Will Massachusetts hospitals be swamped by patients who’ve had a bad experience with pot? What about teens? Will they be more likely to use marijuana now that Massachusetts voters have approved recreational use?
With recreational marijuana set to become legal next month, concerns about the drugs’ effect on a wide swath of life have gained urgency, prompting Boston health officials Wednesday to seek guidance from their counterparts in Colorado, among the first states to legalize the drug.
Colorado has experienced a significant jump in patients seeking emergency medical treatment for complications related to suspected marijuana use since 2014, when the state legalized the drug for commercial sales, according to a presentation by Denver health officials. Still, marijuana-related emergency department visits represent less than 1 percent of all ER visits, said the officials, who shared their experiences and lessons learned during a phone call with the Boston Public Health Commission.
As states weigh whether to legalize marijuana, one of the most contentious issues is whether legalization increases adolescent use. Colorado’s experience offers no definitive answer.
Danica Lee, inspections director at Denver’s Department of Environmental Health, said her agency has hired six additional inspectors since 2014 to monitor more than 470 marijuana facilities that have sprung up in her city.
Massachusetts was one of four states, including California, Maine, and Nevada, that voted last week to legalize marijuana for recreational use, with 54 percent of residents approving the Massachusetts initiative. Recreational use will become legal Dec. 15 for adults 21 and over, and marijuana retail stores would open in January 2018, although the state’s top marijuana regulator is suggesting she might urge a later opening date.
Legalization in Colorado has forced health officials to learn about many facets of the industry they said they never imagined could be so complex.
“It has been overwhelming to try to understand the hazards of all these products,” including oils, tinctures, and marijuana-infused edible products, Lee said.
Because of the tremendous amount of money to be made with marijuana sales — one plant can be worth $1,000 — companies often cram plants into tight spaces during their growth cycle, creating mold contamination, and then use illegal pesticides to battle pests, Lee said. Some companies have also used questionable equipment, including old washing machines, to produce marijuana concentrates, she said.
Those concentrates are used to make a variety of other marijuana-infused products.
Lee advised Massachusetts regulators to take a more incremental approach than Colorado did in approving the sales of different types of marijuana products.
Oversight of marijuana-infused products at Massachusetts medical marijuana dispensaries got off to a bumpy start even before the first dispensary opened in June 2015. State regulators and testing labs disagreed over rules governing the screening of pesticides, forcing the state to allow sales of some products before they were fully tested.
Just nine dispensaries have opened in the four years since Massachusetts voters approved marijuana for medical use.
In Colorado, where medical marijuana use was legalized in 2001, teens say they have changed their opinions of the drug since it became more widely available in 2014.
In the year before Colorado legalized recreational sales, 54 percent of high school students said they believed regular marijuana users were exposing themselves to moderate or great risk. A year after stores opened, that dropped to 47 percent.
But that apparently did not translate to a large increase in students who said they regularly used the drug. Some teenagers, notably those in ninth, 10th, and 11th grades, reported no change, or even a slight decline, in marijuana use after recreational pot shops opened in Colorado.
“There have been some pretty intensive prevention programs” that probably helped hold the numbers down, said Kathryn DeYoung, a disease tracker with Denver’s public health department.
The one noticeable jump was among seventh-graders, with nearly 9 percent saying they were current users compared with 4.5 percent before recreational use was legalized.
The relaxed perception of marijuana’s harms did not correspond to an increase in the percentage of high school students who reported driving after using marijuana. That number actually decreased slightly, from 10.9 percent before legalization, to 10.4 percent after.
Monica Valdes Lupi, executive director of Boston’s Public Health Commission, said her agency will be paying close attention to teens and adolescents.
“This is a really vulnerable population,” she said.
Added Francis Doyle, the commission’s chairman: “There are a lot of influences on them now.”
Doyle said commission members have already started discussing coordination among city agencies to handle monitoring and regulation of marijuana shops, and how to better collect data to measure the effects of legalization.
“We have been talking about this for weeks, in anticipation, as the polling showed this was probably likely to pass,” Doyle said.Kay Lazar can be reached at firstname.lastname@example.org Follow her on Twitter @GlobeKayLazar.