Pubdate: Mon, 06 Jun 2016
Source: New Jersey Herald (NJ)
Copyright: 2016, The New Jersey Herald
Contact:  http://www.njherald.com/
Details: http://www.mapinc.org/media/2162
Author: David Danzis, New Jersey Herald
Note: part 2 of 3
Note: part 1: http://www.mapinc.org/drugnews/v16/n394/a05.html

PUBLIC HEALTH EFFECTS OF LEGALIZED MARIJUANA IN NEW JERSEY

EDITOR'S NOTE: Legalizing recreational marijuana is being seriously
considered in New Jersey.

The most recent Rutgers-Eagleton poll shows public support for
legalizing recreational marijuana in New Jersey is 58 percent -- the
highest it's ever been -- with 39 percent opposed.

Although Gov. Chris Christie has said he would not sign a bill
legalizing recreational marijuana, both the state Senate and Assembly
are working on legislation.

This is the second in a three-part series that will explore the issue
of legalizing recreational marijuana and its potential effects on
Sussex County and the surrounding area. The series will look at the
economic, public health and criminal justice impact legalization could
have.

[end editor's note]

The possibility of legalized recreational marijuana frightens public
health officials, law enforcement and policy makers for a variety of
reasons. The unknown long-term health effects, more intoxicated
drivers on the roads, increased use among adolescents and teenagers, a
higher potency of marijuana and expanded drug use are all positions
commonly taken by legalization opponents.

All of those reasons have merit, but legalization proponents say those
same positions fail to present an accurate picture.

Further complicating the issue is the lack of recognized scientific
research on marijuana, which is the direct result of the federal
government's classification of the substance.

Marijuana is a Schedule I narcotic according to the Controlled
Substances Act (1970), right alongside heroin and LSD. According to
the DEA, Schedule I drugs, "are defined as drugs with no currently
accepted medical use and a high potential for abuse. Schedule I drugs
are the most dangerous drugs of all the drug schedules with
potentially severe psychological or physical dependence."

With marijuana currently accepted for medical use in 24 states and the
National Institute on Drug Abuse stating that just "nine percent of
people who use marijuana will become dependent on it," the federal
government's scheduling of marijuana raises many questions about why
the substance has yet to be reclassified.

Gateway Drug?

The gateway drug theory, or "gateway effect" -- which basically states
that a person who uses marijuana will likely progress to harder
narcotics and commit other crimes -- is arguably the most-often cited
reason against legalizing marijuana.

All three of the 24th District's elected representatives -- Sen. Steve
Oroho, Assemblyman Parker Space and Assemblywoman Gail Phoebus -- as
well as Sussex County Sheriff Michael Strada, called marijuana a
gateway drug in discussing the issue of legalized recreational
marijuana with the New Jersey Herald.

Sussex County Prosecutor Francis Koch said that maybe the term is not
completely accurate, but the premise of the theory is.

"I'm not saying it's a gateway drug in the essence that it's a natural
progression that you definitely go from one drug to the next or you go
from marijuana to opiates or to heroin, that there's an automatic
step," Koch said. "However, I am of the opinion that people that do
marijuana have a vastly greater likelihood of becoming a heroin addict
because it's just the group they hang in with and it's the fact their
defenses are down and that eventually they move on to a higher high."

Like Koch, Newton Police Chief Michael Richards did not use the term
"gateway drug." But, Richards said legalization of marijuana did have
the potential to increase the use of that particular substance.

"If (marijuana) becomes legalized, automatically, you got to imagine,
there would be more people that would do it, so that just makes it a
very good likelihood of (turning) what may be a manageable problem now
into an unmanageable problem," he said.

The gateway drug theory is prevalent because it has been part of the
lexicon against marijuana since President Richard Nixon signed the
Controlled Substances Act in 1970.

But drug abuse professionals have moved away from the term in recent
years, mostly because no clear link exists between marijuana and
further drug use.

The National Institute on Drug Abuse, or NIDA, is a division of the
federal Department of Health and Human Services. The agency
administers a contract with the University of Mississippi to grow the
country's only legal -- as recognized by the federal government --
marijuana crop for research and medical purposes.

In September 2015, NIDA had this to say about the link between
marijuana and expanded drug use: "Most people who use marijuana do not
go on to use other 'harder' substances ... An alternative to the
gateway drug hypothesis is that people who are vulnerable to drug
taking are simply more likely to start with available substances, like
marijuana, tobacco or alcohol, and their subsequent social
interactions with other drug users increases their chances of trying
other drugs."

Evan Nison, director of the New Jersey chapter of the National
Organization for the Reform of Marijuana Laws, or NORML, spoke in
November at the Senate Judiciary Committee hearing. He called the
gateway drug theory "a ridiculous concept."

"Not only is it not a gateway drug (but it's the) prohibition of
cannabis that even makes that argument somewhat real," Nison said.
"The policies against it, which created the black market, puts people
in a position to be upsold harder substances, like cocaine or heroin.
By bringing cannabis under the rule of law and putting it behind a
counter, we are actually decreasing people's exposure to hard drugs.
There's nothing in cannabis that causes you to go out and do other
drugs."

HIGHER POTENCY AND YOUTH

Marijuana is the most used illicit substance in the country. The 2014
National Survey on Drug Use and Health reported that 22.2 million
Americans are current marijuana users. In New Jersey, a report
released last month by New Jersey Policy Perspective and New Jersey
United for Marijuana Reform, titled "Marijuana Legalization &
Taxation: Positive Revenue Implications for New Jersey," said "4
percent of the state's population -- or 365,900 -- use marijuana on a
monthly basis," and "New Jerseyans consume an estimated 2.5 million
ounces of marijuana per year."

Marijuana's popularity is something that concerns drug abuse experts
at the Center for Prevention and Counseling in Newton.

Annmarie Shafer, coalition coordinator at the Center or Prevention and
Counseling, said they already have their hands full with the abuse of
legal substances -- namely tobacco, alcohol and prescription opioids
- -- and that adding marijuana to that list is not a positive message,
particularly to the county's younger population.

"Another addictive substance out on our landscape, targeting our
youth, is something that we really, as a country, need to think
about," Shafer said.

In Colorado, marijuana use among teens and adults is up since
legalization began in 2014, according to the National Survey on Drug
Use and Health. What cannot be discerned from that information is
whether those figures are the result of easier access to marijuana or
if legalization has removed the taboo of admitting use.

Becky Carlson, executive director at the Center for Prevention and
Counseling, said one of the reasons marijuana's popularity is so
disconcerting is that the substance has gotten stronger, meaning it
could be having a more pronounced effect on users.

"We have a lot of health concerns about legalizing marijuana for
younger kids," Carlson said. "Our concern is, and there's a lot of
research out there, that we've got the strongest marijuana ever. It's
so much different that what many people who grew up in the '60s and
'70s remember. It's such a different drug now."

Numerous studies have shown that levels of THC -- or
tetrahydrocannabinol, the active ingredient in marijuana that produces
a euphoric feeling -- have nearly tripled in certain strains of
marijuana in the last couple of decades. Today's marijuana can have
levels of THC as high as 30 percent.

In Colorado, legal marijuana dispensaries sell the product with a
visible THC level on the packaging. Perhaps it's a selling point,
similar to alcohol, as some users will buy a more potent product for a
better result while more novice users can opt for a lower potency
until they are more familiar with marijuana's effects on their bodies.

Nison said the Colorado model -- which mirrors the way alcohol is sold
and consumers know the alcohol content in the product they're buying
- -- demonstrates good public policy because it creates informed consumers.

"(The higher potency) certainly doesn't (pose more of a health risk),"
Nison said. "In a lot of ways, it's safer because you're consuming
less raw material. I will also say that legalization and regulation
requires labeling and packaging to figure out what a dose is. When
people understand what they're consuming, that's important for health
and safety."

Nison also said that regulation might combat teen and adolescent use
- -- which he stated he is firmly against -- because, much like alcohol,
it creates a barrier which currently does not exist. Basically put, he
said a "dealer doesn't ask for ID."

The Monitoring the Future survey -- the annual drug use survey given
to eighth, 10th and 12th grade students every year all across the
country since 1975 -- is sponsored by NIDA. The survey has
consistently found that marijuana is easier to acquire than alcohol
for high school students. In 2014, 81 percent of 12th graders said
marijuana was easier to obtain than alcohol.

"It's just ridiculous to think that regulation is going to increase
usage," Nison said. "You put it behind a counter and that, at least,
forces kids to (try to find another way) instead of just going a few
lockers down."

Nick Bucci, a retired New Jersey State Police narcotics detective,
spoke at the Senate Judiciary Committee hearing in November as a
representative of LEAP, or Law Enforcement Against Prohibition. He
said regulating marijuana is more a practical approach to controlling
use among adolescents and teens, rather than prohibition.

"The first step in ending this failed drug policy is to legalize
marijuana thereby taking control of the marketplace from the drug
gangs and regulating distribution, just as we do with alcohol and
cigarettes. For 30 years, our high school children have told us it's
easier for them to buy marijuana than beer or cigarettes," Bucci said.
"Because when they buy illegal, unregulated drugs no one asked them
how old they are. Shouldn't we try to make it at least as hard for
them to buy marijuana as it is to buy beer and cigarettes?"

PERCEPTION OF HARM

Legalized recreational marijuana may have an unintended effect on a
national health epidemic that should make many people -- particularly
in Sussex County -- take notice.

In states with a medical marijuana program, a July 2015 study by the
Rand Corporation and the University of California-Irvine found
reductions in both fatal overdoses from opioids -- some as high as 33
percent after five years -- and admissions to addiction centers
relating to opioids abuse. Beginning in 2010, the study found a 25
percent average reduction in opioids fatalities in 10 states with a
medical marijuana program, including Colorado and Washington where the
results improved following full legalization.

Opioid addiction treatment is not an approved use under New Jersey's
medical marijuana program.

Dr. Jean-Paul Bonnet, owner of Franklin Health and Wellness Center and
a local physician who has participated in New Jersey Herald panel
discussions about opioid addiction alongside the Center for Prevention
and Counseling, said reform is needed in the way the medical community
views opioids. Bonnet said New Jersey's medical marijuana program is
too strict and some patients should have other options available to
them besides just a prescribed painkiller.

"We need to focus on the real problem, which is the opioid epidemic
and the over-prescribing of Americans," Bonnet said. "I think we've
seen the cases in Colorado and in Washington state where we're
actually seeing a decrease in opioid deaths. I think we very much need
to explore the medicinal uses of marijuana."

Rachel Wallace, the director of clinical services at the Center for
Prevention and Counseling, said she worries that legalization along
with the widespread acceptance of medical marijuana -- currently legal
in 24 states and Washington D.C. -- is creating a perception that the
substance is harmless.

"With the legalization for medicinal purposes it reduces the
perception of harm, so it increases the risk of use," she said. "So,
again, the law says one thing, but what we've seen play out with other
legal substances of abuse, there's great concern that they may happen
again."

DRIVING WHILE STONED

Maybe the issue that directly affects the most people is the argument
that legalized marijuana will lead to an increase in intoxicated
drivers, which could mean more motor vehicle accidents resulting in
injuries or fatalities.

The U.S. Department of Transportation and the National Highway Traffic
Safety Administration study, entitled "Drug and Alcohol Crash Risk,"
from February 2015 said, "drivers who tested positive for marijuana
were no more likely to crash than those who had not used any drugs or
alcohol prior to driving."

Richards said he believes legalization would lead to more work for law
enforcement because of the increased number of intoxicated drivers.

"I think that law enforcement would have a bigger problem on their
hands, in particular, with impaired driving enforcement," he said.

Many police departments now have certified a drug recognition expert,
or DRE, in their ranks, making it easier for departments to identify
an intoxicated driver.

But, as Richards noted, a roadside test for marijuana intoxication
does not exist, leaving officers to make a judgment call about whether
to arrest someone for DUI on suspicion of using marijuana.

"That type of quantitative analysis is not available yet in the law
for (identifying) impairment due to drugs," Richards said. "That's
significant, and to me, that in and of itself (is enough) to really
delay further consideration of any type of legalization."

Carlson and Shafer both pointed to work done by the Rocky Mountain
High Intensity Drug Trafficking Area, or RMHIDTA -- a collaboration
among Colorado, Wyoming, Utah and Montana to combat drug trafficking
- -- as evidence that recreational use has made our roads less safe.

Their most recent report with driving statistics -- "The Legalization
of Marijuana in Colorado: The Impact, 2015, Vol. 3" -- showed
Colorado had an increase in the number of driving fatalities where
the driver tested positive for marijuana in toxicology reports and an
increase in the number of positive screens from drivers suspected of
being under the influence, among other figures that all point to
marijuana having an impact on Colorado's roads.

The RMHIDTA group has been accused by groups, such as the Marijuana
Policy Project and NORML, of being politically motivated because they
receive federal funding based on drug activity in their region and
have a vested interest in projecting a bigger problem than may
actually exist.

Nison said presenting figures, like RMHIDTA does, without context --
such as how marijuana stays in the body for up to 30 days, meaning a
positive test does not equate to impairment at the time of an accident
or arrest -- is disingenuous.

"Cannabis is something that is in society right now, completely
unregulated, and people are driving under the influence now," Nison
said. "And I want to be perfectly clear: I don't suggest people drive
after consuming cannabis. But, I don't think that should be a real
concern against the legalization of cannabis."

Colorado had seen a decline in the total number of traffic fatalities
every year from 2008 to 2014. In 2015, the number of total fatalities
increased by 12 percent, according to the Colorado Department of
Transportation.

The Colorado State Patrol began keeping records of DUID (driving
under the influence of drugs) citations involving marijuana only in
2014, the first full year of recreational marijuana. The CSP
documented a 1 percent increase -- from 665 to 674 -- for the whole
state from 2014 to 2015, according to the state Department of Public
Safety report "Marijuana Legalization in Colorado: Early Findings" in
March 2016.
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MAP posted-by: Jo-D