Lessons Learned Marijuana Education & Prevention in Colorado Jessica Neuwirth Retail Marijuana Education & Youth Prevention Coordinator, Prevention Services Division
CDPHE ON Enact the will of the people while preserving public health RETAIL MARIJUANA Educate for safe, legal and responsible use
1. Medical Marijuana Registry ROLES OF CDPHE 2. Marijuana Health Monitoring and Research 3. Retail Marijuana Education and Youth Prevention 4. Laboratory: MJ Lab Inspections, MJ Ref Lab 5. Consultation: Edible Safety, Proper disposal of waste
Improve data LESSON #1 and trend reporting
MJ USE DURING PREGNANCY- CO 14% 13% 4% 3% 5.7% 11% 10% PRAMS, 2014
MJ USE DURING PREGNANCY- CO 13% 6% 6% Drank Alcohol Used Tobacco Used Marijuana PRAMS, 2014
MJ USE DURING PREGNANCY- CO 11% 6% 5% 3 MONTHS BEFORE DURING POST- PARTUM PRAMS, 2014
ANY SMOKING DURING PREGNANCY- CA 11% 3% 6% 3 MONTHS BEFORE DURING POST- PARTUM MIHA, 2013-2014
What will you LESSON #2 say?
Reports & Factsheets: CA Department of Public Health CO Department of Public Health National Academies of Science
BIOLOGICAL EVIDENCE There is no known safe amount of marijuana use during pregnancy. THC can pass from mother to the unborn child through the placenta.
BIOLOGICAL EVIDENCE The unborn child is exposed to THC used by the mother during pregnancy. THC can be passed from the mother s breast milk, potentially affecting the baby.
EFFECTS ON EXPOSED OFFSPRING Maternal use of marijuana during pregnancy is associated with decreased cognitive function and attention. These effects may not appear until adolescence. Maternal use of marijuana during pregnancy is associated with decreased growth during childhood.
EFFECTS ON BIRTH OUTCOME LIMITED Heart defects Low birth weight Birth defects Gastroschisis MIXED Neural Tube Defects Preterm delivery Decreased birth weight Small for gestational age Still birth
INSUFFICIENT BREASTFEEDING Breastfeeding and SUIDS MIXED Breastfeeding and infant motor development
Cannabidiol (CBD) and other cannabinoids Other methods of use besides smoking RESEARCH GAPS Miscarriage Potency Breastfeeding - Effects on infants - Length of time THC remains in breast milk - Studies to correlate urine THC levels with presence of THC in breast milk
Get LESSON #3 information out quickly
INFLUENCERS
Effects on fetus development and growth. WHAT WOMEN WANT TO KNOW Long-term health effects for their babies How THC is passed/stored in their baby s body.
Recommendations Screen at every visit Encourage cessation & talk about risks of use Discuss plans for breastfeeding
MOTIVATIONAL INTERVIEWING Can you tell me about why you are using marijuana? How does it help you? Do you want to stop using marijuana? How difficult do you think it will be to stop using marijuana? Do you think you can stop?
Talking to patients about medical marijuana Determining if the benefits outweigh the potential risks
Marijuana Pregnancy and Breastfeeding Guidance For Colorado Health Care Providers Pediatric Exposure Prevention Clinical Guidance For Discussions with Children & Adolescents Ages 9-20 Pediatric Exposure Prevention Clinical Guidance For Discussions with Parents or Guardians
Webinar Available Available through www.co.train.org
When? TESTING Who? What happens next?
Mandatory Reporting Some hospitals test babies after birth for drugs. If a baby tests positive for THC at birth, Colorado law says child protective services must be notified. If you as a health care provider have a suspicion of abuse or neglect, it is your duty as a mandatory reporter to report child abuse or neglect.
Listen to your audience FINAL LESSONS Adapt local health policy Respect personal ideology, but know you will upset both sides
RESOURCES AND SOURCES Good to Know Colorado social marketing campaign GoodToKnowColorado.com Free resources for order http://cohealthresources.org/ Colorado Clinical Guidelines https://www.colorado.gov/pacific/sites/default/files/mj_rmep_factsheet-pregnancy- Breastfeeding.pdfects-while-pregnant-or-breastfeeding Monitoring Marijuana in Colorado Report https://www.colorado.gov/pacific/marijuana/effects-while-pregnant-or-breastfeeding
THANKS! More questions? Jessica Neuwirth Jessica.neuwirth@state.co.us
Therese McCluskey, Alameda County Emily Adams, Humboldt