Dr. Karen Randall, an emergency physician of Pueblo, Colorado, sent a letter to the physicians of Vermont. Their state legislature narrowly passed a bill that would legalize marijuana, but it’s hoped that Governor Phil Scott will veto it. There was not enough time to read Dr. Randall’s at a Press Conference on May, 18, 2016. Here’s the contents of that letter:
Firstly, I’d like to thank you all for the opportunity to share some of my experiences as a physician in a region with heavy legal marijuana use.
In 2012, Coloradans voted to pass Colorado Amendment 64 which led to the state-wide legalization of recreational marijuana beginning in January of 2014. Since then, the number of medical and recreational dispensaries in Colorado has grown to more than double the number of McDonald’s and Starbucks combined. While individual counties could and did choose to abstain from allowing recreational marijuana sales, my county, Pueblo, was one of many that embraced Amendment 64 and the projected benefits of recreational legalization, even unofficially rebranding itself the “Napa Valley of Pot”.
This led to an influx of people looking to smoke without the risk of legal consequences and to cash in on the burgeoning “pot economy”. Unfortunately, many of these people arrived only to find that the supply of marijuana-related jobs was far outweighed by the demand, and few had backup plans. Since 2014, Pueblo’s homeless population has tripled, and our low-income housing have occupancy rates of 98% or more. We have seen a drastic increase in the number of homeless camps, and social services and outreach programs are buckling under the strain.
Our medical infrastructure is also reaching critical mass. Out of the 160,000 residents of our community, roughly 115,000 are on Medicaid. As a result, we have been losing primary care providers at an alarming and unsustainable rate. The largest local clinic has been looking to hire 15 new doctors, but has only been able to hire 1 in the past two and a half years. My emergency medical group has been able to fill less than half of our open positions. The average wait time to see a new primary care provider is months with the wait for a specialist even longer, and many primary care physicians in the area are no longer taking new Medicaid patients.
Additionally, the legalization of marijuana has led to normalization of behavior that in my professional opinion is strongly impacting our youth. Despite sales being legally restricted to those ages 21 and over, the Healthy Kids Survey of 2015 shows: 16% of Pueblo High School kids under the age of 13 have tried marijuana, 30% of high school kids had smoked within 30 days of the survey, 64% feel that it would be easy or very easy to get marijuana, and that 6.3 and 6.6% of respondents have used heroin and methamphetamines respectively, compared to 2% for the rest of Colorado. The number of ED visits for cannabis hyperemesis syndrome, accidental
pediatric ingestions, accidental adult ingestions and psychosis have sharply risen. There has been an increase in the number of babies testing positive for marijuana at birth (many internet and dispensaries are now recommending marijuana for nausea in pregnancy).
The potency of marijuana has risen tremendously since legalization, which is also a cause for significant concern. Almost all of what we do know about marijuana is based on studies where the marijuana was 1-3 mg of THC. Currently, dabbing provides 80-90 mg of THC; edibles provide 10 mg THC per bite and are frequently packaged in quantities to total 100 mg of THC. Fortunately, legislation has passed so that edibles must be packaged in safety packages and can no longer be sold as appealing candy gummies, suckers, etc. Currently, law requires that chocolate be labeled with a stamp and dose quantity but it still looks like a chocolate bar to a child.
Ads and claims to the health benefits of marijuana are rampant on the internet with reported cures for almost every ailment, yet there is very little research, if any to support those “health benefits” and frequently people come to the area with a disease process (for instance, Parkinson’s disease) and purchase marijuana. Many of those looking for cures are seniors who are not toleratant to the dosage/strength of the current marijuana being marked and they come to the ED with side effects.
I deeply appreciate having been given a platform to share my experiences with you today, and I strongly encourage the physicians of Vermont to consider the broader medical, economic, and social ramifications of the legalization of marijuana.
Thank you for your attention, Dr. Karen Randall, FAAEM Southern Colorado Emergency Medicine Associates Pueblo Colorado
Dr. Randall presented her experiences at a press conference in Pueblo on October 20, 2016.
To watch the Press Conference of May 18, Orca Media presents the proceedings of the entire Press Conference.
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