“Burying the lede”: heavy cannabis use in Colorado

“Burying the lede” is what journalism teachers call it when the key fact in a story doesn’t make it to the first (“lede”) paragraph but instead gets “buried” somewhere down in the story.

Of course, scientists can make the same mistake: breathlessly reporting routine findings while ignoring what’s surprising or important. Consider, for example, this week’s report from the Colorado Retail Marijuana Public Health Advisory Committee. The authors report relatively encouraging news about the public-health impacts of legalization: cannabis use among adults and minors is high relative to other states, but there’s no observable increase after the opening of retail adult-use stores. The spike of emergency department visits due to edibles seems to have come back to earth.

But neither the report itself, nor the news stories I’ve seen about it, makes much of a fuss about what looks to me like the headline finding: (from p. 4 of the report):

In 2015, 6% of adults reported using marijuana daily or near-daily. This was lower than daily or near-daily
alcohol (22%) or tobacco use (16%). Of 18- to 25-year old marijuana users, 50% report using daily
or near-daily (13% of all 18- to 25-year olds). Among adult past-month marijuana users, 79% smoke, 30%
“vape” and 33% use edibles. Respondents could report using more than one method, which 50% of users
did. Finally, approximately 2% of adults drove a vehicle in the past 30 days after using marijuana.

In case you didn’t notice it: 50% of cannabis users between 18 and 25 use every day or almost every day. (The report defines “daily or near-daily use” as self-reported us 5 to 7 days per week.) We know from other studies by Beau Kilmer and his group at RAND that daily/near-daily smokers consume about three times as much cannabis per use-day as less frequent smokers, enough to be measurably impaired (even if not subjectively stoned) for most of their waking hours. That turns out to be 13% of the entire population of young adults. The National Survey on Drug Use and Health finds that about one-half of daily or near-daily smokers meet the diagnostic criteria for Substance Use Disorder. That’s a frightening share of users, and of the total population, to be engaging in such worrisome behavior.

The comparison with daily use of alcohol and tobacco seems vaguely reassuring: daily cannabis use is less common than daily use of the two others drugs. But that’s a false reassurance, because the behaviors aren’t directly comparable. Tobacco, of course, isn’t an intoxicant at all. Alcohol certainly is, but as sociological (not pharmacological) fact most drinking activity is not to the point of intoxication: most people who have a drink or two, even every day, just have a drink or two: they don’t intend to get drunk, and they don’t in fact get drunk. The scientific literature has a technical term for getting drunk: it’s called “binge drinking,” and is usually defined as four or more drinks at a sitting for a woman, five or more for a man (to allow for gender differences in weight). Binge drinking is a hell of a lot more common than you’d like it to be: about half of all drinks are consumed as part of drinking binges. But it’s still relatively rare.

Cannabis, by contrast – again, this is sociology, not pharmacology – is, under U.S. conditions and practices, usually used to intoxication, as the common terms indicate: “getting medicated,” “getting stoned,” “getting wrecked.” Yes, it’s possible to take a puff or two before a dinner or a concert, or at a party, to enhance the enjoyment of food, music, and companionship, but that’s not in fact the way U.S. consumers typically take the herb. Of course, some of those daily and near-daily users aren’t getting stoned every time they use; their tolerance for THC has developed to the point where smoking just makes them feel normal. Unfortunately, all the studies show that objective impairment – reduced performance on a range of cognitive and motor tasks – can be present even when subjective intoxication is absent, and in fact impairment generally lasts longer than the feeling of being high.

And yet the prevalence of heavy use doesn’t even make it to the report’s list of “trends to continue monitoring” (i.e., things to worry about), and doing something to bring that prevalence down fails to make the list of recommendations.

More and more people using cannabis more and more often is a trend that pre-dates legalization and is not restricted to states that have legalized. Between 1992 and 2014, as Jon Caulkins calculated, the share of cannabis users who are daily or near-daily more than quadrupled nationally, from 9% to 40%. It’s not clear how much Colorado’s retail non-medical legalization in 2012, or the establishment of retail medical outlets in 2009, or legalization for medical use in 2000, influenced the current prevalence there.

What is clear is that lower prices (Colorado retail bud is now down to about $6/gram and headed lower) and aggressive marketing – both accompaniments of cannabis legalization as it’s currently being pursued, though not of alternative legalization proposals – make it easier for users to slip into heavy daily use. Indeed, that’s the main – some of us would say the only significant – risk of legalization. That risk could be reduced by using taxes to prevent the price collapse  So a report on the effects of legalization that neglects heavy use is like a review of the last performance of “Our American Cousin” that doesn’t mention John Wilkes Booth.




Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com

28 thoughts on ““Burying the lede”: heavy cannabis use in Colorado”

  1. A question we cannot, at this point, answer: Assume complete legalization everywhere. Assume, as this report indicates, significant or even massive daily use immediately results. Will that subside over time? And, of course, what does "subside" and "over time" mean in quantifiable terms. Not a happy prospect.

  2. The vast majority of youth 18-25 (87%) are not daily users.

    You're claim that this is a "frightening" problem is hyperbole and is not based on the facts. Furthermore, you have no scientific evidence that heavy, daily use is a "serious" problem.

    There's no "buried lede".

  3. Even if that number was true, the context is that 93.5% of the population has no substance abuse problems whatsoever.

    Let me rewrite that for you:

    Even if that number was true, the context is that 99.5% of the population has no cancer whatsoever.

    You don't get any smarter as you go on.

    1. It's called factual context. Not hysterical opinion.

      Your statement ignores the context, once again.

      Adult-onset Cancer is caused by lifestyle choices, diet, exercise, chemical exposure. Again, not the fault of cannabis.

      You ignored the facts I stated.

      Ignoring facts only makes you ignorant.

      Intentionally ignoring facts makes you willfully ignorant.

      1. I'm ignoring the facts you gave because they weren't relevant. They were just some numbers you picked which added up to a number you didn't like. That's all–number facts picked more or less randomly. Since you don't have relevant facts, you don't have an argument.

        My opinion is that marijuana is by far the safest and best intoxicant of all those I'm aware of. It does less harm while delivering more pleasure and other benefits than any other. The only thing in its league is coffee. And maybe love.

        That said, it's awful easy to piss your life away and not notice it if you're stoned all the time.* Marijuana's relative harmlessness makes that a lot easier than, say, alcohol, which your body will tell you to stop drinking well before it kills you.

        It's a great intoxicant. It's not perfect. Legalization (which I still see coming soon) brings newer, better problems. This is one of them.

        *Or in love.

        1. The fact that a certain % of our population has extremely low IQs, who frequently make bad decisions is irrelevant? That's your opinion.

          And the % of our population that has mental illness is irrelevant to substance abuse? Says who?

          Heavy use of cannabis is not "substance abuse".

          Use of opiates, opiods, alcohol and tobacco certainly are. And some people who abuse those hard drugs have low IQs and mental illness. That's my point.

          1. There are people who consume enough pot that it interferes with living their lives. That's substance abuse. It's probably the least harmful substance abuse imaginable, because pot isn't toxic or debilitating and doesn't generate violence, but it's still a concern.

            It might be you're right the people who Kleiman says exhibit marijuana abuse disorder have underlying problems that are the real issue, but all you said was, "Could be!" Here's a counter-argument that's just as solid as yours, based on your own evidence and your own claims: Since hard drugs are worse for you than pot, people with low IQs tend to use less pot than hard drugs. So those low-IQ pot smokers you say are dragging down the curve don't exist, and it's higher-IQ people becoming dysfunctional.

            I don't believe that, myself, but it's just as well-founded as what you say.

          2. "There are people who consume enough pot that it interferes with living their lives."

            Why are we arguing over this? Because there are people who very strongly believe that they must interfere with everyone's lives in a vain attempt to prevent it. I'd sure like to see a 40 year war on that sort of behavior.

          3. I believe in human freedom. If someone's freedom is limited by their substance use, and they would like to do something about it, I believe their need should be acknowledged and supported. By which I do not mean put them in jail.

            There's a big difference between interfering with peoples' lives and giving them tools with which to do what they want with them. One tool for that is legalized marijuana. Another is substance abuse treatment. It's all about control of your own head.

          4. Agree wholeheartedly on that. What are your thoughts on the author's position that prices should be interfered with even more than they already are in places like Colorado out of concern for "probably the least harmful substance abuse imaginable"?

          5. Human freedom is usually advanced over the free market's dead body, so I think it's a great idea, if I understand correctly that he's proposing going from a percentage of sales to a unit tax. That's especially good if it taxes by THC content and not weight. It'd be nice to have pot available that wasn't designed to get you as high as possible as fast as possible, and wasn't necessarily designed to stupify. To that end, let CBD content go untaxed. Only tax THC.

          6. Well this is where we part ways. I'm not convinced that human freedom is in any way advanced on over-taxation to the degree necessary to "prevent the price collapse" to $6 a gram, or anything close to it. Nothing else is treated like that. How is it justified for, again, "probably the least harmful substance abuse imaginable"? If that can be justified, why not coffee (and maybe love) too?

          7. That's not unlike how alcohol taxes work. People who sell booze for a living don't like it. I say screw 'em. I also say screw corporate cannabis.

          8. To further clarify my point: There are well-understood unintended consequences to such a policy proposal, which an intellectually robust analysis should consider. Such levels of taxation require police-state enforcement, something I find I cannot easily reconcile with my belief in human freedom. You mentioned advancing human freedom over dead bodies; how many Eric Garners should we be willing to sacrifice in our attempt to protect those who might engage in "probably the least harmful substance abuse imaginable" from themselves?

          9. The problem with Eric Garner was that he lived in a society that manufactures poverty for profit and was murdered by police who would face no accountability for their actions. That he had to sell loose deathsticks on the street to get by is shameful. Those are the real problems that led to Eric Garner's death. it's a little shameful of you to use him in this manner.

          10. Annie Rae Dixon
            Veronica and Charity Bowers
            Xavier Bennnett
            Delbert Bonar
            Shirley Dorsey

            I could go on and on and on and on with these.

            Hell no I'm not ashamed to use these examples to make a point. Screw liquor store owners and corporate cannabis all you want, but they aren't the only ones screwed by these policies. They're not even the primary ones, not even close.

            "Murdered by police who would face no accountability for their actions". For taking advantage of the easy arbitrage opportunity provided by a cheap commodity taxed extraordinarily high, though at a far lower rate than that proposed here. That's a police state, Jack. The victims are real. The suffering is real. The damage to social order and respect for law is real. The benefits are…. what? How much reduction in other peoples' substance use disorder is worth all that?

          11. Oh, you sweet summer child! "That's a police state, Jack." An expected consolation over the next few years will be reminding people who thought they lived in a "police state" back in the good old days.

          12. No, you're trying to reframe the question to your liking. It wasn't about racial prejudice – at least 3 of the victims I linked to were Caucasian – only 1 was identified as Black (as was Garner, of course). Police brutality is a natural product of police-state tactics and policies. The question was "How much reduction in other peoples' substance use disorder is worth all that? "

          13. I grant you that not all victims of police brutality are singled out due to race. The problem is still police brutality.

          14. So cops are just naturally brutal and no policy will change that? And the courts too? What's the root cause? Why is there so much police brutality that people are protesting in the streets, and why are the courts letting them get away with it?

          15. There are varying degrees on the spectrum between free-state everyone's on their own recognizance and police-state permission is required to take a dump. I'm personally not comfortable with the point on that line where cops kill citizens in broad daylight in front of witnesses over petty infractions with impunity. ymmv

  4. That certainly explains why so many medical people get addicted to hard drugs–they're stupid. I know whenever I interact with a pharmacist or a nurse or a doctor, my first thought is, "That person has a very low IQ. Sad!"

    You remind me of the title of Chester Hines' last book: Blind Man With A Pistol. You're landing a few shots here and there, but not because you've got good aim, or can even see your target.

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