Michigan voters are pondering many issues when it comes to November’s vote to legalize recreational marijuana.
One issue not getting as much attention is the potential effect on public health.
States where recreational marijuana is legal now may serve as a road map.
For example, Colorado has been closely monitoring marijuana’s effect on public health since adult recreational use became legal in January 2014.
Mike Hartman is the director of the Colorado Department of Revenue. His office oversees the state’s marijuana industry.
“We always, as a regulatory body, try to strike the balance of maximizing public health and safety, but allowing industry the freedom to grow,” says Hartman. “When there is a conflict between the two, we’re always going to err on the side of public health and safety.”
But that doesn’t mean there haven’t been problems.
“We have seen an increase in hospitalizations and emergency room visits with a marijuana code.... It’s kind of hard to say why that is,” says Mike Van Dyke with the Colorado Department of Health.
Van Dyke says the rise in hospitalizations may be because patients are more willing to admit to marijuana use, or because doctors are more willing to ask patients if they have used. But he admits the increase may also be because more people are smoking marijuana.
Van Dyke says adult use of marijuana products stayed relatively steady for the first few years after recreational marijuana was legalized. But he says there was a statistically significant increase in 2017. The increase appears to be driven by a rise in people dabbing and vaping concentrate, as well as eating edibles and drinking marijuana products.
The state of Colorado has tried various public education campaigns to curb excessive cannabis use. This summer, it launched a new public service campaign featuring a chill young woman called “Meg the Budtender,” who gives advice on where and how to use cannabis products.
The Responsibility Grows Here campaign tries to promotes responsible adult use, while also discouraging use by people under 21, as well as women who are pregnant or breastfeeding.
But despite the warnings, for some being able to legally buy marijuana has reignited old health problems.
Robert started using marijuana when he was 15, beginning more than a decade of addiction.
“The first time I got high, it really just kind of clicked,” says Robert.
Robert is part a 12-step program in Colorado for people addicted to marijuana. Since he's part of a group that prefers its members remain anonymous, Robert requested we not use his last name.
Following legalization, and after nearly two decades of sobriety, Robert says he started smoking marijuana again to help with back pain.
“Now looking back in retrospect, I just tricked myself” Robert admits. “I just wanted to start using marijuana again.”
Much of the research predates the rise of legal recreational marijuana. As legal adult use has grown in nine states and the District of Columbia, the levels of tetrahydrocannabinol (THC) in a variety of cannabis products has risen.
For example, the average joint may have 15% THC. By comparison, some concentrates have THC levels of 50% to 90%.
Dr. Rav Ivker prescribes marijuana to his patients at his pain clinic in Boulder, Colorado. He believes the addiction rate for marijuana is higher than research has shown.
“I have a lot of concerns about the concentrates specifically,” says Ivker, “and I’m referring to the shatter, wax and resin that consumers are dabbing.”
Ivker is not only worried about addiction. He’s also concerned about the effect a growing recreational marijuana industry could have on his patients’ ability to get the medical marijuana they need.
Higher potential sales drives many marijuana businesses toward recreational sales.
Ashley Weber is the executive director of Colorado NORML (National Organization for the Reform of Marijuana Laws). She’s also a quadriplegic as a result of a car accident when she was 18. She uses marijuana products to ease her pain.
Despite the positives of legal recreational use, Weber says medical marijuana patients like her have had some issues with price, and access to the strains they need.
“Access for medical patients will become more of a problem because medical patients need a higher quality,” says Weber.
Wanda James is the CEO of Simply Pure dispensary in Denver, Colorado. Her dispensary was licensed in 2009, and originally served an exclusively medical marijuana clientele. Her business now serves both recreational and medical clients.
“Yes, it’s absolutely affected it,” James says.
But she blames overregulation. James says requiring businesses to tag and track medical marijuana plants and products, including having to ring up sales separately, is putting unnecessary financial pressure on businesses.
“Why can’t we just have medicinal patients taxed differently at the register instead of making the producer treat its crop differently?” asks James.
Stuart Carter is among those in Michigan’s medical marijuana industry closely watching to see how a recreational industry could mean to them and the patients who rely on them.
Carter runs Utopia Gardens in Detroit. He also runs a grow operation and extract business.
Carter expects a lot of out-of-state businesses will “swamp” the many existing Michigan dispensaries if recreational use passes in November. But he’s optimistic boutique operations like his that cater to medicinal patients can survive.
“We grow and extract a lot of medicinal products I don’t think the big businesses will be able to provide for the patients” says Carter. “I don’t think the big companies are going to dink around with these kinds of (low yield) plants.”