Seeing through the haze of Amendment 64

With the passage of Colorado’s Amendment 64 only a few weeks in the rearview mirror, follow-up media commentary appears to be sparse. I have often remarked that I have never seen anyone enter the emergency room with a problem directly related to marijuana use.

Problems in the ER from alcohol are daily occurrences – almost hourly on weekend nights. Remember the adage: instant butthead, just add alcohol? Deaths from outright poisoning from alcohol in adolescents and college kids are not rare.

Deaths from marijuana? Oh, yeah, a heavy bale falling from high above might just prove fatal.

However, perhaps my observations have been flawed. The active presence of marijuana is not so easy to detect, whereas the presence of alcohol is easily recognizable and simple to measure – by breathalyzer or blood for blood-alcohol content. Alcohol levels are also very predictable: The body metabolizes alcohol at a constant rate of about 0.6 ounce (alcohol in the “standard drink”) per hour. Tetrahydrocannabinol, or THC, the active component of marijuana, and its cousins are not quite so simple. Saliva, hair, urine and blood can be tested for THC, but THC can persist in blood for several days after smoking, even a week or more in heavy smokers.

Correlating THC levels with altered behavior is also difficult.

This presents a problem for law enforcement and is one reason zero tolerance, i.e., any detectable THC, is being advocated for (driving) conviction from some quarters. It is like being convicted for the six-pack consumed yesterday before driving today. It looks like some THC level will be established eventually. The key issue remains: impairment. Drink responsibly and smoke responsibly.

The transportation industry attacked the problem of worker impairment from drugs and alcohol aggressively in the early 1990s. Two prominent accidents forced Congress to act. On Jan. 4, 1987, an Amtrak passenger train doing 108 mph struck three stopped Conrail locomotives northeast of Baltimore, killing 16. Both locomotive engineers were stoned, and one, at last report a drug counselor, did four years in prison.

In January 1989, a commuter flight, under instrument conditions, went into a ridge five miles north of Durango-La Plata County Airport, killing the crew and seven passengers. The captain had a heavy round of cocaine the night before, degrading his “performance.” He “ineffectively” monitored “an unstabilized approach,” flown by the co-pilot, who had marginal instrument flying skills.

These accidents set the bar for mandatory drug screening in the transportation industry – aircrews, engineers and truckers. Within five years, drug positivity went from 5 percent to 1 percent or less of those tested. The goal was, and still is, zero tolerance in transportation.

Will the passage of Amendment 64 make us less safe? I don’t think so, and I don’t foresee a significant increase in users. The problem of impairment by drugs has been around for a long time, and there has been progress because of education and enforcement. Marijuana use will remain, but without criminality for simple possession. Efforts against methamphetamine, cocaine and prescription narcotic abuse must continue. Dr. Fraser Houston is a retired emergency room physician who worked at area hospitals after moving to Southwest Colorado from New Hampshire in 1990.

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