Questions We Will Consider: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 disclaimersA 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: tstucky@iupui.edu

Trends in Use Trends in Use (see Caulkins et al)(see Caulkins et al)

Trends in Use Trends in Use (see Caulkins et al)(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:

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/

k2spice-synthetic-marijuana

How MJ gets distributedHow MJ gets distributedHow MJ gets distributedHow MJ gets distributed

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 AttitudesTrends in AttitudesTrends in AttitudesTrends in Attitudes

Effects on the BodyEffects on the Body(see Room et al ch.2)(see Room et al ch.2)Effects on the BodyEffects on the Body

(see Room et al ch.2)(see Room et al ch.2)

Reminder on disclaimer Not intended as medical advice or to influence

treatment directly

Short versus long term effects Effects depend on

dosage mode of consumption Potency THC/ CBD ratio

Some positive, some negative

Short term effects Short term effects Short term effects Short term effects

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 effectsLong term effectsLong term effectsLong term effects

Cognitive functioning- mixed findings Risks specific to smoking MJ

Respiratory and Cardiovascular effects Secondhand smoke

Educational outcomes for youth Correlation or cause?

Can become dependent Mental health risk

Psychosis, schizophrenia, depression Especially for youth? Co-occuring disorders

Some open questionsSome open questionsSome open questionsSome 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 Adverse effects compared to other drugs (Room et al, p.42)other drugs (Room et al, p.42)Adverse effects compared to Adverse effects compared to

other drugs (Room et al, p.42)other drugs (Room et al, p.42)

Effect MJ Tobacco Heroin Alcohol

Traffic accidents * * **

Violence/suicide **

Overdose ** *

HIV/liver infections ** *

Cirrhosis **

Heart disease ** *

Respiratory disease * **

Cancers * ** *

Mental illness * **

Dependence ** ** ** **

Effects on fetus * * * **

History of Drug Use History of Drug Use (see Abadinsky)(see Abadinsky)

History of Drug Use History of Drug Use (see Abadinsky)(see Abadinsky)

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 History of Drug Use (see Abadinsky)(see Abadinsky)

History of Drug Use History of Drug Use (see Abadinsky)(see Abadinsky)

Alcohol Tobacco Opium/Morphine/Heroin Coca/Cocaine/Crack Patent medicines

E.g. laudenum Amphetamines Barbiturates/ tranquilizers/sedatives Hallucinogens

History of MJHistory of MJ(see Abadinsky)(see Abadinsky)

History of MJHistory of MJ(see Abadinsky)(see Abadinsky)

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 History of Laws (see Abadinsky)(see Abadinsky)History of Laws History of Laws (see Abadinsky)(see Abadinsky)

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 LawsA Brief look at LawsA Brief look at LawsA Brief look at Laws

Federal law: MJ is a schedule I drug 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

Ohio IndianaOffense Penalty jail/

prisonMax. Fine Offense Penalty jail/prison Max. Fine

Possession PossessionLess than 100 g misdemeanor N/A $150 30 g or less misdemeanor 1 year $5,000

100 - 200 g M 30 days $250 More than 30 g felony 6 - 36 mos $10,000

200 - 1000 g felony 6-12 mos $2,500 Conditional discharge may be available for first-time offenders.

1000 - 5000 g felony 1 - 5 yrs $10,000  

5000 - 20,000 g felony 1 - 5 yrs $10,000  

20,000 - 40,000 g felony 5* - 8 yrs $15,000  

More than 40,000 g felony 8 years* $15,000  

* Mandatory minimum sentence  

Sale/Distribution/Trafficking Sale or CultivationA gift of 20 g or less (first offense)

misdemeanor N/A $150 30 g or less misdemeanor 1 year $5,000

A gift of 20 g or less (2nd offense)

misdemeanor 60 days $500 30 g - 10 lbs felony 6 - 36 mos $10,000

Less than 200 g felony 1 year $2,500 10 lbs+ felony 2 - 8 yrs $10,000

200 - 1000 g felony 6-18 mos $2,500 W/in 1000 ft of school

felony 2 - 8 yrs $10,000

1000 - 5000 g felony 1 - 5 years

$2,500 To a minor felony 6 - 36 mos $10,000

5000 - 20,000 g felony 1 - 5 years

$2,500

 20,000 - 40,000 g felony 5* - 8 yrs $2,500  More than 40,000 g felony 8 years* $2,500        

Correctional Populations by Offense Type 1980-2001

PolicyPolicyPolicyPolicy

If the goal is to reduce drug use, two options:

Supply reduction Primarily legal

Demand reduction Prevention, treatment

Not an either or situation current policy is to do both

Prevention programs Prevention programs (see Mosher and Akins)(see Mosher and Akins)Prevention programs Prevention programs

(see Mosher and Akins)(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 TreatmentsSA TreatmentsSA TreatmentsSA Treatments

Office of National Drug Control Policy, U.S. National Drug Control Strategy: Addiction a disease of the brain

Can be treated and recovery is possible Also focus on prevention

Approaches vary widely No current medication for MJ 13 principles of effective treatment…

See handout

See NIDA report or Crime Solutions.gov for more

Reforms Reforms (see Caulkins et al or Room et al)(see Caulkins et al or Room et al)

Reforms Reforms (see Caulkins et al or Room et al)(see Caulkins et al or Room et al)

What are the range of options for reform?

Some terms Depenalization Decriminalization Legalization De facto v. De jure

Current policies vary widely

ReformsReformsReformsReforms

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?

DiscussionDiscussion

What are the options that are available and what are the likely outcomes one might expect?

Other questions?

Sources used in presentation

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.  http://www.people-press.org/files/legacy-

pdf/4-4-13%20Marijuana%20Release.pdf

This is the National Drug Control Strategy http://www.whitehouse.gov/ondcp/2013-

national-drug-control-strategy

Additional recommended readings and resources

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 http://crimesolutions.gov/

National Institute on Drug Abuse http://www.drugabuse.gov/drugs-abuse/

marijuana http://www.drugabuse.gov/sites/default/files/podat_1.pdf

Principles of effective drug treatment