Lessons from Legalization in Colorado: State of Current and Future Research Andrew Freedman, Director of Marijuana Coordination, Office of Governor John W. Hickenlooper September 8, 2016

Mission To carry out the people’s will on marijuana legalization through effective and efficient regulations, policies, and initiatives that protect and promote public health, public safety, and keep marijuana out of the hands of kids. Policy Priorities 1)Decrease youth marijuana use and consumption through strong regulations, public education, and proven youth-prevention programs. 2)Maintain public safety by preventing marijuana-impaired driving and ensuring marijuana-related crimes are effectively policed. 3)Promote public health by providing options for substance-use disorder treatment services, educating consumers on responsible, legal use, and creating stringent health and safety standards for industry.

Current State of Data Currently, our data is capable of measuring some forms of social impact. The following slides will summarize available data on: Youth Use Adult Use Abuse of Marijuana Hospitalizations Arrest Rates DUIs 2

High School Student Perception of Moderate/Great Risk of Harm from Using Marijuana Regularly Region 11: Northwest CO, including Garfield, Mesa, Moffat, Rio Blanco, and Routt Counties. Region 20: Denver County.

Easy to Access Marijuana (%): Colorado High Schools Region 5: Central Plains, including Lincoln, Elbert, Kit Carson, and Cheyenne Counties.

School Suspension Rate Source: Colorado Department of Education.

School Expulsion Rate Source: Colorado Department of Education.

Adult Marijuana Use in Colorado,18 Years and Older Data Source: Behavioral Risk Factor Surveillance System prevalence estimates for 2013 and 2015.

Adult Marijuana Use in Colorado by Age Data Source: Behavioral Risk Factor Surveillance System prevalence estimates for 2013 and 2015.

Young Adult Marijuana Usage Rates 12 Source: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health. URL:

Adult Marijuana Usage Rates 13 Source: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health. URL:

ChildMarijuanaExposures

Hospitalization Trends 15 Rate per 100,000 hospitalizations with possible marijuana exposures, diagnoses, or billing codes in first three codes. * Indicates statistically significant difference with a p value <.001 Source: Colorado Hospital Association data; analysis provided by Colorado Department of Public Health and Environment. * *

Emergency Department Trends 16 Rate per 100,000 emergency department visits with possible marijuana exposures, diagnoses, or billing codes in first three codes. * Indicates statistically significant difference with a p value <.001 Source: Colorado Hospital Association data; analysis provided by Colorado Department of Public Health and Environment.

Number of Treatment Admissions Marijuana as Primary Drug Source: Colorado Department of Human Services, Drug-Alcohol Combined Data System (2016).

Marijuana Arrests by Age Group Source: Colorado Bureau of Investigation, National Incident-Based Reporting System. 1.These reflect both custodial arrests and citations issued by law enforcement. 2.Rates are marijuana arrests per 100,000 in each age group. 3.From 2012 to 2015 arrests for those 21 and over decreased 82%; those 18 to 20 decreased 50%; those under 18 decreased 28%.

DUI Citations, Colorado State Patrol Source: Colorado State Patrol. Data represent citations from January-July of each year.

Roadway Fatalities Note: A positive test for cannabinoids may be the result of active THC or one of its inactive metabolites and does not necessarily indicate impairment. Source: Data provided by Colorado Department of Transportation, 8/4/ DATA ARE PRELIMINARY AND SUBJECT TO CHANGE

Sales and Excise Taxes Source: Colorado Department of Revenue, Marijuana Enforcement Division. Note: Includes regular sales tax for medical (2.9%), regular sales tax for retail (2.9%), special sales tax for retail (10%), and excise tax for retail (15%). The Colorado fiscal year runs from July 1 st to June 30 th.

Future of Research -Institute of Cannabis Research (ICR) at Colorado State University – Pueblo -CSU Pueblo is uniquely position to do cannabis research. They have the academic and political desire to do so and have already secured funding from state and local sources. -ICR’s Mission: To advance knowledge and understanding in, and support and promote through education and research responsible development of applications for, cannabis-related natural and derived products. -Commitment to ethical and socially responsible activities: The Institute will promote the sound ethical/legal and socially-responsible utilization of cannabis by providing medical research, genetic development, analytical testing services, guidance for public policy-making, conceptualization and planning of new sustainable businesses, assistance with advertising and marketing strategies which will accurately inform the public and private sectors. The Institute will comply with Colorado and Federal laws in its work with cannabis and components thereof.

Last spring/summer (2016), CSU Pueblo was awarded two different funding sources… (1)Pueblo County Excise Tax monies ($270K total) (a) $220K for ‘medical marijuana’ research (3 projects) (b) $50K for ‘impact study’ (4 impact studies: social and economic impacts of legalization of recreational cannabis; buffer zone study; water and power usage study) Status: contract for (a) has been finalized, research underway; contract for (b) being finalized (2) Funding for ‘Institute of Cannabis Research’ from state ($900K total) (a) to fund conference, journal, research Status: approval for $900K for 1 yr from JBC, house, senate, signed by governor in early June, MOA with Colorado Department of Public Health and Environment (CDPHE) in collaboration with Colorado’s Director of Marijuana Coordination. Funding

Year One Activities (through Dec. 2017) County-funded research: Observational human studies (studies of those with drug-resistant seizure disorder who self-report use of marijuana and equip them with E4 wristbands to monitor their electrodermal and seizure activity); Fundamental neuroscience [analyzing certain receptors in mammalian neurons, e.g. the effects of cannabidiol (CBD) on stimulation of 5HT1A receptors in mammalian neurons (important for understanding the effects of CBD in the limbic system, including the amygdala and hippocampus, i.e. the brain areas involved with fear and memory and partly implicated in Post-Traumatic Stress Disorder]; Social and economic impact studies that relate to the legalization of recreational cannabis in Pueblo county; Water and power usage related to various hemp, medical and recreational cannabis grow operations within the county; Cross-contamination issues between low and high THC cannabis.

State-funded research: Will include research in neuroscience and social and economic studies more expansively, for instance: studies that include hemp-based work [e.g. the efficacy of hemp for phytoremediation (bioaccumulation and sequestration of heavy metals such as selenium) identification and quantification of novel compounds in cannabis]. State-funded research will be undertaken in conjunction with entities such as the State of Colorado’s Office of Marijuana Coordination and the Colorado Department of Public Health and Environment, and the Colorado Energy Office. Other sources of funding for research projects may develop during year 1. Year One Activities (through Dec. 2017)

Research Needs Jail and probation terms tied specifically to marijuana arrests Probation violations tied to marijuana usage Human services impacts Drug use impacts on parenting Drug use impacts on youth at risk Comprehensive DUI linked to toxicology results Crash data, including property and injury factors, linked to toxicology results Fatalities linked to comprehensive toxicology data that could indicate impairment School discipline linked to marijuana specifically Marijuana as a substitute or complement to alcohol, tobacco, opioid and prescription drugs