MAT­TER OF PUBLIC HEALTH

Study: Rise in il­licit use in states with med­i­cal pot laws

The Washington Times Daily - - NATION - BY LAURA KELLY

Re­searchers have con­cluded that med­i­cal mar­i­juana laws are a con­tribut­ing fac­tor to in­creased il­le­gal use and abuse of the drug.

In a study pub­lished Wednesday in the Jour­nal of the Amer­i­can Med­i­cal As­so­ci­a­tion (JAMA) Psy­chi­a­try, re­searchers noted a sig­nif­i­cant in­crease in il­le­gal cannabis use and so-called cannabis-use dis­or­ders in states with med­i­cal mar­i­juana laws.

“Given the po­ten­tial con­se­quences of use and per­sis­tent dis­abil­ity as­so­ci­ated with cannabis use dis­or­ders, this rep­re­sents a se­ri­ous public health prob­lem,” the sci­en­tists wrote.

Twenty-nine states and the District of Columbia have en­acted med­i­cal mar­i­juana laws. Eight states and the District have recre­ational pot laws.

Mar­i­juana or a form of it is used to treat sev­eral con­di­tions — from al­le­vi­at­ing painful side ef­fects in­clud­ing: can­cer treat­ment or other fa­tal dis­eases, con­trol­ling seizures, as a mus­cle re­laxer, treat­ing post-trau­matic stress dis­or­der, in­som­nia and anx­i­ety.

“Med­i­cal mar­i­juana laws may ben­e­fit some with med­i­cal prob­lems. How­ever, chang­ing state laws (med­i­cal or recre­ational) may also have ad­verse public health con­se­quences,” the re­searchers wrote.

They con­clude that pro­fes­sion­als and the public should be ed­u­cated on the risks of cannabis use and the ben­e­fits of treat­ment.

The study, ti­tled “U.S. Adult Il­licit Cannabis Use, Cannabis Use Dis­or­der, and Med­i­cal Mar­i­juana Laws 1991-1992 to 2012-2013,” de­fines il­licit use as ob­tain­ing mar­i­juana not from a pre­scrip­tion or a dis­pen­sary with the in­tent of get­ting high. Cannabis-use dis­or­ders are de­scribed as with­drawal symp­toms, de­vel­op­ing a tol­er­ance for the drug, hav­ing crav­ings for the drug and suf­fer­ing im­paired func­tion­ing in daily ac­tiv­i­ties.

Among states with some sort of med­i­cal mar­i­juana law, il­licit use of cannabis in­creased more than in states that had no mar­i­juana laws, the study found. Re­ported abuse of cannabis also in­creased at a higher rate in states with med­i­cal mar­i­juana laws that those that didn’t.

“Amer­i­cans … they’ve come to see cannabis as a harm­less drug or a harm­less sub­stance,” said lead au­thor Dr. Deb­o­rah Hasin, pro­fes­sor of epi­demi­ol­ogy at Columbia Univer­sity Mail­man School of Public Health.

Dr. Hasin added that more education is needed about the risks as­so­ci­ated with cannabis use.

“The down­sides of legalization can be ad­dressed if state laws have reg­u­la­tions to, per­haps, limit the amount of dis­pen­saries or stores or ad­ver­tise­ments or ways it can be di­verted to peo­ple who are not adults, things in the laws and way to en­force them, likely to mit­i­gate [the find­ings],” she said.

For their study, re­searchers ex­am­ined data from three cross-sec­tional U.S. adult stud­ies of 118,497 re­spon­dents be­tween 1991 and 1992, 2001 and 2002, and 2012 and 2013. The time pe­ri­ods were sig­nif­i­cant in that no states had mar­i­juana med­i­cal laws be­tween 1991 and 1992.

In 2001-2002, 18.9 per­cent of Amer­i­cans lived in states with med­i­cal mar­i­juana laws, and one-third of Amer­i­cans lived in states with med­i­cal mar­i­juana laws be­tween 2012 and 2013.

The 15 states with med­i­cal mar­i­juana laws: Ari­zona, Cal­i­for­nia, Colorado, Con­necti­cut, Maine, Mary­land, Mas­sachusetts, Michi­gan, Mon­tana, Nevada, New Jersey, New Mex­ico, Ver­mont, Ore­gon and Wash­ing­ton.

The states that, up un­til 2013, never had med­i­cal mar­i­juana laws: Alabama, Arkansas, Florida, Ge­or­gia, Illi­nois, In­di­ana, Iowa, Kansas, Ken­tucky, Louisiana, Min­nesota, Mis­sis­sippi, Mis­souri, New York, North Carolina, Ohio, Ok­la­homa, Penn­syl­va­nia, South Carolina, Ten­nessee, Texas, Utah, Vir­ginia and Wis­con­sin.

The re­searchers note a grow­ing ac­cep­tance of mar­i­juana could have yielded more af­fir­ma­tive re­sponses in later sur­veys, but they point out that the in­crease of re­ported abuse of mar­i­juana sup­ports their con­clu­sion.

The re­searchers also note that Cal­i­for­nia and Colorado war­rant sep­a­rate anal­y­sis as mar­i­juana use in Cal­i­for­nia was much more preva­lent be­fore it en­acted med­i­cal cannabis leg­is­la­tion in 1996.

Like­wise, Colorado ap­proved med­i­cal mar­i­juana in 2000, and leg­isla­tive changes be­tween 2009 and 2010 saw an in­crease in med­i­cal user ap­pli­ca­tions — from 500 per month to greater than 10,000 per month — and from no known dis­pen­saries to greater than 900, the re­searchers wrote.

“I was some­what sur­prised with rates that in­creased so sharply in Colorado and Cal­i­for­nia, who most ex­pe­ri­enced in­crease in dis­pen­saries in 2009 and 2010,” Dr. Hasin said.

AS­SO­CI­ATED PRESS PHO­TO­GRAPHS

Ac­cord­ing to a new study, states that have med­i­cal mar­i­juana laws have seen an in­crease in il­licit use and abuse of the drug. Med­i­cal pot is le­gal in 29 states and the District. Ac­tivists, like those pic­tured, are fight­ing to have pot le­gal­ized in all 50 states.

Re­searchers pub­lished a study say­ing that med­i­cal pot may have ad­verse public health con­se­quences. Smok­ing pot in public is il­le­gal in the District.

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