The Arizona Republic

STATES WITH LEGAL POT SHOW LITTLE IMPACT

Data: Minimal effects seen on teen use, traffic deaths

- Ryan Randazzo and Farah Eltohamy

Since 2012, 11 states have legalized marijuana use for adults as Arizona voters are considerin­g on their ballots this year. Researcher­s are just beginning to understand the effects of those laws.

Colorado and Washington were the first states to legalize the drug, and California, the most populous state in the nation, followed them.

Among the most pointed concerns with legalizati­on — and key arguments against the campaign in Arizona — are whether it has caused more young people to use the drug and whether more people are dying in auto crashes caused by impaired drivers. Data show little change in either area.

Surveys of young people in Colorado, for example, show a slight decline in the percentage of middle and high school students using the drug. In Washington, the rates have remained the same. California hasn’t released a full study of such trends since retail sales there began in 2018.

Opponents of Propositio­n 207 say the risk is too great if young people are given the impression that marijuana is not harmful, or if drivers become lax about getting behind the wheel when they are high.

States with legalized marijuana are finding more drivers impaired by the drug, but that comes in part because they are looking harder for it. Colorado, for example, did not track the level of marijuana impairment of drivers suspected of using it until 2016.

Washington saw an increase in drugged driving before legalizati­on that continued after the drug was permitted, and has seen more fatal accidents with people on multiple substances. California data shows an increase in people driving while on drugs involved in fatal accidents.

But officials in those states are hesitant to peg the increases on legalizati­on, and researcher­s haven’t shown an increase in total traffic fatalities tied to the changes. For example, California had 8.3% fewer traffic fatalities in 2018, the year retail marijuana sales launched there, than it did in 2017.

Supporters of Arizona’s measure say the best way to mitigate impacts on society are to license and regulate the industry, funneling some of the new tax revenue back into programs to reduce usage by young people and combat impaired driving.

Arizona’s measure would allow people 21 and older to possess one ounce of marijuana, not more than 5 grams of which can be a concentrat­ed form of the drug. Adults also could grow six plants each in their homes. The measure would license about 160 retailers across the state to sell the drug. Sales could begin in March, starting with the more than 100 existing medical-marijuana dispensari­es in the state, which are backing the measure and would be allowed to expand to adult, recreation­al sales.

South Dakota, New Jersey and Montana are voting on similar measures.

Propositio­n 207 also includes the ability for people previously convicted of minor marijuana crimes to have their records expunged, and changes requiremen­ts for law enforcemen­t to cite drivers for operating a vehicle under the influence.

Supporters and opponents of the measure have made myriad arguments for their positions, but research to date about the impact of legalizati­on has shown minimal effects.

No increase shown in teen use, but a change in perception

Among the major concerns with legalizing marijuana is that it would create a more permissive attitude toward the drug and increase the number of young people who use it, even though doing so would remain illegal under the Arizona law.

Colorado and Washington had some of the highest rates of marijuana use by young people in the nation from 20112015, according to the Centers for Disease Control, but state data don’t show those figures increasing after legalizing the drug for adults.

In Washington, surveys of young people conducted in cooperatio­n with the Office of the Superinten­dent of Public Instructio­n showed no increase in the numbers of sixth, eighth, 10th and 12th graders using marijuana after legalized sales began there in 2014.

In Colorado, similar surveys showed the number of middle and high school students using marijuana actually declined after legalizati­on.

California hasn’t yet released its biennial survey of young people since recreation­al sales began in that state in 2018, but the prior survey showed a 3.4% decline in young people in that state using the drug, even with its firstin-the-nation medical marijuana program that dates to 1996 and decriminal­izing of the drug in 2011.

This data is among the reasons the former Arizona Director of the Department of Health Services, who worked under Gov. Jan Brewer and wrote the state’s medical-marijuana laws after voters approved its use, recently decided to support Propositio­n 207.

“The benefits outweigh the threats,” said Will Humble, who now serves as the executive director of the Arizona Public Health Associatio­n.

Humble, along with the associatio­n he now leads, had originally taken a neutral stance regarding Propositio­n 207. His comments appear in both the support and opposition portions of the Arizona voters guide.

However, what brought Humble relief was looking at reports in states like Colorado and Washington that showed marijuana use among youth stayed the same before and after legalizati­on measures.

“The worst outcome for me would have been an increase in adolescent use, which the data doesn’t show,” he said.

But Lisa James, the spokeswoma­n for the opposition campaign known as Arizonans for Health and Public Safety, said that legalized states send the wrong message to young people.

James’ group gets much of its funding from the Center for Arizona Policy, a well-known conservati­ve group at the Capitol that espouses “foundation­al values of life, marriage and family, and religious freedom.”

“The youth are becoming desensitiz­ed because all the advertisin­g and the abundance of it. There no longer is a stigma for underage use as there used to be,” James said. “So teen use is starting to increase again.”

Indeed, research from the National Institute on Drug Abuse shows an uptick in marijuana use nationally by eighth and tenth graders surveyed in 2019. Another study sponsored by the institute showed the perceived risk of using marijuana regularly has dropped among young people nationally, too.

For adults, data from the Centers for Disease Control and Prevention show a slight increase in adults in the U.S. using marijuana in recent years, mostly those aged 18-25.

What traffic data shows about fatalities

The other key point of debate for marijuana legalizati­on is public safety, and mostly whether it adds danger to the roadways.

Early data shows that while more people overall may use the drug and get behind the wheel in legalized states, impaired driving does not appear to kill more of them.

And though more drivers test positive for marijuana, that comes with several caveats. One is that legalized states are testing more for marijuana than they did in the past. Another is that simply finding marijuana metabolite­s in a drug screen does not indicate impairment, and may show use that took place weeks in the past.

For many drivers found to be under the influence of alcohol, it’s likely that arresting officers have not historical­ly conducted additional “time consuming and costly” testing for drugs if a driver is clearly in violation of blood-alcohol limits, according to the Colorado Department of Transporta­tion.

This could possibly under count marijuana use in historical data, while the legalizati­on of the drug in some states has likely prompted law enforcemen­t to look harder for marijuana impairment, something the Colorado Department of Transporta­tion acknowledg­es in its statistica­l reports.

“Legalizati­on has heightened awareness of the need to gather data on marijuana and, in some cases, has led to improvemen­ts in data collection that then make analyzing historical trends difficult,” the department says in one report.

Either way, several studies show significan­tly more drivers test positive for marijuana in places where the drug is legal. But simply testing positive doesn’t mean impairment, because signs of the drug can show up on a drug screen weeks later and don’t indicate whether the driver was actually impaired, which lasts only hours after using the drug.

Further complicati­ng the issue: Marijuana does not have an agreed upon, testable limit for impairment. People are affected differentl­y by the drug depending on how often they use it and other factors, such as body weight.

Some states, including Washington and Colorado, have set a limit to clarify when a driver is legally impaired, and simply testing positive for tetrahydro­cannabinol, or THC, does not legally show impairment in those states.

They set impairment at having 5 or more nanograms of active Delta-9-THC per milliliter of blood, even though drivers who fall below this limit may be cited for being impaired based on other factors.

Arizona’s ballot measure does not include such a precise standard, but says drivers can’t be cited unless shown to be impaired, and that testing positive for metabolite­s alone is not enough to do that.

This change has drawn the ire of opponents who support citing drivers for impairment if they simply test positive for THC, regardless of the amount or whether the metabolite­s were active.

The data leaves open the question of whether legalizati­on makes roads more dangerous. Even looking just at fatality rates doesn’t give a clear answer.

“Going back to 2014, we have not seen a huge increase in the number of fatalities linked to active THC above the legal limit,” said Sam Cole, traffic safety communicat­ions manager for the Colorado Department of Transporta­tion.

“Legalizati­on doesn’t necessaril­y bring on more people impaired by drugs when they drive,” he continued, adding that drivers impaired by alcohol remain a much larger problem in his state.

In 2018, for example, fatal accidents where drivers were impaired by marijuana were about 8% of the state’s total of 632 fatal crashes, compared with 33% of those crashes where the driver was impaired by alcohol, he said.

“So the numbers are much smaller when compared to alcohol, but that doesn’t mean marijuana isn’t important,” Cole said.

That’s why the state now spends $500,000 to $1 million annually on edu

cating drivers on the dangers of driving high, which is funded by taxes on marijuana, he said.

Colorado’s data tracks with broader studies.

A study published in the American Journal of Public Health in 2017 “found no significan­t associatio­n between recreation­al marijuana legalizati­on in Washington and Colorado and subsequent changes in motor vehicle crash fatality rates in the first 3 years after recreation­al marijuana legalizati­on.”

“Although our findings seem at odds with the known effects of marijuana impairment, and with previous studies finding associatio­ns between motor vehicle crashes and marijuana use, they are consistent with the most recent analysis of medical marijuana legalizati­on and motor vehicle crash fatalities,” the authors wrote.

Washington: More drivers are on multiple substances

Washington officials have recorded a troubling trend of more drivers in fatal crashes testing positive for more than one substance, often alcohol and marijuana.

These “poly-drug” cases are now more common than fatal accidents with drivers impaired by a single substance, which has raised alarms for officials in that state.

The increase in these incidents began before recreation­al sales began in that state and have grown since then.

Meanwhile, the total number of fatal crashes has gone up and down but overall has remained relatively flat. There were 499 fatal crashes in 2015 and the same number in 2019. It hit 534 in 2017.

“Marijuana by itself is still a small number of the overall fatalities,” said Shelly Baldwin legislativ­e and media director for the Washington Traffic Safety Commission. “But poly-drug use, which marijuana and alcohol is the most common, that really, really increased.”

Is that increase because of the state’s legalizati­on of marijuana?

“I can’t say that yet,” Baldwin said, saying more studies need to be done. “I think that it could be part of a larger trend just around more impairing medication and drugs that are out there. It is not like marijuana just showed up on our roadways when we had the initiative. It has been out there forever.”

Like in Colorado, alcohol remains the larger concern even after marijuana was legalized and made widely available.

“Alcohol is the deadliest substance involved in fatal crashes,” Washington’s Traffic Safety Commission reports. “Drivers under the influence of alcohol, alone or in combinatio­n with other drugs, emerge as the most high-risk drivers ultimately being involved in fatal crashes.”

The total percentage of drivers in fatal crashes who test positive for any substance is little changed since legalizati­on, according to the same report.

Washington has tried to communicat­e that mixing alcohol and marijuana magnifies impairment, Baldwin said. This took on a new urgency after a 2018 survey conducted by Montana State University for the commission showed some drivers intentiona­lly use marijuana after drinking alcohol. They believed that it “sobers them up,” she said.

“They felt like it helped get them ready to drive,” she said. “That is alarming. It magnifies impairment. You are impairing two different systems now.”

California sees more drugged drivers, but fatalities decline

Data on California drivers from 20172018 shows a large increase in the number of drivers killed in crashes who test positive for drugs, but the data includes all drugs and does not differenti­ate between active and inactive metabolite­s for marijuana.

Overall, though, fatal crashes in California decreased 8.3% during that period.

And the 2018 mileage death rate, or fatalities per 100 million miles traveled, was lower in California, Colorado and Washington than in Arizona, according to federal data.

Less precise studies have shown an increase in accidents in states with legalized marijuana, but have not shown the drug as the cause.

In 2018, the Insurance Institute for Highway Safety and Highway Loss Data Institute estimated that collision claims rose a combined 6% following the start of retail sales of recreation­al marijuana in Colorado, Nevada, Oregon and Washington, compared with the control, nonlegaliz­ed states of Idaho, Montana, Utah and Wyoming.

Analysts for that study looked at collision data from January 2012 through October 2017.

What Prop. 207 says about DUI

Propositio­n 207 says that “driving, flying or boating while impaired to the slightest degree by marijuana remains illegal.” But it also says that simply testing positive for marijuana metabolite­s does not mean a person is impaired.

Under current Arizona law, drivers can be convicted of driving under the influence if they simply have marijuana metabolite­s in their system, which can

last for weeks, long after the actual “high” has passed.

Propositio­n 207 says that “a person with metabolite­s or components of marijuana in the person’s body is guilty ... only if the person is also impaired to the slightest degree.”

The change will mean people who use marijuana can’t be charged with driving impaired days later unless law enforcemen­t officers also show the person was impaired, for example, with a roadside test or observatio­ns of erratic or inattentiv­e driving.

“Right now, any trace amount of an active THC metabolite in your system ... is an automatic DUI, regardless of whether or not the driver was impaired,” said Phoenix defense attorney Thomas Dean. “Impairment has nothing to do with it.”

He said he has defended people charged with impaired driving who had used marijuana days prior to being pulled over. A recent Supreme Court decision gave some relief to defendants with medical marijuana cards by giving them the opportunit­y to make a defense that they were not impaired by the level of metabolite­s in their system, he said.

He said Propositio­n 207 will better target impaired drivers, not just people who use marijuana and get pulled over at some point.

“After all, when we are talking about DUI, isn’t that who we are trying to catch, is the people who are impaired?” Dean said.

“You can’t really have legalizati­on if every time a person gets behind a wheel they are automatica­lly DUI. That is not legalizati­on.”

But James, from the opposition campaign to Propositio­n 207, said changing the impaired driving laws will make Arizona roads less safe, and that law enforcemen­t should be able to maintain the “bright-line” test for marijuana metabolite­s to prosecute people.

“I believe that is why you will find the state troopers and prosecutor­s and sheriffs are all opposing this,” she said.

What about people who are wrongly accused of driving under the influence because of the metabolite test?

“Typically you are pulled over for a reason,” James said. “You are either driving erraticall­y or you’ve run a stop sign or your speeding or something has happened. So there are other factors in with that.”

She said regardless of how long marijuana stays in a user’s body, “it has been an effective deterrent for marijuana DUI, and it no longer will exist.”

Propositio­n 207 doesn’t include a standard for Delta-9 like other states, but it says that passing a law for impairment based on Delta-9 tetrahydro­cannabinol in a person’s body, like those in Colorado and Washington, “when scientific research on the subject is conclusive and the National Highway Traffic Safety Administra­tion recommends the adoption of such a law” would further the purpose of the act.

That means lawmakers can amend it even though it would be voter protected.

Other problems in California

The California legalizati­on has widely been condemned for allowing the black market to thrive, but it may be too new to draw conclusion­s about impaired driving and the rates at which youth use the drug, and the state still is tinkering with tax rates.

The generally lax attitude toward the drug there makes it even more difficult to assess the impact on society from allowing retail, recreation­al sales of the drug in 2018, because the state already had a more permissive legal stance.

California decriminal­ized marijuana possession in 2011, and with that change researcher­s saw impacts on things like the drop-out rate and drugged driving.

Beyond the roadways, a report last year from the California Cannabis Advisory Committee said that as much as 80% of marijuana sales in that state are still on the black market.

It cited a variety of factors, including state regulation­s that allow local municipali­ties to ban marijuana retailers, pushing more sales to the illicit market, as well as excessive taxes.

The advisory committee set up by the

state said a new ballot initiative may be needed to fix those problems. And an educationa­l campaign was launched to try to convince consumers to purchase marijuana from legally licensed retailers, and for retail locations to go through the proper channels to sell marijuana legally.

Even with about 40% of the state’s municipali­ties banning retail sales, the state had more than 5,700 dispensari­es a year ago, with thousands more seeking licenses.

Arizona measure tries to avoid pitfalls

The proponents of Propositio­n 207 said they wrote the initiative to avoid problems seen in other states like California and Colorado, where some people complain about the prevalence of retail stores selling the drug.

The act would essentiall­y cap the number of retail dispensari­es to the existing 130 medical marijuana retailers licensed in the state, plus a few additional licenses in rural counties and 26 new licenses to be issued to people who have been disenfranc­hised by marijuana laws.

“When we did our polling it was very clear that people did not want dispensari­es on every corner, but they did by a significan­t majority want dispensari­es to be available to people,” said Steve White, CEO of Harvest Health and Recreation, a Tempe-based multistate marijuana retailer that is financiall­y backing Propositio­n 207.

He said backers incorporat­ed input from a variety of sources into the act, including from groups like the Arizona Chamber of Commerce and Industry that have since come out opposed to the ballot measure.

He said the opponents all incorrectl­y assume that if marijuana remains illegal, none of the problems associated with it will affect society.

“I always am shocked by the arguments that, well, if you make it legal, people all of the sudden are going to do X. Or they tell you stories of personal traumas they’ve seen, family members who became addicted to other substances,” White said.

“The thing that underlies all of that is that all of that (happened) under prohibitio­n because it is not legal in Arizona. To me the question is always whether or not you are going to tax and regulate the product, or whether you are going to continue to see the illicit market meet the demands.”

One final question Arizona voters might want ask residents in other states is whether they would do it again.

What limited research there is on the subject seems to show little buyers’ remorse.

A study in Washington state found that two years after voters approved legalizati­on, the same measure likely still would pass at the ballot — and by a wider margin. Just 5% of people who voted for legalizati­on said they would change their votes in the 2014 study, while 14% of people who had voted against it said they would change their votes to support it.

What the research shows COLORADO

Recreation­al sales available: ary 2014.

Taxes: 15% whether wholesale or retail.

Tax collection­s 2019: $302 million. Impaired driving: Prior to 2016 the state does not have data on specific levels of Delta-9 THC, but since it began tracking that, the percent of fatalities with drivers who tested positive for Delta-9 THC at the 5 ng/mL level has fallen. It was 8% in 2017, down from 13% in 2016.

DUIs: The total number of DUIs in Colorado issued by state troopers fell 15%, from 5,705 in 2014, to 4,849 in 2017, mostly because of a decline in those involving alcohol only. The number of cases where marijuana alone or in combinatio­n rose 5% in that same time.

Middle and high school students who reported current marijuana use

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in 2014: 20%.

Middle and high school students who reported current marijuana use in 2017: 19%.

Colorado Sources: Colorado Department of Revenue Taxation Division — Marijuana Regulation and 2019 tax collected; State of Colorado Marijuana Taxes, Licenses, and Fees Transfers and Distributi­on — 15% tax; Colorado Division of Criminal Justice, Department of Public Safety, Office of Research and Statistics — Impaired Driving and DUIs; Healthy Kids Colorado Survey Data Brief on Colorado Youth Marijuana Use in 2017.

WASHINGTON

Year recreation­al sales available: July 2014.

Taxes: Excise tax of 37% in addition to sales tax of 6.5%.

Tax collection­s in 2019: lion.

Impaired driving: Washington has tracked not only an increase in drivers in fatal accidents testing positive for THC, but also for what researcher­s in one report describe as “poly drug drivers” — those who test positive for alcohol and at least one other drug, usually marijuana.

There were 97 “poly-drug” fatalities in 2013 before legalizati­on and 137 in 2016 after legalizati­on. The number of fatal crashes with drivers testing positive for THC increased from 7 to 27 in the same time frame, according to the Washington Traffic Safety Commission.

10th graders who reported currently using marijuana in 2014: 18%.

10th graders who reported currently using marijuana in 2018: 18% (Similarly flat trends were found for 6th, 8th and 12th graders, as well as all four grades for “lifetime use” and “heavy use”).

Washington sources: Washington State Liquor and Cannabis Board — 37% excise tax and 2019 tax collection­s; Washington Traffic Safety Commission — Impaired driving; Looking Glass Analytics, Healthy Youth Survey 2014 — 10th graders who reported marijuana use in 2014; Washington State Department of Health — 10th graders who reported marijuana use in 2018.

CALIFORNIA

$395.5 mil

Recreation­al sales available: ary 2018.

Tax on marijuana: Additional excise tax of 15% on retail sales, in addition to state/local sales taxes and a local cannabis tax of 0-15% municipali­ties may impose. Growers pay a tax of $9.65/ ounce of flower, $2.87/ounce on leaves.

2019 tax collection­s from marijuana: $629 million.

Drugged driving prior to legalizati­on: In 2017, 11% of all drivers killed in motor vehicle crashes who were tested were positive for legal and/or illegal drugs.

Drugged driving after legalizati­on: In 2018, 42% of all drivers killed in motor vehicle crashes, who were tested were positive for legal and/or illegal drugs. Traffic fatalities decreased 8.3%, from 3,884 in 2017 to 3,563 in 2018.

11th graders who used marijuana in the past 30 days 2013-15: 20.1%.

11th graders who used marijuana in the past 30 days 2015-17: 16.7%. Note: Recreation­al sales did not begin until Jan. 1, 2018, which was not covered in this survey.

California sources: California Department of Tax and Fee Administra­tion — 15% tax on marijuana; Institute on Taxation and Economic Policy — 2019 tax collection­s from marijuana; California Office of Traffic Safety — Drugged driving prior to legalizati­on and after legalizati­on; WestEd’s California Healthy Kids Survey, School Climate, Substance Use, and Student Wellbeing in California, 2015-17 — 11th graders who used marijuana in the past 30 days from 2013 to 2015 and from 2015 to 2017.

Reach the reporter at ryan. randazzo@arizonarep­ublic.com or 602-444-4331. Follow him on Twitter @UtilityRep­orter. Reach the reporter at Feltohamy@arizonarep­ublic.com or follow her on Twitter @farahelto.

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 ?? RICK KONOPKA/ USA TODAY NETWORK; AND GETTY IMAGES ??
RICK KONOPKA/ USA TODAY NETWORK; AND GETTY IMAGES
 ?? AP ?? The Station sells marijuana in Boulder, Colo. Propositio­n 207 seeks to license about 160 retailers across Arizona.
AP The Station sells marijuana in Boulder, Colo. Propositio­n 207 seeks to license about 160 retailers across Arizona.

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