Cities & counties hurt by liquor privatization

Liquor privatization has hurt local governments and their ability to provide alcohol-related public safety services according to an opinion published in today’s Seattle Times.

Though I-1183 proponents promised more money to address alcohol-related harms, funding was cut.   “In 2012, the state Legislature was balancing its budget and chose to ignore the voters and I-1183’s clear wording. Lawmakers diverted more than $100 million in liquor revenue from cities and counties to the state’s general fund,” write the authors.

They go on to note, “City and county law enforcement currently handle half of all DUI arrests, and cities employ two-thirds of the state’s public safety personnel. The Legislature’s action to reduce liquor revenues for local government is a direct cut to funding for local law enforcement.”

As those of us who advocate for substance abuse-related policy know, diversion of dedicated revenue is nothing new.  The state’s highly successful tobacco prevention program was decimated a few years ago when the legislature diverted dedicated prevention funding to the general fund.

Since even recent history apparently repeats, it is not surprising that public health advocates are concerned about marijuana revenue.  I-502 dedicates marijuana revenue for prevention programming, but how long will it be before it is diverted to the general fund, especially considering our state government still needs to fill holes in their budget?  

Local jurisdictions also have concerns about the impact of I-502 on their budgets.  The opinion piece states, “Marijuana legalization will add new costs for local law enforcement to police legal sales, crack down on the illegal black market and to enforce impaired-driving laws. However, to add insult to the injury of the liquor-revenue cuts, the Legislature has ignored cities’ and counties’ requests to recognize the local impact from marijuana legalization, and share some of the estimated millions of dollars a year in new tax revenue.”

Marijuana poisonings among kids are up

Source: Washington Poison Center

Pediatric exposures to marijuana reported to the Washington Poison Center (WAPC) are on the rise in our state.  As of July 7, 54 cases were reported to the WAPC while in all of 2013 58 cases were reported.  As with all poisonings, the WAPC says marijuana poisonings are likely under-reported.

Earlier this year, study results published in JAMA-Pediatrics reported similar problems in Colorado.  

Susan Mazor, MD, a pediatric emergency medicine physician at Seattle Children’s Hospital and a medical toxicologist at Children’s and the WAPC, says that it makes sense that as marijuana becomes more available in the community, children’s exposures to the drug increases. “More availability of any poison usually translates to more unintentional poisonings in kids,” she says.

In an editorial accompanying the JAMA-Pediatrics article, a public health response is called for:

The public health community needs to be vigilant for unintended consequences of legalized marijuana, such as increased ingestion by children as reported . . . Unfortunately, as with tobacco, some of the most significant health consequences will likely take years to manifest.

In the meantime, we can inform the public about the known harms of marijuana even in states where use has been made legal. This has been happening with tobacco. While rates of adolescent tobacco use remain unacceptably high, they have fallen dramatically since their peak in 1996.  It is nearly impossible to be sentient in 2013 and not know about the health consequences of tobacco. Anecdotally, nearly all of the patients treated in the Adolescent Substance Abuse Program at Boston Children’s Hospital who use tobacco would like to quit because of health concerns, while few adolescents can understand why we advise them to stop using marijuana. The skyrocketing rates of adolescent  marijuana use indicate that we are losing an important public health battle and we have a lot of work to do if we want to reverse these trends.

While our state has made available education materials encouraging parents to talk to their children about not using marijuana, education also needs to be done about the availability of marijuana in homes.  Since I-502 funding for marijuana education campaigns has yet to come in, other sources of funding need to be found by policy makers on the state and local levels.  

As we know from experiences with alcohol and tobacco, and is evident with these latest reports about marijuana, increased availability of a drug is harmful to children.  Limiting availability is one step policy makers can take to ensure that fewer children are exposed to marijuana.  Keeping the number of retail recreational marijuana stores as it is now and eliminating medical marijuana stores is good public health policy.  

Limiting marijuana promotion to reduce public health implications

Though most of his message is a little late for Washington, Dr. DuPont makes the case for limiting the promotion of marijuana as a way to reduce public health costs.

Federal budget cuts hurt local substance abuse prevention and treatment programs

In a time when Washington wants to treat substance use more as a public health issue than a justice system issue, public health funding is not keeping up with changing laws.  Not only has our state reduced funding for substance abuse prevention and treatment programs, the federal government has, too.  According to a report by the Coalition for Health Funding, overall federal funding for public health programs has been drastically cut over the past four years and federal agencies that deal with substance abuse prevention and treatment have been affected the most.

From: http://www.cutshurt.org/ 

The National Institute of Health (NIH), which includes the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and comprises about half the federal government’s spending on public health, has experienced a 10 percent budget cut over the past year.  Funding for the Centers for Disease Control and Prevention (CDC) has been slashed by 16 percent and funding for the Substance Abuse and Mental Health Services Administration (SAMHSA), which includes the Center for Substance Abuse Prevention (CSAP) and the Center for Substance Abuse Treatment (CSAT), has been cut about 8 percent.

In our state, most substance abuse prevention programming is implemented through coalitions.  The state’s Community Prevention and Wellness Initiative coalitions are funded with Substance Abuse Prevention and Treatment block grant monies from SAMHSA.  Drug Free Communities coalitions are also funded through SAMHSA.  Federal cuts to the SAMHSA budget reduce our state’s primary source of prevention funding.   

If Washington is serious about treating substance abuse as a public health issue, and it's not just political rhetoric, both federal and state policy makers need to increase prevention and treatment funds, not reduce or eliminate them.  

No pot gummy bears? WSLCB: Marijuana products that are appealing to children are prohibited

Since the adoption of I-502, I’ve been asking public health advocates, “If we could better regulate the tobacco industry before it became Big Tobacco, what would we do?”  As Washington develops a marijuana industry, answers to that question can guide the way.

This week, the Liquor Control Board adopted a process for approving marijuana-infused foods and beverages to attempt to reduce the number of products that appeal to youth.  This is a wise move considering what public health experts know about alcohol and tobacco products that are attractive to youth. 

As we know from our experiences with tobacco and alcohol, some products are attractive to youth even though they are to be consumed only by people over the age of 21. 

• For instance, several years ago 20% of smokers ages 17 to 19 reported using flavored tobacco products within the last 30 days, compared to 6% of adult smokers.  Soon after the study that produced this finding was released, the Food and Drug Administration banned flavored cigarettes.  Now the FDA is in the process of determining how to regulate e-cigarettes, including flavored nicotine products.    
• Flavored alcoholic beverages are highly popular among underage drinkers.  A recent study shows that among alcohol brands favored by underage drinkers, Smirnoff malt beverages are popular.  This brand includes flavors like blue raspberry lemonade, pineapple, green apple, grape, root beer, and root beer float.  

Regulating products so that they do  not appeal to children is an important component of a multi-pronged strategy for preventing underage substance use.  The LCB's regulations for marijuana-infused products are a perfect example of how multiple sectors in our state have roles to play to prevent underage marijuana use.  

Throwback Thursday: Flavored cigarettes banned for public health reasons

In 2007, the World Health Organization released The Scientific Basis of Tobacco Product Regulation, a report that included information about the public health impacts of flavored tobacco products.  From the report:

Basic public health principles dictate that flavours should not be used to adulterate contaminated food or make highly dependence-causing drugs more enticing.

Studies based on the tobacco industry’s internal documents suggest that flavouring agents may also play an important role in the industry’s targeting of young and inexperienced smokers. Menthol has been used to target new smokers across different ethnic groups, and additives such as chocolate, vanillin and licorice have been part of an intensive industry effort to increase the market share of the Camel brand within the youth market. Additives have also been shown to promote smoking among youths by masking the negative taste of tobacco smoke with flavours.

In 2009, in response to public health concerns, the Food and Drug Administration banned cigarettes that contain flavors other than tobacco or menthol. The ban includes cigarettes that contain “an artificial or natural flavor . . . including strawberry, grape, orange, clove, cinnamon, pineapple, vanilla, coconut, licorice, cocoa, chocolate, cherry, or coffee, that is a characterizing flavor of the tobacco product or tobacco smoke.”

Public health concerns included flavored cigarette use rates among young people.  At the time of the WHO’s report, 20% of smokers between ages 17 to 19 reported using flavored cigarettes within the last 30 days, compared to 6% of adult smokers.

Online resources from the Public Health Law Center at William Mitchell College of Law provide prevention advocates and policy makers with information on how to regulate tobacco and related products. 

Why investing in drug use prevention is important

“The state is no longer wasting law enforcement time on marijuana use,” according to a recent Seattle Times opinion piece about I-502, the initiative that decriminalized and legalized marijuana. 

In 2004, a Seattle Times article about Seattle’s Initiative 75, which made marijuana the lowest enforcement priority for police, reported similar results.  “Statistics for the first six months of 2004 show that the city has prosecuted just 18 cases of marijuana possession compared with roughly 70 during the same time period last year.”  In other words, de-facto decriminalization worked to reduce the number of people arrested and prosecuted for marijuana offences. 

According to a recent report from the National Academies of Science (NAS), the rise in United States incarceration rates can be attributed to “significantly increased sentence lengths, required prison time for minor offenses, and intensified punishment for drug crimes.”  Racial disparities in incarceration rates are exacerbated by sentencing laws, such as three strikes and mandatory minimums, and by “law enforcement strategies associated with the war on drugs.”  In other words, how laws are enforced and how people are sentenced are the primary factors leading to high incarceration rates. 

Authors of the NAS report offer specific suggestions for reducing incarcerations rates:

• changing sentencing policies, especially those having to do with the enforcement of drug laws;
• changing prison policies;
• addressing social policies especially those addressing “economic insecurity, low education, and poor health that are associated with incarceration in the nation’s poorest communities.  Solutions to these problems are outside of the criminal justice systems, and they will include policies that address school drop-out, drug addiction, mental illness, and neighborhood poverty – all of which are intimately connected to incarceration.”  

That’s where youth drug use prevention comes in.  Preventing the onset of drug use among teenagers prevents school drop-out, drug addiction, some mental illnesses, and supports healthy youth development.  To be most effective, multiple community partners must join together to prevent teen drug use.  Parents and schools are only part of effective drug use prevention strategies.  Organizations concerned with economic insecurity, health, and the justice system also have stakes in keeping kids drug-free. 

WA House Committee updated about the implementation of I-502

Earlier this week, the Washington House Government Accountability and Oversight Committee held a work session about the implementation of I-502.  For a limited time, a recording of the session may be viewed online.



From a youth substance use prevention point of view, a few discussion items stuck out.

• Marijuana business owners repeatedly stated that the medical marijuana market and the recreational marijuana market should not co-exist.  One said that the medical marijuana market "is the black market" and another one called it a "free for all."  They agreed that the medical marijuana market is going to be a problem for I-502 businesses.

• A few people talked about the need for preventing youth marijuana use and said that children and parents need to know about the negative affects of the drug on the developing brain.  Nobody talked about how policy is a key part of a comprehensive prevention strategy.  

• The University of Washington is conducting research on the impact of I-502 retail stores on the communities in which they are located.  The research will be conducted in King County and look at youth use rates, crime  rates, and economic impact.  Representative Hurst wondered if marijuana stores will really have much of an impact on communities since we already have "a saturated market" and people who want marijuana can easily get it. 

• Throughout the work session it was obvious that most people think that the marijuana system is going to change a great deal over the years.  Just like the alcohol system, rules will change.  Liquor Control Board Director Garza predicted that more marijuana business licenses, including retail licenses, eventually will be issued by the agency.  

Throwback Thursday: Tobacco companies cast doubt on research

From "Inventing Conflicts of Interest: A History of Tobacco Industry Tactics" published in the January 2012 edition of the American Journal of Public Health:

"One R.J. Reynolds official announced to other industry executives in November 1953 that the company had formed a bureau of scientific information to 'combat the propaganda which is being directed at the tobacco industry.'  At the same time, American Tobacco began to collect the public statements of scientists who had expressed skepticism about the research findings indicting tobacco.  The company's own public relations counsel understood that it would be critical to create questions about the reliability of new findings and to attack the notion that these studies constituted proof of the relationship of smoking to cancer."

The Legacy Tobacco Documents Library includes tobacco industry videos used to attempt to debunk research showing that smoking is harmful to health.

Click here to view videos that cast doubt on scientific research including one in which it is suggested that auto emissions, not cigarettes, may be to blame for increasing rates of lung cancer.

Liquor Control Board issues first marijuana retail licenses

From the Liquor Control Board: 

The Washington State Liquor Control Board (WSLCB) today issued the state’s first 24 marijuana retailer licenses. A complete listing, including contact information of the new retail licensees, can be found online within the Public Records section of the WSLCB website.

The 24 applicants were notified via email early this morning that they were approved for a retail license. Once approved for a license, producers and/or processors are able to file a required manifest for transporting to retail locations. Following a 24 hour quarantine period, they may begin transporting products to retail stores. Marijuana retailers may begin selling marijuana at their discretion following receipt of product and entering it in to the traceability system.

Businesses receiving their licenses today represent the first of 334 licenses allotted by the WSLCB for retail sales who have successfully completed the licensing process. Locations receiving licenses were selected by taking into account population, geographic dispersion and the individual applicant’s readiness to be licensed.

Today’s issuance of the first retail licenses represents the latest step following nearly 18 months of establishing a controlled and comprehensive system of producing, processing and retailing recreational marijuana.

The WSLCB was especially concerned with the impact to children. There are strict rules regarding packaging, labeling and advertising to ensure they not appeal to children. In June, the LCB announced emergency rules that include a label and product approval process.

WSLCB licensing investigators will continue to issue producer, processor and retailer licenses as those applications are completed. To date the WSLCB has licensed over 687,000 square feet of plant canopy for marijuana production, roughly the equivalent of a dozen football fields.

For more information including summaries of the rules frequently requested lists please visit the LCB website at www.liq.wa.gov.

Where will marijuana tax revenue go?

Once marijuana is sold in stores, revenue from sales will be directed to several areas.

Tier 1: Funds collected through marijuana excise taxes, license fees, penalties, and forfeitures will be distributed every three months as follows:

• $1,250,000 to the Liquor Control Board to administer the marijuana system.
• $125,000 to the Department of Social and Health Services (DSHS) to administer the Healthy Youth Survey, analyze data, and produce reports.
• $50,000 to the Washington Institute for Public Policy to conduct a cost-benefit analysis and produce four reports from September 2015 to September 2032.
• $5,000 to the University of Washington's Alcohol and Drug Abuse Institute to develop and maintain web-based public education materials with scientifically accurate information about the health and safety risks of marijuana.  

Tier 2: Of the dollars that remain, the following will receive funding:

• 50% to the Basic Health Plan.
• 19.07% to the General Fund.
• 15% to DSHS to implement substance use prevention strategies among middle and  high school students. 
• 10% to the Department of Health to implement a marijuana education and public health programs.
• 5% to community health centers for primary health and dental care services, migrant health services, and maternity health care services.
• 0.06% to the University of Washington and 0.04% to Washington State University for marijuana research.
• 0.03% to the Building Bridges programs.  

Any of the above can be changed by lawmakers starting next legislative session.  With lawmakers looking to fill budget shortfalls, especially education funding shortfalls, earmarks for prevention needs to be guarded.

Even if the earmarks remain untouched, it is unclear how much revenue will actually be generated by the new marijuana market.  The Liquor Control Board does not expect that all marijuana consumers will use the new system at first, limiting the amount of revenue generated in the short run.  According to researchers, 24% of the current market is made up of people under the age of 21 who will never use the legal "recreational" market. Some predict that a minority of current adult marijuana users will ever use the new market.

Right now, predictions are all that we have to go on.  It may be a few years before we know how much money communities will receive to fully implement prevention strategies.