Pubdate: Thu, 05 Feb 2015
Source: Boulder Weekly (CO)
Copyright: 2015 Boulder Weekly
Author: Leland Rucker


The Colorado Department of Public Health & Environment Monday 
released a review on health issues related to cannabis.

"Monitoring Health Concerns Related to Marijuana in Colorado: 2014 
Changes in Marijuana Use Patterns, Systematic Literature Review, and 
Possible Marijuana-Related Health Effects" is mandated as part of 
Senate Bill 13-283, which demanded a health report to be finished at 
the end of January 2015 and updated every two years.

The report relies on four surveys: The 2013 Healthy Kids Colorado 
survey of middle and high school students, the 2013 Influential 
Factors for Healthy Living for Adults in Colorado, the 2012-13 
National Survey on Drug Use and Health and a one-time, 2014 
Tri-County Health Department survey of women, infants, children and 
cannabis use.

It covers a lot of territory: pregnancy risks, child health, race and 
ethnicity, regions, doses, mental health, birth defects, cancer 
rates, unintentional exposures and ingestion and respiratory effects 
among them.

There is no mention of medical marijuana anywhere in its 188 pages.

Among its findings: Fewer middle school students use marijuana than 
high school students; there is conflicting data on adolescent 
marijuana use in Colorado compared to national averages; past 30-day 
marijuana use among Colorado youth ages 12-17 is 11 percent higher 
than the national average; past 30-day marijuana use among Colorado 
high school students is 3 percent lower than the national average of 
23 percent; there are significant racial, ethnic and sexual 
orientation disparities in the prevalence of use among adolescents, 
and adult marijuana use is higher in Colorado than in most other states.

None of these are conclusions. The authors admit up front that these 
figures should never be used to prove anything, no matter which side 
of the cannabis debate you happen to find yourself on. Survey results 
often come up with differing conclusions and numbers, and given that 
this was mandated, the result is little more than a baseline report, 
mostly outlining attitudes and patterns in the period before January 
2014, when retail stores opened.

"For the most part, the doctors were trying to do a fair job of 
showing possible harms and health effects. I think they were acting 
in good faith," says Mike Elliott of the Marijuana Industry Group. 
"We can all agree that marijuana can have negative health impacts. 
It's the same thing with alcohol and prescription drugs and 
cheeseburgers and other things."

Part of the problem is the lack of any earlier data to match up 
against. There were no questions about marijuana before 2014 on state 
public health surveys, including the Behavioral Risk Factors 
Surveillance System for adults, the Pregnancy Risk Assessment 
Monitoring System for pregnant women and new mothers, and the Child 
Health Survey for kids aged 1 to 14. "The new marijuana-related 
questions added to all of these surveys in 2014 are presented in this 
report," it states. "However, results from these surveys will not be 
available until the fall of 2015."

The report's authors also admit up front that nothing in its pages 
can answer the question of how cannabis use has changed as a result 
of legalization. "However," it concludes, "the data presented here 
provide a snapshot that allows us to begin to measure the public 
health impact."

Perhaps. The authors remind us that since cannabis was illegal in the 
United States up until 1996, any official research into marijuana was 
only allowed to study the drug's adverse effects. "This legal fact," 
the report notes, "introduces both funding bias and publication bias 
into the body of literature related to marijuana use."

Still, by not even mentioning medical marijuana anywhere in the 
report suggests the same kind of bias in this work. I realize that 
every study can't be considered correct or be included. But there 
isn't really one good thing to say about cannabis use in the entire 
document. It's all about possible negative effects.

"It's a helpful gathering of all that data," Elliott says. "It would 
have been nice to have it look into medicinal benefits, which is a 
bit frustrating. It's good to have the info, but I don't think it's 
going to have much impact."

There is no mention of the state's recent decision to fund eight 
medical marijuana studies that look at whether cannabis might help 
alleviate symptoms of adolescent inflammatory bowel disease, 
Parkinson's tremors, PTSD, pediatric epilepsy and brain tumors. 
Results from those studies will take several years, probably after 
the next two-year state study will be produced.

Also important to note is that the report admits that none of the 
studies can absolutely prove a causality between cannabis use and 
adverse health effects. "Rather than continue to review existing 
evidence about marijuana, the state should start investigating 
whether allowing adults to use marijuana might result in less alcohol 
use and fewer alcohol-related problems," says Mason Tvert of the 
Marijuana Policy Project. "Looking at marijuana in a vacuum does 
little to advance the dialogue."

You can hear Leland discuss his most recent column and Colorado 
cannabis issues each Thursday morning on KGNU. Respond:  ---
MAP posted-by: Jay Bergstrom