Lessons Learned

Jessica Neuwirth Retail Marijuana Education & Youth Prevention Coordinator, Prevention Services Division

Marijuana Education & Prevention in Colorado

Enact the will of the people while preserving

public health

Educate for safe, legal and responsible use

CDPHE ON RETAIL

MARIJUANA

1.  Medical Marijuana Registry

2.  Marijuana Health Monitoring and Research

3.  Retail Marijuana Education and Youth Prevention

4.  Laboratory: MJ Lab Inspections, MJ Ref Lab

5.  Consultation: Edible Safety, Proper disposal of waste

ROLES OF CDPHE

LESSON #1 Improve data

and trend reporting

MJ USE DURING PREGNANCY- CO

5.7%

14% 13% 4% 3%

11% 10%

PRAMS, 2014

MJ USE DURING PREGNANCY- CO

13% 6% 6%

PRAMS, 2014

Drank Alcohol

Used Tobacco

Used Marijuana

MJ USE DURING PREGNANCY- CO

11% 6% 5%

3 MONTHS BEFORE DURING POST-

PARTUM

PRAMS, 2014

ANY SMOKING DURING PREGNANCY- CA

11% 3% 6%

3 MONTHS BEFORE DURING POST-

PARTUM

MIHA, 2013-2014

LESSON #2 What will you

say?

Reports & Factsheets:

•  CA Department of Public Health

•  CO Department of Public Health

•  National Academies of Science

BIOLOGICAL EVIDENCE

There is no known safe amount of marijuana use during pregnancy.

THC can pass from mother to the unborn child through the placenta.

BIOLOGICAL EVIDENCE

The unborn child is exposed to THC used by the mother during pregnancy.

THC can be passed from the mother’s breast milk, potentially affecting the baby.

EFFECTS ON EXPOSED

OFFSPRING

Maternal use of marijuana during pregnancy is associated with decreased cognitive function and attention. These effects may not appear until adolescence.

Maternal use of marijuana during pregnancy is associated with decreased growth during childhood.

EFFECTS ON BIRTH

OUTCOME

LIMITED •  Heart defects •  Low birth weight •  Birth defects •  Gastroschisis

MIXED •  Neural Tube Defects •  Preterm delivery •  Decreased birth weight •  Small for gestational age •  Still birth

BREASTFEEDING

INSUFFICIENT

Breastfeeding and SUIDS

MIXED

Breastfeeding and infant motor

development

RESEARCH GAPS

•  Cannabidiol (CBD) and other cannabinoids

•  Other methods of use besides smoking

•  Miscarriage

•  Potency

•  Breastfeeding

- Effects on infants

- Length of time THC remains in breast milk

- Studies to correlate urine THC levels with

presence of THC in breast milk

LESSON #3 Get

information out quickly

INFLUENCERS

WHAT WOMEN WANT TO

KNOW

Effects on fetus development and growth.

Long-term health effects for their babies

How THC is passed/stored in their baby’s body.

Recommendations

Screen at every visit

Encourage cessation & talk about risks of use

Discuss plans for breastfeeding

MOTIVATIONAL INTERVIEWING

Can you tell me about why you are using marijuana? How does it help you? Do you want to stop using marijuana? How difficult do you think it will be to stop using marijuana? Do you think you can stop?

Talking to patients about medical marijuana

Determining if the benefits outweigh

the potential risks

Marijuana Pregnancy and

Breastfeeding Guidance For

Colorado Health Care Providers

Pediatric Exposure Prevention Clinical

Guidance For Discussions with

Children & Adolescents Ages 9-20

Pediatric Exposure Prevention Clinical

Guidance For Discussions with

Parents or Guardians

Webinar Available

Available through

www.CO.Train.org

TESTING

When? Who?

What happens next?

Mandatory Reporting

Some hospitals test babies after birth for drugs.

If a baby tests positive for THC at birth, Colorado law says

child protective services must be notified.

If you as a health care provider have a suspicion of abuse or neglect, it is your duty as a mandatory reporter to report child abuse or neglect.

FINAL LESSONS

Listen to your audience

Adapt local health policy

Respect personal ideology, but know you will upset both sides

RESOURCES AND SOURCES

Good to Know Colorado social marketing campaign GoodToKnowColorado.com

Free resources for order

http://cohealthresources.org/

Colorado Clinical Guidelines https://www.colorado.gov/pacific/sites/default/files/MJ_RMEP_Factsheet-Pregnancy-Breastfeeding.pdfects-while-pregnant-or-breastfeeding

Monitoring Marijuana in Colorado Report

https://www.colorado.gov/pacific/marijuana/effects-while-pregnant-or-breastfeeding

More questions? Jessica Neuwirth

Jessica.neuwirth@state.co.us

THANKS!

Therese McCluskey, Alameda County

Emily Adams, Humboldt