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A Perspective on Marijuana for the LGBTQ Populations and Others

by Brian Couey, PSYD
Friday Aug 25, 2017

State and local laws have been liberalizing throughout California, including in San Diego. To learn what we can expect to see here, it is useful to take a look at the experience of states like Colorado, who were early implementers of legalized recreational marijuana use.

Colorado's legalization has led to increased use among adults and emerging adults and especially LGBTQ populations. In fact, marijuana use among LGBTQ community members in Colorado is nearly three times that of non-LGBTQ populations.

The emergence of retail sales in Colorado also coincided with a significant uptick in the number of poison control center calls related to marijuana use. Aside from increased availability, heightened potency and newer delivery methods may also be playing a role in the negative effects that have been observed in the state.

One significant of concern is the amount of "THC" we are now seeing in marijuana. THC is the cannabinoid, or psychoactive ingredient, in marijuana that is responsible for the "high" that comes from the drug. The amount of THC in marijuana, including that which is commercially produced, increased by as much as three-fold over the past 30 years, possibly driven by market demands. This contrasts with levels of other, more therapeutic, cannabinoids in marijuana, such as "CBD," which remain the same or are decreasing.

Where THC content was once around 10 percent, it is not uncommon to find marijuana with a 30 percent or higher content today, which can lead to toxic reactions.

Consumers are learning that today's marijuana differs markedly from the marijuana of a generation ago. At the same time, many are discovering they are unprepared for the associated harms, which can include addiction, motor vehicle accidents, development of psychosis, lower academic performance and exacerbation of psychological issues. Even occasional users may now find themselves in the ER unexpectedly.

Calculating safe dosages for users, becomes even more complicated with the proliferation of marijuana edibles and vaporizers, as well as concentrated forms of THC such as shatter, wax, resin or dabs. Because such products are not well-regulated, the potential for consuming an unknown quantity of THC is high. Even retail cannabis products from growers and dispensaries have been found to have high variability of dosage potency both between units and within units. For instance, a person who consumes part of an edible may have a portion with incredibly high amounts of THC, while the other portion may have a significantly lower amount.

Additional complications can arise from the use of synthetic cannabinoids, such as K2 and Spice. These commercially-available products contain a synthetic analog of THC dissolved in solvent and applied to inert plant material. These products are generally less "liked" than marijuana, but may be favored to avoid drug testing. These chemicals tend to have greater potency than THC, longer half-lives and greater risk for unpredictable effects. Notably, an outbreak of synthetic cannabis use in New York during the summer of 2016 was reported as a "zombie outbreak."

While increased marijuana potency naturally increases problems, the danger is higher for those who have vulnerabilities. For example, having any history of addiction creates an increased risk for becoming dependent. Those with histories of mental health conditions such as depression, anxiety and schizophrenia also place themselves at increased risk for complications by using THC or cannabis products. Studies have established that one in 10 adults who try marijuana become addicted to it. Among those who are ages 13 to 20, the number rises to one in seven.

In fairness, it is reasonable to say some steps are being taken to address the public health problems that have emerged from increased marijuana potency. Researchers are looking more closely at the problem of rising THC levels and health professionals are becoming increasingly better trained to treat and prevent marijuana-related problems. Substance use treatment centers are seeing a rise in admissions for marijuana misuse, proving once again how antiquated the notion is that "It's just pot."

As a new era of marijuana use emerges, we will likely see increasing problems that will affect communities, families and individuals alike. Addressing emerging problems that continue to arise from the increasing legalization of cannabis and increased potency will require a strong strategy and the collective resources of the medical, academic, business and legislative communities.

For people who might be struggling with marijuana addiction, getting help now is crucial. It is like treating other chronic illnesses such as diabetes. The new Betty Ford Center San Diego facility in Del Mar Heights offers free phone assessments for those concerned about their own substance use or that of a loved one. The Center offers a wide array of evidence-based treatment programs as part of a whole-person approach to treating all addictions, including cannabis use disorder.

Brian Couey is the Director of Outpatient Services, Hazelden Betty Ford Foundation, San Diego. For more information, call 866.261.3734, 24 hours a day or go to

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