Health Policy Solutions

By Bob Semro

Prescription drugs are a big part of the monthly budget for many seniors on Medicare, and provisions in the Affordable Care Act (ACA) are working to lower those costs.

In 2011, 3.6 million Medicare recipients nationwide saved $2.1 billion in prescription drug costs, according to estimates released last week by the Department of Health and Human Services (HHS). In Colorado, 39,746 Medicare recipients saved $22.8 million on prescription drugs, or $579 per person on average, according to these estimates.

HHS projects these savings will increase over time – totaling nearly $4,200 for the average Medicare recipient by 2020. For those with high prescription drug costs, the savings are projected to be as much as $16,000.

Most of the savings come from closing the coverage gap for prescription drugs, the so-called “donut hole.”

The ACA requires drug manufacturers to discount brand-name drugs sold to seniors in the donut hole by 50 percent. In addition, it provides increasing subsidies for seniors purchasing those same drugs (2.5 percent in 2013 and increasing to 25 percent in 2020.) That means that by 2020, the donut hole will be closed, and all Medicare recipients will pay the standard 25 percent co-insurance for generic and brand-name drugs.

“The Affordable Care Act is already saving money for millions of Americans with Medicare,” said HHS Secretary Kathleen Sebelius. “As we move forward, we will close the donut hole completely and save even more money for everyone with Medicare.”

Here are some facts from the report:

• In 2012, the ACA provides a 14 percent subsidy for generic drugs to help close the donut hole. By 2020, the subsidy reaches 75 percent.
• Women especially benefited from the prescription-drug benefit, with 2.05 million women saving $1.2 billion in 2011. In Colorado, 22,102 women saved $12.7 million, or $577 per individual on average.
• The 7 percent subsidy on generic drugs in 2011 saved $32.1 million for 2.8 million Americans.
• People with chronic conditions saw substantial savings on drugs that they must purchase regularly, like high blood pressure and high cholesterol medication. Those drugs are essential in preventing far more serious and costly conditions.

An issue brief from the HHS, Medicare Beneficiary Savings and the Affordable Care Act, offers further explanation on efforts to “strengthen Medicare and provide stronger benefits to seniors, while slowing cost growth.”

Another announcement last week from the department concerned Medicare Advantage, the program that gives seniors the option of enrolling in private insurance instead of the traditional Medicare program. The department reported that Medicare Advantage premiums have fallen by 7 percent and that enrollment has increased by about 10 percent since last year. These real-world results are very different from the predictions of many who opposed the Affordable Care Act and claimed that the new law would significantly damage the Medicare Advantage program.

Contrary to the concerns voiced by many who oppose the new health care reform law, the ACA is already showing real benefits to America’s seniors. And there will be even more significant benefits in the years to come.

Bob Semro is a health policy analyst with the Bell Policy Center, a nonprofit, nonpartisan think tank based in Denver.

Colorado schools have reported a 45 percent spike in drug violations in the past four years, even as the total number of other violations reported to state officials has declined.

Interviews with school officials, health care workers and students across the state depict marijuana as the key factor behind the increase.

What’s happening at your school? Search below to see a four-year history of drug offenses and their disposition, such as expulsion.

Search tips and data notes

• To compare schools or districts, hit “Ctrl” or “command” and click on as many names as you’d like to see.
• Clicking the “Details” button brings up detailed information about the penalties, such as expulsion, that resulted from the drug violations. The most serious penalties, including out-of-school suspension, expulsion and referral to law enforcement, are listed.
• Schools may impose more than one penalty for drug possession or sale, such as an expulsion and a referral to law enforcement. The number of incidents does not always equal the number of sanctions.
• Schools are required to report drug and other incidents annually to state officials and must follow strict reporting criteria. For example, they are asked to report only those incidents leading to suspension, expulsion, referral to law enforcement or “other” serious action. They are specifically asked not to report incidents leading to lesser punishment such as detention.

**Data source: Colorado Department of Education

By Katie Kerwin McCrimmon

The call came last fall while the young single dad was at his construction job.

“It was the hardest day of my life,” he said.

The man’s son, an East High School freshman, had been busted with baggies of marijuana at a Colfax Avenue parking garage adjacent to the school.

His arrest was one of 18 at East for marijuana possession last year and among the 179 arrests for marijuana possession or sale at 43 Denver schools during 2010-11, according to Denver police records.

The boy said he purchased the marijuana from a senior at school. He was naïve enough to divide it into smaller bags and write friends’ names on them.

“His whole intention was to sell it and make some money. There are quite a few kids there with a lot of money. He was trying to fit in and make some money,” the boy’s dad said.

The names of the father and son are being withheld because the boy is still a juvenile.

While Colorado schools report an increase in drug-related incidents and both national and state surveys show a rise in marijuana use among young people, this father has a message to other parents and kids.

“The stakes are a lot higher than you think,” the dad said. “You’re doing something illegal and you’re playing with fire. Sooner or later, you’re going to get burned.”

He believes young people are confused by mixed messages that bombard them. On the one hand, medical marijuana dispensaries are located near schools and advertise their products as “healthy” on storefronts, online and on radio stations with young audiences.

On the other hand, East officials are taking a proactive stance against the use of marijuana by students, and federal law enforcement officials in January announced a crackdown on medical marijuana shops within 1,000 feet of schools.

The 36-year-old father said he never had a strong opinion on the marijuana debate before, but now thinks medical marijuana dispensaries should be illegal.

“Nobody thought about the kids,” the dad said. “How do you tell your kids this is wrong when you’ve got a guy with a sign dancing around and saying, ‘Come get this’?”

Drug violations increase as other violations reported to state decline. Click on image to view full table information.

On the day the boy was caught, school resource officers hauled the 15-year-old back to East, arrested him, and charged him with two felonies: attempted distribution and attempted distribution to a minor.

The dad couldn’t bear to watch as the officers loaded his son into the police car and drove him to the Gilliam Youth Detention Center.

Because of a holiday, the boy ended up spending four days locked up before a judge in Denver’s juvenile court could hear his case. He experienced some bullying that led to a fight and some minor injuries.

Ultimately, he was confined to house arrest for two weeks, expelled from East and later harassed online for being a snitch. He had rocks thrown at his car and had to miss weeks of practice for his elite club sports team.

“It’s been devastating for him,” the dad said.

The boy transferred to another Denver high school and his grades plummeted.

“He had never been in trouble before. He had great grades. He went from a 4.0 to a 2.5” grade point average, the father said.

The boy is now on probation. If he can stay clean for two years, the felonies will be expunged from his record. He returned to East this year and is doing well again in school.

“I don’t want to see other kids go through that,” the dad said. “You don’t realize how this impacts the rest of your life. It impacts him getting into college and getting jobs. This has affected both of us pretty heavily.”

By John Suthers

Eleven years ago the citizens of Colorado passed an amendment to the Colorado Constitution called Amendment 20. The amendment simply created an affirmative defense against the enforcement of state marijuana laws for people with debilitating medical conditions who have physician approval to use the drug. But in recent years, a series of policy decision at the state and federal levels have opened the door to the creation of a medical marijuana industry in Colorado.

We have gone, over the course of a half decade, from a state that had roughly 1,700 medical marijuana patients and a system of individuals or caregivers growing small amounts of the drug to a state with tens of thousands of patients and hundreds of marijuana dispensaries and industrial-scale grow operations.

Why should you care? Are dispensaries just gaudy, neon-green eyesores that we should just learn to live with? And is the occasionally whiff of marijuana smoke nothing more than a passing annoyance?

Many Coloradans, including myself, think otherwise. Indeed, I am convinced that the adverse consequences of legalization of marijuana, or de-facto legalization through widespread distribution of medical marijuana, will far outweigh the benefits in terms of social costs, and that belief stems largely from my concerns about the impact of marijuana use on adolescents.

We know from decades of experience that adolescent use of marijuana is a function of two things: accessibility and acceptability. Marijuana has always been highly accessible to adolescents, but medical marijuana dispensaries on every street corner have taken that to a new level. The majority of teenagers in marijuana addiction treatment indicate that marijuana patients are their primary source of the drug.

The Colorado Department of Public Health and Environment indicates the number of persons between 12 and 25 who used marijuana in the past year in Colorado is now 38.5 percent — 10 percent above the national average. The widespread use of medical marijuana has also significantly impacted the acceptability of the drug to adolescents. By acceptability I mean the perception of risk. When the perception of the risk of the drug decreases, teenage use increases.

As marijuana has become abundantly more available and acceptable, we have seen youth use rate reverse a decades-long downward trend and start to creep back up among eighth, 10th and 12th graders. Even as tobacco and alcohol use among teens has declined, marijuana use has continued to rise among eighth, 10th and 12th graders, according to statistics the National Institute on Drug Abuse released in December.

Coloradans need only to look to Alaska for why widespread use and acceptance of marijuana use are bad for the state. When Alaska decriminalized marijuana use for adults in the 1970s, teenage use of the drug increased tremendously – to twice the national average. Today Alaska has the highest per capita use of illicit drugs in the United States.

This is an alarming trend, nationally and as seen through the Alaska experience, for a number of reasons, including the effects marijuana can have on a developing brain and what it will mean for drug addiction rates among today’s youth.

I am not an expert on the neurological development of teenagers, but doctors have joined me at public events throughout the state and have explained the ill effects marijuana can have on developing brains.

The teenage years are when our brains develop pleasure sensors that have lifelong significance. Typically a teenager derives a small hit of dopamine when parents provide affirmation for doing a good job babysitting, taking out the trash or doing other chores to help the family. These hits of dopamine train us, in a way, to do what is helpful or expected of us and to appreciate relationships.

Marijuana, like other drugs, throws this reward system off. Our bodies and natural sources of dopamine cannot compete with the intense high they induce. As a result, a young person is more likely to eschew normal, positive behaviors and instead seek to get high.

Researchers, including Dr. Bertha Madras of the Harvard Medical School, also have shown that the consequences of marijuana use among youth are dramatic in terms of language, memory, motor coordination and other learning skills. Their work also indicates marijuana is much more addictive than many people think, particularly for adolescents

For those who may have used marijuana in the past and say it is a harmless, youthful dalliance, they need to understand that today’s marijuana is substantially more potent than what they may have encountered in the past. In 1979 when marijuana use was at an all-time high, the average THC potency was 2 to 2.5 percent. In 2009 the average THC potency was 10 percent.

And for those who say marijuana is not a gateway drug, they are simply wrong. In my decades in law enforcement and my time as the director of the Colorado Department of Corrections, I have seen how youth use of marijuana is a strong predictor of future addictions. And research has borne out my experiences. According to the National Center on Addiction and Substance Abuse at Columbia University, one in four Americans who begin using drugs before age 18 become addicts compared with one in 25 who begin using after age 21.

Simply put, today’s medical marijuana industry and the possibility that Colorado could approve marijuana legalization at the polls in November does not bode well for our children and their prosepects down the road.

Years later when policymakers look at Colorado’s rising dropout rates and stagnant graduation rates, how many will consider their decision to create a state-sanctioned marijuana industry? Unfortunately, many will not, but the seeds of these trends have already been sewn in our state.

Coloradans need only look to their local schools districts, where drug-related expulsions and suspensions have skyrocketed since 2007. As the marijuana industry becomes even more widespread despite the best intentions of lawmakers and local leaders, expect these trends to continue.

Marijuana and other drugs have a deleterious effect on youth. Even if marijuana has some palliative benefits for the medically debilitated, policymakers should do everything they can to keep it out of the store front and away from children and schools.

John Suthers is Colorado’s 37th attorney general.

By Michael Elliott and Norton Arbelaez

Staff  Sergeant Mary McNeely joined the military, went to Iraq and served her country with honor. While there, she was injured in a car bombing.

Upon returning to Colorado Springs, physicians at the Veteran’s Administration prescribed her narcotic pain medications to treat her various injuries. Nonetheless, her health kept deteriorating. The drugs did not effectively treat her pain, made her irritable, nauseous and unable to function. She grew distant from her daughter and husband.

Through Colorado’s medical marijuana system, she discovered that cannabis controlled her pain and nausea with minimal side-effects. As a result, she was able to stop taking several high-risk prescription drugs including percocet and vicodin. Medical marijuana allowed her to regain a semblance of a normal life.

Colorado’s medical marijuana program is here for Mary and the tens of thousands of patients like her. While neither pariah nor panacea, medical cannabis provides substantial relief to the sick and injured, and is void of many toxic side-effects common to prescription drugs. Regulated and taxed, medical cannabis also improves public safety and provides Colorado with a sorely needed source of revenue and jobs.

Cannabis Indica has been used as medicine for thousands of years. For most of American history, the United States Pharmacopeia recommended it for conditions as diverse as asthma, nervous disorders and insomnia. In 1937, amid propaganda steeped in institutional prejudice, all uses of cannabis were outlawed by the federal government.

In light of failed attempts at national reform, Colorado voters approved a state constitutional amendment allowing for medical marijuana in 2000. Currently, 16 states and the District of Columbia allow medical marijuana, encompassing about one-third of all Americans. Conservative estimates forecast as many as 25 states will have adopted medical marijuana laws by 2014. As reflected by an October 2010 Gallup poll in which 70 percent of Americans favor making medical cannabis legally available, Colorado’s regulated model reflects a national trend.

In 2010 and 2011, the Colorado General Assembly, in a bipartisan effort, codified the licensing, regulation and taxation of medical marijuana businesses. These regulations created a closed-loop system that requires local and state licensing, establishes “good moral character” standards for ownership and employment, and mandates rules for security and surveillance aimed at eliminating illicit activity. Nationwide, Colorado has the most comprehensive and effective medical marijuana regulatory framework.

In Colorado, regulated medical cannabis has provided medicine to 473 HIV/AIDS patients, 9,771 patients suffering from severe nausea, 14,112 patients suffering from muscle spasms, 75,424 patients suffering from severe or chronic pain, and 2,181 patients with cancer. Despite all the accusations of abuse surrounding this issue, less than 2 percent of Colorado’s population are registered patients. According to state statistics, the average age of a medical marijuana patient in Colorado is 42.

As medical marijuana becomes more accepted, its medicinal uses become more apparent. Recent studies have shown the potential of cannabis to treat premenstrual syndrome, insomnia, migraines, multiple sclerosis, spinal cord injuries, alcohol abuse, arthritis, asthma, atherosclerosis, depression, Huntington’s disease, Parkinson’s disease, Alzheimer’s disease, sickle-cell disease, sleep apnea, anorexia nervosa and many forms of cancer. With so much potential, it’s not surprising that the federally funded National Institute of Health currently holds U.S. Patent 6,630,507 B1 for “Cannabinoids as Antioxidants and Neuroprotectants.”

In addition to providing a mechanism for safe and legal access, regulated medical cannabis is a net positive for the state. It contributes to deferred prosecution and incarceration, as well as providing a source of revenue in hard budgetary times.

In total, Colorado medical marijuana businesses have paid approximately $20 million in local, state and federal taxes, and another $9 million in licensing and application fees. With regard to jobs, some estimates indicate that the medical cannabis industry has created upwards of 20,000 new jobs, as well as a boom in ancillary businesses such as real-estate, accounting, carpentry, engineering, plumbing, law, medicine and security.

With regard to health and safety, a recent University of Colorado study indicates that states which pass medical marijuana laws see on average a 9 percent reduction in traffic fatalities. In addition, a 20-year study documented in the Journal of the American Medical Association (January 2012) indicates that smoking cannabis on an occasional basis does not appear to produce adverse effects on lung function. Moreover, the increase in criminality predicted by opponents of regulated medical marijuana has simply not materialized.

Though much has been made of the supposed link between medical marijuana and teen use, new research by CU professor Daniel Rees finds no evidence that medical marijuana laws are related to the use of marijuana by minors. Other studies show that, on average, teen usage decreases after states pass medical marijuana laws.

Regardless, regulation remains the most effective way to limit unauthorized access and abuse. After all, street dealers do not check IDs. The most comprehensive solution likely involves education and prevention initiatives, restrictions on advertising and increased penalties for illicit diversion to minors.

Though Colorado Attorney General John Suthers opposes the state’s medical marijuana program, consider the alternative – the continuation of a failed policy that criminalizes patients and subsidizes a violent black market operating clandestinely out of homes and public lands. This emboldened black market would pose an immediate threat to public safety and further strain our state’s limited resources.

U.S. Attorney General Eric Holder has issued recommendations to U.S. Attorneys to use their prosecutorial discretion, in light of limited resources, to focus on those individuals and organizations who are not in “unambiguous compliance with state law.”

Meanwhile, in Colorado, the democratic process has made regulated medical cannabis the law of the land, and it is the duty of our state officials and our chief executive to implement the Colorado Medical Marijuana Code.

Patients and providers hold hope that with time the institutional resistance from the federal government and certain state elected officials will be reoriented to conform with the interests of patients, economic realities, and the values of justice, dignity, and tolerance.

Michael Elliott, Esq., is the executive director of the Medical Marijuana Industry Group (MMIG), the largest medical marijuana trade association in Colorado. Norton Arbelaez, JD, is MMIG’s board chair.

By Katie Kerwin McCrimmon of Solutions and Nancy Mitchell of Education News Colorado

A handful of students from Denver’s East High School recently spent a warm January lunch period huddled against a brick home two blocks from the school, passing a joint and discussing the merits of medical marijuana.

It smells better than what you get on the street, they say, and is more potent. The buds are whole, not ground up like oregano.

“I get top shelf,” boasts a 16-year-old boy. “My cousin works at a dispensary. So he brings maybe two zips (plastic bags) a day that they’re just going to throw out.”

Across the street is a medical marijuana dispensary that advertises “a trip to the moon” for customers. It is exactly 753 feet from East, according to the school’s former principal, who has measured it several times. Another dispensary is 1,010 feet away.

“This is not in any sense healthy for our young people,” said John Youngquist, the former principal who has pleaded for years for help in protecting schools from the proliferation of dispensaries.

Federal prosecutors echoed those concerns in January when they targeted medical marijuana dispensaries within 1,000 feet of schools for their first crackdown since hundreds of shops with names like “Dr. Reefer” and “Ganja Gourmet” began spreading across the state in 2009.

U.S. Attorney John Walsh cited a “dramatic increase in student abuse of marijuana” in warning 23 dispensary operators to move within 45 days or face criminal action and seizure of their property. That deadline expires Feb. 27.

Scores of other dispensaries can expect shutdown notices soon. In all, Walsh now says he plans to target over 100 Colorado dispensaries located within 1,000 feet of a school, relying on federal law that creates stiffer penalties for any drug use near schools, playgrounds and places where young people gather.

The federal Drug-Free Schools Act applies to public and private schools from grades 1-12, along with both public and private colleges and universities. For now, Walsh says he is committed only to cracking down on dispensaries near public and private schools and higher education campuses, and not other gathering places.

An investigation by Education News Colorado, Solutions and the I-News Network shows the number of drug violations reported by Colorado’s K-12 schools have increased 45 percent in the past four years, even as the combined number of all other violations has fallen.

The statewide data do not distinguish between marijuana and other drugs, but interviews with school and district officials, health care workers and students across Colorado depict marijuana as the overwhelming cause of the increase.

Some school officials used descriptions such as “drowning” and “under siege” to portray their battle with the increase in drug violations and what they view as a seismic shift in student attitudes about marijuana.

“When I grew up, it was horrible if you got caught with pot,” said East teacher Matt Murphy. “Now there are little green medical signs everywhere. It seems healthy. We’re at the front lines of this huge shift where kids think it’s OK.”

Among other findings of the investigation:

• Suspensions for drug violations in Colorado schools rose 45 percent between 2007-08 and 2010-11 while expulsions for drug violations increased 35 percent and referrals to police increased 17 percent. In contrast, the overall suspension rate for all other violations was down 11 percent while expulsions and police referrals for other violations dropped 25 percent.
• In Denver, the increase in referrals to law enforcement for drug violations was particularly high, spiking 71 percent in four years. Denver police in 2010 began listing marijuana arrests at city schools separately from other drug incidents – their records show 179 arrests for marijuana possession or sale at 43 Denver Public Schools between Aug. 1, 2010 and June 30, 2011, with a third of those arrests occurring at elementary, middle and K-8 schools.
• Suburban and rural areas are not immune. Grand Junction schools saw a 55 percent increase in drug violations in four years while they’ve doubled in the St. Vrain Valley district. Thornton High School in Adams 12 Five Star reported three drug violations per 100 students in 2007-08 and eight violations per 100 students in 2010-11 while Cherry Creek’s Overland High School saw its rate per 100 students rise from two to more than five in four years.
• Up to 53 medical marijuana dispensaries are within 1,000 feet of Colorado public schools. Statewide, 95 elementary schools are within a half-mile of a dispensary while 27 middle schools and 23 high schools are that close.

Located along downtown Denver’s busy Colfax Avenue, a hotspot for marijuana businesses, East is among the schools statewide surrounded by multiple dispensaries. But East is far from alone.

‘Medically sanctioned’ marijuana attractive to kids

The investigation found some of the schools with the biggest increases in drug violations have multiple medical marijuana dispensaries within a mile or closer.

Former East High School principal John Youngquist thinks dispensaries create a climate that makes marijuana seem healthy.

East, seen by many as Denver’s premier public high school, has had up to five medical marijuana dispensaries within a three-block radius of its campus. The number of drug violations at the school has tripled since 2009.

Palmer High School in downtown Colorado Springs is within a mile of as many as eight dispensaries. The school reported one or two drug violations in 2007-08 and 2008-09, then 75 violations in 2009-10 and 45 violations in 2010-11.

But not all schools with nearby dispensaries saw an increase in drug violations and some reported their numbers of drug-related incidents declined.

Brian Vincente, director of Sensible Colorado, an advocacy group pushing for the legalization of marijuana for adults, said dispensaries are not to blame for increases in student drug violations.

“There’s never been a recorded case of dispensaries selling marijuana to high school kids,” he said. “That is not the problem. Dispensaries are a highly regulated industry.”

Vincente says students are getting marijuana the same way they’ve gotten it for the past 50 years – illegally.

Others see a clear link between the dispensaries and increased student use of the drug.

“Of course there’s a correlation,” said Rebecca Hea, executive director of the Denver Children’s Home, which provides a drug and alcohol counselor at East.

“It’s a lot easier to get access to marijuana,” she said, noting the number of referrals to the East counselor “is growing so astronomically, she’s unable to meet the need.”

“There is a perception that if it’s medically sanctioned, it can’t be that bad,” Hea added. “It seems condoned because the name medical is in front of it.”

Nicole Veltze, principal at Denver’s North High School, which also has a number of dispensaries nearby, said the actual location of the dispensaries doesn’t matter as much as the fact they’re widespread.

“The kids aren’t going to the dispensaries,” she said. “The kids have access to other people who have access to dispensaries. So whether you live near or far from a dispensary, if you have a friend, you can get it.”

Veltze is particularly concerned about long-term repercussions for kids.

“When marijuana is found on students, we have to call law enforcement,” she said. “Due to the rise in availability of marijuana, we’re making more and more calls to law enforcement for this, and so we’re contributing to the criminalization of our kids.”

Students say medical marijuana cheaper, easier to obtain

Youngquist, who was principal at East for five years until getting a promotion in December, is convinced that dispensaries near schools increase use.

“They create a context for students that is all about marijuana, a context that says this is healthy,” he said. “There’s just a very, very large amount of marijuana present in our community and there’s easy access for young people.”

The school has taken a proactive stance, with administrators frequently patrolling nearby Colfax Avenue during lunch. It’s then, and driving to and from the school, that Youngquist noticed students hovering near some dispensaries.

“It’s as easy as standing outside,” he said. “If you keep your eyes open and drive by, kids will be out front waiting for the possibility” to buy.

Some East students have a term for it. They call it “shoulder-tapping.”

“You stand there and when someone goes in, you say, ‘Hey, will you get me some weed in there?’” explained a 17-year-old boy.

Some older students, older siblings and recent graduates have medical marijuana cards, the boy said. There are even coupons to sweeten the transaction.

“Buying through dispensaries is cheaper than buying on the streets,” he said. “You call people who have a card. There are buy-one, get-one free deals.”

Managers of dispensaries near East did not return calls for comment.

East students are divided over whether nearby dispensaries are fueling an increase in marijuana use.

“The fact that they’re close by makes it easier for it to happen at school,” said one 16-year-old girl, but she added, “If kids really want to do it at school, they’ll find a way to do it.”

Another boy, 16, said he thinks the sheer number of dispensaries may make the drug more attractive.

“That’s probably the effect that dispensaries have,” he said. “It’s like Starbucks. You think what’s so good about Starbucks? And you’re going to go try some.”

More than a dozen students interviewed said they see a growing number of their classmates using marijuana.

“It’s become more of a thing to do at school, to rebel or if you don’t like a class,” a 16-year-old girl said. “It’s a way to not skip class, but not be there in a way.”

Some communities ban dispensaries, others disregard schools’ buffer

Schools are singled out in contradictory local, state and federal regulations governing the use of marijuana.

While Colorado voters have approved the use of marijuana for medicinal purposes, and voters will consider an initiative this fall to legalize it altogether in this state, federal law still views it as illegal.

State laws regulate medical marijuana businesses to some extent, including creating a 1,000-foot buffer around schools, but they also allow leeway for local authorities. So while 85 municipalities have banned dispensaries altogether, others have allowed them as close as 400 feet to schools.

In Denver, City Councilwoman Jeanne Robb said city officials acted only after the dispensaries began proliferating – so they compromised in allowing dispensaries already less than 1,000 feet from a school to continue operating.

Robb supports the federal crackdown but isn’t sure it will make a difference.

“Once medical marijuana was accepted in the dispensary form, it can be 1,000 feet from a school or 1,005 feet from a school. The youth who are inclined to find it will find it,” she said.

“Our society has said it’s medicine. I’m afraid it removes the idea that it’s still a drug. Now the question is how do we deal with the fallout on our youth? I’m not sure we can really go back.”

Denver City Councilman Charlie Brown, a key sponsor of city’s medical marijuana regulations, said he was “shocked and disappointed” by the increase in drug violations in schools.

“We need to get the people out of the business who shouldn’t be in the business,” he said. “Our job is to clamp down and make sure they don’t abuse it and if they are, we’re going to close them down.”

The federal action is likely to shut down only one dispensary near East. But for Youngquist, that’s a start.

For years, he said he felt nobody was listening as his staff struggled to respond to the growth in medical marijuana dispensaries around the school.

“I’ve gone and spoken with members of city council and state legislators and asked the question regarding the impact on youth,” Youngquist said. “They told me, ‘It’s not something we thought about.’

“I’m disappointed that young people weren’t considered when our government decided to implement a law and make medical marijuana legal.”

Contributors Burt Hubbard of I-News Network and Rebecca Jones of Education News Colorado

Drug violations increase as other violations reported to state decline. Click on image to view the data.

By Rebecca Jones of Education News Colorado

CARBONDALE – If a friend hadn’t turned him over to cops in November, 15-year-old Charles would most likely still be dealing medical marijuana.

As it is, the Roaring Fork High School sophomore has just completed a stint in juvenile detention, is back in school and eager to get his life back on track. He’s hoping to join the military after high school, and he knows a drug conviction could scuttle those plans.

“But the DA worked out a deal where, as long as I don’t get in trouble for the next six to eight months, I’ll be fine,” he said. “I’ll be allowed to go in the military.”

Much has changed for the one-time honor student, who agreed to be interviewed on the condition that his last name is not used.

A year ago, he’d never smoked pot. But then came the night of the party. Someone offered him a joint and, when he didn’t know what to do with it, showed him. “I took a hit,” he said. “I felt the high. I wasn’t in love with the feeling. But I liked it.”

A week later, the older brother of a friend made Charles an offer. “He told me ‘Hey, if you’re willing to sell for me, I’ll give you money.’ I go ‘All right.’ So he’d go down to the dispensary once or twice a week and get his marijuana, then give it to me and I would distribute it.”

The brother, who is in his 40s, had sold marijuana for decades, he said, but began selling medical marijuana exclusively after obtaining a state-issued registry card for back pain.

“They’re really easy to get them around here,” Charles said of the cards. “You can get them for headaches.”

Far from the Front Range population centers, Colorado’s resort communities are dealing with their own medical marijuana dilemmas.

The number of drug-related incidents in the 5,000-student Roaring Fork School District, which includes Glenwood Springs, Basalt and Carbondale, spiked at 61 during the 2009-10 school year, up from 11 the year before. Last year, drug incidents were down to 36.

Other indicators of drug usage have not trended downward.

In 2010-11, the number of teens with marijuana charges referred to Youth Zone, a diversion system for young offenders, was up 58 percent over the year before, said Lori Mueller, program director.

“It could be that judges just decided to send more kids to us,” she said. “It could be that police officers are more focused on stopping the kids smoking marijuana. I don’t want to assume that the only reason is because more kids than ever are smoking pot.”

But whatever the reason, Mueller sees teens’ attitudes toward marijuana changing rapidly.

“Marijuana is no big deal to them,” she said. “And it’s very hard to work with kids who truly believe – or whose parents believe – that marijuana is medicine. If it’s medicine, how can it be wrong? When they see a medical marijuana shop on every other block, and they have friends or parents of friends who have medical marijuana cards, it doesn’t feel to them like there’s anything to worry or be nervous about.”

Based on what referred teens tell her, she said, marijuana seems to be everywhere in the Roaring Fork Valley. Getting it is as easy as helping yourself to the stash your parents or a friend’s parents keep.

Or you could have called Charles, one of the teens referred to Mueller’s program. He would get it for you.

“A kid could call me and say ‘meet me here.’ Or would say ‘I left some money under the front left tire of my dad’s truck.’ And I’d go and get the money and leave the marijuana,” Charles said. “There were unlimited ways for me to distribute it.”

Drug violations increase as other violations reported to state decline. Click on image to enlarge.

Sometimes his clients asked for marijuana-infused candy or other edibles. But mostly, the smoke-able kind was what they wanted.

It’s certainly the kind he wanted. And he smoked a lot.

“Kids are always looking for something to do, and smoking marijuana is something to do,” he said. “It calms you down, and it’s fun. Most kids won’t refrain from it. But what that leads to – I never got any of my homework done. None of it. I would rather be out with friends. I stopped really caring what people thought about me”

Charles’ fling with marijuana didn’t last long. He’d only been smoking – and selling – for about six months when he was busted. “A kid told on me,” he said. “His parents found the marijuana and they asked where he got it, and he told them it was me. Three days later, I was getting in a car and police cars pulled up and said ‘Come with us.’ ”

He spent a month in juvenile detention, has been on home detention since before Christmas and went back to school Jan. 23. He’s got a court date in February, but he’s hopeful that his record will eventually be expunged if he can stay clean.

Charles says his days dealing marijuana are behind him – “It’s not worth spending a month in detention to make $20 a day” – but smoking is another thing.

“I have court-appointed (drug tests) for now,” he said. “But it’s so widely available. After I finish those, I’ll try not to use again because I don’t want to go down that road, but I can’t say for sure I’ll be 100 percent clean.”

Charles refused to identify his supplier to police and said he hasn’t talked to him since his arrest. He said he didn’t know of any other students dealing drugs for him.

By Diane Carman

Despite the spirited testimony of seven opponents to routine circumcision, the Senate Health and Human Services Committee Thursday voted 6 to 3 to restore Medicaid funding for the procedure.

A change in the long bill, the budget document developed by the Joint Budget Committee, dropped funding for the procedure last year, making Colorado one of 18 states to defund circumcision under Medicaid. Senate Bill 90, introduced by Sen. Joyce Foster, D-Denver, would restore the funding, estimated at $186,500 annually.

Foster told the committee that the bill was about disease prevention, fairness and “social justice.”

More important, she said, is that “it’s about parental choice.”

Dr. Jeremiah Bartley, a Brighton obstetrician-gynecologist, cited studies suggesting that circumcision reduces the risk of HIV infections.

“AIDS is a life sentence,” he said, adding that any way that the disease can be prevented should be pursued.

Scot Anderson, a physicist who opposes funding for routine circumcision, challenged Bartley’s assertion that circumcision reduces the rate of HIV transmission in this country, saying that the studies Bartley cited referred to HIV rates in Africa where myriad other factors affect HIV transmission.

“In this country we’ve been circumcising children longer than 60 years and we have the highest rate of HIV of any developed country in the world,” Anderson said.

The United States and Europe provide a “huge database” on the relationship between HIV and circumcision, he said. About 80 percent of European men are not circumcised while 80 percent of American men are and Europe’s HIV infection rate is a fraction of that of the U.S.

Anderson also disputed the estimated cost of circumcision to the state, saying that, based on average costs and the number of procedures reported in hospitals across the state, the likely cost to taxpayers was closer to $4 million annually.

Sen. Shawn Mitchell, R-Broomfield, questioned proponents about spending scarce Medicaid funds on a procedure that is not considered medically necessary and isn’t recommended by the American Academy of Pediatrics. “Should the money for the poor go to more pressing medical needs?”

Sen. Irene Aguilar, D-Denver, compared the procedure to routine mammograms for women under 50 and tests for Prostate-Specific Antigens – both of which are not recommended by medical organizations but are covered under Medicaid.

Gillian Longley, a registered nurse in Louisville, described routine circumcision of newborn boys as “elective, non-therapeutic, cosmetic surgery.

“It is neither medically necessary nor cost-effective,” she said.

Mark Filbert challenged the assertion that public funding for circumcisions was a matter of social justice.

“Nobody has said anything about the choice of the person on whom this is done,” he said. “I very much resent that this decision was made for me. … I don’t think state money should be used to potentially violate the individual human rights of men.”

Senators Ellen Roberts, R-Durango; Jean White, R-Hayden; and Kevin Lundberg, R-Berthoud, voted against restoring the funding. Senators Jeanne Nicholson, D-Black Hawk; Betty Boyd, D-Lakewood; Linda Newell, D-Littleton; Mitchell; Aguilar; and Foster voted for the bill.

SB-90 will move to the Appropriations Committee for further consideration.