Sheila Polk, Yavapai County Attorney Merilee Fowler ......• Decline in personal relations • Poor...
Transcript of Sheila Polk, Yavapai County Attorney Merilee Fowler ......• Decline in personal relations • Poor...
Sheila Polk, Yavapai County AttorneyMerilee Fowler, Executive Director
MATFORCE, Yavapai County Substance Abuse Coalition
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Presentation Overview
• To examine the changing attitudes and other changes with Marijuana in thelast 20 years.
• To look at youth marijuana use trends and what youth are telling us inArizona.
• To review the science on the harms of marijuana.
• To answer questions from the audience.
Changing Attitudes toward Marijuana
How has marijuana changed from 1990 to 2015?
What is:
A Grassroots Movement
A movement with a focus on the facts and the facts only
The prevention community united with one message
Over 25 organizations working together
A vehicle to share the message of what current trends in marijuana will mean to our kids future and the future of our country
Components of the Movement
What do youth tell us?
Insights on youth marijuana use in Arizona
2014 Arizona Youth Survey
Arizona Criminal Justice Commission
1. Consumption
2. Consequences
3. Contextual Factors
CONSUMPTION
Identifying the severity of the problem and who is most affected
Percentage of Arizona Youth Reporting Past 30 Day Substance Use (2014)
24.1
13.69.4
6.6 6.33.4 2.0 1.4 1.2 1.0 0.8 0.6 0.3 0.3
0
10
20
30
40
50
60
70
80
90
100 A
lco
ho
l
Mar
ijuan
a
Cig
are
tte
s
Ch
ewin
g To
bac
co
Pre
scri
pti
on
Dru
gs
OTC
Inh
alan
ts
Hal
luci
no
gen
s
Ecst
asy
Co
cain
e
Syn
thet
ics
Ste
roid
s
Her
oin
Met
h
Pe
rcen
t (%
) R
ep
ort
ing
Use
Percentage of Arizona Youth Reporting Past 30 Day Use of the Most Common Substance Types
0
5
10
15
20
25
30
35
40
2006 2008 2010 2012 2014
Per
cen
t (%
) R
epo
rtin
g U
se
Alcohol Marijuana Cigarettes Rx Drugs
Cumulative Percent Change in Arizona Youth Substance Use Rates (2006-2014)
-33.61
3.82
-38.56-41.12
-45
-40
-35
-30
-25
-20
-15
-10
-5
0
5
10
Alcohol Marijuana Cigarettes *Rx Drugs
Pe
rce
nt
(%)
Ch
ange
*Rx Drug Cumulative Change is from 2008-2012
Percentage of Arizona Youth Reporting Past 30 Day Marijuana Use (2014)By County
19.3 18.3 16.7 16.6 15.5 15.3 15.3 14.4 13.3 12.9 12.7 11.2 9.4 8.6 5.20
10
20
30
40
50
60
70
80
90
100
Pe
rce
nt
(%)
Re
po
rtin
g U
se
State Average = 13.6%
CONSEQUENCES
Identifying the Costs of Substance Use and Markers of Return on Investment
for Prevention
Percentage of Arizona Youth Reporting Delinquent Behavior
0
2
4
6
8
10
12
14
16
18
20
2006 2008 2010 2012 2014
Pe
rcen
t (%
) R
ep
ort
ing
Use
Assault Drunk or High at School Suspended from School Sold Illegal Drugs Been Arrested
Note: scale reduced for visibility; accurate depiction is out of 100%
Percentage of Arizona Youth Reporting Delinquent Behavior
8.8 6.8 3.2 5.6 2.0
23.918.8 18.1
60.0
29.5
0
10
20
30
40
50
60
70
80
90
100
Suspended from School Assault Been Arrested Drunk or High at School Sold Drugs
Pe
rcen
t (%
) R
ep
ort
ing
Use
No Past 30 Day Marijuana Use Past 30 Day Marijuana Use
2.7x Higher Rate
10.7x Higher Rate
5.7x Higher Rate
14.8x Higher Rate
2.8x Higher Rate
Percentage of Arizona Youth Reporting Delinquent Behavior
23.918.8 18.1
60.0
29.522.2 23.9
18.0
50.7
27.2
18.5 16.4 13.2
39.0
18.4
0
10
20
30
40
50
60
70
80
90
100
Suspended from School Assault Been Arrested Drunk or High at School Sold Drugs
Pe
rcen
t (%
) R
ep
ort
ing
Use
Past 30 Day Marijuana Users Past 30 Day Rx Drug Users Past 30 Day Alcohol Users
CONTEXTUAL FACTORS
Identifying What Can Be Changed
Where Arizona Youth Obtained Marijuana*
78.6
28.6
14.8 11.6 13.46.1
75.7
27.1
14.3 14.3 11.35.7
0
10
20
30
40
50
60
70
80
90
100
Friends Parties Family/Relative Someone with amedical mj card
School Home
Pe
rce
nt
(%)
Yo
uth
Re
po
rtin
g Ea
ch S
ou
rce
2012 2014
*Students could pick more than one source; will not sum to 100%
Risk Factors of Note in Arizona Past 30 Day Youth Marijuana Users (2014)
14.018.5
24.0 23.029.0 28.3
35.0
54.1
65.169.0
78.1
56.1
65.1
54.760.7
91.8
0
10
20
30
40
50
60
70
80
90
100
Early Initiationof
Drug Use
AttitudesFavorable
to Drug Use
Friend's Use ofDrugs
ParentAttitudes
Favor Drug Use
PerceivedAvailability
of Drugs
Laws & NormsFavor Drug Use
Poor FamilyManagement
No/SlightPerceived Risk
ofDrug Use
Pe
rce
nt
(%)
Yo
uth
at
Ris
k
Non Users Users
Users had 1.5-4.7x the rate of risk as non-users
Age of First Use by Substance Type in Arizona
12.8
12.9
13.1
12.8
12.9
12.5
12.7
12.9
12.7
12.9
13.2
13.5
13.6 13.613.7
13.5
13.4
12.00
12.50
13.00
13.50
14.00
2006 2008 2010 2012 2014
Ave
rage
Age
in Y
ear
s
Alcohol Cigarettes Marijuana Rx Drugs
Age of First Use for Arizona Youth Marijuana Users
13.61
13.81
13.99 13.96
14.08
13.05
13.31 13.31
13.53
13.64
12.83
12.97 12.97
13.3113.27
12.28
12.57 12.57
12.78 12.78
12
12.5
13
13.5
14
14.5
2006 2008 2010 2012 2014
Ave
rage
Age
in Y
ear
s
Experimental Use (1-2x past 30 days)
Weekend Use (3-9x past 30 days)
Weekend+Some Weekday Use (10-19x past 30 days)
Habitual Use(20+ x past 30 days)
Percentage of Arizona Youth Reporting No/Slight Risk of Marijuana Use
0
10
20
30
40
50
60
70
80
90
100
2006 2008 2010 2012 2014
Pe
rcen
t (%
) R
ep
ort
ing
Use
Try Marijuana Regular use of marijuana
25.8%% Increase
116.6% Increase
Factors Contributing to Arizona Youth Attitudes About Marijuana (2014
21.117.9
29.0
38.6
28.4
38.7
55.0
85.288.7
78.1
68.7
96.1
0
10
20
30
40
50
60
70
80
90
100
Cool to use marijuana
Not wrong to usemarijuana
Peer approval ofmarijuana use
Know adults whouse marijuana
Siblings usemarijuana
Best friends usemarijuana
Pe
rce
nt
(%)
Yo
uth
at
Ris
k
No Past 30 Day Marijuana Use Past 30 Day Marijuana Use
Over HALF of Arizona youth have never talked to their
parents about alcohol or drugs!
Factors Contributing to the Lack of Parent-Child Conversations (2014)
34.6
22.4
14.3
40.0 38.6
46.8
34.529.9
54.9 53.2
0
10
20
30
40
50
60
70
80
90
100
Can't sharewith parents
Can't go toparents with problems
Honesty withparents not important
Parents never/rarely notice good job
Parents never/rarely say they are proud
Pe
rce
nt
(%)
Yo
uth
at
Ris
k
No Past 30 Day Marijuana Use Past 30 Day Marijuana Use
Reasons Past 30 Day Arizona Youth Marijuana Users Gave for Using Substances (2014)
55.854.0
41.0
32.2
26.622.9
20.5 20.4
11.19.3 8.2
5.0 2.8 2.3 1.6
0
10
20
30
40
50
60H
ave
fun
Get
hig
h
Dea
l wit
h s
tres
s
Kee
p f
rom
feel
ing
sad
Sto
p b
ore
do
m
Oth
er
To f
ocu
s
Try
som
eth
ing
new
Fee
l no
rmal
Bec
au
se I
nee
ded
it
Fit
in
Lose
we
igh
t
Get
bac
k at
my
par
ents
Be
mo
regr
ow
n u
p
Be
like
afa
mo
us
per
son
Pe
rce
nt
(%)
Yo
uth
Re
po
rtin
g R
eas
on
s
*Students could pick more than one reason; will not sum to 100%
Reasons Non-Marijuana Users Gave for Not Using Substances (2014)
77.4
53.1 52.5
44.740.6 40.5 40.4 39.6
33.4
25.8
19.9
6.9 5.9
0
10
20
30
40
50
60
70
80
90
No
t in
tere
sted
Can
hu
rt m
e
Par
ent
dis
app
rova
l
Co
uld
be
arre
ste
d
Oth
er a
du
ltd
isap
pro
val
Mo
rally
wro
ng
Lose
pri
vela
ges
Mig
ht
get
exp
elle
d
Get
a b
adre
pu
tati
on
Frie
nd
s d
isap
pro
ve
Aga
inst
be
liefs
Do
n't
like
Co
uld
n't
fin
d a
ny
Pe
rce
nt
(%)
Yo
uth
Re
po
rtin
g R
eas
on
s
Percentage of Each Age of Marijuana Initiation for Arizona Youth (2014)
12 years, 11.6%
13 years, 19.5%
14 years, 18.9%
15 years, 17.4%
19 or Older, 0.3%
1 out of 8 Arizona youth who use marijuana started
using in elementary school
80% of Arizona youth who use marijuana started
using before they could legally drive a car
1 in 5 Arizona youthwho use marijuanastarted at age 13
Why Does This Matter?
Marijuana and the Brain
THC and Your Brain
• THC stimulates the “reward circuit” of the brain
• Causes intense surges in dopamine to create the “high” or euphoria
EFFECTS Euphoria, laughter Distorted perception of time Impaired coordination Reduced inhibition & risky
behavior Difficulty with thinking and
problem solving Memory loss
Impaired Driving Slower reaction times Impaired judgment Problems responding to signals and
sound
Marijuana Rewires the Brain
Substitutes the high of a drug for the high from a job well done.
Reward without effort
Long-term damage to brain’s natural reward system (brain is re-wired)
Long-term cognitive damage Memory & learning skills impaired
Marijuana Slowly Hijacks Brain’s Natural Reward System
Amotivational Syndrome• Persistent procrastination• Low productivity; low energy• Grandiosity• Low self-confidence• Lack of clear thinking• Bad or guilty feelings• Anxiety; panic attacks; paranoia• Unreliable• Decline in personal relations• Poor academic outcomes
Weekly Teen Use of Marijuana Lowers IQ By 7-8 points by Age 38
IQ Drops in Adults Who Regularly Used Marijuana Before Age 18
• Frequent Use at age 38 = 7-8 point drop
• Infrequent Use at age 38 = 4-5 point drop
• Lost cognitive abilities not fully restored even in adults who quit
Regular Marijuana Use is Harmful to Developing Adolescent Brain
Marijuana’s negative effects on attention, memory and learning can last for days or weeks (even after intoxication is gone)
Impairment, low energy and reduced initiative mean poor academic outcomes
• Users 3.6 times less likely to graduate from high school• Daily users 60% less likely to graduate• Users 2.3 times less likely to enroll in college• Users 3.7 times less likely to get a college degree
Daily Users of Marijuana Before Age 17
Clear and consistent associations between the frequency of adolescent cannabis use and all adverse young adult outcomes.
Clear reductions in the odds of high-school completion Clear reductions in degree attainment Substantially increased odds of later cannabis dependence Substantially increased odds of use of other illicit drugs Substantially increased odds of later suicide attempts
“Young adult sequelae of adolescent cannabis use: an integrative analysis.” The Lancet Psychiatry, Volume 1, Issue 4, Pages 286 - 293, September 2014.
• About 9% (1 in 11) of users may become dependent• 17% (1 in 6) who start use in adolescence• 25-50% of daily users
32
15
9
17
118
5
23
0
5
10
15
20
25
30
35
Percen
t
Addiction
* Nonmedical Use
Source: Anthony JC et al., 1994
ADDICTION IS A DEVELOPMENTAL DISEASEIt starts in adolescence and childhood
NIAAA National Epidemiologic Survey on Alcohol and Related Conditions, 2003
Age at tobacco, at alcohol and at cannabis use dependence as per DSM IV
Prolonged drug use changes the brain in fundamental and long-lasting ways
Brain is “rewired” Adjusts to the drug Drug use becomes necessary simply to feel
normal
Drug use continues despite tremendous negative consequences
Addiction is a disease that affects both the brain and behavior
Cycle of Addiction
Steps in Drug Addiction and Recovery
* Used to get high or change their mood
Teen Users of Marijuana More Likely to Use All Other Substances
Marijuana a “Gateway” Drug
Partnership Attitude Tracking Study (PATS) 2011
THC OF TODAY
Average THC and CBD Levels in the US: 1960 - 2011
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 0.2 0.2 0.4 0.5 1 1 1.5 3.3 3.3 3.5 3.5 3.1 3.1 4 4.5 5.2 5 4.7 5.4 6.2 7.3 7.2 8.3 8.1 9.1 10 10 9.9 11 11
CBD 0.3 0.3 0.4 0.4 0.3 0.3 0.4 0.4 0.4 0.4 0.5 0.5 0.4 0.5 0.5 0.5 0.5 0.5 0.4
0
2
4
6
8
10
12
14
MA
RIJ
UA
NA
PO
TEN
CY
NON-Psychoactive
Ingredient
THC:Psychoactive
Ingredient
Potency of THC – Colorado vs. Nation
THC National Average
1970s = 1%
1995 = 3.5 %
2012 = 15%
COPYRIGHT BY SAM; USED WITH AUTHORS’ PERMISSION
Increases Potency and Emergency Department Visits Involving Marijuana, Cocaine, or Heroin
Effects of THC on Mental Illness
• Since 2002, almost a dozen studies have shown that regular use of marijuana carries a significant increased risk of developing psychotic illnesses like schizophrenia.
• Higher risk for:• Those with a family history of the disorders• Those with a psychosis-prone personality• Those who start using in early adolescence
• Risks increase with potency and frequency of use
Effects of THC on Mental Illness
- Adolescents who use marijuana have a 2-4 fold increase risk of developing psychosis and this risk is dose-dependent (Hall and Degenhardt, 2009)
- Marijuana, especially high potency marijuana, may cause acute anxiety attacks and psychosis (Hall and Degenhardt, 2009). MJ accounted for 461,028 ED visits in 2012 (DAWN, 2013). Symptoms of withdrawal include anxiety and depression (Budney et al., 2002).
- Controlling for other possible confounds, those who use marijuana are twice as likely to have had a suicide attempt requiring hospitalization (Hall and Degenhardt, 2009).
- Marijuana withdrawal causes a doubling in aggressive episodes compared to controls (Kouri et al., 1999; Smith et al., 2013).
- Daily use sees an increase in psychosis of 5x (Lancet Journal 2014)- Weekend use sees an increase 3x- 24% of psychosis cases in the study group caused by weed alone
Effects of THC on Mental Illness
Meta-analysis was conducted by Australian researchers in 2011 for the Archives of General Psychiatry• used 83 studies to assess the impact of marijuana use on
the early onset of psychotic illness.
The findings were clear and consistent: “The results of meta-analysis provide evidence for a relationship between cannabis use and earlier onset of psychotic illness…[The] results suggest the need for renewed warnings about the potentially harmful effects of cannabis.”
Effects of THC on Mental Illness
2013: Researchers analyzed data from interviews with more than 43,000 respondents over the age of 18 from the National Epidemiologic Survey on Alcohol and Related Conditions.
Study published in the journal Comprehensive Psychiatry, researchers at Toronto’s Centre for Addiction and Mental Health (CAMH) found that people with mental illness are seven times more likely to use marijuana weekly than people without a mental illness.
Rates elevators for:• Bipolar disorder• Other substance abuse disorders.
The Connection
Does marijuana use come first, or does mental illness come first?
Regardless of the mechanism, it is clear that marijuana is harmful to mental health.
Use of Marijuana Increasing, Perception of Marijuana’s Risk Decreasing
Percentage of U.S. 12th Grade Students Reporting Past Month Use of Cigarettes, Marijuana and Alcohol
0
10
20
30
40
50
60
919293949596979899000102030405060708091011121314
Legalization = More Teen Users
Number More LikelyTo Use if Legal
% of Arizona’s High School Students
Students Who Have Never Used
~32,000 10%
Students Who Have Used in Lifetime
~76,000 24%
• The Partnership Attitude Tracking Study (PATS): Teens and Parents, 2012• ACJC Arizona Youth Survey, 2012
% of Arizona’s Teens More Likely to Use Marijuana IF IT IS LEGALIZED
Teen Illicit Use Highest in Medical Marijuana States
*23 Medical Marijuana states
ARIZONA #20
Arizona Medical Marjuana Act
Medical Conditions Profile
Age and Gender of Cardholders as of 9/30/14
Quarterly Report 2014
• Report published November 13, 2014 by the Department of Health Services• 615 physicians provided certifications to 51,783 patients during this time
period. • 25 physicians certified approximately 60% of the patients.
FERRELL & REED-KALIHER CASES
SUPREME COURT OF THE STATE OF ARIZONA STATE v. JENNIFER LEE FERRELL,
Filed April 7, 2015
KEENAN REED-KALIHER v. STATE OF ARIZONA, No. CV-14-0226-PR Filed April 7, 2015
Substance Abuse Is Preventable
Marijuana -- Past Year Prevalence – General Population
World Average5.2%
SUGGESTED STRATEGIES
The best treatment is still prevention
Normalizing sobriety is key
Treatment/Prevention
The best treatment is still preventionNormalizing sobriety is key
Pushing back in a way that will resonate with the culture they are in
Family and social groupsMUST BE RELEVANT!
Call to Action: Looking outside the box
Good Behavior Game
Don’t Get Me Started
Teach Coping Skills
Kids at Hope – Be an Ace! Time Travel“Every Kid can Succeed, No Exceptions”
FOR MORE INFORMATION
• Marijuana Harmless? Think Again!, www.marijuanaharmlessthinkagain.org
• ACJC SAC website: http://www.azcjc.gov/ACJC.Web/sac/Default.aspx
• Community Data Project website: http://www.azcjc.gov/cdp_site/default.aspx
• Substance Abuse and Mental Health Services Administration, www.samhsa.org
• National Institute on Drug Abuse, www.nida.nih.gove
• National Institute on Alcohol Abuse and Alcoholism, www.niaaa.nih.gove
• Sheila Polk, [email protected]• Merilee Fowler, [email protected]
Paige Gullikson
Growing Kids Preschool
2014