Opiates and Marijuana
In May 2017 House and Senate passed S.22 a modest marijuana legalization bill which Governor Phil Scott vetoed. The Governor also vetoed the state budget and the “yield” bill that sets statewide property tax rates for the coming year. On June 21st the Legislature will reconvene to deal with all three vetoes. In his marijuana bill veto message, the Governor requested modifications regarding protecting children and to the commission that is proposed to study how or whether to provide for commercialization of marijuana in Vermont. While the Governor’s suggestions would be helpful, there is no reason why he couldn’t have made them in May before we adjourned. Specifics of S.22 are covered later in this post.
The opiate background
Much of the nation is in the midst of a opiate crisis and Vermont is not exempt. In the northeast, our state is near the top of the list in substance abuse. There is a well established path that leads from over prescription of legal painkillers such as OxyContin to heroin or other substances in increasingly dangerous doses. Initially, opiates were prescribed for acute pain following surgery. Over prescription occurred when opiates began being prescribed for chronic pain, such as for backsand joint injuries. According to the Vermont Department of Public Safety, one Vermonter dies of an opioid overdose approximately every 3.4 days. In some states, the percentage of infants born with withdrawal symptoms has increased over 300% since 2000.
Most alarming is the arrival of fentanyl, a synthetic opioid that is easier to produce and far cheaper than heroin. Fentanyl is around 50 times more potent than heroin and 100 times more potent than morphine. Much of the fentanyl is manufactured illegally in China and shipped to the US in small packets, even disguised as silica gel packs in vitamins. 1 kilogram of fentanyl costs $4,000 to import from China and may produce $1.6 million on the streets. Drug dealers often cut heroin with fentanyl to boost the potency, but unfortunately the addict may have no clue how much fentanyl is in a hit and may overdose and die. Law enforcement and health officials are finding increasing presence of fentanyl in overdose victims.
Of further concern is that fentanyl is turning up in black market marijuana, and that is intentional. Drug dealers want to ply their customers with increasingly exotic drugs while increasing profit margin and user dependence. So when unsuspecting customers head out to the corner to buy a little marijuana from someone they don’t know, they may find themselves on a darkening path to a very difficult future.
Marijuana – questions and studies
As the legislature debates whether or not to legalize marijuana, the opiates crisis has been ever lurking near the foreground. Of great concern are several important questions:
Is marijuana is a gateway drug, leading casual users to addictive and deadly substances?
To what extent might legalization lead to increased impaired/drugged driving?
To what extent might legalization lead to increased risky behavior, even suicide, in young people - particularly teens?
To what extent might legalization increase or decrease black market marijuana in Vermont, and
What of the fact that Massachusetts, Maine have legalized marijuana and that Canada may soon also?
Not all of these question can be easily answered. For the past several years, legislators have been inundated with information and opinions from all sides of the issue. Among them are
Sensible Approaches to Marijuana or SAM at www.learnaboutsam.org,
National Families in Action www.nationalfamilies.org,
Cannabis Business Times www.cannabisbusinesstimes.com and
The Vermont Youth Risk Behavior Survey http://www.healthvermont.gov/alcohol-drugs/reports/data-and-reports.
In 2015 the legislature commissioned the Rand Corporation to undertake a comprehensive study on issues concerning potential legalization in Vermont. The Rand study is available here https://www.rand.org/news/press/2015/01/16.html
In addition to these, I have included links to several other studies below.
In the face of this important but often conflicting information, how should the legislature proceed when the most fervent plea is, “What is the message legalization will send to our young people?” Researchers at UVM have concluded that the most important factors influencing youth are perceived risk and availability. Studies have shown that marijuana use impacts cognitive development in teens and may lead to addiction. Unfortunately, many users in this age group don’t believe there is much risk associated with marijuana. After all, they say, it’s cool because it is illegal. Regarding availability, it is easier for many to obtain marijuana than beer. That’s sobering but confirmed by personal inquiry.
Concerned people of all stripes cling very tightly to their beliefs. The information referenced here is useful in sorting through all the rhetoric, but it is important to recognize that statistics can be used to bolster a particular perspective. For example, one study of increased teen use of marijuana in Washington state claims that use among teens has increased 15% each year since legalization. But the same data shows that use has increased from 11% to 15% over the same period which is a net increase of 4% not 15%. The same study shows that in 2015 Vermont teen use of marijuana to be on par with Washington state and Colorado where the growing and sale is legal but highly regulated.
Of particular importance today is the Vermont Youth Risk Behavior Survey YRBS cited above. This survey is conducted periodically and is particularly useful because it can detect changes is risk behaviors such as marijuana use from year to year. Contrary to what many may think, it shows that risk behaviors in teens in almost all categories including marijuana have declined slowly during the past several years despite increased availability. That provides hope but points to the increasing importance of substance prevention in schools and beyond.
Teen suicide and drug impaired driving
Heavy use of marijuana among teens decreases motivation, sense of purpose and increases paranoia. There is evidence that marijuana and other drugs is a contributing factor in some Vermont suicides, and this should be a great concern to all of us. I introduced H.184 through which the Department of Health will begin evaluating trends and patterns of suicide deaths, identify and evaluate suicide risk factors and inform the implementation of suicide prevention strategies going forward. Tim Briglin helped shepherd the bill through the Health Care Committee. Studies have shown that those who attempt suicide face serious underlying factors well beyond their use of drugs. Regardless, any suicide is one too many. Fortunately, H.184 has been signed into law and this important work of the Department of Health will go forward.
Impaired driving is a different concern, and drug induced traffic accidents are on the rise. The worst impairment comes not from marijuana alone, but from drugs taken in combination. Nonetheless, drugged driving by any means is unacceptable, and unfortunately there is no test for roadside drug impairment as there is for alcohol. Impairment must be determined by a trained law enforcement officer. On the bright side, the State Police are adding trained troopers and will have 50 such officers on the the force by the time the marijuana legalization bill takes effect in 2019, should it actually be signed into law.
S.22 the Marijuana Bill
Many do not realize that Vermont decriminalized the possession of up to one ounce of marijuana several years ago. Currently possession is a civil crime, but when violators are cited to court, they pay a fine similar to a traffic ticket. In the intervening years since decriminalization, Vermont has not seen a significant rise in marijuana possession or marijuana related crime. The basic provisions of S.22 are as follows:
Legalizes possession of up to one ounce of marijuana and possession of 2 mature plants and up to 4 immature plants for persons 21 years of age or older
Creates a Marijuana Regulator Commission to study whether and how to provide a legal framework for commercialization, growing and retail sales
Retains criminal penalties for possession of more that one ounce of marijuana and more than two mature plants
Retains civil penalties, court diversion and Youth Substance Abuse Safety Program for persons under 21 years of age who are in possession of marijuana or plants that would be legal if possessed by a person 21 years or older
Defines marijuana to follow more closely the federal definition
Prohibits public consumption of marijuana and establishes civil penalties for violations
Limits the number of marijuana plants at a dwelling unit to two mature and four immature plants regardless of how many persons 21 years or older reside in the dwelling unit
Creates a new crime for a person 21 years of age or older to furnish marijuana to a person under 21 year of age and creates substantial penalties for violations
Creates substantial penalties where persons under 21 years of age cause death or serious bodily injury while operating a motor vehicle
Creates a new crime for the manufacture of concentrated marijuana chemical extracts unless authorized by a treatment facility.
When a bill comes before the full House, we have a binary choice. Regardless of how we feel about a bill, we can either vote “yes” or “no.” There is no maybe. The law enforcement people I have spoken to about drugs are for more concerned about opiates than they are about marijuana. Those addicted to heroin or similar circumstances may turn to crime to feed their habit, while those who smoke marijuana rarely do. Legal marijuana is or will soon be available in Massachusetts, Maine and Quebec. Some 80,000 Vermonters currently use marijuana on a regular basis and with a very few exceptions do so responsibly. Nevertheless, those who use marijuana and other drugs and then commit crimes get the substances illegally. Preventing the passage of S.22 won’t change that. In fact things will likely get worse as the black market reaches ever deeper into our communities. Hence on balance, we are better off facing marijuana head on than continuing ineffective prohibition. Better to direct resources towards substance abuse prevention than pretending we don’t have a problem. Better to pass the bill.
Studies and reports on marijuana use you may find interesting: