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

. . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . .

.

. . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . .

.

. . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . .

. . . . . .

. . . . . . . . . . . .

. . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . .

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

1965

1970

1974

1978

1980

1983

1984

1985

1986

1990

1992

1993

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

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!

Kevin@learnaboutsam.org www.learnaboutsam.org

www.kevinsabet.com www.dpi.psychiatry.ufl.edu aimee@learnaboutsam.org