Dispensary

By John Ingold, The Denver Post

The number of teenagers going to the emergency room at Children’s Hospital Colorado for what appeared to be marijuana-related reasons increased significantly after legalization, a new study by a Children’s doctor found.

Dr. Sam Wang said his study contrasts with surveys that suggest youth marijuana use in Colorado has not increased since legalization. But he said the study also has its limitations, meaning it adds important data to the debate over legalization but is not the final word on it.

“Everything has to be taken with a grain of salt,” he said. “I don’t think one database is perfect. But this is just another way to look at the data that shows more teenagers are coming to the ER.”

Wang gathered data on marijuana-related emergency room visits to Children’s Hospital and its satellite clinics for teenagers and young adults up to age 21 by looking at two measures.

The first is a hospital billing code used on a patient’s chart when marijuana is involved in a patient’s medical problem. Wang said marijuana might not be the primary reason the patient went to the hospital, but marijuana usually has to be sufficiently connected to the patient’s symptoms to warrant the code being written down. He said it is unlikely the code would be put on a patient’s record for marijuana use unrelated to the symptoms.

The second measure is when a patient has a urine drug screen that comes back positive for marijuana. Such drug screens occur when a patient ingested an unknown substance or before a patient undergoes a psychiatric evaluation.

Collecting those numbers, Wang said he found that 106 teens and young adults visited Children’s emergency room for marijuana-related reasons in 2005 and that number jumped to 631 in 2014. The rate of those visits increased as well — though by 2015 marijuana still accounted for only four out of every 1,000 visits.

Perhaps most worrisome, Wang said he found that the number of kids and young adults in the emergency room for marijuana-related reasons and who subsequently needed a psychiatric evaluation also increased rapidly — from 65 in 2005 to 442 in 2014. Wang said patients who receive psychiatric evaluations may be severely intoxicated or may have tried to commit suicide or talked about committing suicide.

Colorado’s medical marijuana dispensaries began opening in large numbers in 2010, and Colorado voters legalized the sale and possession of limited amounts of marijuana for any purpose in 2012, with recreational stores opening on Jan. 1, 2014.

“Looking at the trend, it is definitely significant,” Wang said.

Wang’s study results were first presented earlier this month at an academic conference in San Francisco. He said he hopes to publish the findings in a journal later this year.

The findings add another layer to understanding how marijuana legalization has affected kids. Thus far, much of the survey data of Colorado teens has suggested little impact. Both state and federal surveys have found that Colorado teen marijuana use rates — though among the highest in the country — have remained flat since legalization.

“Our worst nightmares haven’t materialized,” Colorado Gov. John Hickenlooper said earlier this year of legalization.

In a previous study, though, Wang found that the number of young kids going to the emergency room for accidental marijuana exposure increased following legalization. He said his new study shows there is still more to learn about why a subset of kids is ending up in the hospital.

“We’re finding things contrary to other national survey data,” he said. “And so we feel like, to really better understand the impact in this particular population, I think we need to use multiple data sources.”

This story was first published on DenverPost.com

By Alicia Wallace, The Cannabist Staff

Colorado Reps. Diana DeGette and Mike Coffman have introduced a bill to protect states’ marijuana laws from federal enforcement.

The Respect States and Citizens Rights’ Act of 2017 aims to insert a provision into the Controlled Substances Act that would ensure against federal preemption of state law:

“(b) SPECIAL RULE REGARDING STATE MARIHUANA LAWS.–In the case of any State law that pertains to marihuana, no provision of this title shall be construed as indicating an intent on the part of the Congress to occupy the field in which that provision operates, including criminal penalties, to the exclusion of State law on the same subject matter, nor shall any provision of this title be construed as preempting any such State law.”

Related: Why the federal government still calls cannabis “marihuana”

The bipartisan bill is a reintroduction of legislation proposed by DeGette, a Democrat, and Coffman, a Republican, following Amendment 64’s passage in 2012.

Passing the bill “is now more important than ever before,” DeGette said in a statement, referring to signals that the Trump administration may bring greater enforcement against state marijuana laws.

“My colleagues and I — along with our constituents — spoke out frequently during the Obama administration to make clear we didn’t want the federal government denying money to our states or taking other punitive steps that would undermine the will of our citizens,” DeGette said in the statement. “Lately, we’ve had even more reason for these concerns, given Trump administration statements. This bill makes clear that we’re not going back to the days of raids on legal dispensaries, of folks living in fear that they’re not going to get the medical marijuana they need, or that they might get jailed for using it.”

Coffman, in a statement, argued that this issue is a matter of states’ rights:

“While I have opposed the legalization of marijuana, the people of Colorado voted for an initiative in 2012 that legalized marijuana and placed it in our state’s constitution. … Since this is clearly not a matter of interstate commerce, I believe that the people of Colorado had every right, under the U.S. Constitution, to decide this issue for themselves and as their representative in Congress, I have an obligation to respect the will of the people of Colorado and that’s why I’m reintroducing this bill with Congresswoman DeGette.”

The Cannabist has requested interviews with DeGette and Coffman.

This story is developing and will be updated.

By The Associated Press

SAN FRANCISCO — A federal appeals court has sidestepped making a ruling on whether U.S. prison officials can hold people who were convicted of marijuana offences that were legal under state medical marijuana laws.

In a decision Wednesday, the 9th U.S. Circuit Court of Appeals focused instead on a narrower issue.

The court was considering a legal challenge by prisoner Matthew Davies, who was convicted of federal marijuana charges. Davies said he ran medical marijuana dispensaries that complied with California law.

He argued that the Bureau of Prisons could not hold him because of a federal regulation that restricted interference by U.S. officials in the implementation of state medical marijuana laws.

The 9th Circuit avoided the issue, ruling instead that Davies’ plea agreement did not allow his legal challenge. Davies’ attorney, Cody Harris, said he is analyzing the ruling.

By Danielle Paquette, The Washington Post

Workers at McLane drive forklifts and load hefty boxes into trucks. The grocery supplier, which runs a warehouse in Colorado, needs people who will stay alert – but prospective hires keep failing drug screens.

“Some weeks this year, 90 percent of applicants would test positive for something,” ruling them out for the job, said Laura Stephens, a human resources manager for the company in Denver.

The state’s unemployment rate is already low – 3 percent, compared to 4.7 percent for the entire nation. Failed drug tests, which are rising locally and nationally, further drain the pool of eligible job candidates.

“Finding people to fill jobs,” Stephens said, “is really challenging.”

Job applicants are testing positive for marijuana, cocaine, amphetamine and heroin at the highest rate in 12 years, according to a new report from Quest Diagnostics, a clinical lab that follows national employment trends. An analysis of about 10 million workplace drug screens from across the country in 2016 found positive results from urine samples increased from 4 percent in 2015 to 4.2 percent in 2016.

The most significant increase was in positive tests for marijuana, said Barry Sample, the scientist who wrote the report. Positive tests for the drug reached 2 percent last year, compared with 1.6 percent in 2012.

Although state laws have relaxed over the past four years, employers haven’t eased up on testing for pot, even where it’s legal.

California, Maine, Massachusetts and Nevada moved last year to legalize recreational marijuana, joining Alaska, Colorado, Oregon and Washingtona. Twenty-nine states and the District of Columbia, meanwhile, permit medical marijuana.

Under federal law, however, weed remains illegal – and employers in the United States can refuse to hire anyone who uses it, even if they have a prescription, according to the Society for Human Resource Management.

In the oral fluid testing category, which picks up on recent drug use, and is typically used to test workers on the job, positive drug tests for marijuana surged about 75 percent in the United States over the past four years – from 5.1 percent in 2013 to 8.9 percent in 2016, according to Quest. The data show smaller increases in urine and hair testing (a 4.2 percent increase over the past year).

Colorado and Washington, which became the first two states to legalize weed in 2012, showed the largest growth in positive tests. Urine screens that detected pot rose 11 percent in Colorado and 9 percent in Washington, the first time either state outpaced the national average since residents could lawfully light up a joint.

Quest noted that employers are also increasingly encountering job applicants who take other illicit substances. Tests that turned up cocaine increased 12 percent in 2016, hitting a seven-year high of 0.28 percent, up from 0.25 percent in 2015. Positive test results for amphetamine jumped 8 percent.

The culture change in pro-marijuana states hasn’t broadly altered the way employers screen applicants, said Sample, the scientist. “Ninety-nine percent of drug panels we perform in Colorado and Washington,” he said, “still test for marijuana.”

Companies such as McLane, where employees operate heavy machinery, keep testing for marijuana out of concern for everyone’s safety, said Stephens, the human resources manager. The firm conducts follicle tests, which can catch traces of weed for up to three months after someone smokes.

She said the company saw “a big spike” is failed tests after pot became legal.

Meanwhile, Colorado’s legal marijuana business is booming. By 2016, Colorado had 440 marijuana retail stores and 531 medical dispensaries, one report showed last year – double the number of McDonald’s and Starbucks stores in the state.

Curtis Graves, the information resource manager at the Mountain States Employers Council, a business group in Colorado, said a small number of his members have dropped THC testing from drug screens, but others don’t have that option,

Truck and school bus drivers, for example, are required by law to prove they don’t have marijuana in their system before taking a job. Same goes for pilots, subway engineers and security guards. The Department of Transportation does not recognize medical marijuana as a “valid medical explanation” for failing a drug test.

“Some employers are extremely worried about filling jobs,” Graves said. “Work that is considered ‘safety sensitive’ typically requires that test, and that’s not changing.”