ATTACHMENT 8 Talking Pints fr Actin Plans t Prevent Yuth Access t Marihuana Accrding t the U.S. Centers fr Disease Cntrl and Preventin, marihuana use may have a wide range f health effects n the bdy and brain. Additinally, marihuana is still an illegal drug at the federal level. Backgrund On Nvember 6, 2018, Michigan vters apprved Prpsal 1, creating the Michigan Regulatin and Taxatin f Marihuana Act. Amng ther things, this Act delegates respnsibility fr marijuana licensing, regulatin and enfrcement t the Michigan Department f Regulatry Affairs (LARA). LARA s Bureau f Medical Marihuana Regulatin (BMMR) is respnsible fr the versight f medical and recreatinal marihuana in Michigan. The Act requires LARA t start accepting license applicatins 12 mnths after the effective date f the Act. The law desn t take effect until 10 days after the results f the electin are certified by the Bard f State Canvassers, which legally must ccur by Nvember 26. Therefre, there will be a perid f time between the electin and befre peratrs can start applying fr a license frm LARA t legally perate. Fr licensing infrmatin, cntact LARA BMMR Enfrcement Sectin at 517-284-8597 r LARA- BMMR-Enfrcement@michigan.gv Althugh the Act allws peple t be in pssessin f certain amunts f marihuana fr persnal use, any frm f sales requires a license frm LARA. N amunt f marihuana prduct can be sld withut a license frm LARA. Fd and Agriculture Impact A fd establishment license issued by the Michigan Department f Agriculture and Rural Develpment des NOT allw peratrs t prduce r sell marihuana r marihuana-infused prducts. Selling marihuana r marihuana infused prducts requires a license frm LARA. The Cttage Fds exemptin under the Michigan Fd Law des nt apply t marihuana infused prducts. Yu must be licensed by LARA t sell marihuana infused prducts. This includes any sales f marihuana r marihuana infused prduct sales at farmers markets r thrugh nline marketplaces. At this time, incrprating CBD il r industrial hemp int fd prducts is nt allwed under the Act. While the Act separates industrial hemp frm the definitin f marihuana, that des nt autmatically make it acceptable t incrprate int fd. Thse substances are still illegal at the federal level and MDARD typically relies n the federal gvernment t determine what is cnsidered generally regarded as safe. Public Health and Marihuana 1
Accrding t the U.S. Centers fr Disease Cntrl and Preventin (CDC), marihuana is the mst cmmnly used illegal drug in the United States, with 37.6 millin users in the past year, and marihuana use may have a wide range f health effects n the bdy and brain. Like any ther drug, marihuana s effects n a persn depends n a number f factrs, including the persn s previus experience with the drug r ther drugs, bilgy (e.g., genes), gender, hw the drug is taken, and hw strng it is. The marihuana plant has chemicals that may help symptms fr sme health prblems. Mre states, including Michigan, are making it legal t use the plant as medicine fr certain cnditins but there isn t enugh research t shw that the whle plant wrks t treat r cure these cnditins. Als, the U.S. Fd and Drug Administratin (FDA) has nt recgnized r apprved the marihuana plant as medicine. Because marihuana is ften smked, it can damage yur lungs and cardivascular system (e.g., heart and bld vessels). These and ther damaging effects n the brain and bdy culd make marihuana mre harmful than helpful. Anther prblem with marihuana as a medicine is that the ingredients are nt exactly the same frm plant t plant. Right nw, there s n way t knw what kind and hw much f a chemical yu re getting. Tw medicines have been made as pills frm a chemical that s like THC, ne f the chemicals fund in the marihuana plant that makes peple feel high. These tw medicines can treat nausea if yu have cancer and make yu hungry if yu have AIDS and dn t feel like eating. But the chemical used t make these medicines affects the brain als, s it can d things t yur bdy ther than just wrking as medicine. Anther marihuana chemical that scientists are studying, called cannabidil (CBD), desn t make yu high because it acts n different parts f the nervus system than THC. Prpsal 1 Passage Scientists think this chemical might help children wh have a lt f seizures (when yur bdy starts twitching and jerking uncntrllably) that can t be cntrlled with ther medicines. Sme studies have begun t see whether it can help but mre science is needed t determine if it is r nt. Under Prpsal 1, persnal use and pssessin f marihuana will be legal fr thse 21 and ver. Persnal use is defined as 2.5 unces in pssessin, r up t 12 plants in a hme fr persnal use. Accrding t state law, the Bard f Canvassers will meet n r befre the 12th day after the electin and must certify the results n later than the 40th day after the electin. Frm there, 2
the Michigan Cnstitutin says that ballt initiatives take effect 10 days after the electin results are certified. The prpsal will likely g int effect smetime in late Nvember/early December. Cmmercial marihuana will be established fllwing rules develped by the Michigan Department f Licensing and Regulatry Affairs (LARA). Municipalities can prhibit cmmercial businesses in their cmmunities. The Ballt Prpsal requires LARA t begin issuing licenses within 12 mnths f the passage f the act. This act als allws fr the prductin f industrial hemp. This act des nt authrize: peple t perate vehicles r ther machinery under the influence f marihuana butane extractin in residential prperty pssessin in schls cnsumptin in a place prhibited by the prperty wner cnsumptin in public marihuana edibles that can appeal t children Cmmercial sales f marihuana will be subject t a 10 percent tax. The revenue generated frm this tax will be distributed as fllws: 15 percent t cities and twnships 15 percent t cunties 35 percent fr the schl aid fund 35 percent fr rads There are a number f implementatin issues that must be wrked ut by the State f Michigan ging frward. Sme f these issues include: Michigan s indr smking law des nt prtect against secnd hand marihuana smke. Current law that prevents secnd-hand smke is limited t tbacc. While public use is nt authrized by the act, public use is likely t ccur. This act wuld prhibit legal use f marihuana frm being the reasn child custdy r visitatin are restricted unless they are creating an unreasnable danger fr the child. This culd ptentially impact children services wrkers and cases. In additin, there are likely t be questins abut hw legalized marihuana will impact the public health f all residents. There will need t be wrk dne by the entire State f Michigan t gather mre infrmatin as the act ges int effect. 3
Frequently Asked Questins Why is marihuana spelled with an "h" instead f a "j"? The Bureau f Medical Marihuana Regulatin (BMMR) within LARA is frequently asked why marihuana is spelled with an h instead f a j. Bth spellings, marijuana and marihuana are acceptable. Many in the industry, t avid cnfusin refer t the btanical plant cannabis. While the spelling with a j is mre cmmn tday, yu will still see Michigan law using the h spelling. The spelling f marihuana has a lng histry in the United States. Michigan s histry primarily starts frm the spelling that was chsen fr the Marihuana Tax Act f 1937. Michigan adpted its statutry definitin f marihuana in the Public Health Cde, utilizing the then current federal spelling. As gverning state laws spell marihuana with an h, cmmunicatin frm BMMR in relatin t the Medical Marihuana Act r facility licensing and the applicable administrative rules will use an h in the spelling f Marihuana. An act f the Michigan Legislature wuld be required in rder t change the spelling f marihuana in the Michigan statutes, such as the Public Health Cde r the newer marihuana laws. It s legal in many states, s desn t that mean marihuana is safe? The fact that it s legal des nt mean that it is safe. Using marihuana at an early age can lead t negative health cnsequences. Heavy marihuana use (daily r near-daily) can d damage t memry, learning, and attentin, which can last a week r mre after the last time smene used. Using marihuana during pregnancy r while breastfeeding may harm the baby, just like alchl r tbacc. Marihuana use has been linked t anxiety, depressin, and schizphrenia, but scientists dn t yet knw whether it directly causes these diseases. Smking any prduct, including marihuana, can damage yur lungs and cardivascular system. Is it pssible fr smene t becme addicted t marihuana? Yes, abut 1 in 10 marihuana users will becme addicted. Fr peple wh begin using yunger than 18, that number rises t 1 in 6. 1-3 Fr mre infrmatin visit CDC s sectin n addictin r the Natinal Institute n Drug Abuse s pages n addictin science. Is it pssible t verdse r have a bad reactin t marihuana? A fatal verdse is unlikely, but that desn t mean marihuana is harmless. The signs f using t much marihuana are similar t the typical effects f using marihuana but mre severe. These signs may include extreme cnfusin, anxiety, parania, panic, fast heart rate, delusins r hallucinatins, increased bld pressure, and severe nausea r vmiting. In sme cases, these reactins can lead t unintentinal injury such as a mtr vehicle crash, fall, r pisning. 4
Des marihuana use lead t ther drug use? The majrity f peple wh use marihuana d nt g n t use ther, harder substances. 5 Mre research is needed t understand if marihuana is a gateway drug a drug that is thught t lead t the use f mre dangerus drugs (such as ccaine r herin). Fr mre n why visit risk f using ther drugs. What are the effects f mixing marihuana with alchl, tbacc r prescriptin drugs? Using alchl and marihuana at the same time is likely t result in greater impairment than when using either ne alne. Using marihuana and tbacc at the same time may als lead t increased expsure t harmful chemicals, causing greater risks t the lungs, and the cardivascular system. Als, be aware that marihuana may change hw prescriptin drugs wrk. Always talk with yur dctr abut any medicatins yu are taking r thinking abut taking and pssible side effects when mixed with ther things like marihuana. Hw harmful is K2/Spice (synthetic marihuana r synthetic cannabinids)? Synthetic cannabinids (e.g., synthetic marihuana, K2, Spice, Spike) r plants sprayed with unknwn chemicals are dangerus and unpredictable. Synthetic cannabinids are nt marihuana, but like THC, they bind t the same cannabinid receptrs in the brain and ther rgans. Synthetic cannabinids are als illegal in Michigan. Research shws that synthetic cannabinids affect the brain much mre pwerfully than marihuana creating unpredictable and, in sme cases, life-threatening effects including nausea, anxiety, parania, brain swelling, seizures, hallucinatins, aggressin, heart palpitatins, and chest pains. Fr additinal questins arund synthetic cannabinids, visit CDC s Natinal Center fr Envirnmental Health page n synthetic marihuana r the Natinal Institute n Drug Abuse page n synthetic marihuana. Is it safe fr a breastfeeding mm t use marihuana? We d nt yet knw. Chemicals frm marihuana can be passed t yur baby thrugh breast milk. THC is stred in fat and is slwly released ver time, meaning that yur baby culd still be expsed even after yu stp using marihuana. Hwever, data n the effects f marihuana expsure t the infant r baby thrugh breastfeeding are limited and cnflicting. T limit ptential risk t the infant, breastfeeding mthers shuld reduce r avid marihuana use. Can secndhand marihuana smke affect nnsmkers, including children? Secndhand marihuana smke cntains tetrahydrcannabinl (THC), the chemical respnsible fr mst f marihuana s psychlgical effects, and many f the same txic chemicals in smked tbacc. 6-8 Smked marihuana has many f the same cancer-causing substances as smked tbacc, but there are still a lt f unanswered questins arund secndhand marihuana smke expsure and its impact n chrnic diseases such as heart disease, cancer, and lung diseases. 5
Hw is eating and drinking fds that cntain marihuana (edibles) different frm smking marihuana? Because marihuana cntains tetrahydrcannabinl (THC), there are health risks assciated with using marihuana regardless f the hw it is used. Sme f these negative effects include having difficulty thinking and prblem-slving, having prblems with memry, learning and maintaining attentin and demnstrating impaired crdinatin. Additinally, frequent use can lead t becming addicted t marihuana. Hwever, sme risks may differ by the way it is used. Smke frm marihuana cntains many f the same txins, irritants, and carcingens as tbacc smke. Smking marihuana can lead t a greater risk f brnchitis, cugh, and phlegm prductin. Whereas, edibles, which take lnger t digest, take lnger t prduce an effect. Therefre, peple may cnsume mre t feel the effects faster. This may lead t peple cnsuming very high dses and result in negative effects like anxiety, parania and, in rare cases, an extreme psychtic reactin (e.g. delusins, hallucinatins, talking incherently, and agitatin). 6
Specific Marihuana and Health Detail (direct frm the CDC) ADDICTION Abut 1 in 10 marihuana users will becme addicted. Fr peple wh begin using befre the age f 18, that number rises t 1 in 6. Sme f the signs that smene might be addicted include: Unsuccessful effrts t quit using marihuana. Giving up imprtant activities with friends and family in favr f using marihuana. Using marihuana even when it is knwn that it causes prblems fulfilling everyday jbs at hme, schl r wrk. Peple wh are addicted t marihuana may als be at a higher risk f ther negative cnsequences f using the drug, such as prblems with attentin, memry, and learning. Sme peple wh are addicted need t smke mre and mre marihuana t get the same high. It is als imprtant t be aware that the amunt f tetrahydrcannabinl (THC) in marihuana (i.e., marihuana ptency r strength) has increased ver the past few decades. The higher the THC cntent, the strnger the effects n the brain. In additin, sme methds f using marihuana (e.g., dabbing, edibles) may deliver very high levels f THC t the user. 5 Researchers d nt yet knw the full extent f the cnsequences when the bdy and brain (especially the develping brain) are expsed t high cncentratins f THC r hw recent increases in ptency affect the risk f smene becming addicted. BRAIN HEALTH Marihuana use directly affects the brain specifically the parts f the brain respnsible fr memry, learning, attentin, decisin making, crdinatin, emtins, and reactin time. Heavy users f marihuana can have shrt-term prblems with attentin, memry, and learning, which can affect relatinships and md. Marihuana als affects brain develpment. When marihuana users begin using as teenagers, the drug may reduce attentin, memry, and learning functins and affect hw the brain builds cnnectins between the areas necessary fr these functins. Marihuana s effects n these abilities may last a lng time r even be permanent. This means that smene wh uses marihuana may nt d as well in schl and may have truble remembering things. The impact depends n many factrs and is different fr each persn. It als depends n the amunt f tetrahydrcannabinl (THC) in marihuana (i.e., marihuana ptency r strength), hw ften it is used, the age f first use, and whether ther substances (e.g., tbacc and alchl) are used at the same time. Develping brains, like thse in babies, children, and teenagers are especially susceptible t the hurtful effects f marihuana. Althugh scientists are still learning abut these effects f marihuana n the develping brain, studies shw that marihuana use by mthers during pregnancy may be linked t prblems with attentin, memry, prblem-slving skills, and behavir prblems in their children. 7
CANCER Cannabinids are the active chemicals in marihuana that cause drug-like effects thrughut the bdy, including the central nervus system and the immune system. The main active cannabinid in marihuana is delta-9-thc. Anther active cannabinid is cannabidil (CBD), which may relieve pain and lwer inflammatin withut causing the high f delta-9-thc. Althugh marihuana and cannabinids have been studied with respect t managing side effects f cancer and cancer therapies, there are n nging clinical trials f marihuana r cannabinids in treating cancer in peple. Studies s far have nt shwn that cannabinids help cntrl r cure the disease. And like many ther drugs, marihuana can cause side effects and cmplicatins. Relying n marihuana alne as treatment r fr managing side effects while aviding r delaying cnventinal medical care fr cancer may have serius health cnsequences. Studies f man-made frms f the chemicals fund in the marihuana plant can be helpful in treating nausea and vmiting frm cancer chemtherapy. Studies have fund that marihuana can be helpful in treating neurpathic pain (pain caused by damaged nerves). At this time, there is nt enugh evidence t recmmend that patients inhale r ingest marihuana as a treatment fr cancer-related symptms r side effects f cancer therapy. Smked marihuana delivers THC and ther cannabinids t the bdy, but it als delivers harmful substances t users and thse clse by, including many f the same substances fund in tbacc smke, which are harmful t the lungs and cardivascular system. Researchers have fund limited evidence f an assciatin between current, frequent, r chrnic marihuana smking and testicular cancer (nn-seminma-type). Because marihuana plants cme in different strains with different levels f active chemicals, it can make each user s experience very hard t predict. Mre research is needed t understand the full impact f marihuana use n cancer. CHRONIC PAIN Even thugh pain management is ne f the mst cmmn reasns peple use medical marihuana in the U.S., there is limited evidence that marihuana wrks t treat mst types f chrnic pain. A few studies have fund that marihuana can be helpful in treating neurpathic pain (pain caused by damaged nerves). Hwever, mre research is needed t knw if marihuana is any better r any wrse than ther ptins fr managing chrnic pain. HEART HEALTH Using marihuana makes the heart beat faster. It culd als lead t increased risk f strke and heart disease. Hwever, mst f the scientific studies linking marihuana t heart attacks and strkes are based n reprts frm peple wh smked it. Smked marihuana delivers THC and ther cannabinids t the bdy, but it als delivers harmful substances t users and thse clse by, including many f the same substances fund in tbacc smke, which are harmful t the lungs and cardivascular system. S it s hard t separate the effects f the cmpunds in marihuana n the cardivascular system frm the hazards psed by the irritants and ther chemicals cntained in the smke. Mre research is needed t 8
understand the full impact f marihuana use n the circulatry system t determine if marihuana use leads t higher risk f death frm these causes. LUNG HEALTH Hw marihuana affects lung health is determined by hw it s cnsumed. In many cases, marihuana is smked in the frm hand-rlled cigarettes (jints), in pipes r water pipes (bngs), in bwls, r in blunts emptied cigars that have been partly r cmpletely refilled with marihuana. Smked marihuana, in any frm, can harm lung tissues and cause scarring and damage t small bld vessels. Smke frm marihuana cntains many f the same txins, irritants, and carcingens as tbacc smke. Smking marihuana can als lead t a greater risk f brnchitis, cugh, and phlegm prductin. These symptms generally imprve when marihuana smkers quit. The knwn health risks f secndhand expsure t cigarette smke t the heart r lungs, fr instance raise questins abut whether secndhand expsure t marihuana smke pses similar health risks. While there is very little data n the health cnsequences f breathing secndhand marihuana smke, there is cncern that it culd cause harmful health effects, including amng children. Recent studies have fund strng assciatins between thse wh said there was smene in the hme wh used marihuana r a caretaker wh used marihuana and the child having detectable levels f THC the psychactive ingredient in marihuana. Children expsed t the psychactive cmpunds in marihuana are ptentially at risk fr negative health effects, including develpmental prblems fr babies whse mthers used marihuana while pregnant. 8 Other research shws that marihuana use during adlescence can impact the develping teenage brain and cause prblems with attentin, mtivatin, and memry. MENTAL HEALTH Marihuana use, especially frequent (daily r near daily) use and use in high dses, can cause disrientatin, and smetimes cause unpleasant thughts r feelings f anxiety and parania. Marihuana users are significantly mre likely than nnusers t develp temprary psychsis (nt knwing what is real, hallucinatins and parania) and lng-lasting mental disrders, including schizphrenia (a type f mental illness where peple might see r hear things that aren t really there). Marihuana use has als been linked t depressin and anxiety, and suicide amng teens. Hwever, it is nt knwn whether this is a causal relatinship r simply an assciatin. POISONING Edibles, r fd and drink prducts infused with marihuana and eaten, have sme different risks than smking marihuana, including a greater risk f pisning. Unlike smked marihuana, edibles can: Take frm 30 minutes t 2 hurs t take effect. Sme peple eat t much, which can lead t pisning and/r serius injury. Cause effects that last lnger than expected depending n the amunt, the last fd eaten, and medicatins r alchl used at the same time. 9
Be very difficult t measure. The amunt f THC, the active ingredient in marihuana, is very difficult t measure and is ften unknwn in edible prducts. Many users can be caught ffguard by the strength and lng-lasting effects f edibles. It is als imprtant t remember that marihuana affects children differently than adults. Since marihuana has becme legal in sme states, children have accidentally eaten marihuana prducts that lked like candy and treats, which made them sick enugh t need emergency medical care. 3 If yu use marihuana prducts, keep them in childprf cntainers and ut f the reach f children. Fr additinal questins, yu can cntact yur health care prvider, yur health department, the Pisn Helpline at 1-800-222-1222, r 911 if it s an emergency. RISK OF USING OTHER DRUGS The cncept f marihuana as a gateway drug where using marihuana leads a persn t use ther drugs generates a lt f disagreement. Researchers haven t fund a definite answer yet. Hwever, mst peple wh use marihuana d nt g n t use ther, harder drugs. It is imprtant t remember that peple f any age, sex, r ecnmic status can becme addicted t marihuana r ther drugs. Things that can affect the likelihd f substance use include: Family histry. Having anther mental health illness (such as anxiety r depressin). Peer pressure. Lneliness r scial islatin. Lack f family invlvement. Drug availability. Sciecnmic status. 10