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You’ve seen the anti-marijuana billboards in Boise. Are they telling the truth?

Uniting States of Marijuana: the country’s evolving laws on cannabis

Several states have adopted new rules on the use of recreational and medicinal marijuana in several states, with more than half now allowing for the latter. Is this the beginning of the end of marijuana prohibition?
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Several states have adopted new rules on the use of recreational and medicinal marijuana in several states, with more than half now allowing for the latter. Is this the beginning of the end of marijuana prohibition?

You’ve seen the billboards around town. They warn that marijuana legalization will poison, kill and injure Idaho’s residents, and their pets and children.

For months, locals have wondered: Who’s behind it? What’s their goal? And, perhaps most important is this: Are the claims true?

Who is behind the anti-marijuana billboards?

In short, a local nonprofit by way of the government.

The group DrugFree Idaho created the billboards and associated website, KeepIdaho.org, under a grant from the state’s Office of Drug Policy, according to DrugFree Idaho Executive Director Rob Stevenson.

The names displayed on those materials — “Keep Idaho” and “Office of Transparency” — aren’t actual organizations or offices, Stevenson said. They’re monikers that a local marketing company came up with for the campaign.

What is DrugFree Idaho? It’s a nonprofit led by a board of community members, and its stated mission is “to create a drug-free culture within workplaces, schools and communities.”

DrugFree Idaho has existed since 1999 and partners with other organizations such as Boise State University on alcohol and drug prevention and education. Its legal headquarters is the Boise Police Department, but it isn’t attached to the department, Stevenson said.

Why the billboards? Why now?

“We’re a substance-abuse prevention organization, so that’s what we do,” Stevenson said in an interview.

He said the group’s goal is to counteract attempts to “normalize the use of marijuana.” With five of Idaho’s six neighboring states having some form of legalization on the books, DrugFree Idaho is trying to get ahead of medical or recreational legalization efforts in Idaho.

“We wanted to educate Idahoans,” Stevenson said. “We wanted to show them there’s another side to the story.”

Proponents of legalization have just filed a medical marijuana/industrial hemp petition with the Idaho Secretary of State’s Office, intending to push for a ballot measure in 2020.

Marijuana billboards: True or false?

The Statesman investigated some of the claims on the billboards. We interviewed sources and looked at medical journals, annual reports, primary source documents, news reports and state laws. We also ran our conclusions by Stevenson, who disagreed with some of them, and by the spokesman for the Idaho Cannabis Coalition behind the Idaho legalization petition.

We set out to answer two questions: “Is the claim true or false? Is it a problem that can be blamed on marijuana legalization?”

There’s no proven cause-and-effect relationship to back up a lot of the claims. Stevenson argues that the big picture backs up his group’s claims.

“When you add up all these puzzle pieces together, there’s a lot of correlation,” Stevenson argued. “It’s just a lot of things going on where marijuana is the common denominator.”

Here’s what we found.

Pot shops diagnose patients?

The claim: “Patients are being diagnosed and treated from the marijuana shops by those without any medical training.”

The facts: That statement comes from a Colorado emergency room doctor, Brad Roberts.

“I have had patients bring in bottles with a recommended strain of cannabis and frequency of use for a stated medical problem given at the recommendation of a marijuana shop employee,” Roberts wrote in an article for the American College of Emergency Physicians.

If you’re not a licensed health care provider in Idaho, such as a physician, it is illegal for you to diagnose and treat patients. There is some haziness there, though, because marijuana isn’t a federally regulated drug that you need a prescription to buy.

(If marijuana were legalized as medicinal, a licensed health care provider would have to give a “recommendation” for weed; recreational legalization wouldn’t have a medical gatekeeper at all.)

Should someone with anxiety, diabetes and chronic pain trust a budtender to give them advice? That’s a good question. It’s also not unique to marijuana sales. Right now, customers can walk into a nutrition store with an ailment and buy potentially ineffective or unsafe supplements from an employee who lacks medical training.

Roberts told the Statesman that his interest in this topic started a couple of years ago, when a patient came into his ER with a story he found alarming.

The patient had trigeminal neuralgia, which caused excruciating pain in his jaw, radiating into the rest of his face, Roberts said. He handed the doctor a small vial and said he’d been to a shop whose budtender told him he could stop taking his prescription medication and switch to marijuana. Now, he was in the ER with pain, Roberts said.

So what does the research say?

A study published in the medical journal for the American College of Obstetricians and Gynecologists used a “mystery caller” approach to see how dispensaries would respond to a phone call from a pregnant woman with nausea. It found that employees recommended marijuana and usually didn’t offer up the advice that the caller talk to a doctor first.

“If this becomes regulated, we would need training just like you would train any other employee,” said Bill Esbensen, spokesman for the Idaho Cannabis Coalition.

Roberts says he doesn’t understand why regulators have not stepped in to keep marijuana retailers from offering what amounts to medical advice.

True or false? True.

Is this a problem caused by legalization? Maybe. Idaho law forbids lay people from acting like doctors. Legalization wouldn’t change that, and marijuana isn’t the only substance where this kind of thing happens. If pot were recreationally legal in Idaho, it could happen more.

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An anti-marijuana billboard on Orchard Street. Katherine Jones kjones@idahostatesman.com

Pets get sick?

The claim: “Over the past six years, Pet Poison Helpline has experienced a 448 percent increase in the number of cases for pets that have ingested marijuana.”

The facts: That’s true, according to a Pet Poison Helpline blog post written by a certified veterinary technician.

Ahna Brutlag, director of veterinary services for the hotline, said they got nearly 800 calls related to marijuana last year. She couldn’t say how many they got in 2012, the start of recreational legalization. But the Statesman calculated it would have been fewer than 200 such calls.

Brutlag couldn’t say whether all types of calls had such a drastic increase or whether the pet owners were calling from states with legal weed.

She also couldn’t describe the nature of the calls — “Fluffy is really lethargic, and I’m worried maybe she ate a gummy?” versus “I just caught Fido chowing down a pan of pot brownies.” The hotline doesn’t collect that exact data, Brutlag said.

So, is legal weed hurting pets?

The hotline’s veterinary staff say it is.

Brutlag says dogs and, occasionally, cats are consuming more marijuana — usually in the form of “edibles.” She provided some examples:

“A few of our notable feline cases include ‘Puff,’ a cat that snuck into his owner’s purse and stole brownies made with marijuana-infused butter. Another case involved ‘Monster,’ a giant of a cat that ate most of a large homemade marijuana muffin. Yet another cat, ‘Salvador,’ ingested marijuana after it had been vaped and also went on to develop intoxication. Thankfully, with supportive care, all three made a full recovery.”

While marijuana rarely kills pets, it can make them sick. Edibles are dangerous for other reasons, too, because they may have ingredients such as chocolate or raisins that are toxic to dogs and cats.

“Thankfully, the margin of safety for marijuana is very wide, with the lethal dose being approximately 1,000 times greater than the effective dose,” Brutlag wrote. “Recovery may take 24-72 hours, depending on the dose ingested.”

True or false? True, but this claim leaves out some important context. Pets rarely die from marijuana products. They do get sick.

Is this a problem caused by legalization? Probably. While the hotline’s data don’t prove it, other research supports it.

In November, Ontario repealed its ban on marijuana dispensaries. Is it going to be an economic boom? A surge in Treasure Valley visits?

No money for schools?

The claim: “So far, the only thing that marijuana legalization has brought into our school has been marijuana.”

The facts: That’s a statement by Harry C. Bull, former superintendent of Cherry Creek School District in Colorado. He was quoted in an August 2017 USA Today op-ed opposing legalization.

But it’s not true, the Denver alt-weekly Westword reported later that month.

Marijuana sales began in Colorado in 2014. Citing records from the Colorado Department of Education, the school district “will have received over $125,000 in pot tax revenue between the fiscal years of 2014-15 and 2016-17,” wrote Thomas Mitchell, who covers marijuana for the Westword.

Marijuana tax revenues gave the district money for buildings, bullying prevention and education grants, he reported.

Mitchell’s story quoted the school district’s Director of Communications Abbe Smith as saying: “The superintendent was making the point that the problem of school funding shortages is a complex challenge that cannot be solved by quick fixes. And that Cherry Creek has not seen a huge influx of money from the marijuana tax.”

Stevenson said that’s the point.

“If people are under the illusion that taxing and bringing marijuana into the state is going to start pouring money out of the sky for schools ... that’s not going to happen,” Stevenson said.

Colorado schools used about $118 million of marijuana tax money to pay for school construction as of 2017, and more than $5 million was distributed to a public schools fund, Mitchell reported.

How much is that in the big picture of education funding?

The Colorado Department of Education says it received about $225 million in marijuana tax dollars from the 2015-16 through the 2017-18 school years. Marijuana taxes comprise about 3.6 percent of Colorado’s education budget.

True or false? False.

Is this a problem caused by legalization? Rather, can marijuana help solve education funding problems? In Colorado, it funded 3.6 percent of them.

Teens end up in the ER?

The claim: “In 2017, researchers reported ‘the number of teenagers sent to emergency rooms more than quadrupled after marijuana was legalized in Colorado — mostly for mental health symptoms.’”

The facts: That’s from a May 2017 NBC News story on post-legalization ER visits among teens.

NBC said researchers found 639 teenage ER patients tested positive for the drug or told doctors they had used it — up from 146 in 2005.

George Sam Wang of the University of Colorado, the lead researcher, told NBC News that as marijuana becomes legal in more states, “the perception of risk has gone down quite a bit.”

“Wang said people believe marijuana is safe — but it is not,” the NBC News story said.

Wang and other researchers published a study last year of 4,202 marijuana-related ER and urgent-care visits by teens from 2005 to 2015. They found “marijuana-related visits increased from 1.8 per 1,000 visits in 2009 to 4.9 in 2015.”

Doctors diagnosed 71 percent of the teens with a mental illness. It was “common” for the teens to have another substance in their system, most often alcohol, the study said.

Other researchers questioned their findings.

“In our view, the veracity of this claim is questionable for at least two reasons,” researchers from the New York State Psychiatric Institute and Columbia University wrote in a response to the findings. The study “too broadly defined” what it meant to be “marijuana-related” — that could mean a patient used marijuana long ago, they argued. They also questioned why the study looked at teens, for whom marijuana is never legal.

Wang and the co-researchers shot back, saying their goal was to look at medical records instead of unreliable survey answers, to get a clearer picture of how legalization affects teens in Colorado. “Although our findings are not without limitation, we demonstrate the importance of further detailed studies on the impact of various aspects of adolescent physical and mental health,” they wrote.

What about the alarming suggestion that marijuana use caused teens to have mental illness? First, the research there is limited. Second, for things such as bipolar disorder or depression, it’s impossible to know what caused them. And third, a mental illness could make someone more inclined to use marijuana — and, separately, more likely to end up needing emergency psychiatric care.

“Several studies have linked marijuana use to increased risk for psychiatric disorders, including psychosis (schizophrenia), depression, anxiety, and substance use disorders, but whether and to what extent it actually causes these conditions is not always easy to determine,” the National Institute on Drug Abuse says.

One enormous study by the National Academies of Science, Engineering and Medicine drew some conclusions on the relationship between cannabis and mental health. Among the findings, it said, “Cannabis use is likely to increase the risk of developing schizophrenia and other psychoses; the higher the use, the greater the risk.”

The study found that cannabis didn’t appear to make someone more likely to develop depression, anxiety or PTSD. But, it said, “Heavy cannabis users are more likely to report thoughts of suicide than are nonusers.”

Stevenson calls legalization a “time bomb” for mental illness.

“What happens 10 years from now, 15 years from now, what if [the Wang study] is right? What if a huge percentage of them do go on to have schizophrenia or bipolar disorder or whatever?” Stevenson said. “We should probably get those answers before putting up store shops to sell it.”

One thing that Stevenson and the Idaho Cannabis Coalition agree on is that more research should be done on marijuana. Of course, their theories on what the research would find are totally different.

True or false? Mostly true. ER visits went up, but the study isn’t conclusive, like most research on this topic.

Is this a problem caused by legalization? Who knows. There’s not enough research on how marijuana affects kids and teens. The study cited by KeepIdaho.org adds one piece to the puzzle.

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An anti-marijuana billboard on Franklin Street near Bishop Kelly High School. Katherine Jones kjones@idahostatesman.com

Traffic deaths doubled

The claim: “Marijuana-related traffic deaths when a driver was positive for marijuana more than doubled from 55 deaths in 2013 to 123 deaths in 2016.”

The facts: This is an often cited statistic in a report by the anti-drug Rocky Mountain High Intensity Drug Trafficking Area organization, which credits the numbers to the Colorado Department of Transportation.

Colorado traffic deaths where the driver tested positive for marijuana did rise that much — growing in number and making up a larger share of all traffic deaths. Drivers tested positive for marijuana in about one in 10 cases in 2013. It was about one in five in 2016.

What’s unclear is whether marijuana impairment is to blame for those crashes. The drivers in 64 percent of them also had alcohol and/or other drugs in their system at the time.

Also, marijuana can be detected weeks after use, as critics of these types of claims have pointed out. So a positive test may not actually mean someone was high when they crashed.

But the Denver Post found that in 2016, of the drivers in fatal crashes who tested positive for marijuana use, about 62 percent “were found to have [test results] indicating use within hours, according to state data.”

States where marijuana is legal have marijuana-impaired driving laws, similar to the blood alcohol level for drunken driving. The limits range from zero to some THC.

Esbensen contends that DrugFree Idaho’s statement is a red herring.

“If you are, let’s say, new to marijuana, and you ate a brownie, you might as well be drunk, and you shouldn’t be driving anything,” Esbensen said. “And probably if you aren’t new to marijuana and you eat a brownie, you shouldn’t be driving. ... Yeah, marijuana can definitely be intoxicating.”

He said he knows people who smoke throughout the day and continue to drive.

True or false? True, but fuzzy. Fatal crashes that involved marijuana went up. It’s unclear how much marijuana alone was to blame for those crashes.

Is this a problem caused by legalization? Probably. Driving while intoxicated is illegal, no matter what the law says about buying marijuana, but it obviously happens. The numbers suggest at least some increase in people driving while high.

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Watchdog reporter Audrey Dutton joined the Statesman in 2011. Before that, she covered finance policy in Washington, D.C., during the financial crisis. She also worked as a reporter in Maryland, Minneapolis and New York. Audrey grew up in Twin Falls.
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