Trends, Tactics and Toxicity: Marijuana Movement on Missouri College Campuses. Janice Putnam PhD, RN Amy Kiger MS, ABD Kelly Skinner DNP, FNP-C

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1 Trends, Tactics and Toxicity: Marijuana Movement on Missouri College Campuses Janice Putnam PhD, RN Amy Kiger MS, ABD Kelly Skinner DNP, FNP-C 1

2 Marijuana/Cannabis Marijuana use is growing in popularity Consumption: Joints, blunts, vaporizers Drinks Derivatives - wax, dabs, oils and shatter Capsules Tinctures and spray (under tongue) Edibles

3 Marijuana possession <10 grams Current Laws in Missouri criminal misdemeanor punishable by fine only Cultivation remains illegal. Medical CBD oil for treating persistent seizures is permitted 6/2/ AIHce 3

4 College and Marijuana Most prevalent users 18 to 25 y.o. 20% using in the past month (NIH, 2016) ER visits by year-olds doubled from 1.7 to 4 per 1,000 between 2009 and 2015 (U. of CO) 30 states have adopted legalized marijuana student recruitment crosses these state lines Decreases student performance measures and retention rates Effect short-term memory impairment, detachment, decreased alertness, and depression

5 Survey Racial Demographics Other Asian/ Pacific Islander Hispanic Black (non-hispanic) White (non-hispanic)

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11 8% Parked on campus Being driven Use In Car Missouri Parked off campus 7% 6% 5% 6% 5% 4% 2% 0% 3% 3% 1% 1% 1%

12 Not everyone who uses marijuana experiences the feeling of relaxation and calm. In some users, it can cause fear, distrust, anxiety and even a feeling of panic. This is more likely to occur in someone who takes too much or too high of a concentration. These reactions are serious, but temporary, and may resemble symptoms of schizophrenia with only short lasting psychotic symptoms The Correlation Between Ultra-Potent Pot and Psychosis - video

13 Problematic Usage and Intervention Marijuana toxicity fainting, passing out, extreme paranoia, excitement, the body frozen in time, and loss of reality Marijuana addiction used marijuana at least once, risk is 9% starting to use in adolescence, risk is 17% use daily, risk is 25-50%. Chronic marijuana use is linked to psychosis, schizophrenia, anxiety, depression

14 Diagnosing Cannabis Use Disorder Cannabis take in larger amounts or over longer periods of time than desired Desire to decrease or control of cannabis use More time than desired working to obtain, use or recover from the effects of cannabis Strong craving to use cannabis Use results in failure to fulfill role obligations such as work, school or home Continued use despite interference with social or interpersonal relationships Continued use with the knowledge that it causes or exacerbates current physical or psychological problems Withdrawal symptoms develop when not used Mood disorder Behavioral disorder Nausea Tolerance: Need for more cannabis to achieve the high Diminished effect with the continued use of the same amount

15 Withdrawal Syndrome: Impaired motor coordination Euphoria Anxiety Impaired judgement Slow time sensation Social withdrawal Difficulty sleeping Irritability Conjunctival injection Increased appetite Dry mouth Tachycardia Perceptual disturbances: Hallucinations, Auditory disruption, Visual disruption Tactile Illusions (e.g. feeling a soft object but not being able to describe it)

16 Acute intoxication: ER treatment 1. Close monitoring 2. Quiet Environment Dimly lit room Assign one caretaker Calm and limited conversation 3. Benzodiazepines if severe agitation or anxiety develops

17 Marijuana Cessation Techniques Cognitive behavioral therapy Contingency management Motivational enhancement therapy (National Institute on Drug Abuse, 2018)

18 Medical Use MARINOL/SYNDROS (dronabinol) A cannabinoid indicated in adults for: Anorexia Nausea and vomiting Adverse Effects: Dizziness Drowsiness Confusion or feeling high Exaggerated sense of well-being Nausea and vomiting Stomach/abdominal pain

19 Given PIPs track record with alcohol and substance abuse, college healthcare providers and staff are in a strong position to anticipate the needs of college students who are likely to struggle with problematic marijuana use or addiction 6/2/ AIHce 19

20 What We Wanted To Find Out What is the environment of health assessment skills, student resources, and professional development for marijuana use by college students in the state of Missouri?

21 How We Answered the Question 3 PIP Focus Groups 15 schools N=42 Questions covered Assessment Resources Professional development

22 Voluntary Participation IRB Audio recordings Any information which identified individual schools or staff was coded Thematic analysis by three researchers Debriefed findings with PIP prior to dissemination

23 6/2/ AIHce 23

24 Campus Perceptions of Marijuana are Already Strong In Missouri, campus-wide marijuana perceptions are already strongly influenced by marketing and low-risk health messages encountered through the media and social interactions. Campus-wide perceptions of marijuana as just pot and harmless is shared by many including students, staff, and faculty. As an issue, marijuana use is seen across campus as a secondary priority to many issues of higher prevalence - specifically alcohol. Talking to students about marijuana has been reported as volatile in group settings, but not in individual discussions. There is usually little faculty and parental involvement when college staff work on issues of marijuana use by students. 6/2/ AIHce 24

25 Tone of Message is Disciplinary Students are not voluntarily using college services for problems with marijuana use. Students are using prevention services only if required by disciplinary actions. An awareness of a desire to use less has been heard, although rarely. 6/2/ AIHce 25

26 Prevention and Practice Aligns with Substance Abuse Primary prevention on campus is varied; participants reported using educational brochures, webinars, and social norming. Campus activity related to marijuana have included activities such a public burns (to educate the campus) and drug dog use (for law enforcement). Assessment of student marijuana use is often part of other substance abuse assessments. Motivational interviewing is recommend as an available treatment in established substance abuse programs. 6/2/ AIHce 26

27 Specific Professional Development Needs Related to Marijuana Professional development needs for marijuana are generally being met as it is included in substance abuse topics. Professional development needs specific to marijuana not being met include variability in marijuana forms, routes, and dosages, language and advocating statements for decreased marijuana use, hooks for discussion, and safe levels of use. 6/2/ AIHce 27

28 Discussion The results are valuable to Missouri colleges - they provide insight into the current attitudes, environment, skills, and practices related to marijuana use by college students The results may provide a foundation for further studies related to channels of communication, tone for messages, influential social models, practice models, and professional development Programs may find the results helpful for future decision making, strategic planning, and program improvement 6/2/ AIHce 28

29 Limitations Small sample size may make the conclusions non-transferable Focus groups tend to be less depthful than individual interviews Focus group member contributions may have been influenced by other members of the group or the researchers leading the discussions 6/2/ AIHce 29

30 Questions? 6/2/ AIHce 30

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