Testimony of John Adams Immediate Past President, Pennsylvania District Attorneys Association Berks County District Attorney Before the House and Senate Democratic Policy Committees Hearing on the Legalization of Recreational Marijuana

April 29, 2019

Good Morning Chairman Sturla and Chairwoman Boscola and members of the House and Senate Democratic Policy Committees. My name is John Adams, and I am the District Attorney of Berks County. I am also the immediate Past President of the Pennsylvania District Attorneys Association and a member of the PDAA Executive Committee. Before I was elected District Attorney as a Democrat, I was a defense attorney for 13 years and a probation officer for three years.

On behalf of the PDAA, I want to thank you for inviting us to testify and for engaging in a serious discussion of the issue of legalizing recreational marijuana. Our association believes conversations and debates, even among opposing views, are productive and in the best interest of the Commonwealth.

The PDAA opposes the legalization of recreational marijuana. Our opposition stems from science, research, and data, as well as information from our drug addiction treatment specialists. The professional experience that addiction treatment specialists have with working with those with substance use disorders, as well as with the available research and data, should weigh considerably as you consider this public policy issue. Indeed, the effects of marijuana use are harmful to public health, and legalizing the recreational use of it would only exacerbate the already negative effects of marijuana use.

At the outset, we agree with the 2017 findings of the American Medical Association: marijuana is a dangerous drug and serious public health concern and that the sale of recreational marijuana should be opposed. Indeed, late last year the President of the New York Medical Society noted studies that showed a statistical linkage between marijuana smoking and health issues as well as adverse impacts, such as unintentional pediatric exposures resulting in increased calls to poison control centers and emergency department visits. The New York Medical Society also addressed one of the very negative consequences of legalizing marijuana: increased traffic fatalities. The Medical Society noted that there was a 70 percent increase in hospitalizations connected with marijuana use between 2013 and 2015 in Colorado, where marijuana use was legalized in 2014. During the same time period, there was an 80 percent increase in instances where drivers tested positive for marijuana.1

Before I discuss in more detail the public health consequences of legalizing recreational marijuana, I would like to note that PDAA was supportive of the medical marijuana law and, in fact, I serve on its advisory board. Our association would support legislation to decriminalize the possession of small amounts of marijuana. Such legislation would help to clear cases from the criminal docket and allow law enforcement officials to focus on other matters, while still recognizing the negative consequences of marijuana use. We consider this a smart, commonsense approach.

Harmful Effects of Marijuana

Marijuana is significantly stronger, and therefore, more dangerous today because of the stronger THC content. In addition, the Centers for Disease Control and Prevention (CDC) has reported the many specific harmful effects of marijuana usage:

  • About 1 in 10 marijuana users will become addicted. For people who begin using before the age of 18, that number rises to 1 in 6.2
  • People who are addicted to marijuana may also be at a higher risk of other negative consequences of using the drug, such as problems with attention, memory, and learning.3
  • Marijuana use directly affects the brain — specifically the parts of the brain responsible for memory, learning, attention, decision making, coordination, emotions, and reaction time.4These conclusions are buttressed by a relatively new study published in Psychiatry Research that examined whether marijuana use was associated with clinically problematic outcomes for patients with depression and alcohol use disorder (AUD). Patients with AUD using marijuana had greater depressive symptoms and worse functioning than those without AUD.5 These findings indicate that marijuana use is clinically problematic for psychiatry patients with depression and AUD.
  • Marijuana use has also been linked to depression and anxiety, and suicide among teens. The American Academy of Pediatrics has shown that long-term marijuana use initiated in adolescence has negative effects on intellectual function and that the deficits in cognitive areas, such as executive function and processing speed, did not recover by adulthood, even when cannabis use was discontinued.6

The National Institute on Drug Abuse has catalogued the physical damage that comes with marijuana use, including breathing problems, increased heart rate, problems with child development during and after pregnancy, and intense nausea and vomiting.7

Marijuana and Mental Health

According to the CDC, the negative effects of marijuana use on mental health are similarly significant:

  • Marijuana use, especially frequent (daily or near daily) use and use in high doses, can cause disorientation and sometimes cause unpleasant thoughts or feelings of anxiety and paranoia.8
  • Marijuana users are significantly more likely than non-users to develop temporary psychosis and long-lasting mental disorders, including schizophrenia. Researchers have found that daily use of moderate amounts of marijuana increase the risk of a psychotic outcome like schizophrenia 4-to 5-fold.9

States That Have Legalized Marijuana Are Seeing Negative Consequences on Youth

The experiences of states that have legalized marijuana are instructive and disconcerting.

  • Young adult use (youth aged 18–25) in legalized states is increasing.10
  • Since Colorado, Washington, Oregon, Alaska, and the District of Columbia legalized marijuana, past-month use of the drug has continued to rise above the national average among youth aged 12–17 in all five jurisdictions.11
  • Colorado toxicology reports show the percentage of adolescent suicide victims testing positive for marijuana have increased.12
  • In Anchorage, school suspensions for marijuana use and possession increased more than 141% from 2015 (when legalization was implemented) to 2017.13

Indeed, these sorts of studies have demonstrated to the American Society of Pediatrics that “[b]ased on the limited data that does exist, as pediatricians, we believe there is cause to be concerned about how the drug will impact the long-term development of children.”14

States That Have Legalized Marijuana Have Seen DUI Increases

Legalizing marijuana has resulted in significant increases in marijuana-related DUIs. This should give everyone significant pause. The Governor’s Highway Safety Association reports that since legalization:

  • Marijuana presence among drivers increased in Washington, which also experienced a doubling in drugged driving fatalities in the years following legalization.15
  • Marijuana presence in arrested and crash-involved drivers increased in Washington. Fatal crashes involving marijuana increased in both Colorado and Washington.16
  • Marijuana users believe that marijuana does not affect their driving and will drive “high” regularly in both Colorado and Washington.17

More specifically, the number of drivers in Colorado intoxicated with marijuana and involved in fatal traffic crashes increased 88% from 2013 to 2015.18 And according to the National Highway Traffic Safety Administration, marijuana-related traffic deaths increased 66% between the four-year averages before and after legalization.19

Particularly concerning is an online survey in Colorado from last April that found that 69 percent of marijuana users said they had driven under the influence of marijuana at least once in the past year, and 27 percent said they drove high almost daily.20

Other Health Problems in States That Have Legalized Marijuana

We should also consider that hospital visits have increased in states that have legalized marijuana. In Colorado, calls to poison control centers have risen 210% between the four-year averages before and after recreational legalization, and the annual rate of marijuana-related emergency room visits increased 35% between the years 2011 and 2015.21

Washington has seen a 70% increase in calls to poison control centers between the three-year averages before and after legalization.22

Marijuana Legalization Has Not Ended the Black Market

Marijuana legalization has not ended the black market. Narcotics officers in Colorado have been busy responding to the 50% increase in illegal grow operations across rural areas in the state.23 In 2016 alone, Colorado law enforcement confiscated 7,116 pounds of marijuana, carried out 252 felony arrests, and made 346 highway interdictions of marijuana headed to 36 different U.S. states.24

A leaked police report in Oregon revealed that at least 70% of marijuana sales in 2016 were on the black market and around three to five times the amount of marijuana consumed in Oregon leaves the state for illegal sales.25

Legalizing Marijuana Is Not A Way to Solving the Opioid Epidemic

A new study published in the Journal of Addiction Medicine shows that sufferers from chronic pain who use marijuana in conjunction with prescription opioids demonstrated higher instances of mental health issues and further substance abuse problems than those who used opioids alone. According to the study, instances of depression and anxiety as well as opioid addiction, alcohol, and cocaine use were higher in patients who used both drugs. Additionally, there was no reported difference in pain for either group.26

A four-year study in a leading medical journal followed medical marijuana patients with a dual opioid prescription and found that marijuana use did not reduce opioid use or prescribing. Users reported greater pain severity and more day-to-day interference than those that did not use marijuana.27

Tax Revenue From Marijuana Does Not Outweigh Costs

Policymakers must be careful about merely accepting that the tax revenue from legal marijuana sales can outweigh the costs. In other states it has been a false promise. Over half the money promised for drug prevention, education, and treatment in Washington never materialized. Bureaucracy consumes a significant portion of Colorado marijuana tax revenue. And California took in far less than originally projected from taxes on legal marijuana.

We should also be concerned that tax revenue will decrease as there is more and more marijuana, and it decreases in price, unless there is a tax increase.

Finally, we should also consider that which will also increase the direct and indirect costs of legalizing marijuana:

  • Hospital room visit costs
  • Drugged driving
  • Absenteeism
  • Drug Treatment

Marijuana Is A Big Corporate Business

Marijuana is a big business. We cannot underestimate the potential of creating another Big Tobacco. We know already that the makers of Corona and Marlboro cigarettes have gotten into the business. 28 Late last year, the Tilray company entered into a global agreement with Sandoz AG, a leader in the generic pharmaceutical industry.29 In California, 20% of cultivation licenses are held by just 12 licensees – or 0.7% of licensed cultivation businesses in California.30 And the Wall Street Journal reported recently that Anheuser Busch is making its first foray into the cannabis market, striking a partnership with a Canadian marijuana grower to research nonalcoholic beverages laced with weed.31

Perspective of One Addiction Specialist

During a recent debate on legalizing recreational marijuana on WITF, Dr. Joseph Garbely, the Vice President of Medical Services and Medical Director of the Caro Foundation in Wernesville, called into the program and had the following to offer:

Studies have shown that all psychiatric disorders increase with marijuana smoking. In fact, there is an increase in psychotic conversions because of the increased strength of the active ingredient. . . .

Ninety-two percent of adolescent patients that come into Caron for treatment have marijuana as a drug of choice and an ever-increasing amount over the last couple of years come in with cannabis-induced psychosis — meaning that they don’t have a psychotic disorder but the marijuana that they are smoking caused them to look like a psychotic patient.

You need to look at the epidemiological studies, the Monitoring the Future Studies, the National Survey on Drug Use and Health Studies, these are studies that are well done, they have been done for years. . . . I would caution everyone not to just look at your friend group and yourself to see if this is a dangerous substance or not but actually look at the epidemiological studies that our country does to show you the increase in the use of marijuana and some of the side effects from that use and how many go on to have an actual, fully codified substance use disorder from cannabis use. That percentage is borne out in these epidemiological studies –13% go on to have cannabis use disorder. And the earlier you start, the greater your risks.

There have been a number of studies that show a decrease in IQ points by 8 points with daily use . . . and that’s what we are talking about here. . . . On the argument that marijuana is no more harmful or less harmful than alcohol: 88,000 deaths per year with alcohol. No question alcohol is a dangerous substance in the long haul, but that doesn’t make marijuana safe . . . and there are other effects that are happening with marijuana that are impeding someone’s ability to have a normal life if they are using it on a regular basis.

Conclusion

We greatly appreciate your consideration of our views on this important topic. As district attorneys, we recognize that the crimes we prosecute are often foreshadowed by so much more than the act itself – education, economics, and public health issues. Because of this, we are highly engaged in our communities and work with community-based experts on public safety initiatives and policies, including preventing crime and the cascade of consequences of crime before it happens. As you explore legalizing recreational marijuana further, we hope you will pay particular attention to the public health issues that surround legalizing marijuana and carefully consider what those on the frontlines of the medical and addiction fields have to say. Their perspectives are invaluable and indeed resonate strongly with us.

1 NY Med Society: Legalized Marijuana Is Bad For Public Health, October 8, 2018, https://www.syracuse.com/opinion/2018/10/ny_medical_society_legalized_marijuana_is_bad_for_public_health_commentary.html
2 https://www.cdc.gov/marijuana/faqs/marijuana-addiction.html
3 https://www.cdc.gov/marijuana/health-effects.html
4 https://www.cdc.gov/marijuana/health-effects.html
5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5742048/
6 https://pediatrics.aappublications.org/content/139/3/e20164069
7 https://www.drugabuse.gov/publications/drugfacts/marijuana
8 https://www.cdc.gov/marijuana/health-effects.html
9 https://www.cdc.gov/marijuana/health-effects.html
10 https://learnaboutsam.org/wp-content/uploads/2018/04/SAM-Lessons-Learned-From-Marijuana-Legalization-Digital.pdf
11 https://learnaboutsam.org/wp-content/uploads/2018/04/SAM-Lessons-Learned-From-Marijuana-Legalization-Digital.pdf
12 https://learnaboutsam.org/wp-content/uploads/2018/04/SAM-Lessons-Learned-From-Marijuana-Legalization-Digital.pdf
13 https://learnaboutsam.org/wp-content/uploads/2018/04/SAM-Lessons-Learned-From-Marijuana-Legalization-Digital.pdf
14 https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Raises-Concerns-About-Increasing-Marijuana-Use-During-Pregnancy-and-Breastfeeding.aspx
15 https://www.ghsa.org/sites/default/files/2018-10/GHSA_SafetyImpacts_Final.pdfhttps://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2018/05/31/drugged-driving-deaths-spike-with-spread-of-legal-marijuana-opioid-abuse
16 https://www.ghsa.org/sites/default/files/2018-10/GHSA_SafetyImpacts_Final.pdf
17 https://www.ghsa.org/sites/default/files/2018-10/GHSA_SafetyImpacts_Final.pdf
18 https://www.denverpost.com/2017/08/25/colorado-marijuana-traffic-fatalities/
19 https://www.ghsa.org/sites/default/files/2018-10/GHSA_SafetyImpacts_Final.pdf
20 https://www.codot.gov/news/2018/april/cdot-survey-reveals-new-insight-on-marijuana-and-driving
21 https://learnaboutsam.org/wp-content/uploads/2018/04/SAM-Lessons-Learned-From-Marijuana-Legalization-Digital.pdf
22https://ofm.wa.gov/sites/default/files/public/legacy/reports/marijuana_impacts_update_2016.pdf
23 https://learnaboutsam.org/colorado-2/
24 https://learnaboutsam.org/colorado-2/
25 https://learnaboutsam.org/wp-content/uploads/2018/03/SAM-Digital-C-4-1.pdf
26 https://patch.com/new-york/glencove/safe-gc-coalition-rising-concern-over-marijuana-use-opioids
27 https://www.thelancet.com/action/showPdf?pii=S2468-2667%2818%2930110-5
28 https://www.nytimes.com/2018/12/12/business/cannabis-business-altria-canopy-constellation-cronos.html
29 https://www.businesswire.com/news/home/20181218005141/en/Tilray%C2%AE-Signs-Global-Collaboration-Agreement-Leading-Pharmaceutical
30 https://mjbizdaily.com/chart-handful-growers-hold-hundreds-cultivation-licenses-california-legal-marijuana-market/
31 https://www.wsj.com/articles/abinbev-to-partner-with-canadian-cannabis-company-11545258424

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