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Of all the candidate races and issues on next month’s general election ballot, Florida’s Constitutional Amendment No. 2 — the infamous medical marijuana and Charlie Crist-John Morgan get-out-the-vote initiative — will likely generate as many, if not more, votes than the Crist-Rick Scott gubernatorial race.
We all wonder: Will Florida end up going to pot just like Colorado?

Come on. We’re all smart enough to realize where all of this is headed. Medical marijuana is Step 1. Colorado is Step 2. Regulating marijuana nationally like cigarettes and alcohol will be Step 3.

And let’s face it: We know that no matter what regulations the Legislature devises, if voters approve medical marijuana, people will skirt the regulations for profit. (Remember pill mills?)

But before Floridians decide to take the first step, perhaps they would benefit from knowing more about the likely consequences of accessible marijuana.

Christian Thurstone, M.D., an attending physician with the Adolescent Substance Abuse Treatment, Education, and Prevention Program at Denver Health, wrote last month for Colorado’s Centennial Institute, “The Big Deal — How Marijuana Endangers Young People and What Policymakers Should Do.”

Here are key excerpts:

RATES OF ADOLESCENT MARIJUANA USE AND ADDICTION
There is no debate among reputable scientists: Marijuana is addictive and more potent than ever. Its use is the No. 1 reason young people in the United States are admitted for substance-abuse treatment.

For adults, it’s the No. 2 reason, behind alcohol.

We’re no longer talking the weed of Woodstock, either. That’s when the content of marijuana’s active and intoxicating ingredient, THC, hovered around 3% …

Today, Colorado’s hundreds of dispensaries commonly sell strains of marijuana with THC levels exceeding 15%.

Concentrates — called “hash oil” and typically infused into foods called “edibles” — often exceed 80% THC. Many Colorado teens refer to concentrates as “the crack cocaine of marijuana.”…

Marijuana use in the United States peaks at age 20, followed by ages 19 and age 18, according to the National Survey on Drug Use and Health.

… Of those who try the drug before age 18, one in six will become addicted to it (Hall and Degenhard, 2009, Lancet 374:1383-1391) …

Adolescent marijuana use has increased as our country has loosened marijuana laws to accommodate the drug for medical and optional use.

Today, 6.5% of high school seniors nationwide — that’s not including younger students with the same problem — report smoking marijuana daily … In 2013, past-month marijuana use by the nation’s eighth, 10th and 12th graders jumped 1.2%, 4.2% and 3.3%, respectively, over the previous year.

Colorado’s past-month marijuana use rate of 10.7% among youth ages 12 to 17 is the fifth highest in the country and significantly higher than the national average of 7.6%.

If Denver Public Schools were a U.S. state, it would have the highest marijuana use rate in the country, according to analyses of Centers for Disease Control and Prevention’s Youth Risk Behavior Survey.

All of this means … the vast majority of lifelong, heavily using customers … start their drug habits as kids.

WHY MARIJUANA IS ESPECIALLY HARMFUL TO THE DEVELOPING BRAIN
The brain isn’t fully developed until about the age of 25, making young people especially vulnerable to addiction…

The brain matures from the bottom up and from the front back … It means the parts of our brain that drive up our desire to seek pleasure, rewards, thrills and adventure outpace development of the areas that help us stop what we’re doing long enough to think through the potential consequences of our actions.

In other words, the adolescent brain craves pleasure and doesn’t know how to weigh risks or say enough is enough as well as an adult brain. It has a great gas pedal and poor brakes.

ADVERSE HEALTH IMPACTS FROM CHILD MARIJUANA EXPOSURE AND USE
By age group, here are some of the prominent research findings about marijuana’s impact on child health.

• Marijuana and pregnancy:

Marijuana exposure during the first trimester of pregnancy has been found to be especially dangerous to the developing fetus. It’s also important to note that the first three months of pregnancy are when women are least likely to know they’re pregnant.

• In utero marijuana exposure is associated with:

• IQ loss of up to five points by age 6.

• Increased depression at age 10.

• Increased hyperactivity, impulsivity, inattention at age 10.

• Increased odds of marijuana use by age 14, heavier marijuana use.

• Lower achievement at age 14.

• Marijuana and adolescence:

• Permanent IQ loss. Heavy use starting in adolescence predicts up to an eight-point irreversible IQ drop from age 13 to 38.

• A two-fold increase in risk of psychosis in adulthood …

• Daily adolescent use or cannabis dependence predicts a doubling in odds of having anxiety disorder at age 29.

• Poor school performance. Adolescents who use marijuana by age 15 are 3.6 times less likely to graduate from high school, 2.3 times less likely to enroll in college and 3.7 times less likely to get a college degree.

• Teenagers who use marijuana before having sex are half as likely to use a condom.

• Adolescent marijuana use is associated with aggression.

• Adolescent marijuana use predicts two times the risk of using other drugs.

SIX POLICY RECOMMENDATIONS
To combat the harms of marijuana legalization, Colorado communities — and elected leaders — should consider an array of strategies. Here are six urgent ones:

One: Opt out of retail sales of marijuana
Amendment 64 permits municipal and county governments to opt out. This is crucial because we know that the commercialization of substances leads to increased use.

Two: Demand adequate data collection
Colorado must be honest about how marijuana legalization affects citizens — and the rest of the nation. Anyone who wishes to mitigate and/or correct problems associated with the drug’s use must know the scope and scale of those problems. But so far, the state of Colorado’s data collection and public reporting related to marijuana use and abuse have been poor.

Three: Further restrict marijuana packaging and serving sizes
Highly potent edibles already have proven to be more than problematic. Two deaths are attributed to their use …

Four: Raise the minimum age for use of marijuana and other legal, addictive drugs
In the world of adolescent brain health, the legal ages of 18 and 21 still mean the brain isn’t fully mature and is especially vulnerable to addiction.

Wouldn’t now be a smart time for Colorado to also raise the minimum tobacco-smoking age to 21 — if not higher?

Five: Adequately fund and monitor drug-abuse prevention and early intervention programs
Because more than half of Colorado’s high school seniors have used marijuana at least once in their life, we also need early intervention and access to treatment.

Six: Learn from Sweden and put children first
Sweden once had one of the world’s most permissive approaches to drug use — complete with government-funded “clean rooms,” where heroin addicts could shoot up — and one of the world’s highest rates of drug addiction.

Swedish officials eventually determined that if they wanted different results, they needed a radically different approach to drug use and drug policy-making.

Today, Swedish drug policy … holds real promise as a model for many other nations … What did Sweden do?

Many things — including the development of zero-tolerance laws and robust care for people struggling with addiction.

But most critical was … national officials have shifted the paradigm of their drug policymaking to this very different starting point: What is in the best interests of children — young people who are especially vulnerable to addiction because of their developing brains and who will, eventually, grow up to lead our nation?

“Put childen first” — the cliché American policymakers so often cite but ignore, made real for once in a Scandinavian setting.

What an obvious shift — yet what a bold and brave shift … Remarkable.

So if Sweden can do it, why can’t Colorado?

For a complete copy of Dr. Thurstone’s report, go to:

ccu.edu/uploadedFiles/Pages/Centennial_Institute/thurstone%20policy%20brief%20final%200826.pdf.

Dr. Thurstone can be reached at [email protected].