A Review of the Rocky Mountain High Intensity Drug Trafficking Area 2017 Report

Bleeding Kansas Advocates

Kelly Rippel, Advisor

This response to the Rocky Mountain High Intensity Drug Trafficking Area’s (RMHIDTA) annual report was created to evaluate results in order to identify areas of opportunity and improvement in Kansas, among other states. The intention of this work is not simply to negate findings, since a number of observed trends indeed deserve attention. In contrast, this work seeks to provide a non-biased, objective context and highlight areas of focus demonstrating how proposed legislation in Kansas will help with multiple issues already identified. By evaluating methods of obtaining data certain established programs can be strengthened as even state-operated surveying and individual reporting from medical facilities contains gaps in accuracy. It is also important to remember the original report resulted in observations from compliance-driven and law enforcement agencies. In fact, the choice of using the commonly used term ‘marijuana’ throughout demonstrates an ever-present, discriminatory and punitive outlook on individuals who choose to use cannabis for any reason regardless of its legal status.

The selected areas of focus are important as they reflect broader public health areas (specifically ones which involve law enforcement agencies.) At the same time methods used for obtaining this data inherently carries barriers and biases as traditionally agencies operate under a strictly zero-tolerance and eradication-based philosophy. Student surveys have been questioned as showing inconsistent trends based on inaccurate disclosures from student populations for a variety of reasons. The following is from a 2015 Forbes review of a previous report:

Despite its pose as a dispassionate collector of facts, the RMHIDTA, which issued similar reports in 2013 and 2014, is committed to the position that legalization was a huge mistake, and every piece of information it presents is aimed at supporting that predetermined conclusion…The RMHIDTA, a federally supported task force dedicated to suppressing marijuana and other illegal drugs, claims only 50 percent of Colorado voters supported legalization in that Quinnipiac survey — eight points lower than the actual result. It also understates the 2012 vote for Amendment 64 by a point, but the comparison still supports the story that the task force wants to tell: The consequences of legalization in Colorado have been so bad that public support for the policy already has fallen.

The excerpts below are taken from a more recent review:

The local branch of the organization is operated under the supervision of director Tom Gorman, who has acknowledged in this space that some of the data assembled by the RMHIDTA is opinion-based, meaning it may not pass muster in a scientific survey. But in his view, the studies allow folks “to look at trends over a period of time to see if this data supports other data.”

The press release for the document asserts that “Colorado legalized recreational marijuana in 2013,” which is incorrect in two different ways; the vote for legalization, via Amendment 64, happened in November 2012, while recreational sales began on January 1, 2014. Keep that in mind when considering the following statements about what’s happened in the state over the past four years.

Unfortunately, many questions are left unanswered in the section about impaired driving. For example, the exact equipment was not disclosed, therefore it is unclear whether outdated DUI(D) monitoring was used or if newly-discovered enzymes were tested allowing for a better understanding about windows of impairment. It is true there cannot be an exaggeration of total deaths that have occurred, but while direct causation has been difficult to pinpoint there are now tools agencies can use to help inform the wider public about cannabis and driving from a harm reduction standpoint.

Regardless of recreational or medical laws in place, it is the duty of law enforcement agencies and health departments to utilize available technologies to ensure public health as well as constitutionally protected user and patients’ rights. Such guidance of utilization is both encouraged and required within the Kansas Safe Access Act. Finally, taking into account the non-disclosure of exact methods used in identifying “marijuana-related traffic deaths”, the finding stating that all traffic deaths increased by 16% does not coincide with a four-year average of a 66% increase. It would appear there is not sufficient data to prove a strong causation between the two, as an observed increase in population could have contributed to an overall rise in total traffic deaths.

The simplified claim representing that marijuana-related traffic deaths more than doubled in a seven year period requires close attention. This is a complex issue omitting crucial details as to who tested which enzymes, after what specific timeframe from the accident or death and under what circumstances, what other chemicals were found and their precise ratios, how the information was reported and/or if it was approved by a third party laboratory or entity. As with any reporting structure, and especially when there is often not consistency between facilities, human error, individual opinions about substance reporting, and limited resources or staff can all contribute to gaps in otherwise objective data analyses.

According to the Westword review:

The report itself contends that “marijuana-related traffic deaths when a driver was positive for marijuana more than doubled from 55 deaths in 2013 to 123 deaths in 2016,” adding that “marijuana-related traffic deaths increased 66 percent in the four-year average (2013–2016) since Colorado legalized recreational marijuana compared to the four-year average (2009–2012) prior to legalization.” However, it’s important to note that prior to 2014, many jurisdictions didn’t actually track the link between marijuana and traffic accidents, and meaningful stats are still hard to find — a fact that naturally inflates these digits in significant ways.

When reviewing the following figures it is important to point out (using the included graphs below) this data contradicts overall findings from numerous organizations including SAMHSA, local Colorado police departments, and the Colorado Department of Education. Other independent and government-funded surveys demonstrate there has been an overall stagnation and even decrease in youth marijuana use over time: It cannot be ignored the data proves there has now been a documented decrease in past month use in youth, an overall decrease since 2014 in DUIDs involving marijuana, a steady decrease in drug-related suspensions/expulsions, unlawful public display/consumption arrests, referrals to law enforcement and high school dropout rates.

According to the Westword review:

Plenty of other studies come to very different conclusions, as marijuana reformer Mason Tvert pointed out after the fourth RMHIDTA report. He noted, “The federal government already spent money to research use by people in Colorado, and SAMHSA [Substance Abuse and Mental Health Services Administration] has the national survey, and it showed teen use in Colorado hasn’t changed in the last several years. The National Institute on Drug Abuse (NIDA) has a survey that showed teen use hasn’t changed, the Centers for Disease Control shows the same thing, and Colorado has the Healthy Kids survey done by the Colorado Department of Public Health and Environment in conjunction with the departments of human services and education — and that shows teen marijuana use hasn’t gone up, either. But this little group of narcotics officers has decided to put out something that says the opposite of what all these surveys show. And even though it’s not news, it’s being treated that way.” Indeed, TV stations such as Denver7 and KKCO have already published pieces on the report that portray it as an objective look at the situation rather than an attempt to undermine the entire rationale for marijuana legalization by an organization with a vested interest in maintaining the status quo.

Another recent analysis states the following:

Many experts foresee the decrease in teen marijuana use as a combined result of less black market activity and more serious vetting of underage users. “Teen use appears to be dropping now that state and local authorities are overseeing the production and sale of marijuana,” said attorney Brian Vicente of Vicente, who assisted in drafting Colorado’s marijuana ballot measure, in a statement to Marijuana Moment. “There are serious penalties for selling to minors, and regulated cannabis businesses are being vigilant in checking IDs.” Twenty-nine states and the District of Columbia have legalized marijuana in some shape or form, eight of which, including Colorado, have legalized for recreational use.

The following is from a CBS News piece15 on the subject:

More than half of the teenagers also had positive urine tests for other drugs, according to the report. Ethanol, amphetamines, benzodiazepines, opiates and cocaine were most commonly detected, the researchers said. According to Sean Clarkin of the Partnership for Drug-Free Kids, “That raises the question of what landed them in the ER. Was it the marijuana, or was it one of these other drugs?” Clarkin is the director of strategy and programs at the nonprofit organization.

Dr. George Sam Wang agreed that his study does not show that pot caused these kids to need emergency care. “All it is saying is we are seeing more teenagers coming into the ER or urgent care who are being diagnosed with cannabis abuse or have a urine drug screen positive for marijuana,” Wang said. The increase also could be “the result of increased awareness and an increased emphasis toward detection by hospital staff,” said Paul Armentano, deputy director of NORML, an advocacy group for reform of marijuana laws.

The number of increases (except in 2015) in marijuana-related hospitalizations reflects multiple changes including laws allowing for recreational use versus regulated access through a licensed medical professional. Trends can also be attributed to a growing number of people moving to Colorado simply because marijuana availability is constitutionally protected for adults over the age of 21.

Andrew Freedman, former Director of the Marijuana Enforcement Division, has cited

other contributing factors which resulted in an increase in hospitalizations even though these rarely receive attention. Known incident causes include but are not limited to: a need for strategic education about methods of administration such as edibles, child-proof packaging guidelines and advertising strictly for adults, plus earmarked funding for interventions like prevention programs and youth empowerment. An often overlooked cause has been an influx of tourists leaving unfinished products in hotel rooms where non-English speaking staff have ingested edibles unknowingly and end up in hospitals (rarely with serious, long-term complications.) The Kansas Safe Access Act contains all of the aforementioned components as the lessons have already been learned from states like Colorado and incorporated into proposed legislation. It should be noted these safety and public health protection measures have been recognized by both the Foundation of Cannabis Unified Standards located in Denver, and the Kansas Health Institute for meeting all of its 2015 health impact assessment requirements.

Statistics claiming cannabis exposures exceeded 100% should be closely examined, as such figures are often deemed as exaggerated and can result from questionable methods. What constitutes as a true exposure versus a perceived possibility? How was exposure evaluated, under what circumstances, and who was the original defining entity? Was there also room for human error or bias within the reporting structures? Unfortunately, the following summary does not provide sufficient information to make a conclusive determination, and should therefore be taken into consideration when assessing its credibility. Through regulating cannabis in other states, this data highlights a need to put in place evidence-based education and awareness campaigns prior to a legal administration programs for citizens. Fortunately for Kansas, this has also been accounted for within the Kansas Safe Access Act.

Section 6 provides a glimpse into how law enforcement agencies, medical and insurance entities generally categorize cannabis use or “abuse.” Despite its medical utilization for a variety of purposes, there does exist a systemic perception that cannabis can, and is more often than not, abused. Although it is not widely referred to as “abuse” when individuals over utilize caffeine or sugar, the fact we still place some substances above others in a hierarchy is reflected in the outdated scheduling of cannabis by the U.S. Drug Enforcement Agency. When reviewing treatment statistics it is also important to remember that coding systems such as the newly-implemented ICD-10 codeset has exponentially increased the number of medical codes that define such conditions or occurrences, further explaining why an uptick in utilization of specific codes does not necessarily translate to a statistically relevant trend in treatment cases.

It cannot be overstated that while it may be true certain states have been destined to receive cannabis, the most important factor is asking ourselves the question, why is this so? Out of the most common ones identified, with the exception of Florida, each state has yet to enact cannabis laws and therefore reflects a demand. Lawmakers in the identified states must take this information into account given the revenue leaving their states and the misinformed and disproven theory that cannabis prohibition decreases overall use. This simply is not true and the 32 states that have enacted industrial hemp and/or medical cannabis laws is testimony to this fact.

The findings on seizures of marijuana through U.S. mail is alarming, and also requires evaluation. How was each seizure carried out, where, and by whom? Were there opportunities for human error in reporting, exaggeration or translation of data? What is defined as a parcel and under what circumstances was it seized? Law enforcement agencies have always been guided by a for-profit mode of operation which in most places, not excluding Kansas, historically leads to corruption within the ranks. Section 8 cited statistics well over 100%, which in the eyes of the DEA is positive and justifies continued resources to agencies for eradicating such activities, despite federal guidelines outlined in the Cole Memo issued by the U.S. Department of Justice.

The data summaries in Section 9 offer a look into other related areas of interest, yet not from a causation perspective but an anecdotal, correlative frame of reference. While it is often argued that increases in crime can be attributed to cannabis, multiple statistically relevant and peer-reviewed research studies proves otherwise. In fact, a variety of factors can contribute to such trends, most commonly including the City of Denver alone has experienced an increase of nearly a million people since legalization in 2009. The figure on retail marijuana stores can be viewed as both positive and negative, depending on one’s overall perspective about health and wellness. While comparisons are often futile and inconsistent, it is crucial to take into account McDonald’s is a fast food establishment that contributes to multiple, preventable chronic health conditions in our society ranging from obesity to diabetes. Starbucks is also known for selling sugary-sweetened beverages which are known to directly cause poor oral health and an increase in cavity rates, especially in younger populations. At the same time there is not an overwhelming outcry to demand that Starbucks stores shut down or cease advertisements targeting children or youth.

The following information must be evaluated and taken into account for its anecdotal value holds merit from a local perspective. Every community is different and the lessons taken from Colorado must be seen as opportunities for other states when considering cannabis-related regulations. For example within the Kansas Safe Access Act there are explicit guidelines, restrictive parameters as to the proximity of other properties in relation to medically-licensed compassionate care centers. There are also provisions allowing municipalities to opt out of proposed guidelines, preventing authorized facilities within local jurisdictions.

The KSAA also provides a protected, not for profit cooperative model that allows for communities to divert surpluses of product to optimally-secured facilities, while also utilizing revenue to directly fund locally-based interventions like education programs, empowerment initiatives for youth and substance abuse prevention. It is through these evidence-based approaches that law enforcement is able to help rebuild trust with communities and simultaneously neighborhoods can become more economically autonomous and sustainable, which is increasingly important for Kansas rural and frontier counties. By observing other states we know it is through working together in collaboration on these initiatives that makes diversion from non-regulated markets and the protection of youth successful.

The remaining case studies and research citations deserve careful consideration, as do peer-reviewed and statistically relevant findings based on often longitudinal evidence. Science itself must be looked at from a broad and holistic perspective, gathering all accurate and legitimate data conclusions from sources following established research integrity guidelines. This includes studies demonstrating public health concerns pertaining to homicides related to cannabis all the way to usage trends, hyperemesis, and effects of consumption by specific populations. These explorations are in fact driving precision medicine in states that have legalized for medicinal purposes such as California. Kansas also stands to be among the top leaders with the established, long-standing history of exceptional contributions from KU Medical Center, Stormont-Vail (now a system within Mayo Clinic), Topeka’s VA facility, among other psychiatric and specialty organizations. Each piece of information in the emerging field of cannabis research is crucial in understanding how cannabis affects each mammal’s individual endocannabinoid system differently. At the same time, it is irresponsible and short-sighted to discard research from credible medical communities which points to improving symptoms and benefitting conditions such as fibromyalgia, insomnia, depression and anxiety, HIV/AIDS, cancer, muscle and autoimmune diseases, plus other serious conditions plaguing our older populations like Alzheimer’s and Parkinson’s.

Collectively we must learn to take the good with the bad in regards to cannabis, and vice versa in order to protect public health to the best of our abilities. In doing so our society will become better-informed, translating to more fully educated decisions, proven best practices, and effective policies that take into account equity and social determinants of health. Integrating cannabis into daily life has indeed been an experiment for multiple states including Colorado, and the nation owes a great deal of acknowledgment and gratitude to those pioneers who have worked hard to share related data since legalizing in 2009. At the same time, if lawmakers do not wish to go against the will of their constituents, these lessons learned by legalized states must now take on a life of their own and be implemented in places like Kansas sooner than later.

It is no longer acceptable to society at large that a person can on one side of the border be considered a patient and just a few feet away the same person is deemed a criminal. From a strictly medically speaking standpoint, Kansas is losing not only revenue to states like Colorado from cannabis refugee families moving, but we are also experiencing a growing gap in mistrust of non-educated medical professionals who are not allowed to engage in proven therapies with patients. Citizens not only deserve to have their voices heard (medical cannabis now has a 76% approval in Kansas), but as civil servants we also must accept that it is our responsibility to protect others through education about proper administrations, potential barriers and harm reduction approaches to mitigating risk, especially among vulnerable populations. Until the Kansas Safe Access Act is enacted, Kansas and other non-legal states will continue to see activities perpetuating the status quo that are driving people to locations where demands can be supplied.

For more information on research and active legislation in Kansas please visit:

www.bksadvocates.org

Additional Resources

  1. http://m.ljworld.com/news/2005/oct/21/d_alleges_corruption_topeka_narcotics_unit/
  2. http://cjonline.com/indepth/meneley/stories/042099-1_meneley.shtml
  3. http://cjonline.com/stories/062108/lei_293347362.shtml#.WkgPInpMHMI
  4. https://www.leafly.com/news/cannabis-101/what-is-the-cole-memo
  5. http://www.monitoringthefuture.org/data/17data.html#2017data-drugs
  6. http://www.monitoringthefuture.org//pressreleases/17drugpr.pdf
  7. https://www.colorado.gov/pacific/sites/default/files/PF_Youth_HKCS-2015-Exec-Summary.pdf
  8. http://onlinelibrary.wiley.com/wol1/doi/10.1111/add.13906/full
  9. https://www.theatlantic.com/health/archive/2017/06/marijuana-legalization-college-students/530607/
  10. https://www.scientificamerican.com/article/colorado-s-teen-marijuana-usage-dips-after-legalization/
  11. https://jamanetwork.com/journals/jamapediatrics/article-abstract/2593707
  12. https://www.psychologytoday.com/blog/abcs-child-psychiatry/201704/does-legalized-marijuana-result-in-more-teen-use
  13. https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-2015.pdf
  14. https://www.marijuanamoment.net/teen-marijuana-use-legalized-states-federal-data-says/
  15. https://www.cbsnews.com/news/pot-legalized-colorado-teens-hospital-er/
  16. http://www.cjcj.org/news/8200
  17. http://www.cjcj.org/uploads/cjcj/documents/cjcj_marijuana_reform_comparison.pdf
  18. https://www.washingtonpost.com/graphics/national/police-shootings-2017/
  19. https://mappingpoliceviolence.org
  20. 36. http://killedbypolice.net