|
Abstract
|
When one thinks of Colorado, images of mountains, untouched wilderness, outdoor activities, and recreation come to mind. Colorado has always been a place of untold beauty and friendly people. However, currently, other images may come to mind as well. Medicinal marijuana became legal for use in Colorado in November 2000. Voters in Colorado passed Amendment 20, which allowed qualifying patients, and/or caregivers of these patients, to possess up to 2 oz of marijuana and grow up to 6 marijuana plants to be used for personal medical purposes.
Between 2000 and 2008, close to 6000 applications were submitted for medical marijuana cards, yet only 55% of those applicants had a designated primary caregiver.
Marijuana originates from the plant cannabis sativa, which contains delta-9-tetrahydrocannabinol, also known as “THC. Cannabis also contains other chemicals referred to as cannabinoids; however, THC is thought to be responsible for the psychoactive effects or “high” associated with cannabis. Cannabis is commonly used in 3 forms: marijuana, hash, and hashish oil. Marijuana is the least potent form and the most frequently used type of cannabis. It is made from the dried flowers and leaves of the cannabis plant and is usually smoked or ingested via “edibles” such as brownies or candy.
Marijuana is used medicinally to address a variety of issues including but not limited to nausea, vomiting, anorexia, and pain. It is also used recreationally to achieve a mood- and mind-altering effect. Although marijuana appears to be only a small contributor to drug-related mortality and morbidity, there are known risks of acute intoxication, including increased risk for injury due to cognitive impairment. Significant risks also exist for children who consume marijuana given the unpredictability of edible dosing and effects. Cannabis is currently the most widely used illicit drug in all age groups.
The legalization of marijuana has increased access, and concern exists that legalization may result in the perception that risks associated with marijuana use are minimal. Colorado has taken the lead in confronting the issues surrounding the long-term effects of legalized marijuana. The State of Colorado has funded numerous programs on prevention of marijuana use targeting adolescents.
Despite these efforts, Colorado continues to have the highest percentage of adolescent marijuana use and exposure in the USA. According to 2013/2014 data, Colorado ranked No. 1 in past-month marijuana use—up from No. 4 in 2011/2012, which was prior to the recreational legalization. In collaboration with the Colorado Department of Public Health and Environment, the State of Colorado is positioned to spend $2.15 million in the fiscal year 2015/2016 on a marijuana public education campaign. Community education is needed to increase awareness about the effect that edible marijuana products have on children and the importance of securing all edibles away from children, just as with prescription drugs or guns. Colorado now mandates proper labeling of all marijuana products. Marijuana products are required to be labeled using the Colorado Universal Symbol along with a list of all nonorganic pesticides, fungicides, and herbicides used to produce the marijuana and a list of solvents and chemicals used to produce marijuana concentrate. Containers for edible marijuana products must be labeled with all ingredients, indicate if refrigeration is required, and state the standard serving limit and expiration date. Additionally, every marijuana product sold must leave the store in a package or container that is child-resistant.
Colorado has set a limit of a standard size of an edible to no more than 10 mg of THC per serving. These servings tend to be small—for example, one fourth of a cookie—and children can easily consume multiple servings of edibles.
The legalization of marijuana has led to the perception that it is safe to drive a vehicle or engage in other activities that require focus and attention. However, marijuana is known to “slow reaction time, impair judgment of time and distance, and decrease coordination.” According to Cooper and Logan, marijuana use has been shown to impair performance for up to 3 hours using both driving simulation and open and/or closed driving courses.
Emergency nurses should be providing education for patients and the public on the hazards associated with impaired driving. Education should focus on not driving while under the influence of marijuana. Injury prevention education similar to that provided for drunk driving, like having a designated driver, should be provided to known and potential marijuana users. Education and injury prevention related to marijuana use is limited and not far reaching; therefore, it is important that emergency nurses advocate for additional research about the impact that both legal and illicit cannabis use has on health, safety, and injury rates. To date, little research has been conducted about the effects of marijuana use, cannabis-related adverse events, and ED visits. Emergency nurses should take a special interest in marijuana-related trends in ED visits, including injury rates.
Further research is needed on the broad impact of marijuana usage in Colorado and other states. ED nurses are at the forefront of this new culture and are in the best position to lead the research efforts and educate the public. While it is fairly easy to find a marijuana dispensary anywhere in Colorado, a push for more public education on prevention of accidental marijuana exposures should be the priority.
Keywords: Cannabis impaired driving
Language: en |