MONDAY, JULY 8, 2019

UPDATE: Friday, November 1, 2019

Missourians left little doubt about their feelings toward amending the state constitution to legalized medical marijuana.

Nearly two-thirds—65.5% to be precise—voted “yes” last November for Missouri Amendment 2, allowing marijuana for medical purposes and taxing medical marijuana sales at 4% to fund healthcare services for veterans. Support for the measure was even higher in Jackson County, topping 70%.

The Missouri Department of Health & Senior Services (DHSS) recently completed its initial rules regulating medical marijuana in the state. DHSS began vetting medical marijuana Patient Registration Applications last week. The department’s formal review of business applications to grow, manufacture and dispense medical marijuana begins Aug. 3.

Through June 26 Jackson County led the entire state in the number of business applications submitted to DHSS, according to The Kansas City Star.



Clearly, medical marijuana legalization is being seen as an opportunity by many. But there are also causes for concern.

‘What Legalizing Might Lead To’

“This is something I thought I’d never see in Missouri, but it passed with overwhelming support across the state,” said Randy Hudspeth, Major/Interim Chief for the Raytown Police Department. “I know there’s a lot of people worried about what legalizing medical marijuana might lead to, especially those of us in law enforcement.”

Those concerns range from security in and around the licensed dispensaries to medical marijuana being exploited illegally like other prescription medications.

“Personally, I don’t have an issue with medical marijuana,” Jackson County Drug Task Force Officer-In-Charge (OIC) Dan Cummings said. “If it helps one child with seizures, I am all for it.

“What I have an issue with is the abuse of medical marijuana that is going to happen. And it’s going to happen. A lot of prescription drugs are obtained legally, then resold illegally. We’ll see that with medical marijuana, too.”

What About Kids?

Beyond the legal ramifications are legitimate worries about medical marijuana’s possible adverse impact on some individuals’ health—from negative reactions among those exceeding recommended dosages, to the effects on a child’s developing brain. (The DHSS website includes a Parent/Legal Guardian Consent Form “for a minor’s use of marijuana for medical use.”)


MIXED MESSAGE — Studies have shown that regular marijuana use can stunt the development of a teenager's brain, but according to many researchers, cannabis may be an effective treatment option for children with some medical conditions.

Earlier this year TIME magazine published a special edition dedicated entirely to “Marijuana: The Medical Movement.” One article—"Keeping Kids Safe”—pointed out “some of the strongest research backing up marijuana as medicine involves treating children.” Cannabis has reduced seizures in children with a severe form of epilepsy and studies are being conducted to determine its effectiveness helping kids with autism.

“Still,” TIME reported, “experts stress that more study is needed on safe use in kids.”

The article cited a 2012 study linking regular marijuana use before age 18 with an average drop in IQ of eight points. “There are studies showing that the earlier you start [using marijuana], the worse your cognitive growth becomes,” Dr. Yasmin Hurd told TIME.

Hurd, a neuroscientist, runs the Addiction Institute at the Mount Sinai School of Medicine in New York City. The human brain doesn’t reach full development until a person is in his or her mid- to late 20s—a fact that prompted TIME’s Jeffery Kluger to write, “Mixing any intoxicating chemical into the soft clay of an unfinished brain can alter forever the way it works.”

From Medical To Recreational

In alignment with American Academy of Pediatrics (AAP) policy, Lee’s Summit CARES opposes marijuana use in anyone under 21 years old. The non-profit agency is dedicated to preventing youth substance abuse and violence.

“One concern of parents and pediatricians, noted by AAP, is whether the legalization of medical marijuana results in increased use of recreational marijuana by adolescents?” Lee’s Summit CARES indicated in a statement.


RESTRICTIONS IN PLACE — Medical marijuana facilities in Missouri must follow packaging restrictions that include rules against designs that might appeal to a minor.

The statement quoted AAP studies that concluded “marijuana alters brain development, with detrimental effects on brain structure and function, in ways that are incompletely understood.” Lee’s Summit CARES also poses multiple questions and raises other issues related to the shifting attitudes—and legal limits—regarding marijuana:

• Could “legitimizing marijuana as a medication” lead adolescents to believe marijuana, whether prescribed or not, is safe?
  
  
• Access to marijuana will likely become more widespread.
  
  
• Will there be provisions to prevent youths from being targeted by marketing that promotes marijuana and the possible full decriminalization of its use recreationally, not just medically? 

The DHSS general guidelines (PDF) governing all medical marijuana facilities restricts packaging marijuana “in a false or misleading manner; in any manner designed to cause confusion between a marijuana product and any product not containing marijuana; or in any manner designed to appeal to a minor.”

RELATED LINKS – THE NATIONAL INSTITUTE ON DRUG ABUSE: 

• What are marijuana’s long-term effects on the brain?
• Is marijuana a gateway drug?

THC Levels On The Rise

Many legal authorities and education administrators in Jackson County are concerned not enough medical studies have been conducted to explore the long-term effects of marijuana use. Meanwhile, mairjuana edibles often have a high concentration of tetrahydrocannabinol (THC), the psychoactive component in cannabis that triggers a “high.” A heavy dose of THC can have an immediate adverse impact.




“In the 1960s and 1970s, the marijuana people would get their hands on had a THC level of between 3% and 6%. Now everything is over 20%—at the low end,” said a legal official from Eastern Jackson County. “In the dispensaries out in Colorado, the THC levels are 30% or higher. The marijuana they’re growing legally has a higher THC concentration level.”

The Drug Task Force has confiscated marijuana edibles that exceeded 60% THC levels. “We’ve come across these pods for vaping that were 100% liquid THC,” Cummings said.

Eating More Than Supposed To

Finding the DHSS regulations restricting THC levels—among the many pages of medical marijuana rules posted on the department’s website—can be a daunting task. The Division of Regulation and Licensure chapters regarding Cultivation, Dispensary and Infused Products facilities make no references to “THC” or “tetrahydrocannabinol.”

But Page 4 of the Testing Facility Rules (PDF) states “testing of the cannabinoid profile of the final medical marijuana product” allows for an “acceptable [THC] limit” of 15%— “or less.”

UPDATE: DHSS is continually updating the Medical Marijuana Section of its website, editing, adding and deleting information. Guidelines about "acceptable [THC] limits" are now listed on these Emergency Rules (PDF) published July 1.

“The problem they’ve had in other states and we’ll probably see here is people exceeding the recommend dosage,” Cummings said. “A lot of people are likely going to eat more of the edibles than they’re supposed to and end up with more THC in their system.”

THC can trigger anxiety attacks, paranoia and hallucinations. Among younger people, a major side effect can be respiratory insufficiency—the inability to simply get enough air.

BLACK MARKET TRADE CONTINUES — Even in states that have legalized marijuana for recreational use the drug continues to be sold illegally.

Illegal Sales Won’t Go Away

Raytown Interim Police Chief Hudspeth appreciates that the state is capping how many dispensary licenses will be issued. “In some other states, it was a bit of a free-for-all.”

Hudspeth has been attending multiple training sessions about what he and others in law enforcement can expect once medical marijuana sales commence sometime in 2020. Recently, he went to a special seminar the Missouri Highway Patrol sponsored, Colorado: Lessons Learned.

“Really, the concerns I have now aren’t going to change much with the legalization of medical marijuana,” Hudspeth continued. “I do know the black market is not going away. We’re going to have people continue growing marijuana in their homes, using it or selling it illegally.”

Cummings agrees.

“Pot is still sold illegally in Colorado,” the Drug Task Force OIC said. “The dispensaries are heavily regulated. They can only sell so much, and their prices are higher than what marijuana is being sold for illegally in Colorado.”

NOTE: COMBAT funds Lee’s Summit CARES (LSC) Resilience Building for Youth and Families prevention program but provided no input regarding the writing of the Lee's Summit CARES statement cited in this article.