Paula Lantsberger, MD, MPH, FACOEM, MRO

History of Marijuana Legalization in gWashington StateState

Marijuana Legislation in Washington StateMarijuana Legislation in Washington StateI-692

Initiative 692 was approved on the 1998 ballot in Washington State.

The initiative was to permit patients with certain debilitating The initiative was to permit patients with certain debilitating conditions to use medical marijuana. Voters approved this initiative by 59%.

The medical conditions covered under this statute included terminal The medical conditions covered under this statute included terminal or debilitating conditions including:

Cancer, HIV (AIDS), multiple sclerosis, epilepsy and other seizure disorders, spasticity disorders, glaucoma, pain not relieved by standard medical treatmentsspasticity disorders, glaucoma, pain not relieved by standard medical treatments and other medical conditions approved by the state medical quality assurance board.

Washington State Initiative 1068 in 2010 Initiative 1068 (I 1068 or the Marijuana Reform Act) was a proposed Initiative 1068 (I-1068 or the Marijuana Reform Act) was a proposed

initiative for the November 2010 Washington state general election that would have removed criminal penalties from the adult use, possession,

d lti ti f ij i W hi tand cultivation of marijuana in Washington.

The initiative failed to gather enough signatures on the petition to beThe initiative failed to gather enough signatures on the petition to be included in the general election.

History of Marijuana legislation in Washington I 502Washington I-502

Washington Initiative 502 was placed on the ballot for general vote in N b 2012November 2012.

The initiative passed with 56% of the vote. Legal possession and DUI limits go into effect on 12/9/2012.g p g Rules for producers, processors and retailers were in place by

December 1, 2013.

Rules for I-502 Medical Marijuana is under theMedical Marijuana is under the

control of the Washington State Liquor and Cannabis Board.

There are 3 license categories: There are 3 license categories: producer, processor and retailer.

Each step is taxed and the revenue is apportioned between several agencies.

Office of Drug and Alcohol Policy andOffice of Drug and Alcohol Policy and Compliance Notice

“We want to make it perfectly clear that the state initiatives will have no bearing on the Department of Transportation’s regulated drug testing program. The Department of Transportation’s Drug and Alcohol Testing Regulation – 49 CFR Part 40 – does not authorize the use of Schedule I drugs includingCFR Part 40 – does not authorize the use of Schedule I drugs, including marijuana, for any reason.

Therefore, Medical Review Officers (MROs) will not verify a drug test as negative based upon learning that the employee used ‘recreational marijuana’ g p g p y jwhen states have passed ‘recreational marijuana’ initiatives.”

Jim L. Swart, Director Office of the Secretary of

Transportation Office of Drug and Alcohol Policy andOffice of Drug and Alcohol Policy and

Compliance Department of Transportation December 3, 2012

Drug free workplace programs The initiative did not change theThe initiative did not change the

ability of employers in Washington State to have drug free workplace programsprograms.

The State of Washington continues to support drug free

k l f f tworkplace programs for safety sensitive workers.

Colorado Supreme Court Ruling 2015 Brandon Coats v. DISH Network Case Conclusion Date: 06.15.2015 Practice Area: Employment & Labor Outcome: Court of Appeals Affirmed in favor of DISH Description: CO Supreme Court Colorado's current laws do NOT protect MMJ Description: CO Supreme Court - Colorado s current laws do NOT protect MMJ

employees private, off-duty use - even when not impaired at work (Coats v. DISH). The Colorado Supreme Court decided, in Coats v. DISH, that Colorado’s current laws – the most powerful in the world – do NOT protect a medical marijuana patient-employees private off duty use of MMJ even if they are not impaired at work Quoteemployees private, off duty use of MMJ, even if they are not impaired at work. Quote from the decision: “The supreme court holds that under the plain language of section 24-34-402.5, C.R.S. (2014), Colorado’s ‘lawful activities statute,’ the term ‘lawful’ refers only to those activities that are lawful under both state and federal law. Therefore, employees who engage in an activity such as medical marijuana use that p y g g y jis permitted by state law but unlawful under federal law are not protected by the statute. We therefore affirm the court of appeals’ opinion.”

ACOEM Statement on Medical Marijuana jin the Workplace: JOEM 57:5:May 2015

Drug screening: Quest Data Marijuana Positivity Increases Nationally for the Second Consecutive j y y

Year Marijuana continues to be the most commonly detected illicit drug, according

to the Quest Diagnostics Drug Testing Index. Marijuana positivity in the l U S kf i d 14 3 t (2 4% i 2014 2 1% igeneral U.S. workforce increased 14.3 percent (2.4% in 2014 vs. 2.1% in

2013). By comparison, marijuana positivity in the same workforce category increased 5 percent between 2012 and 2013. In the safety-sensitive workforce marijuana positivity increased 6 percent (0 71% vs 0 67%)workforce, marijuana positivity increased 6 percent (0.71% vs. 0.67%) between 2013 and 2014, compared to 5.6 percent between 2012 and 2013. The steady increase in the marijuana positivity rate is consistent with findings from other data sources, such as the National Survey of Drug Use and Health (NSDUH)(NSDUH).

Quest Data: Colorado and Washington Colorado: Marijuana positivity rate increased from 2.30% to 2.62%Colorado: Marijuana positivity rate increased from 2.30% to 2.62%

(14% increase) from 2013 to 2014

W hi t St t M ij iti it t i d f 2 38% t Washington State: Marijuana positivity rate increased from 2.38% to 2.75% (16% increase).

Liquor and Cannabis Board LicensingLiquor and Cannabis Board Licensing Data: 8/2015

Li iLicensing

Producer licensesissued

Producer/Processor licensesissued

Processor licensesissued

Retail licensesissued

160 490 56 193

Pending build out /applicant place on hold

Producer/Processorpending inspection

Retailer pendinginspection

Retailers reportingsalesapplicant place on hold pending inspection inspection sales

114 27 6 173 out of 193

Weekly Data: Sales: 9/5/2015

Sales: Weekly Data: Department of Revenue, Washington State

Average daily sales Total sales* (shelf price) Total tax obligationAverage daily salesWTD

Total sales (shelf price)FY 2015

Total tax obligationFY 2015

$2,137,638 $259,785,729 $64,946,432

Washington State Marijuana Production

j y y6/1/14 to 8/31/15

Legal Marijuana is the Fastest GrowingLegal Marijuana is the Fastest-Growing Industry in the US Published by the Huffington Post on 1/26/2015. The US market for legal cannabis grew 74% in 2014 to $2.7 billion, up

from $1.5 billion in 2013.

Medical marij ana a gro ing orkersMedical marijuana: a growing workers compensation challenge Business Insurance commented on medical marijuana on 7/9/15. Minnesota Department of Labor and Industry adopted a rule

establishing criteria for long term opioid treatment that also saidestablishing criteria for long-term opioid treatment that also said medical marijuana is not an “illegal substance” for injured workers under state law. It remains illegal under federal law, however.

Dr. Amy E Thompson, quoted in JAMA, 6/2015: “so far, evidence suggests that marijuana may be an effective treatment for chronic pain, neuropathic pain and muscle spasms due to multiple sclerosis or p p p pparaplegia.”

Impaired Driving:Impaired Driving: Washington State

Washington State compiles data on positive drug screens taken from DUI data.data.

The prevalence of marijuana in suspected p j pimpaired driving cases in Washington state Journal of Analytical Toxicology 2014 Oct; 38(8): 569-574Journal of Analytical Toxicology 2014 Oct; 38(8): 569 574 Couper FJ, Peterson BL The authors compared the data from 2009- 2012 for the presence of

ij i i i d d i i t th i 2013marijuana in impaired driving cases to the cases in 2013. The percentage of cases tested positive for THC at 19.1% The percentage of cases tested positive for carboxy THC 27.9%The percentage of cases tested positive for carboxy THC 27.9%

The prevalence of marijuana in suspected p j pimpaired driving cases in Washington state 2009-20122009 2012 The percentage of cases tested positive for THC at 19.1% The percentage of cases tested positive for carboxy THC 27.9%

2013 The percentage of cases tested positive for THC at 24 9% The percentage of cases tested positive for THC at 24.9% The percentage of cases tested positive for carboxy THC 40.0%

(P<0.05)

The prevalence of marijuana in suspected p j pimpaired driving cases in Washington state The median THC concentration over the 5 year period increased fromThe median THC concentration over the 5 year period increased from

5.2 ng/ml to .3 ng/ml of blood. The prevalence of alcohol and the majority of other drugs in the same

population of suspected impaired drivers did not changepopulation of suspected impaired drivers did not change.

Cannabis effects on driving lateral control gwith and without alcohol Cannabis effects on driving lateral control with and without alcohol,Cannabis effects on driving lateral control with and without alcohol,

Hartman RL, Brown TL, MilavetzG, et al. Drug and Alcohol Dependency 2015; 154: 25-37.

A federally funded driving simulator study demonstrated that alcohol A federally funded driving simulator study demonstrated that alcohol has a greater effect on drivers than marijuana and found additive effects on the combination of alcohol and marijuana.

Alcohol dosing to 0.065 showed weaving and lane departures at high speed.

Marijuana dosing at blood THC levels of 8 and 13 ng/ml showed a jua a dos g a b ood C e e s o 8 a d 3 g/ s o edincreased weaving but the drivers did not depart from their lanes.

Washington State Drug Screen There are 3 MROs, and we screen for over 2000 companies,There are 3 MROs, and we screen for over 2000 companies,

nationwide. We reviewed the drug screens for 2012, 2013 and 2014 for all positive

and negative screensand negative screens. The Washington state data was collected from the chain of custody

forms with identifying the donor’s phone number area code. We used all area codes from Washington State.

The data from 2014 was divided into Washington state area codes that were positive for marijuana in DOT and Non- DOT.e e pos e o a jua a O a d o O

DOT Drug screens 2012 vs. 20132012 2013 Total

Positive 25 59 84 p 0.0046

Negative 5228 6345 11573g

Total Screens 5253 6404 11657

Non-DOT drug screens: 2012 vs. 20132012 2013 Totals

Positive 327 526 853 p 0.238

Negative 3940 5813 9753g

Total screens 4267 6339 10606

Washington DOT marijuana positive drug g j p gscreens 2013 vs. 2014

Washington Non-DOT marijuana positive g j pdrug screens 2013 vs. 2014

Positive drug screens for marijuana, DOT

2012 2013 2014

Positive 25 59 75 p 0.000000000109

Negative 5228 6345 3893

Total 5253 6404 3968

P iti D f M ij NPositive Drug screens for Marijuana, Non-DOT

2012 2013 2014

Positive 327 526 753 p 0.000000003429

N ti 3940 5813 6240Negative 3940 5813 6240

Total 4267 6339 6993

Positive Results TotalPositive Results, Total2012-2014

Positive Results as a Percent of TotalPositive Results as a Percent of Total2012-2014

Learning Questions 1. The number of overall positive drug screens for marijuana has __________ since the passage of the Washington Initiative 502 in 2012.

a. increased b. decreased c. stayed the same

2 The percentage of positive drug screens for marijuana in regulated industries has since the passage of the Washington Initiative 502 in 2012 2. The percentage of positive drug screens for marijuana in regulated industries has _______ since the passage of the Washington Initiative 502 in 2012.

a. increased b. decreased c. stayed the same

3. The percentage of positive drug screens for marijuana in non-regulated industries has _______ since the passage of the Washington Initiative 502 in 2012.

a. increased b. decreasedb. decreased c. stayed the same

Answers to learning questions: 1. The number of overall positive drug screens for marijuana has __________ since the passage of the Washington Initiative 502 in 2012.

a. increased b. decreased c. stayed the same

2 The percentage of positive drug screens for marijuana in regulated industries has since the passage of the Washington Initiative 502 in 2012 2. The percentage of positive drug screens for marijuana in regulated industries has _______ since the passage of the Washington Initiative 502 in 2012.

a. increased b. decreased c. stayed the same

3. The percentage of positive drug screens for marijuana in non-regulated industries has _______ since the passage of the Washington Initiative 502 in 2012.

a. increased b. decreasedb. decreased c. stayed the same