided in this chapter, a registered qualifying patient who uses marijuana for medical purposes shall be afforded all the same rights under state and local law, including those guaranteed under  ______ [the state’s disability rights law], as the individual would have been afforded if he or she were solely prescribed pharmaceutical medications, as it pertains to: (1) any interaction with a person's employer; (2) drug testing by one's employer; or (3) drug testing required by any state or local law, agency, or government official. (b) (1) The rights provided by this section do not apply to the extent that they conflict with an employer’s obligations under federal law or regulations or to the extent that they would disqualify an employer from a monetary or licensing-related benefit under federal law or regulations. (2) No employer is required to allow the ingestion of marijuana in any workplace or to allow any employee to work while under the influence of marijuana. A registered qualifying patient shall not be considered to be under the influence of marijuana solely because of the presence of metabolites or components of marijuana that appear in insufficient concentration to cause impairment.

  40. Marijuana Policy Project Model Language • Section 2G – Issues • If metabolites are taken away, how do we measure impairment? • Scientific testing is undefined. • Roadway safety • Employers – how safe is their workforce? • Crane operators, bus drivers, teachers, etc.

  41. Marijuana Policy Project Model Language Drug Use Impacts: increased absences, tardiness, accidents, workers' compensation claims, productivity and job turnover 3.6 times the accidents on the job 5 times the accidents off the job Which then effects - BWC rates Insurance coverage HR responsibilities

  42. Michigan – Joseph Casias sued his employer • Case dismissed by Sixth Circuit Court of Appeals • Maine – Brittany Thomas sues Adecco • ACLU is taking this case up • Colorado – Brandon Coats sued Dish Network • Court ruled wasn't illegal firing because marijuana is an illegal drug federally • WSJ article - "Medical Marijuana Poses Litigation Risk to Employers." (August 15, 2013) – Cost employers between $69,000 and $107,000 in costs, not including any award. • New Mexico – Employer must pay for pot? Discrimination

  43. Marijuana Policy Project Model Language Section 5a(4) – Operating a Motor Vehicle (4) Operating, navigating, or being in actual physical control of any motor vehicle, aircraft, or motorboat while under the influence of marijuana, except that a registered qualifying patient or visiting qualifying patient shall not be considered to be under the influence of marijuana solely because of the presence of metabolites or components of marijuana that appear in insufficient concentration to cause impairment.

  44. Marijuana Policy Project Model Language • Section 5a(4) – Issues • If metabolites are taken away, how do we measure impairment? • Scientific testing is undefined. • Roadway safety • Biggest problem in pro-pot states • Crane operators, bus drivers, truck drivers, etc. • 2 ng to 15 ng/ml • 40% increase in THC in drivers in Washington

  45. Marijuana and Driving • Marijuana is the most prevalent illegal drug in impaired drivers, fatally injured drivers and motor vehicle crash victims. (NHTSA) • Fatally injured drivers – 4.2% in 1999 to 12.2% in 2010. (NHTSA) • Colorado – 27% of blood tests for impaired driving showed THC. (Colorado Public Safety) • 3 times as many HS seniors reporting driving after marijuana than after drinking alcohol. (Monitoring the Future)

  46. Teen Driving Liberty Mutual/SADD survey • 19% admitted to driving after smoking marijuana • 36% - marijuana smoking no distraction while driving • 34% who admitted to smoking while high said it made them a better driver

  47. Marijuana and Driving • NIDA - After alcohol, THC (delta-9-tetrahydrocannabinol), the active ingredient in marijuana, is the substance most commonly found in the blood of impaired drivers, fatally injured drivers, and motor vehicle crash victims. • British Medical Journal - Drivers who smoke marijuana within a few hours of driving are almost twice as likely to get into an accident as sober drivers.

  48. Marijuana Policy Project Model Language Section 18 – Local Ordinances Nothing shall prohibit local governments from enacting ordinances or regulations not in conflict with this chapter or with department regulations regulating the time, place, and manner of registered compassion center operations and registered safety compliance facilities, provided that no local government may prohibit registered compassion center operation altogether, either expressly or though the enactment of ordinances or regulations which make registered compassion center and registered safety compliance facility operation unreasonably impracticable in the jurisdiction.

  49. Marijuana and Public Safety ER Admissions • 374,000 ER visits due solely to marijuana – ER visits increase nationally more than 50% from 2004 to 2011. • Between 2005-2011, states with marijuana decrim. laws increased by 30%. • Children’s Hospital of Colorado – 2.3% of all poisonings of children under 12 were marijuana-related.

  50. June, 2014– Harvard Medical School • 5 Times Increase of Heart Attack Risk • Average Increase • Smaller increase if younger/Larger increase if older • “Marijuana causes increased heart rate, fluctuations in blood pressure, and a decreased ability for the blood to carry oxygen. The heart is both working harder and getting less oxygen, a situation that increases heart attack risk.” Marijuana and Heart Attacks -University Hospital of Toulouse in France Small study – 2006-2010 3x the risk 20 heart attacks and 9 deaths Caution: In half the cases, the afflicted pot users already had risk factors for heart disease such as high blood pressure or high cholesterol

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