The Colorado Department of Public Health and Environment has published a comprehensive report titled, “Monitoring Health Concerns Related to Marijuana in Colorado: 2018.” The report summary contains an overview of the panel’s major findings on marijuana use patterns and potential health effects as well as the most recent scientific findings associated with marijuana use.
The key objective of the report, which was produced by the Marijuana Health Monitoring and Research Program on behalf of the Retail Marijuana Public Health Advisory Committee, is to “enable evidence-based policy decisions and science-based public education campaigns.”
“The data presented here,” write the authors, “provide important insights into marijuana use in adults, as well as the disparities among vulnerable populations such as pregnant women and youth. There continue to be disparities in marijuana use based on age, sex, race/ethnicity, and sexual orientation for both adults and adolescents, signifying health inequities in certain populations in Colorado. It is too early to determine if documented trends will persist in years to come.”
The back story
Colorado was one of the first two states in the nation to legalize adult recreational use of marijuana. Within the bill, the Colorado Legislature mandated that the Colorado Department of Public Health and Environment study the potential public health effects of marijuana.
The work is required under statute “25-1.5-110, C.R.S. Monitor health effects of marijuana,” which requires the department to monitor changes in drug use patterns, broken down by county or region, race, ethnicity, age, and so on.
As directed, the department appointed a panel of health care professionals with expertise in cannabinoid physiology to monitor the relevant information.
The panel is required to provide a report to the state Board of Health, the Department of Revenue, and the General Assembly every two years starting in 2015.
“Legalized retail marijuana presents a paradigm shift, grouping marijuana with other legal substances like alcohol, tobacco and prescription drugs, as opposed to illicit drugs like cocaine and heroin… The standard public health approaches to alcohol, tobacco and prescription drugs are to monitor use patterns and behaviors, health care use, potential health effects, and emerging scientific literature to guide the development of policies or consumer education strategies to prevent serious health consequences.”
Where does the data in the report come from?
To compile the report, the panel relied on data from a number of self-reporting surveys. Although there’s no way to confirm whether each respondent has answered truthfully, the accuracy of these types of surveys has been validated in a number of studies.
Here are short descriptions of each of the surveys used to produce the report:
Adult use: Behavioral Risk Factor Surveillance System
This BRFSS is a telephone survey of adults ages 18 years and older. The survey is sponsored by the U.S. Centers for Disease Control and Prevention. CDPHE has been managing BRFSS in Colorado since 2014.
Marijuana in homes with children: Child Health Survey
The Child Health Survey is a telephone survey conducted among respondents to the BRFSS Survey who have children ages 1-14. This annual survey has been collecting data on a wide range of health issues and risk factors affecting children and youth in Colorado since 2014.
Adolescent and young adult use: Healthy Kids Colorado Survey
The HKCS collects health information from public high school and middle school students in collaboration with CDPHE, the Colorado Department of Education, and the Colorado Department of Human Services. This survey is conducted every odd-year since 1999.
Adolescent and adult use: National Survey on Drug Use and Health
This report by the Substance Abuse and Mental Health Services Administration tracks national and state-level data on tobacco, alcohol, marijuana, and illicit drug use through the National Survey on Drug Use and Health.
Use during pregnancy: Pregnancy Risk Assessment Monitoring System
PRAMS is an annual survey of women who recently gave birth sponsored by the CDC by CDPHE in Colorado on an annual basis. It collects data about maternal and child health indicators, such as unintended pregnancy, prenatal care, breastfeeding, infant health, smoking, and alcohol use during pregnancy and the first few months after delivery.
Adolescent and young adult use: Youth Risk Behavior Surveillance System
The YRBSS is a national biennial survey of high school students sponsored by the CDC and administered by health and/or education agencies in every state.
Summary of key findings
The main focus of the report is to identify trends in adult marijuana use in Colorado. Some particular trends of interest include an increase in adult use, a possible downtrend in adolescent use, a significant increase in dabbing and edibles by adolescents, and an increase in marijuana use among young mothers.
The report also delivers some encouraging news. According to the authors, daily or near-daily marijuana use among adults is much lower than binge drinking and daily or near-daily tobacco use. Also, the estimated prevalence of past 30-day marijuana use and frequencies of marijuana use by adolescents has not changed since legalization and continues to be lower than past 30-day alcohol use.
Here is a quick summary of some of the key findings in the report:
- In 2017, marijuana use in the past 30 days among adults 18 years and older significantly increased to 15.5 percent from 13.6 percent in 2016.
- Young adults aged 18-25 years reported the highest prevalence of marijuana use in the past 30 days (29.2 percent).
- Use among adults aged 26-34 years significantly increased to 19.4 percent.
- Use among adults aged 65+, increased to 5.6 percent.
- Adult past 30-day marijuana use remained significantly higher in men than in women.
- Daily or near-daily marijuana use by adults increased significantly to 6.4 percent.
- In 2017, 50 percent of adult past 30-day marijuana users reported multiple methods of marijuana use. That’s significantly higher than 2016 at 43.1 percent.
- Past 30-day use by dabbing, vaporizing, and/or eating or drinking marijuana increased significantly from 2016 to 2017.
- An estimated 19.4 percent of Colorado high school students and 5.2 percent of middle school students reported using marijuana in the past 30 days. This is not statistically different from 2015 (21.2 percent and 4.4 percent).
- Marijuana use is higher than smoking cigarettes but lower than alcohol and nicotine vaping among high school students
- There were significant increases in dabbing and edible use among high school students.
- Marijuana use among younger moms and those with unintended pregnancies increased.
Some encouraging trends
There are some silver linings in the report:
- The frequency of use has declined or remained stable among adolescents. An estimated 4.7 percent of high school students reported using marijuana daily or near-daily.
- There has been no change in the age of first-use among high school seniors.
- There were no changes in driving behavior among adult marijuana users.
- There were also no changes in marijuana-related driving/riding behaviors among high school students.
- Daily or near-daily marijuana use among adults is much lower than binge drinking and daily or near-daily tobacco use.
- For adolescents, the estimated prevalence of past 30-day marijuana use and frequencies of marijuana use have not changed since legalization.
- Among adolescents, past 30-day marijuana use continues to be lower than past 30-day alcohol use and electronic vapor products with nicotine use.
- The majority of homes in Colorado with children do not have marijuana present or being used inside the home. Among homes that do have marijuana present, the majority of homes are storing marijuana safely.
Recommendations and future directions
The report makes recommendations for future direction including continue assessing the prevalence of marijuana use via large Colorado-based surveys. “Continued surveys using the same methodology can act as a feedback loop to ensure marijuana policies and education campaigns are effective.”
Authors also call on the state to develop, improve and explore additional data sources to monitor marijuana use patterns in collaboration with other state and national agencies.
Detailed findings and data are available at colorado.gov/marijuanahealthinfo.
*Header image credit: Darrin Harris Frisby/Drug Policy Alliance