State health report looks at the negatives of cannabis use


The Colorado Department of Public Health & Environment Monday released a review on health issues related to cannabis. “Monitoring Health Concerns Related to Marijuana in Colorado: 2014 Changes in Marijuana Use Patterns, Systematic Literature Review, and Possible Marijuana-Related Health Effects” is mandated as part of Senate Bill 13-283, which demanded a health report to be finished at the end of January 2015 and updated every two years.

The report relies on four surveys: The 2013 Healthy Kids Colorado survey of middle and high school students, the 2013 Influential Factors for Healthy Living for Adults in Colorado, the 2012-13 National Survey on Drug Use and Health and a one-time, 2014 Tri-County Health Department survey of women, infants, children and cannabis use.

It covers a lot of territory: pregnancy risks, child health, race and ethnicity, regions, doses, mental health, birth defects, cancer rates, unintentional exposures and ingestion and respiratory effects among them.

There is no mention of medical marijuana anywhere in its 188 pages.

Among its findings: Fewer middle school students use marijuana than high school students; there is conflicting data on adolescent marijuana use in Colorado compared to national averages; past 30-day marijuana use among Colorado youth ages 12-17 is 11 percent higher than the national average; past 30-day marijuana use among Colorado high school students is 3 percent lower than the national average of 23 percent; there are significant racial, ethnic and sexual orientation disparities in the prevalence of use among adolescents, and adult marijuana use is higher in Colorado than in most other states.

None of these are conclusions. The authors admit up front that these figures should never be used to prove anything, no matter which side of the cannabis debate you happen to find yourself on. Survey results often come up with differing conclusions and numbers, and given that this was mandated, the result is little more than a baseline report, mostly outlining attitudes and patterns in the period before January 2014, when retail stores opened.

“For the most part, the doctors were trying to do a fair job of showing possible harms and health effects. I think they were acting in good faith,” says Mike Elliott of the Marijuana Industry Group. “We can all agree that marijuana can have negative health impacts. It’s the same thing with alcohol and prescription drugs and cheeseburgers and other things.”

Part of the problem is the lack of any earlier data to match up against. There were no questions about marijuana before 2014 on state publichealth surveys, including the Behavioral Risk Factors Surveillance System for adults, the Pregnancy Risk Assessment Monitoring System for pregnant women and new mothers, and the Child Health Survey for kids aged 1 to 14. “The new marijuana-related questions added to all of these surveys in 2014 are presented in this report,” it states. “However, results from these surveys will not be available until the fall of 2015.”

The report’s authors also admit up front that nothing in its pages can answer the question of how cannabis use has changed as a result of legalization. “However,” it concludes, “the data presented here provide a snapshot that allows us to begin to measure the public health impact.”

Perhaps. The authors remind us that since cannabis was illegal in the United States up until 1996, any official research into marijuana was only allowed to study the drug’s adverse effects. “This legal fact,” the report notes, “introduces both funding bias and publication bias into the body of literature related to marijuana use.”

Still, by not even mentioning medical marijuana anywhere in the report suggests the same kind of bias in this work. I realize that every study can’t be considered correct or be included. But there isn’t really one good thing to say about cannabis use in the entire document. It’s all about possible negative effects.

“It’s a helpful gathering of all that data,” Elliott says. “It would have been nice to have it look into medicinal benefits, which is a bit frustrating. It’s good to have the info, but I don’t think it’s going to have much impact.”

There is no mention of the state’s recent decision to fund eight medical marijuana studies that look at whether cannabis might help alleviate symptoms of adolescent inflammatory bowel disease, Parkinson’s tremors, PTSD, pediatric epilepsy and brain tumors. Results from those studies will take several years, probably after the next two-year state study will be produced.

Also important to note is that the report admits that none of the studies can absolutely prove a causality between cannabis use and adverse health effects. “Rather than continue to review existing evidence about marijuana, the state should start investigating whether allowing adults to use marijuana might result in less alcohol use and fewer alcohol-related problems,” says Mason Tvert of the Marijuana Policy Project. “Looking at marijuana in a vacuum does little to advance the dialogue.”

You can hear Leland discuss his most recent column and Colorado cannabis issues each Thursday morning on KGNU.

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