Transcript Marijuana, Pills, and Bath Salts, Oh My!

Questions We Will Consider:
 What are the trends in use, abuse, attitudes
and laws on MJ?
 Historically how have MJ attitudes, use, and
laws changed?
 What short and long term effects does it
have on the body?
 What treatments appear to be effective?
 What reforms might happen and what might
impact be?
A couple of disclaimers
 The information presented here is not
intended as direct medical advice or specific
treatment information
 Information is for general educational
purposes only and the presentation should
not be disseminated or cited without my
express permission
 My email is: [email protected]
Trends in Use
(see Caulkins et al)
Many people have tried MJ
Use patterns skewed- a few use a lot
Price and potency vary a lot
Consumption varies w/ price not enforcement
Potency higher in recent years
A note about Spice/ K2:
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Synthetic, similar to MJ, chemical makeup varies, use
increasing, may be more potent
Not much research yet on effects
reporthttp://www.drugabuse.gov/drugs-abuse/k2spicesynthetic-marijuana
How MJ gets distributed
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Young people most likely to use and get arrested
Most arrests for possession
Avg user has a 30% chance of arrest in a 10 year
using career.
Lots of people get it for free
Distributed through social networks unlike other
drugs
Grows just about anywhere
Violence NOT common in MJ markets
Trends in Attitudes
Effects on the Body
(see Room et al ch.2)
 Reminder on disclaimer
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Not intended as medical advice or to influence
treatment directly
 Short versus long term effects
 Effects depend on
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dosage
mode of consumption
Potency
THC/ CBD ratio
 Some positive, some negative
Short term effects
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Euphoric effects/ duration
Effect on heart rate/BP
Reduces cognitive performance
Some argue enhances creativity
Can induce anxiety and paranoia
Risk of overdose low, but….
Decreases reaction time so affects driving (DWI)
Appears to reduce immune function
Some research suggests can harm fetal
development
Long term effects
 Cognitive functioning- mixed findings
 Risks specific to smoking MJ
 Respiratory and Cardiovascular effects
 Secondhand smoke
 Educational outcomes for youth
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Correlation or cause?
 Can become dependent
 Mental health risk
 Psychosis, schizophrenia, depression
 Especially for youth?
 Co-occuring disorders
Some open questions
 Does MJ have medicinal value?
 Why not just make the THC part legal
and prescribe it?
 How much “medicinal” use is actually
recreational use?
 Is it a gateway drug?
 Do people just use MJ?
Adverse effects compared to
other drugs (Room et al, p.42)
Effect
Traffic accidents
MJ
Tobacco
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Heroin
Alcohol
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Violence/suicide
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Overdose
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HIV/liver infections
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Cirrhosis
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Heart disease
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Respiratory disease
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Cancers
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Mental illness
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Dependence
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Effects on fetus
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History of Drug Use
(see Abadinsky)
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Around since dawn of civilization
Attitudes & laws vary dramatically over
time
Often seen positively initially
Use spreads
Dependence (addiction) problems
Associated with problem populations
Stigma attaches to drug
Prohibition creates black markets
History of Drug Use
(see Abadinsky)
Alcohol
Tobacco
Opium/Morphine/Heroin
Coca/Cocaine/Crack
Patent medicines
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E.g. laudenum
Amphetamines
Barbiturates/ tranquilizers/sedatives
Hallucinogens
History of MJ
(see Abadinsky)
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Around for thousands of years
Used as medicine and for recreational use
Commonly used in India and China
Hemp used for rope, clothes, & medicinally
In U.S. in early 1900s associated with
Mexican immigrants and Blacks
History of Laws
(see Abadinsky)
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Mistakenly treated as a narcotic despite
reports (1890s/1930) not dangerous
Harrison Act of 1914 (focused on opium,
cocaine)
Propaganda such as Reefer Madness
Many states banned MJ
Marijuana Tax Act of 1937
Never much of an issue until use rose in
1960s
Comprehensive Drug Use Prevention and
Control Act of 1970 (Schedule I drug)
A Brief look at Laws
Federal law: MJ is a schedule I drug
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High potential for abuse
No accepted medical use in U.S.
Lack of accepted safety for use under medical
supervision
http://norml.org/laws/
Comparing Indiana and Ohio
Offense
Less than 100 g
100 - 200 g
200 - 1000 g
1000 - 5000 g
5000 - 20,000 g
20,000 - 40,000 g
More than 40,000 g
Ohio
Penalty
jail/
prison
Possession
misdemeanor
N/A
M
30 days
felony
6-12 mos
felony
felony
felony
felony
1 - 5 yrs
1 - 5 yrs
5* - 8 yrs
8 years*
Max. Fine
$150
$250
$2,500
Offense
Indiana
Penalty
jail/prison Max. Fine
Possession
30 g or less
misdemeanor
1 year
More than 30 g
felony
6 - 36 mos
$5,000
$10,000
Conditional discharge may be available for first-time offenders.
$10,000
$10,000
$15,000
$15,000
* Mandatory minimum sentence
Sale/Distribution/Trafficking
A gift of 20 g or less misdemeanor
N/A
(first offense)
A gift of 20 g or less misdemeanor 60 days
(2nd offense)
Sale or Cultivation
misdemeanor
1 year
$150
30 g or less
$5,000
$500
30 g - 10 lbs
felony
6 - 36 mos
$10,000
Less than 200 g
200 - 1000 g
felony
felony
1 year
6-18 mos
$2,500
$2,500
10 lbs+
W/in 1000 ft of
school
felony
felony
2 - 8 yrs
2 - 8 yrs
$10,000
$10,000
1000 - 5000 g
felony
$2,500
To a minor
felony
6 - 36 mos
$10,000
5000 - 20,000 g
felony
20,000 - 40,000 g
More than 40,000 g
felony
felony
1-5
years
1-5
years
5* - 8 yrs
8 years*
$2,500
$2,500
$2,500
Correctional Populations by
Offense Type 1980-2001
Policy
 If the goal is to reduce drug use, two
options:
 Supply reduction
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Primarily legal
 Demand reduction
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Prevention, treatment
 Not an either or situation current
policy is to do both
Prevention programs
(see Mosher and Akins)
 DARE
 PSA’s
 Abstinence only doesn’t work well
 What does work?
 Harm reduction, focus on facts,
talking with instead of talking at
SA Treatments
 Office of National Drug Control Policy, U.S.
National Drug Control Strategy:
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Addiction a disease of the brain
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Can be treated and recovery is possible
Also focus on prevention
 Approaches vary widely
 No current medication for MJ
 13 principles of effective treatment…
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See handout
 See NIDA report or Crime Solutions.gov for more
Reforms
(see Caulkins et al or Room et al)
 What are the range of options for
reform?
 Some terms
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Depenalization
Decriminalization
Legalization
De facto v. De jure
 Current policies vary widely
Reforms
 What are the pros and cons of
legalization?
 Can we treat MJ like alcohol?
 How is legalization of MJ like and
unlike legalization for other drugs?
 Middle ground?
Discussion
 What are the options that are
available and what are the likely
outcomes one might expect?
 Other questions?
Sources used in
presentation
 Caulkins, Jonathan P., Angela Hawken, Beau Kilmer, and Mark
A. R. Kleiman. 2012. Marijuana legalization: What everyone
needs to know. Oxford University Press.
 Room, Robin, Benedict Fischer, Wayne Hall, Simon Lenton, and
Peter Reuter. 2010. Cannabis Policy: Moving Beyond Stalemate.
Oxford University Press.
 Abadinsky, Howard. 2010. Drug use and abuse: A
comprehensive introduction. Cengage Learning.
 Faupel, Charles E., Greg S.Weaver, and Jay Corzine (3rd ed.)
2013. The sociology of American drug use. Oxford Press.
 Mosher, Clayton J., and Scott Akins, eds. 2007. Drugs and
drug policy: The control of consciousness alteration. Sage.
More sources used in
presentation
 Link to Pew Research Center study on
attitudes regarding marijuana legalization.
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http://www.people-press.org/files/legacypdf/4-4-13%20Marijuana%20Release.pdf
 This is the National Drug Control Strategy
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http://www.whitehouse.gov/ondcp/2013national-drug-control-strategy
Additional recommended
readings and resources
 Bostwick, J. Michael. "Blurred boundaries: the
therapeutics and politics of medical marijuana."
Mayo Clinic Proceedings. Vol. 87. No. 2. Elsevier,
2012.
 Crime Solutions.gov
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http://crimesolutions.gov/
 National Institute on Drug Abuse
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http://www.drugabuse.gov/drugs-abuse/marijuana
http://www.drugabuse.gov/sites/default/files/podat_1.pdf
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Principles of effective drug treatment