Cannabis Grow

Terpene synthases catalyze the cyclization of the hydrocarbon moiety of isoprenoids to yield cyclized hydrocarbons. While terpene synthases generally have one major product, they are fairly promiscuous and can produce several different terpenes with one enzyme. For example, the humulene synthase from Abies grandis species mainly produces humulene, but also produces 51 additional sesquiterpenes at lower levels. The benefit of producing 52 different compounds with one enzyme is to maximize the diversity of secondary metabolites made from one bio-synthetic pathway, or better yet one enzyme. Due to the myriad of beneficial properties of terpenes, a great deal of research has been dedicated to engineering microbial strains to produce terpenes. Limonene is a rather simple, well characterized monoterpene that is commonly used in the fragrance industry and as a food additive. While limonene has a relatively high natural abundance in the rind of citrus fruit, several groups have engineered E. coli to produce this molecule as proof of concept. Additionally, a derivative of limonene, perillyl alcohol, is reported to have anticancer properties, and a low natural abundance making it an interesting target for an engineered microbe. Alonso-Gutierrez et al engineered E. coli to produce limonene at 435 mg/L from glucose, and then introduced a cytochrome P450 to hydroxylate limonene to produce perillyl alcohol at 100 mg/L.However, this level of limonene production still falls short of the theoretical maximum, 3.2 g/L, cannabis dryer indicating the system is not an efficient producer of limonene. Willrodt et al improved on the E. coli production system by introducing different mevalonate pathway enzymes, and reached a titer of 2.7 g/L of limonene.

While the authors were not able to determine the limiting factor in their system, they identify high acetate levels in the high limonene producing strain. While the authors determine this to mean there was sufficient levels of acetyl-CoA, they do not discuss how a competing pathway, like phosphotransacetylase and acetate kinase, could limit the flux of acetyl-CoA into the desired mevalonate pathway. Engineering microbes to produce monoterpenes is further complicated due to the effects monoterpene toxicity. To address this issue both studies utilized an organic overlay to extract the secreted product. Amorphadiene is a sesquiterpene and a precursor to the essential anti-malarial drug artemisinin. The highest titer of amorphadiene was achieved by Westfall et al. They reached a titer of 40 g/L of amorphadiene in yeast by overexpressing enzymes in the mevalonate pathway and the amorphadiene synthase, and limiting competing pathways. In an attempt to produce artemisinic acid in an engineered microbe, the strain developed by Westfall et al was further engineered to express a cytochrome P450 to produce artemisinic acid. However, despite the high titers of amorphadiene, the artemisinic acid levels remained significantly lower at ~150 mg/L. Amyris improved the titer substantially to 25 g/L of artemisinic acid. The improvement in artemisinic acid was due to the discovery of an aldehyde dehydrogenase from A. annua that improved the conversion of artemisinic aldehyde into artemisinin. Additionally they increased the viability of the strains by introducing an organic overlay, isopropyl myristate, which helped solubilize the product.

While amorphadiene is a precursor in the biosynthesis of artemisinin, artemisinic acid is not. Therefore, Amyris designed a four step synthetic approach to convert artemisinic acid into artemisinin. The combination of synthetic and bio-based approaches is known as semi-synthesis, and is another approach for the production of natural products. This approach can reduce the difficulty of chemical synthesis, and lead to a more cost effective option. Amyris demonstrated this by chemically converting artemisinic acid derived from microbial fermentation into artemisinin in a 4 step chemical synthesis with an overall yield of 40%. This semi-synthetic process is currently being used by Sanofi to supplement the world’s supply of artemisinin. Taxadiene is a diterpene and the first intermediate in the biosynthesis of paclitaxel. Several groups have engineered microbes to produce taxadiene and one study produced taxadien-5a-ol, the second intermediate in the pathway. While taxadiene has been produced at moderate titers in E. coli , the production in other organisms, such as S. cerevisiae, B. subtilis and the fungi A. alternata TPF6 remains low . The E. coli system that generated 1 g/L taxadiene was also engineered to produce taxadien-5a-ol, but the titers of taxadiene remain significantly higher indicating inefficiencies with the hydroxylation of taxadiene. This is most likely because cytochrome P450s are challenging to express in E. coli. Biggs et al were able to improve hydroxylation of taxanes by optimizing for P450 expression, reductase partner interactions and modifications of the N-terminus of the P450.  While it may be possible to complete the paclitaxel biosynthetic pathway in a microbe, it would be extremely challenging. Therefore, plant cell culture is still the best route for paclitaxel production. While there are some success stories of engineering microbes to produce terpenes and terpene derived molecules , several challenges still remain. Monoterpenes are toxic to both E. coli and yeast at relatively low concentrations . While cell viability can be improved by using an organic solvent to extract the product, slow diffusion out of the cell can still have an impact. There are also issues with precursor availability. The data from Willrodt et al indicates that competing pathways reduce the availability of the precursor acetyl-CoA. 

Additional challenges, like functional enzyme expression create issues with the production of complex natural products like artemisinin and paclitaxel. While yeast and E. coli are relatively easy to engineer, they do not always possess the cellular machinery needed for the functional expression of necessary enzymes.Alkaloids are a broad group of natural products that are produced by plants, fungi and bacteria, they are loosely classified as molecules that include one or more nitrogen atoms. Some examples of alkaloids are caffeine , opiods and psilocybin . Due to the broad classification of alkaloids, their biosynthesis is rather diverse . For example, the molecules listed above are derived from different precursors, caffeine is derived from xanthosine, opioids are derived from tyrosine and is derived from tryptophan. Several alkaloids found in plants have been produced in engineered microbes. Although caffeine is naturally abundant, Jin et al engineered S. cerevisiae to produce the stimulant. The conversion of xanthosine to caffeine is four enzymatic steps requiring three enzymes, however the nucleosidase is naturally present in yeast, so they only introduced two genes into the strain, a caffeine synthase and a methyl transferase. The strain produced 0.38 mg/L of caffeine, when supplemented with xanthosine. The authors hypothesized the low titer could be due to low nucleosidase activity and screened several non-native nucleosidases, however this did not increase titers. Additionally, Jin et al demonstrate that substrate consumption is not correlated with caffeine production, and that no caffeine is produced if the culture is not supplemented with xanthosine. Because xanthosine is required for primary metabolism of yeast, it is likely that the added xanthosine is being diverted into primary metabolic pathways instead of caffeine biosynthesis, limiting the titers of caffeine. As mentioned previously, vertical farming systems many opioids are still isolated from their natural source. In attempt to find a better production method yeast was engineered to produce the opioid, hydrocodone. It required introducing over twenty genes into the yeast genome . The resulting strain produced 0.3 µg/L of hydrocodone. At this titer it would require nearly 17,000 L of yeast to produce one dose of hydrocodone. The low titer is likely due to the length and complexity of the biosynthetic pathway, but it is a proof of concept suggesting that long, complex exogenous pathways can be functional in yeast. The remaining challenge is identifying the bottlenecks and adjusting flux accordingly. Aspergillus nidulans was engineered to produce psilocybin, a psychotropic molecule under FDA investigation as a treatment for anxiety, depression and substance abuse. Because psilocybin is naturally produced by fungi, it is logical to use the fungal model organism A. nidulans to produce this molecule. The four step pathway, shown in Figure 1-4, was transformed into A. nidulans, which resulted in a final titer of 110 mg/L, or 1.5% of mycelium dry weight, similar to the amount naturally produced in mushrooms. However, besides using a fluorescence based assay to identify positive transformants, the authors did not make any additional changes to the fungi. Therefore, by engineering the fungi to limit competing pathways and direct flux into the desired pathway it is possible to reach higher titers. The microbial production of alkaloids has similar challenges to that of terpenes. It is a challenging to balance competing pathways with a target pathway, like for the production of caffeine. Xanthosine is required for primary metabolism, and so most of the added substrate is diverted into primary metabolism instead of caffeine production. A similar challenge is presented for opioids with tyrosine being an essential metabolite that is required for opioid biosynthesis as well. In addition, longer more complex pathways are generally extremely difficult to engineer into a heterologous host. First, over expressing twenty enzymes can create a metabolic burden, and it can be difficult to express the enzymes at appropriate levels. Additionally, the enzymes used in the study were sourced from mammals, plants, bacteria in addition to yeast enzymes, which means there could be issues with functional expression.

The opioid pathway also produces several non-native intermediates which could have an impact on cellular metabolism. Interestingly, the baseline production of psilocybin in Aspergillus nidulans was 110 mg/L, however it may be possible to reach significantly higher titers by engineering the organism further. Previous studies have indicated that altering central metabolism to increase precursor pools can have a dramatic improvement on overall titer. Polyketides are produced by all kingdoms of life, and are a rich source of medicinal compounds. In fact, several are FDA approved antibiotics, immunosupressants, anticancer and cholesterol reducing medications. The biosynthesis of polyketides is similar to fatty acid biosynthesis, where small extender units are added to a growing acyl chain; however the subsequent steps are less uniform than FA biosynthesis allowing for more diversity in the final polyketide product. While the chemistry for the biosynthesis of polyketides is highly conserved, the types of polyketide synthases involved are very different. There are three general types of PKS reviewed previously by Hertweck in 2009. While several bacteria have been engineered to increase natural production of FDA approved antibiotics, herein the focus will be on producing plant polyketides in microbial hosts. Stilbenoids and flavonoids are a classes of aromatic polyketides produced by plants, and they have an array of useful bio-activities. These molecules can further modified to yield prenylflavonoids and prenyl-stilbenoids , which has been shown to increase the potency of flavonoids and resveratrol. Due to the low natural abundance of flavonoids, stilbenoids and their prenyl derivatives, they are an interesting target for microbial engineering. The molecule is potent antioxidant cited to have neuroprotective, cardioprotective and anti-aging properties. The molecule is sold as a supplement, and is also used as an additive in food products and cosmetics. The market for resveratrol in 2017 was valued at $69.1 million based on a report published by Coherent Market Insights. Several groups have engineered microbes to produce this molecule . The most successful was Lim et al, reaching a titer of 2.3 g/L. They attribute the high titer to directing carbon flux into the malonyl-CoA precursor, and limiting pathways, like fatty acid biosynthesis that would compete with the resveratrol pathway. Naringenin is a flavonoid produced by an array of plants. It is a fairly potent estrogen mimic, and is sold as a supplement to ease the symptoms of menopause. In addition it is a potent antioxidant with potential antimicrobial and antiviral properties. There are numerous studies dedicated to engineering E. coli and S. cerevisiae to produce naringenin, however the best titer of 474 mg/L was reported by Xu et al in 2011. Unlike the number of other studies, Xu et al did more than simply transform the biosynthetic pathway for naringenin into E. coli. They sought to increase carbon flux into the pathway by increasing the precursor, malonylCoA. To do this they overexpressed key enzymes in the native glycolysis pathway to increase the available pool of acetyl-CoA. Then they introduced acetyl-CoA carboxylase from Photorhabdus luminescens to convert the acetyl-CoA into the precursor malonyl-CoA. Additionally, they downregulated genes that would direct carbon into the citric acid cycle. Although Xu et al were able to increase the pool of malonyl-CoA, they did not address the issue of native E. coli pathways that siphon off the available malonyl-CoA. This data along with data for resveratrol production would indicate that one of the limiting factors in the production of polyketides in E. coli is the availability of the precursor malonyl-CoA, and that increasing malonyl-CoA levels increases product titers. However, there is potential for other issues that may not be as clear. For example, it is possible that some of intermediates or the product of the target pathway could negatively impact cellular metabolism. 

The NASEM, CDPHE, and WHO reports state there is substantial evidence of a statistical association between marijuana smoking and worse respiratory symptoms and more frequent chronic bronchitis episodes. These data were based primarily on a systematic review by Tetrault et al. from 14 studies that assessed the association between long-term cannabis smoking respiratory symptoms including chronic cough , increased sputum production , and wheezing . There is also evidence of a statistical association between the cessation of cannabis smoking and improvements in respiratory symptoms. On histology, this is associated with a reduction in ciliated cells and increase in mucus secretion from the larger number of mucus-secreting cells. Reported exposures to children less than age 10 have sharply increased in Colorado following recreational marijuana legalization. A retrospective cohort study of hospital admissions and regional poison control center cases between January 1, 2009–December 31, 2015 at a tertiary-care children’s hospital found that the mean rate of marijuana-related visits to the children’s hospital increased from 1.2 per 100,000 population in the two years prior to legalization to 2.3 per 100,000 after . The median age of exposure was 2.4 years. The majority were exposure to an infused edible product ; 65% were observed in the ED or UC; 21% were admitted to an inpatient ward; and 15% were admitted to the intensive care unit. Two of these children required respiratory support. The median length of stay for all patients was 11 hours, ebb and flow rolling benches and the median length of stay for admitted patients was 26 hours. Annual RPC pediatric marijuana cases increased more than five-fold from 2009 to 2015 . 

Colorado had an average increase in RPC cases of 34% per year while the remainder of the United States had an increase of 19% . In a follow-up study in October 2018, the same author found that despite multiple public health interventions in legislation after 2014 , the incidence of children’s hospital visits and RPC calls has continued to rise in Colorado with an observed doubling of children’s hospital visits in 2017 compared to 2016. Edibles are sold as cookies, candies, and sodas with advertising that appeals to children. Varying cultivation techniques and end-product alterations further complicate the understanding of the physiological effects of cannabis. Cannabis plants can be altered to achieve higher growth rates, changes in potency, and increased bud production. These techniques can include use of varying soil types, fertilizers, and pesticides that can result in physiological effects. These changes may also result in exposures to possible fungal agents such as powdery mildew and botrytis; budworm or mite infestations have been reported in the literature. Historically, there have been reports of bacterial contamination with salmonella, enterobacter, streptococcus, and klebsiella, as well as case reports of fungal spore contaminants, including mycotoxin‐ producing strains of aspergillus. There are three pathways through which cannabis may be contaminated with heavy metal substances. Firstly, cannabis is able to remove heavy metals from substrate soils and deposit these in its tissues by virtue of its bio-accumulative capacity. Secondly, cross‐contamination may occur during processing . Thirdly, post‐processing adulteration may occur, whereby metals may be added to the preparation to increase weight and thereby appreciate its street value. There are case reports of lead and arsenic poisoning from cannabis. Pesticides are also commonly used in cannabis cultivation. In a report from Washington State, laboratory analysis revealed that 84.6% of legalized cannabis products contained significant quantities of pesticides including insecticides, fungicides, miticides, and herbicides.

These comprised a wide array of different substances and encompassed proven carcinogens , endocrine disruptors, as well as a variety of developmental, reproductive, and neurological toxins. There are also changes in end-product concentrations through post-processing of the plant. These changes include creation of oils, waxes/shatter, and dabs. Oils are created by removing the hydrophobic components such as THC with a heated butane solvent. THC concentrations may reach up to 55.7%. Waxes and shatter are concentrated and solidified oil with THC concentration reaching up to 90% THC. Dabs are composed of heated wax and are inhaled off of an object such as a nail, which even further concentrates THC content over 90%. Preparation of these concentrated products has also led to fires and explosion injuries in amateur production attempts in garages, tool sheds, and vacant homes. In Colorado 29 patients with butane hash-oil burns were admitted to the University of Colorado Burn Center from 2008-2014. Zero cases presented prior to medical liberalization, 19 during medical liberalization , and 12 from January–June 2014 at the study’s conclusion. The median total body surface area burn size was 10% . Median length of hospital admission was 10 days. Six required intubation for airway protection while 19 required skin grafting. Marijuana shop employees not trained in medicine or pharmacology are giving medical advice that may be harmful to patients. A recent study in Colorado found that employees are giving medical advice 70% of the time to use cannabis for treatment of nausea and vomiting in pregnancy and few dispensaries encouraged discussion with a healthcare provider without prompting. The author has personally had patients bring in products recommended by dispensary workers with a recommended potency and frequency of use and report being advised to stop their usual medications and use the cannabis product instead. Cannabis dispensaries provide medical advice and offer treatment without medical training even when this may harm the patient.

There are potential therapeutic intervention targets for cannabinoids. In general, these therapeutic targets require a high ratio of cannabidiol compounds , and are from products that significantly differ from those found in commercial dispensaries. The NASEM report found substantial evidence that cannabis or cannabinoids are effective for the treatment of chronic pain in adults, as an antiemetic for chemotherapy-induced nausea and vomiting, and for improving patient-reported multiple sclerosis spasticity symptoms. They also found moderate evidence that cannabis or cannabinoids are effective for improving short-term sleep outcomes associated with obstructive sleep apnea, fibromyalgia, chronic pain, and multiple sclerosis. Studies have also demonstrated that cannabinoids may improve cardiovascular outcomes. Likely the most significant treatment implication has been in patients with refractory epilepsy, most commonly in patients with Dravet’s syndrome and Lennox-Gestault syndrome, but also in other patients. This has led to the U.S. Food and Drug Administration approving Epidiolex in June 2018 for the treatment of Dravet’s syndrome and Lennox-Gestault syndrome. Despite these potential medicinal uses, current Colorado legal distribution of cannabis products goes through an intermediary bud tender before making it to the patient which may not consistently promote therapeutic benefit; there is insufficient training of dispensary staff to serve this purpose.The potential positive health effects of cannabis rest on which of the multiple species and hybrids are studied and their specific chemical composition. One of the difficulties in determining the physiological effects of cannabis is that “marijuana,” or “cannabis,” can refer to multiple species of plants with widely varying chemical compounds and corresponding variable physiological effects. The cannabis genus includes multiple species, most commonly Cannabis sativa and Cannabis indica, and within those are hybrids specifically developed by growers to achieve a specific effect. For example, the commonly used term, hemp, refers to a variety of Cannabis sativa that is fast growing and can be spun into usable fiber for paper, textiles, clothing, bio-fuel, animal feed, and other industrial uses. Hemp has low concentrations of THC and higher concentrations of CBD. The differences in composition offer different potential treatment effects. For example, rolling grow benches the effect for pain control cited in the NASEM review was primarily found with nabiximols , a cannabis extract mouth spray that delivers a dose of 2.7 mg of THC and 2.5 mg of CBD. For comparison, a typical marijuana cigarette or joint contains 0.5 g of marijuana and THC content ranges from 12-23%; therefore, a typical joint contains 60-115 mg of THC, 20-40 times the medicinal dose. The NASEM cautioned that many of the cannabis products sold in state regulated markets bear little resemblance to those available for research at the federal level in the U.S. This is further complicated in that commonly sold cannabis products are often mislabeled for CBD and THC content. One study showed only 17% of dispensary products were accurately labeled. Scientific studies, particularly for treatment of pain, have been limited by a substantial bias, and results have varied. Some demonstrate improvement in pain with coinciding decreases in opiate abuse, while others show the opposite.

The conflict between federal and state laws on the medical use of cannabis products, the lack of consistency among state laws, and the availability of artisanal products in dispensaries, with high variability between composition of products, have caused significant confusion for researchers and limited the ability to fully and accurately research the true effects of commonly available dispensary cannabis products. This was not a systematic review of the literature but rather a summary of selected research including several large reviews from the NASEM, the WHO, and the CDPHE. There is undoubtedly much literature, some of it conflicting, not cited here. However, as other states and countries wrestle with decriminalization and legalization of cannabis for personal use and sale, it is crucial to report the Colorado experience as a cautionary tale. This review summarizes a large body of research for practicing emergency physicians who are increasingly confronted with questions and patients who use cannabis. Although the author practices in Colorado, the information is likely generalizable. This review clearly reflects the author’s biases, yet its composition was motivated by alarming experience in everyday practice. Discussions of cannabis’ effects are relevant not only to the healthcare system, but to legal, business, environmental, legislative, and other branches within a public health framework. This article does not address those other facets. Neither have numerous other physiological effects of cannabis been reviewed here. Many of the previous research studies have focused on cannabis with a much lower THC level limiting applicability to cannabis sold at dispensaries today. Finally, the words “marijuana” and “cannabis” were used interchangeably throughout the article. This was done to maintain the wording from the studies cited consistent with their original language. No difference should be implied with the alternating use of these terms. Cannabis legalization has led to significant health consequences, particularly to EDs and hospitals in Colorado. The most concerning include psychosis, suicide, and other substance abuse. There are deleterious effects on the brain and some of these may not be reversible with abstinence. Other significant health effects include increases in fatal motor vehicle collisions, adverse effects on cardiovascular and pulmonary systems, inadvertent pediatric exposures, cannabis contaminants exposing users to infectious agents, heavy metals, and pesticides, and hash-oil burn injuries due to preparation of concentrates. Finally, cannabis dispensary workers not trained in medicine are giving medical advice that could be harmful to patients. Cannabis research may offer opportunities for novel treatment of seizures, spasticity from multiple sclerosis, nausea and vomiting from chemotherapy, chronic pain, improvements in cardiovascular outcomes, and sleep disorders. However, progress has been difficult due to absent standardization of the chemical composition of cannabis products and limitations on research secondary to federal classification of cannabis. Given these factors and the Colorado experience, other states should carefully evaluate whether and how to decriminalize or legalize non-medical cannabis use. Cannabis sativa L. has been cultivated and used around the globe for its medicinal properties for millennia. Some cannabinoids, the hallmark constituents of Cannabis, as well as analogues thereof have been investigated extensively for their potential medical applications. Certain cannabinoid formulations have been approved as prescription drugs in several countries for the treatment of a variety of human ailments. However, greater study and medicinal use of cannabinoids has been hampered by the legal scheduling of Cannabis, low abundances of nearly all of the several dozens of known cannabinoids in planta, and their structural complexity, which limits bulk chemical synthesis. Here, we report the complete biosynthesis of the major cannabinoids cannabigerolic acid , Δ9 -tetrahydrocannabinolic acid , cannabidiolic acid , Δ9 -tetrahydrocannabivarinic acid , and cannabidivarinic acid in Saccharomyces cerevisiae from the simple sugar galactose. To accomplish this, we engineered the native mevalonate pathway to provide high flux of geranyl pyrophosphate and introduced a heterologous, multi-organism-derived hexanoyl-CoA biosynthetic pathway as well as the Cannabis genes encoding the enzymes involved in olivetolic acid biosynthesis, a previously undiscovered enzyme with geranylpyrophosphate:olivetolate geranyltransferase activity, and corresponding cannabinoid synthases. Furthermore, we established a biosynthetic approach, harnessing the promiscuity of several pathway genes, for the production of cannabinoid analogues.

Suicides with marijuana toxicology by year and overall suicide by year data are displayed in Figure 5.Cannabis has been associated with adverse social outcomes which may impact EDs and patient health. The large cohort study of Swedish men drafted at age 18-20 and followed to age 40 showed increased risk of unemployment and need for welfare assistance in those using cannabis greater than 50 times . These results were repeated in a longitudinal birth cohort study in New Zealand to 25 years old, which found high levels of cannabis use correlated with statistical significance to poorer educational outcomes, lower income, greater welfare dependence and unemployment, and lower relationship and life satisfaction. This cohort was classified into six levels of cannabis use, and found that as cannabis use increased, the odds ratio of adverse outcome increased. Both of these studies adjusted for confounding factors including socioeconomic background of the family, family functioning and exposure to adversity, exposure to child sexual and physical abuse, childhood and adolescent adjustment, academic achievement in early adolescence, comorbid mental health disorders, and other substance use. A prospective cohort study from upstate New York found that, compared with cannabis nonusers or minimal users , chronic users and users who began use in early adulthood and then tapered off use into later adulthood, had a significantly higher likelihood of unemployment at mean age 43 , even after controlling for covariates. The NASEM review stated that there was a limited level of evidence of impaired academic achievement and education outcomes, cannabis grow systems increased rates of unemployment and/ or low income, and impaired social functioning or engagement in developmentally appropriate social roles. 

The report stated that although there was evidence to suggest these outcomes, it was difficult to document a direct link between cannabis use and these outcomes because other variables played a role. Social outcome data for cannabis users specifically in Colorado are currently unavailable and could be an area for further research.A number of review articles on cannabis have described adverse effects on brain imaging. These findings may help establish a mechanistic link between the epidemiological studies on the adverse effects of cannabis. Structural, functional, and chemical changes to the brain have been established. These include both the gray matter and white matter . Structural changes to the brain include reductions in the hippocampus and amygdala volumes in cannabis users. Several studies also identified reductions in volume of specific areas of the prefrontal cortex, as well as functional magnetic resonance imaging studies demonstrating reduced functional connectivity in the prefrontal networks responsible for executive function and the subcortical networks, which process habits and routines. Other fMRI studies show reduced connectivity in the fimbriae of the hippocampus and commissural fibers extending to the precuneus, and suggest that this disturbed brain connectivity in cannabis users may underlie cognitive impairment and vulnerability to psychosis, depression, and anxiety disorders. Multiple other areas of the brain have also been shown to demonstrate changes on fMRI studies in response to cannabis and include the orbitofrontal cortex, anterior cingulate cortex, striatum, amygdala, hippocampus, and cerebellum. In general, these changes on both structural and functional MRI studies corresponded with frequency of use and earlier age of onset of use. Changes to neurotransmitters in the brain have also been well described in systematic reviews and include disruptions in glutamate, dopamine, N-acetylaspartate, myo-inositol, choline, and γ-aminobutyric acid.

Taken together, these changes may underlie the clinical features being observed in observational and epidemiological studies demonstrating increases in psychosis, impulsivity, depression, anxiety, suicidality, decreases in cognition, IQ, and executive function, abnormalities in habits, routines, decision making capacity, and deficits in learning, memory, attention, and social interaction. Cannabis use has also been associated with abuse of other illicit substances. According to the NASEM report, there is a moderate level of evidence of a statistical association between cannabis use and the development of substance dependence and/or substance abuse disorder for alcohol, tobacco, and illicit drugs. Multiple cohort studies have demonstrated these results. Four separate discordant twin studies have found that the twin who used marijuana was more likely to use other substances even after controlling for environmental and genetic influences.53-56 Although some studies reported that medical cannabis has resulted in improvements in opiate-related deaths, Colorado has had an increase in poisoning and deaths from opiates and methamphetamines since 2010, with the highest in 2017. These rates have increased nationwide as well and the influence of cannabis in Colorado is difficult to discern. Nevertheless, the increase in overdose deaths in Colorado is alarming. These data are shown in Figure 6.25 Although animal studies do not consistently translate to human effects, rat studies can provide some mechanistic clues. After exposure to tetrahydrocannabinol , rats have an increased behavioral sensitization response to not only THC but also opiates and nicotine. Studies also demonstrate that these behavioral changes in rats correspond to neuronal activity changes in mesolimbic dopamine neurons in the ventral tegmental area and nucleus accumbens and that cross tolerance results with exposure to morphine, amphetamines, and cocaine. Repeat morphine self-administration has been shown to be significantly lower in CB1 knockout mice and opiate withdrawal symptoms significantly less when the knockout mice are administered naloxone. 

Dependence rates are reported at one in 10 among those who ever use cannabis, one in six among adolescent users, and one in three among daily users. Withdrawal symptoms may include anxiety, insomnia, appetite disturbance, and depression. These symptoms are sufficient to impair everyday functioning and are markedly attenuated by doses of an oral cannabis extract. Cannabinoid hyperemesis syndrome has been well described in the literature. The symptoms of CHS include significant nausea, violent vomiting, and abdominal pain in the setting of chronic cannabis use. Cardinal diagnostic characteristics include regular cannabis use, cyclic nausea and vomiting, and compulsive hot baths or showers with resolution of symptoms after cessation of cannabis use. CHS patients present similarly to cyclic vomiting syndrome patients with the exception that cannabis use is required to make the diagnosis. Following legalization, the prevalence of cyclic vomiting presentations to Denver Health and the University of Colorado Hospital increased 1.92-fold from 41 per 113,262 ED visits from a year prior to marijuana liberalization to 87 per 125,095 ED visits a year following marijuana liberalization . Patients with cyclic vomiting in the post-liberalization period were more likely to have marijuana use documented than patients in the pre-liberalization period . These patients often are evaluated with multiple imaging studies, lab work, endoscopies, and admissions to the hospital as well as antiemetic treatment. These studies are often non-diagnostic and treatment is often ineffective. This may also influence ED crowding. Traffic fatalities with blood or urine drug screens positive for cannabinoids have sharply risen across Colorado. Total fatal motor vehicle collisions in Colorado had been decreasing from a high of 677 in 2002 to a low of 407 in 2011 but then began increasing each year since then to 600 in 2017. Total MVCs mirror this trend. The NASEM review found substantial evidence of a statistical association between cannabis use and increased risk of MVCs. CDPHE found substantial evidence that recent marijuana use by a driver increases his or her risk of a MVC and that the higher the blood THC level, the higher the risk of MVC. The use of alcohol and marijuana together increases risk of impairment and MVC more than either substance alone. For less-than-weekly marijuana users, using marijuana containing 10 milligrams of THC is likely to impair the ability to safely drive, bike, or perform other safety-sensitive activities. A typical marijuana cigarette, or joint, contains 60-115 mg of THC. A systematic review of observational studies and meta analysis for acute cannabis consumption and MVC risk found that driving under the influence of cannabis was associated with a significantly increased risk of MVCs compared with unimpaired driving , ebb and flow tables especially for fatal collisions . However, a recent study of crash fatality rates after recreational marijuana legalization in Washington and Colorado found changes in motor vehicle crash fatality rates were not statistically different from those in similar states without recreational marijuana legalization. This was, however, only after further statistical regression analysis . Initial data demonstrated that after legalization, motor vehicle crash fatality rates increased by a mean of +0.1 fatalities per billion vehicle miles traveled in Washington and Colorado, and decreased by a mean of -0.5 fatalities per billion vehicle miles traveled in the control states each year. The effect of cannabinoids on the cardiovascular system is complex and an area of ongoing research. Of concern to practicing emergency physicians is ST-segment elevation myocardial infarctions and acute stroke presentations with a close temporal relationship with cannabis use, which have been documented in multiple case reports in otherwise young, healthy, male patients. The NASEM summary found there was a limited level of evidence of a statistical association between acute cannabis use and triggering an acute myocardial infarction , ischemic stroke, or subarachnoid hemorrhage. The WHO review states: “There is evidence that cannabis use can trigger coronary events. Recent case reports and case series suggest that cannabis smoking may increase cardiovascular disease risk in younger cannabis smokers who are otherwise at relatively low risk.” CDPHE found moderate evidence that marijuana use increases risk of ischemic stroke in individuals younger than 55 years of age and limited evidence that acute marijuana use increases risk of myocardial infarction. The main case crossover study cited for the AMI findings demonstrated that the risk for AMI associated with cannabis use during the hour preceding symptoms of AMI was elevated 4.8 times over baseline .

This risk was substantially reduced following that hour. A review of nationwide inpatient sample data from 2010 to 2014 demonstrated a 32% increase in inpatient admissions for primary diagnosis of myocardial infarction and secondary diagnosis of cannabis use disorder . The overall mean age of patients was 41 years old. These patients also had longer lengths of stay, higher hospitalization costs, and higher levels of morbidity due to AMI following hospitalization than non-cannabis users. In a study reviewing secondhand marijuana smoke exposure, the authors found that one minute of exposure substantially impaired endothelial function in rats for at least 90 minutes, considerably longer than comparable impairment by tobacco secondhand smoke. The pathophysiological basis of these events is not fully understood and a full discussion is beyond the scope of this review. In short summary, it may encompass a complex interaction between exogenous cannabinoids and the endocannabinoid system, autonomic nervous system, oxidative stress, direct cellular effects on the endothelium, and pro-coagulant effects. Exposure to THC causes activation of the sympathetic nervous system and inhibition of the parasympathetic nervous system. These effects include elevated heart rate, serum norepinephrine levels, elevated supine blood pressure, and increases in left ventricular systolic function. Smoking results in decreasing oxygen delivery to the heart and other vital organs and may be further compromised by increasing carboxyhemoglobin levels. The impaired myocardial oxygen demand-to-supply ratio following cannabis smoking has been shown to reduce the time to onset of symptoms during exercise in patients with stable angina. Direct effects of cannabis on blood vessels are complex due to the differing compounds in cannabis and the functional properties of the blood vessels examined. Studies are inconsistent regarding the effects on vasoconstriction and dilation. Cannabis has been consistently shown to produce vasodilation with resultant orthostatic hypotension, but it has also been implicated in vasoconstrictive arteritis mechanisms. A large review article suggested that there are three phases in cardiovascular parameters affected by the endocannabinoid system and that different chemical constituents of the cannabis plant have varying effects at different target organs, which may account for the differences. Transient vasospasm and reduction in cerebral blood flow are well described and may underlie changes in coronary, cerebral, and peripheral arterial systems leading to end organ ischemia. Myocardial blood flow has been shown to correlate inversely with circulating plasma levels of endocannabinoids. Cannabis has also been shown to be a potent source of cellular oxidative stress through formation of reactive oxygen species, and this may contribute to endothelial dysfunction and promote regional arterial vasospasm. THC has also recently shown a dose-dependent procoagulant effect. This ex vivo observation has been supported by reports of thrombotic coronary artery occlusion in young individuals without underlying atherosclerosis. There are also cannabinoid receptors on the surface of platelets and THC has been shown to increase the surface expression of glycoprotein IIb–IIIa and P selectin in a concentration-dependent manner resulting in platelet activation. Figure 7 summarizes these effects.Marijuana smoking leads to adverse pulmonary outcomes.

The route of administration also affects motivation. As discussed earlier, edible forms of cannabis typically tend to be much stronger and last much longer than smokable forms . Many edible users experience extreme body and mental highs that leads to extreme lethargy. High-C, after I asked him why she smoked so much instead of just eating an edible that would last much longer told me that edibles were too strong and that he would be completely out of commission if he consumed cannabis too often. On the exact opposite spectrum, other users experience a jolt of energy when smoking cannabis. These users frequently use cannabis sativa. In a study conducted by Carlini and Kramer, rats performed better on maze trials after being injected with cannabis sativa. Depending on the type of strain and strength of the strain, sativa can be either mildly or extremely stimulating. Dorian took me on hikes with him. I never would have thought about using cannabis and exercising before his suggestion. It always seemed antithetical to the goal and practicality of exercise. After seeing Dorian smoke, I noticed an upbeat mentality and a somewhat jittery disposition. I am used to seeing users smoke, taking 30 or 40 minutes to smoke, and then getting so tired after smoking that they do not want to do anything. Dorian on the other hand, commercial racks suggested that this strain of cannabis made him want to get outside and gave him an extreme amount of energy. He told me about a website/podcast called the StonedHiker.com. This website discusses different forms of cannabis strains that are mentally stimulating and are useful for exercise.

Sativa and hiking is particularly effective, according to Dorian, because it stimulates the mind and body while allowing for an upbeat, unique and pleasurable outlook on the surrounding landscape. Dorian was not the only user that uses cannabis sativa for stimulation. Natty told me about a patient in his early 40s who used cannabis as a way to deal with back pain while working. He previously used cannabis at home after work, but he needed pain relief while at work but I couldn’t deal with the draining effects of opiates or most cannabis. Sativa was a godsend when he found it. It kept his mood and energy elevated the entire day. Unfortunately, there is no way to completely predict the effect of a particular cannabis strain, and many users find that sativa and indica are not mutually exclusive and the effects are not as simplistic as one would hope. Cannabis growth is still an unregulated industry in the U.S. and the quality and potency of cannabis is inconsistent at best. Moreover, the prohibition of cannabis has produced a system where scientific study of cannabis is still underdeveloped. One user, a 25-year-old female patient Dorian told me about had to take Xanax mixed with indica at night sometimes because the indica was too stimulating for her and she would stay up until 4am some nights after smoking stimulating indica. Likewise, many sativa users claim they need to be careful and test their sativa because of the risk that it may put them to sleep, or make them drowsy when they have something to do during the day. Nico Escondido , a High Times journalist suggests that our common understandings of the distinction between Sativas and Indicas are wrong. He suggest that terpenoids, which are organic chemical compounds produced by plants, may be responsible for the variations in effects from onestrain to another. Terpenes such as Myrcene are found in strains of cannabis that produce the stoned “couch lock” effect. Myrcene is also present in hops and is often credited with the sedated feeling that comes from drinking hoppy beers.

Other factors such as setting can affect motivation and user experience in general. Some people use cannabis during parties to calm social anxiety, others use cannabis to provide a jolt of energy when partying, while others like to sit and watch TV and go to sleep while under the influence. The effect of cannabis is not always what the user expects or hopes for sometimes, but experienced users know how to alter their consumption to fit their individual needs. Thus, cannabis is used in a variety of settings for a variety of reasons, and the expectations and settings are many times just as relevant as the cannabis itself. Back to the original question, is the anti-motivation syndrome real? The answer is not a simple yes or no. It is certainly the case that cannabis has the ability to affect a user’s motivation to succeed at work, take care of themselves and thrive. However, the negative perception of such an act is more indicative of a workaholic, consumerist, conformist and irrationally rational bureaucratic society than an indication about anything negative about the cannabis plant itself. Yes, cannabis can lead to less motivation to work and make money, but since when did work and money become the ultimate goal? This is perhaps most indicative in my opinion of the anti-cannabis camp. The uncritical acceptance of social conformity to the logics of capitalism, consumerism, materialism and work blinds individuals to the reality of cannabis as a unique plant that has the ability to change one’s perspective on the world in contradiction to the logic of a workaholic capitalist model. Thus, cannabis opponents typically point to the dangers of cannabis to society, such as demotivation without critically examining the direction society is going. This is characteristic of the conservative ethnocentric views of the world that the way things are is the way things should be. Cannabis has the ability to change minds and this in my opinion is the real threat that conservatives, politicians, and capitalist fear that people will not blindly follow the logic of the system set up to exploit and oppress them. Furthermore, it must also be noted that cannabis can have the exact opposite effect of anti-motivation.

Many users have told me that cannabis, and particular cannabis sativa, has a stimulating effect on par with coffee and tea. Likewise, many users state that cannabis increases their motivation to succeed at work, and leads to a type of near paranoia about one’s life and ones direction in life. Cannabis may occasionally lead to lack of work, but it also leads to less crime and less violence. Researchers found that for couples, marijuana use is inversely related to intimate partner violence . Similarly, researchers studying the effect of medical marijuana laws found that crime was not exacerbated by reforming medical marijuana and pointed to the fact that medical marijuana laws may be correlated with a reduction in homicide and assault rates . Goldstein found that, early studies that sought to attribute violent behavior to the use of opiates and marijuana have been largely discredited. Indeed, cannabis has been historically recognized as a peaceful substance as Indian’s refer to it as “Sattvik Nasha” translated as “the peaceful intoxicant” . Furthermore, Goldstein suggest some drug may have reverse psychopharmacological effect and may ameliorate violent tendencies . In my own study, I cannot think of a single instance in which I saw any act of violence out of the group or their associates and customers. In fact, my interviews with TBC and Natty suggest that cannabis was used to control violent impulses. TBC explained, “I’m kinda an asshole without weed. I would have fought these guys already if it wasn’t for weed.” In a similar vein, Natty confided that he did not like to drink with High-C because he was a violent drunk. Smoking helped them to maintain group interaction without conflict. However, in TBC’s case, it was never truly clear if cannabis mellowed him out, or if the addiction he developed from cannabis made him agitated and restless when not smoking. Although they participate in a semi-illegal activity, greenhouse rolling benches violence is relatively nonexistent, but always possible in their lives. What is particularly striking is the relative banality of the Kings’ behaviors and lives. When interviewing the Kings I was expecting to hear a bottom to top Scarface type story. What I got was a story of stoner hippies that seem eccentric yet ordinary in practically every way. In fact, other than the fact that cannabis and other drugs are illegal, and the occasional driving under the influence, I cannot think of a single criminal act these individuals participated in while the study was ongoing. The main proponents of “problem-prone behavior theory,” Jessor and Jessor , indicate that drug users, in comparison with those that do not partake in drug use, tend to be rebellious, hold unconventional attitudes, and are much more willing to take risks. Although these personality characteristics can frequently manifest themselves as artistic and creative in nature, Jessor and Jessor contend that these characteristics, more often than not, manifest themselves in ways that become problematic for both the individual and society. Examples of this could be deviant sexual behavior, underachievement in school and the likelihood of delinquent and criminal behavior. Jessor and Jessor explain the drug user’s personality as, “concerned with personal autonomy, a lack of interest in the goals of conventional society, and a more tolerant view of transgression” . As Jessor and Jessor explain marijuana use, “the differences between users and non-users might be termed conventionality unconventionality” .

Consistent with this theory, the group I seek to studied fit the mold of a counterculture in that they reject the norms of mainstream society and believe they are actively undermining “the system” through the sale and use of pot. Yet Jessor and Jessor consider behavior such as deviant sexual practices and underachievement in school or at the job injurious to society. This view is emblematic of the extremely conservative and conformist nature of most criminological theories. In contrast, I argue that what are termed by Jessor and Jessor as problematic behaviors such as deviant sexual practices and underachievement in school or jobs are themselves, a form of social expression. Deviant sexual practices are more of a cultural prescription that any inherent moral right or wrong. Likewise, schooling, in particular K-12 is in my opinion, more of a mechanism designed to promote conformity, obedience and docility to the capitalist system than it is a mechanism to enlighten minds and engender creative expression. Moreover, the Eurocentric curriculum does as much to reproduce race class and gender inequality than it does to change the structure.Another theory relevant to my dissertation is Robert Merton’s anomie theory. Without drawing out the various dimensions of Merton’s anomie theory, the two elements that have been considered particularly useful for an understanding of substance use are, “retreatism” and “innovation.” Cloward and Ohlin utilize retreatism when explaining drug addicts. From Cloward and Ohlin’s standpoint, the drug addict represents the double failure in Merton’s taxonomies. The drug addict failed to achieve the American dream through both legitimate and illegal means, and consequently, has retreated into a life of resignation and addiction. The other aspect of Merton’s theory, innovation, appears to at least partially explain the decision to sell, produce, or transport drugs. The ability to cut different forms of drugs, disguise the transportation of drugs, and sell without getting caught is certainly an innovative process. William Julius Wilson , in When Work Disappears, agrees with this line of reasoning. He argues that high levels of drug selling activity within poor inner-city neighborhood is related to a lack of social organization within those areas. Social disorganization theory posits that as neighborhoods loose resources and the positive social organizations and role models the society becomes disorganized. As neighborhoods become disorganized, the traditional mechanisms of social control, schools, families, police lose their effectiveness in maintaining social order. In addition to the lack of resources to maintain social cohesion in the community, a profound loss of trust in traditional mechanisms of social control arises and a breakdown occurs. This was documented in Anderson’s The Code of the Street, where a violent street culture arose to govern interpersonal communication on the streets of Philadelphia. High rates of joblessness and closed economic opportunities due to racism feed drug trafficking crime and other types of gang violence. Attempts to lock up drug dealers usually fail to stem the violence as the structure that gave rise to the problem remains in tact. Dohan’s study of a Mexican barrio also illustrates how many individuals cut out of the formal economy, view drug dealing as a path towards upward mobility. Particularly in the barrio of Chávez drug dealing, stripping cars and peddling stolen merchandise was common.

Prior to these new laws, finding high quality marijuana was difficult. Now, with store front dispensaries with delivery services, high quality potent cannabis is available with the THC content listed on the bag. Moreover, as was discussed earlier, new and stronger routes of administration are being developed daily. Even the most fanatical drug dealer would never dream of operating a marijuana shop the way the Kings did prior to the establishment to the medical marijuana laws. A modern cannabis dispensary, as was outlined in this chapter, is far beyond anything on the illegal market today, and far beyond what drug dealers sold prior to these changes. Recent shifts in cannabis laws have led to an increase in delivery services and a decrease in dispensaries. While medical marijuana is legal in the state of CA, it is illegal federally and the DEA has consistently targeted large-scale dispensaries for raids. Cease and-desist letters has led to many dispensaries closing shop one place and opening up under another name another place; others have given up on storefronts all together and switched over to strictly delivery services. Delivery services are much more dangerous than dispensaries and many female bud tenders consider it to be a dangerous a line of work. Delivery services are dangerous because of the lack of security guards, security precautions and the inability to control the environment. The Kings told me many stories of delivery drivers being robbed for their cannabis.The Kings established a functional, vertical grow rack competent growing operation that led to a functional, safe and profitable medical marijuana dispensary.

Unlike common perceptions of drug users and sellers as indolent potheads, crazy meth addicts’ urban gangbangers, my researcher has shown that cannabis users and sellers are normal in practically every way. During my ethnographic observations with the Kings, I did not see any shootouts, never saw instances of white slavery,14 and never saw a stickup kid attempt a jacking, I never even saw the police. Unlike the images perpetuated in the media of gang violence and drug fueled beefs , this market was relatively subdued plain and quite normal. Instead of black and Latino gang members shooting at each other over a bad drug deal, there were pasty white people buying cannabis in sanitary shop from a cordial, happy and inviting bud tender. The overemphasis on drug markets that reside in broken down inner-cities that lack social control and police trust has led to a mental blinder on the rampant drug use present within upper-middle class white communities. Moreover, this type of narrow research by criminologist has furthermore led to a pathologizing of the communities within which these studies take place. In a type of voyeuristic gaze, white Americans love stories of street violence in communities of color and seek to attribute them to drugs while dismissing the real social structural and economic barriers that give rise to this type of violence. Truly, what this chapter shows is that drug markets are neither inherently violent, dangerous, nor pathological, especially when they are legal, taxed and regulated.Occasionally their girlfriends would attend the meetings and smoke along, other times they would just hangout and not partake of the rituals. Having known their girlfriends quite well I found it surprising that they never brought their kids along. All of the members seemed to believe the experience gained from marijuana is sacred knowledge for which children are not ready.

It was never clear when they believed the appropriate age to start smoking, as they themselves started at a young age. But what is clear, is that they take various steps to keep their children away from Ganj until they reach the appropriate age. Friends, acquaintances, and old smoking buddies would frequently be called to these sessions. They would tickle in slowly; however, the four members were usually present. There was a set series of practices that were strictly adhered to and deviations were sanctioned. The sessions always began after 10pm. By that time, their children were in bed, the collective was closed and everybody could meet. Although some would consider it nothing more than a smoke out session, the group took it seriously and used it as a time to discuss business and other important matters. The first time I was invited to a board meeting, I showed up to Dorian’s house at 10pm on the dot. Dorian answered the door and said, “You’re early.” I told him, “You said 10pm.” He replied, “We’re stoners, everybody is gonna be late. Let’s chill.” He explained that he recreated the holy drink Soma. I did not know what he meant, or what he was talking about so he told me to wait. He explained to me that it is like a chai tea milk cannabis infused drink. As stated earlier, the Kings were vegetarians and were strong raw foodist. He told me he recreated the famous drink Soma from the Rig Veda. He called it Holy Soma and used it as a way to keep the smoking high going for long periods of time. He stated, “It also helps with cotton mouth.” Cottonmouth is a common side effect of cannabis consumption. The ingredient list he used was raw milk, raw honey, cinnamon stick, cannabis and peppermint. He put the cannabis in a pot of milk and boiled it for 30 minutes. The cannabinoids found in the plant are fat-soluble so when one wishes to make a liquid drink, they must decarboxalate the drink in a fat substance. Milk fit this bill. He told me holy soma is frequently consumed when they smoke together. He said it would be sacrilege to drink Soma without the other group members present. The living room was cut off from the kitchen with hanging beads. His music was blaring form the speakers and his living room was decked out in black light Bob Marley and Shiva posters and beanbag chairs. The self-produced music was an infusion of reggae and futuristic beats.

There were no words in the song, just a trippy rhythm that was meant to be heard while high. However, as I entered the most noticeable thing was the centerpiece of the entire room, The Shiva. The Shiva, as the group calls it, is a five-foot green glass on glass bong with an ash catcher, arm percolator and down stem15. The Shiva was all green except red and gold ribs every foot marking the bongs height. Dorian told me his friend made it for him as a gift. They originally had it at the dispensary as a decorative piece but moved it out of fear a patient might break it. I asked him why they called it the Shiva and he told me because it is the “Destroyer of Worlds.” In the Hindu tradition, Shiva is a God that is responsible for the destruction of the world. The Kings play off this metaphor by claiming the bong, combined with cannabis destroys and transforms their conception of the world. In the Hindu tradition, destruction opens the path for a new creation of the universe. Moreover, many Sadhus believe a chilam is a representation of Shiva himself. The bowl piece is Shiva’s head the stem is his torso and limbs. Natty was the first to show up. TBC and High-C showed up shortly after together.In addition to discussing cannabis and its revelatory properties, hydroponic shelf system the Kings would occasionally use the meetings as corporate board meetings. They discussed their own business, legalization, and general market dynamics and trends. Monthly meetings were held by the Kings to discuss various issues related to the operation of the dispensary. The Kings, Lucy and another recommending physician who was an early investor with the Kings sit in on the meetings. They physician would always skype into the meeting, he never attended in person. The meetings typically proceed with Natty giving a report on important issues relevant to the operation of the dispensary. New types of sample buds and other types of products that could be sold at the collective, changes in ordinances that effect the dispensary and occasionally employee compensation was brought up in the executive report. Natty would frequently distribute the various forms of sample provided by vendors to the rest of the Kings to try. It may be the first and only corporate board meeting where the drugs were openly passed around as samples and used. The board would vote on whether or not the dispensary would carry the product based on the strength and potency of the product. However, the Kings were willing to give any product a shot to see how it would sell before they dismissed it. Different shelf heights let patients know about differences in the potency so potency, or lack thereof, was not a deal breaker. Lucy would give the financial report on the dispensary. Everybody had access to the finances of the collective because of the MMJmenu system the Kings employed. However, the expenses of the dispensary frequently went beyond the accounting of product. Some of these other expenses included security for the dispensary, banking needs, employee , rent, electricity and other incidentals.As discussed prior, Dorian, Lucy and Natty and a handful of volunteer bud tenders are primarily left to run the dispensary.

However, the other Kings and other investors not named and unbeknownst to me invested in the collective and enjoy periodic updates on the functioning of the dispensary. As loosely illustrated in the previous chapter, cash is the only source of currency accepted at cannabis dispensaries. As a result of this, the money collected at the end of each day must be handled by a private security guard and deposited to a bank from which it is dispersed to the Kings and investors. A video monitor feed of the dispensary is accessible by all of the Kings and investors through an internet connection and the dispensaries accounting is kept and tracked on the MMJmenu website which is also accessible by the investor group. One interesting feature about the operation of the dispensary is that despite the high markup on the price of cannabis, the dispensary does not make a huge profit. After factoring in the cost of running the collective such as rent, advertising, employee compensation, security and the like, the dispensary hardly makes a profit. As Lucy explained to me, “The money has to go to a lot of places before we can turn a profit. The dispensary always makes a profit, but when considering all the competition and the cost of running a legal dispensary, it is not the green rush I think people may think it is.” It is intriguing that the Kings engaged in this risky business when their profit margins are so small. However, the Kings motivations are not as much financial as social and spiritual as will be explained below. Notwithstanding, the investors main objective was to make money and the keep tabs on the operation of the dispensary.Each member grew their own side stash at their house. And although they ran a grow-op together, they used the grow-op for the collective, and they smoked their own personal stashes during smoking sessions. Each member of the group is expected to chip in equally, similar to an offering. They all gathered around the Shiva and one by one took their sack out and placed it in the community smoking pot. It was expected that members bring their best weed and share their weed freely. Reciprocation was a vital part of the session and signs of stinginess were heavily frowned upon. It was also crucial that the Kings brought their best product as individual members were judged on the strength of their grow. Much of the interaction was symbolic and did not serve a purpose other than the meaning the group members created for themselves. But the symbolic purpose was important to the group. And any indication that a member brought swag weed to the session, or was stingy with his weed, would cause a demotion in one’s status and prestige within the group. Having weak weed would indicate the member did not know how to grow or no longer prided himself on the grow, and being stingy would be a hint that the member could not yield the same level of bud as other members. Smoking status is an important component of the Kings identity, and thus, the Kings employ various mechanisms to maintain that status.

Approximately 23 years later, the same type of system of taxation and self-incrimination would be implemented for marijuana.As Doris Marie Provine illustrates in her book UnEqual Under the Law , Drug laws in the U.S. have always been predicated on racist assumptions of criminality and social control. The first drug law implemented in 1872 in San Francisco’s China Town banned opium smoking. Opium smoking was a common practice amongst the Chinese laborers that worked on the railroad. Various notions about Chinese men luring white women in to opium dens and selling them into sexual slavery pervaded at the time. The Opium law was seen as a way to control the population. White opium users were frequently shielded from the law as they frequently used opium from a vile. In a similar vein, cocaine was outlawed during the Harrison tax act not because of its dangerous properties, but because racist ideas abounded that the use cocaine put black men into frenzies that caused them to rape white women. It was believed that cocaine gave black men super human strength that allowed them to withstand bullets . Much the same way that Chinese and African-American men were demonized in popular culture, Mexicans faced a similar racial drug fear mongering campaign . Following the Mexican revolution of 1910, Mexicans flooded into the United States introducing the recreational use of cannabis. This was the first large scale use of cannabis as a recreational drug in the U.S. although it had been around since colonial times and had been in use in medical practice since the mid-1800s. However, plant growing rack in the 1930s, as the depression era took hold and many white Americans could not find jobs, Mexicans became the target of discrimination .

The hatred of Mexicans was so severe, that in 1931 Mexican repatriation began. Much like the opium laws and ordinances that targeted the Chinese in San Francisco, and the black codes that pursued blacks in the south, anti-marijuana laws were designated primarily for controlling the unwanted immigrant Mexican population . By 1931, based on dubious scientific studies showing links between marijuana use and violence, over 29 states outlawed marijuana. Many newspapers at the time, combined with the film Refer Madness in 1936 promoted this type of propaganda as legitimate. The specific reason given for the outlawing of the hemp plant was its supposed violent, effect on the degenerate races. In 1937, Congress implemented the Marijuana Tax Act, which levied a tax on anyone who dealt commercially in cannabis, hemp, or marijuana. Like the 1914 Harrison Narcotics act, the act itself did not criminalize cannabis use, it simply penalized cannabis handlers who did not get the proper marijuana stamp and pay the proper tax for handling marijuana. The act restricted cannabis use by never issuing marijuana stamps to anybody that may wish to sell, purchase or use the plant. Moreover, in order to get a stamp one would have to have marijuana in hand to get the license, effectively creating a system of self-incrimination .The fact that the marijuana tax act led to a system of self-incrimination, the law was abolished after the court case of Leary v. United States in which the Supreme Court held the tax act unconstitutional since it violated the Fifth Amendment . However, drug laws were by this time so entrenched in the American consciousness, drug crusaders had no problem enacting a law that outright illegalized the plant. This led to the 1970s Controlled Substances Act. This act regulated the manufacture, importation, possession, use and distribution of certain substances . The legislation created five schedules for a substance to be included.

A discussion of the classification criteria and the drugs listed in all five schedules would be far too extensive and not germane to this dissertation. Therefore, I will only discuss marijuana’s classification as a schedule I drug. Schedule I substances are defined by the Controlled Substances Act as a drug or substances that has a high potential for abuse, has no currently accepted medical use, and there is a lack of accepted safety for the use of the drug or other substance under medical supervision . What is noteworthy about this classification is that pure THC is listed as a schedule III narcotic5 under the trademark Marinol . Likewise, far more dangerous drugs such as cocaine, methamphetamine and oxycodone are classified as schedule II drugs, implying that they are less dangerous and less like to cause dependence and abuse . In 1996, California voters passed historic legislation, Proposition 215, concerning the use of cannabis for medical purpose. The proposition was a statewide voter initiative to allow patients with a valid doctor’s recommendation to possess and cultivate cannabis for personal medical use. This was the first stepping-stone in the legalization of marijuana. It also created a conflict between state and federal law, with prosecution and imprisonment still enforceable at the federal level. In response to Proposition 215, the federal government threatened to revoke the license of any physician who recommended the use of cannabis to any patient . Such threats did not last long as the Ninth Circuit Court of Appeals held that, “the harm to patients from being denied the right to receive candid medical advice” and the “the harm to doctors from being unable to deliver such advice” were both insupportable. Proposition 215 was later expanded in 2004 with the introduction of SB 420. Senate Bill 420 was to create a uniform system of guidelines for medical marijuana regulation .

The provisions allows for an individual to possess a minimum of 6 mature or 12 immature plants and a half pound of processed cannabis. The bill established the voluntary medical marijuana identification card program and guidelines on aggregate possession and the operation of cooperatives and collectives . Theoretically, collectives/cooperatives are collectively owned non-profit establishments designed to grow and distribute cannabis on behalf of its members that have neither the time, resources or knowledge to grow on their own behalf. By operating collectively, growers and distributors, known as growing operations and dispensaries/delivery services pull together the aggregate passion of its members to grow on their behalf. Aggregate possession allows for a cooperative to grow and distribute medical cannabis on behalf of its members. This allows cooperatives the ability to grow much more cannabis than would typically be legal for an individual grower or growers. Many medical marijuana patients have not the time, knowledge or ability to grow medical marijuana plants. Moreover, the sale, purchase and trafficking of cannabis is still illegal under California state and federal law for both medical marijuana patients and non-medical marijuana patients alike. Joining a cooperative or collective allows medical marijuana patients that otherwise would have to grow cannabis on their own or buy it from a street dealer the ability to obtain cannabis in a relatively safe and secure way. However, indoor vertical garden system cooperatives are expressly non-profits that operate for the benefit of their members. Cannabis is grown for the benefits of the members and donations are made to keep the cooperative operational.The passage of California’s Compassionate Use Act and the enactment of Senate Bill 420 opened the floodgates for the shifting of public opinions about cannabis and cannabis legalization in the United States. As of this writing April 2016, there are currently twenty-three states in the U.S. that have some form of legalized marijuana production and distribution system either already in place or in the works. On top of that, four states , and the District of Columbia , have outright legalized recreational cannabis for adult use , and another twenty states are working to put pot legalization measures on their November 2016 election ballots . Although times are changing and a trend towards legalization appears inevitable, a new form of racial and class hierarchy is emerging in the recreational marijuana system. As stated earlier in the chapter, drug prohibition and the war on drugs has always relied on a system of racialized assumptions. Today, in response to mounting state debt, and a per capita prison population that far surpasses that of nation states typically considered to be repressive, states are enacting laws to help reduce the economic cost of mass incarceration and the war on drugs. Unfortunately, as history has proven time and time again, the more things change the more they stay the same. Much of the pro-legalization and anti-mass incarceration rhetoric centers around the issue of the taxation burden on the white middle class. In fact, one of the most cited statistics, and perhaps one of the most significant reasons for the wild fire spread of pro-cannabis legislation has been the boon to state coffers following the Colorado and Washington’s marijuana legalization. The state of Colorado alone collected nearly 135 million dollars in marijuana taxes in its first year following the institution of legal recreational marijuana. In the state of Colorado in 2015, licensed marijuana stores sold approximately 1 billion dollars worth of medical and recreational cannabis. Additionally, the state collected 135 million in taxes in year over year totals for taxes and license fees in 2015 .

What is going on today is nothing short of what many have described as a modern day gold rush, or, a “Green Rush” to be exact. In Oregon’s first month of legal recreational marijuana sales, the retailers sold an estimated 13.9 million dollars worth of pot generating 3.48 million dollars in taxes . Unfortunately, everybody does not share in the spoils of cannabis legalization equally. Similar to the way certain cities institute ordinances to effectively bar medical marijuana dispensaries in cities, many of the states that have enacted rules for the application process that effectively bars poor and middle class Americans from participating in the industry.In addition to maintaining class hierarchy, the racial inequity remains intact as a criminal record bars individuals from working in the marijuana industry . By barring former criminals, and in particular, criminals charged with prior drug offenses, the laws practically guarantee a middle-class white work force. Although research unequivocally shows that whites and blacks use drugs at approximately the same rates, blacks have been disproportionately arrested and convicted of drug offenses. And as a consequence of this racial targeting, a defacto system of racial segregation is emerging in this newly found industry. As Amanda Chicago Lewis so eloquently puts it, “After having borne the brunt of the “war on drugs,” black Americans are now largely missing out on the economic opportunities created by legalization.” Moreover, as the application process has become prohibitively expensive, minorities are excluded from entrepreneurial ventures as the lack of wealth of keeps many from attempting to enter the industry. It is estimated that it takes a quarter of a million dollars to start a recreational marijuana business . Thus, the legal marijuana system, at the dispensary ownership level and the production process is still very much dominated by white upper class males. Notwithstanding, regardless of the barriers enacted by the state, city or any other type of governmental entity, it is important to understand that cannabis as a plant can not be controlled, unlike other forms of drugs such as cocaine and methamphetamine, a chemically rigorous production process is not necessary. Any individual with a pot and a plant can grow cannabis and thus the system can never be completely controlled. According to a report released by the Center on Juvenile and Criminal Justice pot legalization hasn’t done anything to shrink the racial gap in drug arrest rates. Although the study pointed to the fact that arrest rates plummeted in states in Washington and Colorado, the racial disparity between black and white arrest remains unchanged . However, it should be noted that while disparity in arrest rates remain consistent, arrest overall in states with legal recreational marijuana has seen dramatic decreases . In the state of Washington alone from 2008 to 2014, arrest rates dropped by 90 percent. Thus, one of the major consequences of our half semi-legalized marijuana system in the U.S. is much the same that it has been for generations, as poor and minorities are locked up for selling and using marijuana, white male capitalists get rich off from the exact same act. Thus, the cannabis industry in the U.S. today is at an interesting crossroad between legalization, taxation and regulation on end and prohibition and the war on drugs and more of the same on the other. However, it is important to understand that the inequities of the war on drugs cannot be redressed with a simple process of legalization without redressing and remediating the inequities the war on drugs produced.

Sociologist Kathy Charmaz describes how to perform grounded theory by, “You begin with an area to study. Then, you build your theoretical analysis on what you discover is relevant in the actual worlds that you study within this area.” . A grounded theory approach gives extra credence to the interactionist nature of the study because my opinions and interpretations of the practice of marijuana use and selling is not clouded by preconceived notions of what I expect to find. Research Setting The study will take place in Costa Mesa, California, following a community of heavy marijuana users and sellers who participate in the partially illicit marijuana trade. All participants names in this study will be changed to conceal their identity. Costa Mesa is a city in Orange County with a population of about 100,000 inhabitants. It is nestled between the extremely upper class, predominantly white area of Newport Beach and Irvine , and the poorer, older, larger and predominantly Latino cities of Santa Ana and Anaheim3 . Costa Mesa is a type of buffer zone between the haves and have-nots in Orange County and it is from this offset situation that the group gets its unique racial and class character . Furthermore, this balanced and relatively stable environment allows the group to avoid the more dangerous nuances of the illicit substance trade while serving as a mechanism where they still have a constant supply of customers from both the richer and poorer elements of the county. The main meeting place for the group is The Corner . The other common “kick it” spot for the group is Natty’s mother’s house. The house is near a popular pool hall in the city of Costa Mesa. It is an older wood house with a front porch type stoop that serves as a gathering and kick it point for the CottonMouth Kings.

Although just off the largest street in Costa Mesa , weed growing systems marijuana is smoked openly on the porch, and Natty Dreads Mother is surprisingly permissive of the behavior. Many nights begin at the House and end at the pool hall and many transactions occur at both locations. The group I decided to research was a cannabis selling and smoking group based in Mid-Orange County. I decided to use the group understudy for two main reasons. One, through a social-network snowball sampling I was able to get in contact with the members of the group. And two, the members of the group each had years of experience smoking, growing and selling cannabis in both the illegal market and the semi-legal medical marijuana market. This gave me the added benefit of comparing cannabis markets before and after the medical marijuana system. Furthermore, having access to a unique set of individuals who participate in a semi-legal, and partially illegal economic venture provided rich data for an under explored market dynamic. This, combined with the groups unique beliefs about cannabis and its beliefs about their own cannabis selling behavior and what it meant made for a fascinatingly rich and distinctive ethnography. Moreover, I chose this group of individuals because of unique characteristics of the group understudy. For one, the group members are not young teenagers. In fact, they are in their late twenties and early thirties and many are parents. Most criminological research examining drug users and sellers focuses on teenage offenders. Two, the members are not dispossessed minorities selling drugs in a dangerous urban area for survival. The study takes place in a relatively middle class area of Orange County with other legitimate economic ventures to pursue. And three, the members are not the typical rich drug dealers documented in films likeScarface. The relative normality of the group with their unique perspective on cannabis and cannabis selling led me to study this group. I provided confidentiality to the participants of the study. Since I as the researcher can identify the members of the study the project is not anonymous. However, all steps possible were taken to insure the confidentiality of the study’s participants.

The names and ages of all participants have been changed. I paid close attention to make sure there was no way to be able to discern the actual identity of the study’s participants. Moreover, the city, and certain locations discussed in the preceding chapters are meant to be purposefully misleading in case anybody who is familiar with the area or with the people I study were to try to determine the actual identity of the participants of the dispensary in the study. Psuedonyms are particularly relevant for qualitative researchers to assure that deductive disclosure does not occur. Deductive disclosure occurs when individual traits of individuals or groups makes them identifiable in research reports . Qualitiative research, and ethnographic research in particular tends to be rich, descriptive and vivid. For this reason, researchers need to pay particular attention to not tipping off potential readers to the actual identities of the participants. Breaches in confidentiality also have the potential to damage the public’s trust in researchers . One famous case of deductive disclosure was Carolyn Ellis’s Fisher Folk . The research participants were able to identify themselves and their neighbors and people from neighboring communities were able to identify them. Ellis later went on to write that the research participants felt ashamed and betrayed by her book . Because of these problems, simple name changes were not enough to protect the anonymity of my informants since deductive disclosure is a possibility. Thus, other aspects such as age and location were changed as well. I employed a confidentiality approach that Kaiser termed the Dominant approach. Although Kaiser is not a proponent of the approach is was ideal for my particular study. I chose to name the group the CM Kings for a couple of reasons. First, they do not consider themselves a gang and thus have no formal name for themselves. Rather, the Kings are a compilation of a group of friends that sold and grew in various capacities and eventually pulled their resources together to set up a marijuana dispensary. However, the name serves another purpose. I use the name as a play on Sudir Venkatesh’s Black Kings. In Gang Leader for A Day Venkatesh chronicles the structure and practices of urban drug dealers on the streets of Southside Chicago.

In this study I counter Venkatesh notion that drug markets are inherently dangerous and violent by showing the structure of suburban cannabis markets and the semi-legal medical marijuana markets and its success in stifling crime and violence in the market.Although not traditionally defined as vulnerable populations such as children, the mentally disabled or individuals with low social status, research on criminal populations present unique challenges for the researcher. Because of the unique circumstances of doing criminological research, the American Society of Criminologist code of ethics states, in relation to research populations that they: a. comply with appropriate federal and institutional requirements pertaining to the proper review and approval for research that involves human research subjects, materials, indoor farming systems and procedures; b. do not mislead respondents as to purposes for which that research is being conducted; c. ensure subjects’ rights of personal anonymity unless they are waived; d. ensure confidentiality of any data not obtained from records open to public scrutiny; e. anticipate potential threats to confidentiality, including the Freedom of Information Act, and adopt various means of coding, storing, and maintaining data to protect the confidentiality of research subjects; f. fully inform potential subjects in cases in which they are unable to guarantee confidentiality; g. make every effort to ensure the safety and security of respondents and project staff; h. obtain informed consent when the risks of research are greater than the risks of everyday life; and i. take special efforts when individuals studied are illiterate, are mentally ill, are minors, have low social status, are not comfortable or familiar with the language being used in the research, are under judicial or penal supervision, or are unfamiliar with social research and its constraints and purposes. . I made sure to follow all the research ethics and more. Social research, by its very nature represents an invasion of people’s daily lives. Moreover, criminological research ask respondents to reveal deviant behavior that may have lasting ramifications such as potential arrest and imprisonement, beyond the study. Revealing information may harm the participants so extra care was taken to shield the participants from potential harm.I attained informed consent from all the study’s participants. Consent forms provide valid and legitimate documentation that the subjects knowingly participated in the project. Notwithstanding, as Dixon noted several years ago research of criminal populations, “is coming under increasing threat from institutional ethics committees which have raised legal and ethical objections to proposed projects” . In particular, Dixon notes the inability of researchers to protect the confidentiality of research subjects, particularly when illegal activities are concerned. Unfortunately, as pointed out by Roberts , signed consent forms provide an identifying link between the participant and the data.

However, they were collected at the request of the University of California, Riverside Human Research Review Board. Yet, as stated earlier, the acitivities of the participants are legal in the state of California where the research was conducted. Natty Dreads is the key informant of the group and the access I have to the group. Thus, to some degree, the study is filtered through the lens of his and my eyes. I met Natty Dreads approximately 15 years ago in high school. At that time, he did not smoke. His transition into marijuana culture was relatively abrupt. Living down the street from me made it convenient to hang with Natty on a relatively frequent basis. In-depth face-to-face interviewing will be conducted with the study’s participants, using an interview question list that will consist of three parts: history of substance and marijuana use, what marijuana culture and marijuana smoking and selling means to them and questions about why the respondent continues to participate in these acts. The interviews lasted approximately two hours each, with follow up interviews conducted as new developments that I witnessed occured, or, if the respondents decided they wanted to share more information about their views on marijuana use. The interviews were semistructured for the purpose of getting the conversation flowing and to learn various demographic and social history factors, but the main purpose of the interviews was to let the group members discuss what marijuana use and dealing means to them and why they participate. Other than a few preset questions, I did not script or prime the interviewees towards certain answers. I allowed the respondents to express what marijuana culture means to them. The interview questionnaire is listed in the appendix. The field notes were recorded in the language my informants spoke and decoded in the dissertation so that is understandable to academics. My informants spoke a form of English heavily coded in marijuana slang. The group frequently discusses marijuana openly but the coded language allows them to stay undetected by non-users. Using phrases like “gaining knowledge” to represent smoking marijuana is one such technique. After recording conversations and viewing the surrounding environment, I will take the condensed account and expand it to discuss relevant information that I did not have time to write down while in the field. Ethnographer James Spradley considers this to be an integral part of ethnographic methods because it allows the ethnographer to fill in detail and record things that were not possible in the field. A key aspect of “grounded theory” ethnographies is an analysis that is inductive, interactive and recursive. Inductive research identifies data and amasses them into larger taxonomies and categories. These categories are explored in interviews as well as in participation and observation to test their internal validity. New observations are compared and contrasted until stable patterns emerge that begins to explain cultural practices. Recursivity refers to the cyclical nature of this process as it moves from inductive analysis, in which the theory is created based on what is observed, and deductive processes through which the datum is compared to the theory. This iterative model is the process I intend to use while in the field to understand the practice of marijuana use. This works by continually raising questions in the field and modifying and clarifying ideas about what is discovered.

This disconnect between the farmers’ perceptions of the industry compared with its rapid expansion could mean that the specific type of producers we interviewed were not benefitting from the industry increase that accompanied legalization. Other research on small scale cannabis producers from northern California supports this interpretation . It is also possible that landscape-scale industry change does not translate to the scale of an individual farm. If this is the case, it might help explain why the model of change in plant count had the fewest significant predictors—rather than being a more simplified process, it might instead be that the drivers for farms that existed before legalization are highly individualized or localized.Despite the uncertainty surrounding the trajectory of legacy cannabis farms, the models for new cannabis development provide insights into predicting the growth of the industry. While we did not project our predictions into the future, due in part to large policy changes that were not explicitly addressed in our interviews or models , our results do provide a baseline and contextualized understanding that could be used for future predictions. For example, based on farmer descriptions for why they may seek out large and rural parcels, it is unlikely that the strength of those drivers would decrease over time. On the other hand, farmers’ stated preference for farm-zoned parcels, which by contrast ended up as a significant driver in the opposite direction for new farm development, rolling hydro tables might be more likely to change over time as a potential driver due to shifts in regulation, enforcement, or social pressures for those renting/selling farm zoned parcels.

While our results are broadly useful for understanding cannabis landscapes in southern Oregon, there are many levels of complexity that are not captured by the models. For example, we treat cannabis agriculture as a single entity for these models, while in reality it contains a diversity of production styles and regulatory statuses. It is entirely likely that a large-scale licensed hemp farmer and a small-scale unlicensed cannabis farmer will reveal different drivers of their land use. Similarly, whether a farmer owns their own land or rents it, or whether a farmer lives on site or off, could also change the relationship with potential drivers. While we did not have detailed information on each cannabis producer at the county level to classify or group production styles, this would be an important avenue for future research. Future research would also benefit from added time points, particularly after the 2018 federal hemp legalization. In addition, this study was largely confined to a small number of small-scale farmers, and thus an expanded interview or focus group data collection process might reveal new drivers that would be relevant for other production styles. The relatively low pseudo r-squared values for our models suggests that there may be additional drivers functioning in this system, which extended interviews could help uncover. Our study focused on private land production, but it is important to remember that public land production also occurs in this area and influences not only the local environment, but the public perceptions of cannabis in the region. Incorporating the links between public and private industries might strengthen our understanding of these systems. Similarly, linking different scales of drivers would be a valuable next step. The interview data indicates that the southern Oregon industry is tied to regional and national markets , and that much of the economic decisions are either very fine scale at the level of the farm, or broader scale at the level of the state. Within the scale of Josephine County, the significant effect of mapped year implies that there may also be different dynamics in the two halves of the county that were mapped at different time points .

Although it did not directly emerge in the interviews, while living in Josephine County, PPS observed different local approaches to integrating cannabis farmers into the community in Williams as opposed to the Illinois Valley. This is an example of a secondary way in which the observations that occur during the interview process can assist with model interpretation. Further research on differences in local policies, community standards, or other regional differences might elucidate this pattern. Capturing interrelated dynamics such as local to county-wide processes would require a complex modeling approach but might lend insights into multi-scalar drivers. Understanding wildlife response to disturbance across landscape gradients is a complex endeavor. Individual animals can respond to anthropogenic disturbance with a variety of different behavioral changes , but these responses are all context dependent . For example, in some studies, coyotes demonstrate a space use preference for agricultural areas , while in others, they avoid farmland ; similarly, at times they are labeled as urban exploiters , and at times avoiders . These differences are often tied to context-dependent responses and differences in landscape configurations . At a wildlife community level, the complexity of responses increases even more. Disturbance may affect some species more than others, or in opposite directions, leading to broader contractions or expansions in species assemblages and interactions . Changes in species interactions, especially if they involve keystone species, can have cascading effects on ecosystem function . The context-dependence of these shifts means that consistently predicting how wildlife communities will respond to rapid land use change at a local level is very difficult and requires understanding multiple interacting mechanisms . Nevertheless, wildlife community responses to disturbance matter because the context-dependent consequences in turn can affect ecosystem health , effectiveness of wildlife management strategies , and human-wildlife conflict . Thus, there is a continuing need to examine the effects of disturbance on wildlife in order to develop strategies to mitigate the negative effects of land use change. Understanding wildlife response to disturbance is particularly important in areas where land use change is occurring rapidly.

Spaces of rapid development for agriculture are called frontiers, and are often spurred by the growth of a new industry, while accompanied by the movement or growth of human populations, and transportation structure improvements . Frontiers are naturally spaces of rapid land use change, and often sites where different approaches to land use planning and conservation clash . While frontiers present a novel disturbance scenario, most studies of wildlife response to agricultural land use have been concentrated in Asia, South America, and Europe , and often in areas that have long been dominated by agriculture. Such studies may miss some of the immediate responses of wildlife to development that occur over shorter spatial and temporal scales . Recreational cannabis agriculture represents an ideal opportunity to study wildlife community response to disturbance generated by a currently expanding land use frontier. In the US, state level legalization of recreational cannabis has initiated a rapid land use frontier for outdoor cannabis production . This frontier is particularly noticeable in rural areas of the western US. Influenced by its illicit history, outdoor cannabis is often grown in remote, bio-diverse regions with minimal other non-timber agriculture . Regardless of individual legal status, private land cannabis farms are typically smaller than those of other commercial crops, and are clustered in space, creating a unique land use pattern of small points of development surrounded by less developed land . This pattern of development locates the cannabis frontier directly at the wilderness boundary—a somewhat rare characteristic for agriculture in the United States . At a broad scale, cannabis development in rural areas overlaps with regions that may be important habitat for wildlife , yet it is unclear whether, where, vertical horticulture and to what extent this broad scale spatial overlap actually results in negative impacts on animals at a local scale. There have been studies suggesting that cannabis production may lead to habitat destruction or modification , and wildlife death due to toxicant use and poaching . However, most studies on direct impacts of cannabis farming have largely been conducted on illegal public land production sites , as opposed to private land sites. The research conducted to date on private land has not encompassed a full landscape gradient around cannabis farms. Not only have private land sites likely seen the largest production increases due to legalization in recent years , they are also often characterized by very different production practices than public sites. For example, on many private land farms, indirect sources of disturbance to wildlife such as noise and light are more common than direct causes of mortality. Private land sites may use high-powered grow lights, drying fans, and visual barrier fencing, which could create potential wildlife disturbance . Such practices are less common on public land. It is possible that as cannabis production expands, particularly in the licensed industry, these forms of indirect impact may be more typical of cannabis production overall. Indeed, indirect effects of production practices on wildlife space use and behavior is a common concern for other agricultural crops , and may also interact with direct effects on mortality .

Therefore, it is critically important to study both indirect and direct effects of cannabis on wildlife communities, particularly on private lands where research is lacking. Because outdoor cannabis farming is a land use frontier and therefore often characterized by different land use practices and patterns from traditional established farming in the US, it is uncertain whether other agricultural systems provide the best models to predict wildlife responses to cannabis development. Wildlife may use, avoid, or display differential responses to cannabis development, depending on whether production more resembles small scale countryside farming , industrial agriculture , or exurban/suburban development . In the case of differential responses, it’s also unclear whether cannabis production would have widespread enough effects to trigger mesopredator release , or generate novel food sources that could be exploited by behaviorally adaptable species like omnivores and small mammals . We based our study in Josephine County, in southwestern Oregon , in 2018- 2019, three years after statewide recreational legalization took effect. Josephine County was an ideal location to capture the start of the cannabis frontier expansion post-legalization in a rural, bio-diverse legacy production region. Our study area sits within the Klamath-Siskiyou Ecoregion, which is one of the most bio-diverse temperate forest regions on Earth . The Klamath-Siskiyou Ecoregion straddles the Oregon-California border and contains several areas identified as critical climate change refugia . Within this ecoregion, Josephine County contains several protected areas including state and federal protected lands , as well as several species of concern, including native salmonids, threatened Humboldt martens , fishers , and spotted owls , all of which are hypothesized to be directly or indirectly affected by cannabis agriculture . Unlike other forms of traditional agriculture, outdoor cannabis is often grown directly alongside or nestled within areas of high biodiversity . Southern Oregon, and Josephine County in particular, has a long history of illicit and medical cannabis cultivation, as well as an active presence in the growing legal industry in Oregon . Southern Oregon became known as a prime destination for outdoor cannabis production even before legalization, and Josephine County had the highest number of licensed producers relative to population size in the state by 2019 . Production in the county accelerated after recreational legalization went into effect in 2015 , in a similar pattern to cultivation occurring across the border in northern California, with clusters of small farms surrounded by undeveloped or less developed rural land . Our study area consisted of farms spread across three sub-watersheds in Josephine County . We set cameras at 1,110 m to 2,470 m above sea level. The study area included a mix of vegetation types, including open pasture, serpentine meadows, oak woodland, and mixed conifer forest. Rainfall in this region varied seasonally and by elevation, with an average of 82.7 cm annually . Mean temperatures ranged between 3.9-20.6°C in 2018–2019 .The small-scale, private-land cannabis farms for this study included one licensed recreational production site, one medically licensed production site, and six unlicensed sites. All farms were producing cannabis for sale, though in different markets depending on their access to licensed markets. We also had cameras placed in three hemp fields next to cannabis farms. We selected these eight cannabis farms because they: were representative of the size and style of cultivation predominant in Josephine County in the years immediately following recreational legalization in 2015 , were all established after recreational legalization except for the medical farm, did not replace other plant-based agriculture, granted us permission to set up cameras on site, and were located next to a large section of unfarmed land that could grant researchers access in order to place cameras across a gradient of distance to cannabis farms.

Proponents often argue that smaller-scale styles of farming are more sustainable , sometimes drawing parallels to industries such as craft vineyards . However, these farms are also often located in more rural, bio-diverse watersheds close to protected wilderness and managed timberlands that could be at environmental risk from expanding development . As land managers and policymakers decide where to prioritize cannabis farming, there is a growing need to contextualize the potential effects of the legacy pathway in ecologically sensitive regions. In Josephine County, Oregon, the co-occurrence of cannabis agriculture within the highly bio-diverse Klamath-Siskiyou Ecoregion has created a natural experiment to examine how the post-legalization expansion of small-scale, private land farms might affect freshwater and terrestrial biodiversity. In this study we ask: what was the development pattern of cannabis land use in Josephine County during the first year of recreational legalization, and how might cannabis production overlap with sensitive ecological features? To address these questions, our objectives were to: map and characterize the spatial configuration of cannabis farms in Josephine County, Oregon in an early stage of cannabis legalization, and examine the proximity of cannabis production to undeveloped land cover, freshwater, sensitive fish species , Chinook salmon , and Steelhead, and terrestrial carnivore richness , coastal marten , ring tail , cougar , bobcat , gray fox , and coyote. We anticipated that due to the cultural dominance of historical growing practices, grow trays 4×4 cannabis production in this region would be comprised of relatively small-scale farms representative of the legacy industry pathway , but most farms would be new since legalization.

Based on research from California pre-legalization , we expected that cannabis in our study area would also be clustered at the subwatershed level. Concerning proximity to ecologically sensitive areas, we expected that cannabis agriculture would be located in more undeveloped lands, closer to freshwater streams or rivers, and closer to sensitive fish species compared with the surrounding context of all private land parcels. The proposed mechanisms behind these predictions are summarized in Table 1 and draw on the five hypothesized pathways of effect for cannabis on the surrounding environment listed earlier . Finally, we quantified spatial overlap of cannabis farms with projected terrestrial carnivore distributions. We focused on carnivores because previous studies have described this group as particularly sensitive to cannabis cultivation , and because this group includes species of regional conservation concern, such as the fisher.Our study focused on Josephine County in Southern Oregon . Josephine county was an ideal location to measure cannabis dynamics of legacy areas and to gain broader insights on the ecological outcomes of cannabis legalization. Josephine County had a long history of illicit and medical cannabis cultivation, and an active presence in the growing legal industry in Oregon . In 2014, Oregon became one of the first U.S. states to legalize recreational cannabis. Southern Oregon has become known as a prime destination for outdoor cannabis production , and Josephine County had the highest number of applications for licensed producers relative to population size in the state . Widespread cultivation of cannabis started in the region during the 1960s and is now viewed as one of the county’s main economic drivers . Josephine County is also located in a biodiversity hotspot.

The study area is part of the KlamathSiskiyou Ecoregion, one of the most biodiverse temperate forest regions, and an area of increasing conservation focus . The KlamathSiskiyou Ecoregion straddles the Oregon-California border and contains several regions identified as critical climate change refugia . The study area contains several protected areas including state and federal protected lands , and several federally threatened and endangered species including northern spotted owl and coho salmon , and state sensitive species such as fisher . To characterize the spatial distribution of cannabis farming, we hand-digitized cannabis production sites across Josephine County using high spatial resolution Google Earth images taken after statewide legalization . We based our methods on those previously used to map cannabis production in regions of northern California . We used publicly available satellite imagery for May or July 2016, the first year with a full growing season after recreational legalization went into effect in July 2015. Next, we characterized the farms themselves. Digitizers counted the number of plants visible in outdoor gardens, recorded whether there was a visible fence surrounding each cannabis production site, and recorded whether each site was new . To estimate the number of plants produced in greenhouses, we used 180 instances where we could count the number of plants through the see through top of greenhouses and divided this count by greenhouse area. This yielded an average of one plant per 7.23 m2 of greenhouse area, which we then used to estimate greenhouse plant counts. See supplement online for full mapping procedure.To test the accuracy of image-based data collection, we visited approximately 30 farms between 2017-2019 to verify and refine our mapping protocol after a pilot mapping process. Because systematic ground-verification for all grow sites was not possible, we used a qualitative confidence score to represent digitizers relative certainty about each mapped site . For consistency, we thoroughly checked all mapped polygons and associated scoring using the same person who conducted on-the-ground site verification . We used only high confidence sites for these analyses, but see supplemental materials for a comparison to the full data set . Finally, we used only sites with more than four plants for analyses because we were focused on the cannabis industry rather than plants grown for personal consumption .

To assess the potential ecological effects of cannabis at the landscape scale, we quantified spatial characteristics and proximity of cannabis to landscape features, fish populations, and carnivore distributions . This proximity doesn’t directly infer effect, but rather whether the configuration of cannabis may increase the opportunities for negative environmental outcomes. We focused on spatial metrics that might approximate some of the five main hypothesized effects of cannabis farming on local environments . To approximate the potential loss of wildlife habitat, we assessed cannabis production in developed versus undeveloped lands. We extracted elevation and 2013 land cover at the centroid of each farm, and then grouped land cover classes into developed and undeveloped categories . The National Land Cover Database Cultivated category includes hay, annual crops such as corn, or perennial crops such as orchards and vineyards; given the resolution of the NLCD dataset compared to average farm size, this is unlikely to include cannabis pre-recreational legalization. To approximate the potential degradation of forested habitat, we assessed the forest structure on farms used for cannabis production . To do so, we extracted canopy cover and stand age at the centroid of each farm . To approximate the potential effects on carnivores, we examined the overlap of cannabis with projected carnivore richness and individual carnivore species distributions. We extracted the average carnivore richness, and individual carnivore occupancy value at the centroid of each farm . For carnivore richness and individual carnivore distributions, we used projected model data for southern Oregon, from Barry and Moriarty et al., unpublished data . Within our study area, the richness layer represents the total number of carnivores expected in a given grid cell for the following species: fisher, coastal marten, ring tail, cougar, bobcat, gray fox, and coyote. For individual species, horticulture products we used calculated distribution data from projected occupancy and this represented the average probability that a given area would be occupied by that species. Marten projected occupancy was almost entirely absent in this region and was not included in individual species summaries. Finally, to approximate the potential effects of freshwater extraction or declines in freshwater quality due to cannabis production, we assessed the proximity of cannabis to freshwater rivers or streams and fish habitat for potentially sensitive species. For vector data with the proximity analysis , we calculated the distance from the centroid of each cannabis farm to the nearest river and fish habitat in R using the ‘simple features’ package . For rivers, we used the National Hydrography Database . We filtered out canals/ditches and underground aqueducts . For fish habitat data, we used Oregon Fish Habitat Distribution data for coho salmon, fall and spring run Chinook salmon, and winter and summer run Steel head . The fish dataset includes any areas used within the past five reproductive cycles for each species. We then calculated summaries of proximity and overlap metrics in R. In order to inform the interpretation of the fish habitat data, we also extracted the stream order of the nearest stream to each cannabis site, and summarized results in R. The conservation effect of these metrics for cannabis likely depends on how they compare to the potential effect of surrounding land uses and available land for development . Therefore, we contextualized the proximity metrics by comparing cannabis farms to all private land parcels in the county. We used all private parcels instead of parcels without visible, high-confidence cannabis because we were mainly interested in how cannabis production fits into the surrounding landscape context of available private lands.

See the supplement for a more local comparison in which we calculated the proximity and overlap metrics for all parcels within a buffer around each cannabis site. For buffer size we used the average home range of fishers from southern Oregon . Outdoor cannabis production across Josephine County in 2016 was generally small-scale but also pervasive, and suggested that recreational legalization greatly expanded the industry locally. We mapped nearly 4,000 individual gardens and greenhouses on 2,220 different farms, all identified as highly likely to be cannabis . Most sites were new since legalization . Most production was in outdoor gardens , but a greater proportion of greenhouses were new . Farms contained an average of 1.76 individual sites, with a maximum of 14. The average size of individual sites and farms was small but highly variable in terms of cultivated area and number of plants . The average parcel size for farms was 0.098 km2 . 99.6% of detected farms were on private land parcels. Out of all private land parcels in the county, 5.7% contained a farm identified as highly likely to be cannabis. The Ripley’s K analysis indicated that cannabis sites were clustered at all observed spatial scales . At the county level, the Getis-Ord Hotspot maps identified two regional hotspots near Williams in the SouthEast, and in the Illinois Valley in the South-West . The sub-watershed analysis indicated that even within these larger regional hotspots, there were pockets of more and less intensive production . Both the county and sub-watershed hotspots seem to follow primary roads or river networks.Overall, cannabis was produced on more undeveloped and forested parcels compared to all available private lands as a whole . The most common land cover for individual outdoor gardens was shrubland , followed by cultivated , and forest . Greenhouse cannabis production occurred in areas already cultivated with other crops , followed by shrubland , and forest . At the farm scale, however, where outdoor and greenhouse production was combined, forest was the most common land cover type . The predominance of cannabis in forest and undeveloped land covers was also supported by the Gradient Nearest Neighbor data on forest structure. Although the GNN dataset uses a broader categorization for forest, it also indicated that cannabis was disproportionately grown in forested areas . Nevertheless, the forest structure of farms was similar to that on all available private parcels .This study is one of the first landscape-scale assessments of small-scale outdoor cannabis farming and its potential broad-scale ecological effects in a rural biodiversity hotspot. Our results suggest two main conclusions. First, private land cannabis farming in Josephine County, Oregon in 2016 was common and spatially clustered, expanded post-recreational legalization , and yet only covered a small portion of the total land area. This supports our expectation that cannabis farming in Josephine County would exhibit characteristics typical of the legacy development pathway, but that these farms would largely be new post legalization. Second, our spatial proximity results highlighted areas of overlap or proximity of cannabis farms and sensitive habitats and species. Compared to the surrounding context of all available private land parcels, cannabis was more frequently located in forested areas and undeveloped land, closer to rivers/streams and coho salmon habitat, and in areas of high value as fisher habitat. These results provided mixed support for our expectation that cannabis production would be in areas that increase its potential ecological impact.

Furthermore, this evaluation may inform limited research of RJP program evaluation with a small, rural school district in a region with a prevalent cannabis cultivation industry. Findings from this project may help to fill the gap in the literature on restorative program evaluation for drug-related incidents in school-based settings. This may inform efforts for developing, implementing, and evaluating public school-based restorative programs with a substance use focus. Data from this project may also provide the grantee with crucial intermediate findings to inform the continuous development and optimization of RAYS program components and implementation strategies.The General Activity Log database was developed utilizing the SeaTable Cloud software service . UCSD researchers conducted training sessions with RAYS program coordinators where data recording protocols were reviewed to ensure accurate and efficient collection of activity data. Links between the GAL and the case management database were established to track participation in RAYS activities at the individual enrollee level. RAYS program coordinators recorded all relevant activity data in the GAL at the time of implementation or ideally within the same month the activity was implemented. Critical activity data for process evaluation included activity name, implementation date, number and type of attendees , engagement levels, vertical racking system and duration of the activity .The case management database was embedded in the same SeaTable cloud-based platform as the GAL.

Core components of the case management database that informed both process and outcome evaluation measures included data from the Enrollment Form, Exit Form, and the Demographics Questionnaire. Upon enrolling a student, a RAYS program coordinator was responsible for recording the reason for referral to the RAYS program, date of enrollment, student status, school information, point of youth diversion, participation status , and any notes from the disciplinary incident report. During this same meeting, students were prompted to complete the Demographics Questionnaire, which collected information on race/ethnicity, gender identity, and age. Once the student completed RAYS, a program coordinator would submit an Exit Form where they would document the RAYS activities that the student was initially assigned via their Restorative Plan, which ones they completed, reason for exiting the program , and date of the program exit. Individual data from the Enrollment Form, Exit Form, and Demographics Questionnaire all formed each enrollee’s Student Profile which was linked to any RAYS activities that a student participated in.To inform the outcome evaluation, pretest and posttest surveys were developed and administered to students to examine any changes in the enrollees’ sense of self-responsibility, past 30-day AOD use behaviors, perceptions of AOD use, and awareness of resources. Questions and scales were adapted from the 2019-20 California Student Tobacco Survey and the 2021-22 Mapping Youth Health Behavior Survey , both of which are population-based survey instruments developed and utilized by Professor Shu-Hong Zhu’s research team with dimensions in substance use and relevant covariables . Both pretest and posttest survey instruments were programmed and administered using the Qualtrics PlatformXM .

The pretest included approximately 35 questions on the above mentioned variables while the posttest included an additional 6 questions on student experiences in RAYS. Students took approximately 8-10 minutes to complete either survey. Participants were asked whether they had used marijuana , vapes with nicotine or just flavoring, alcohol, or opioids to get “high” in the last 12 months. Questions pertaining to opioid use were not added to the pretest and posttest instruments until Fall 2022; as such, data on opioid use behaviors and perceptions are not reported here due to the low number of responses. Utilizing a skip logic design, participants were asked to indicate past 30-day use of any products they said they had used in the last 12 months. Participants were also asked product-specific follow-up questions on frequency of use and intentions to quit any product they reported using in the past 30 days . All students were prompted to indicate their perception of the harm of using each substance “some days” and “every day” with a 5-point scale ranging from “not at all harmful” to “extremely harmful”. A 4-item scale on self-responsibility and personal awareness included questions derived and adapted from Mergler and colleagues’ personal responsibility scale for adolescents. A 4- item Likert scale was used to assess student awareness of resources. For the posttest instrument only, students were also prompted to assess their overall experience in RAYS via a 3-item Likert scale reflecting on RAYS components and likelihood of recommending the program to others. Additional open-text questions prompted students to provide feedback on what they liked and disliked about the program, as well as what they believed could be changed. RAYS program coordinators administered the pretest to students upon program enrollment, ideally prior to their first exposure to an intervention activity. The posttest was administered to students upon exiting the program . Each RAYS student was randomly assigned an alphanumeric passphrase upon enrollment which was linked to their student profile in SeaTable. Students were instructed to enter their assigned passphrase when taking the pretest and posttest surveys to allow for longitudinal linkage. Pretest and posttest responses were linked utilizing these passphrases in lieu of student names.

Prior to analysis, data was deidentified by reassigning each linked pretest and posttest response pair with a new passphrase to ensure student confidentiality and by removing the linkage to their respective student profiles. Suspension data was extracted from the CDE’s public data repository, DataQuest.19 Multi-year, aggregate reports on suspension counts were exported for each of the four school sites in Nevada County. Four comparable school sites were matched to the Nevada County sites and used as comparators. Discipline data reports from comparable sites were included in this study to examine any differences in the number of suspensions over time from Nevada County sites. Data was categorized into overall suspension and drug-related suspension counts to allow for the examination of changes in drug-related disciplinary incidents from the 2017-18 to 2021- 22 academic year.Data from the SeaTable activity log and case management databases for the reporting period May 2021 to January 2023 were exported and converted to Microsoft Excel® files. Activity data was cleaned, filtered by implementation date, and tabulated to report the number of activity exposures by attendee type . Case management data, including demographics and enrollment and exit data, was cleaned and relinked to passphrase-matched enrollee profiles. Suspension data for Nevada County schools and matched comparable sites was examined for changes in overall and drug-related suspensions from the 2017-18 to 2021-22 academic years. Comparable school sites from a neighboring county were identified utilizing school-level data from CDE site profiles. Each Nevada County school was matched with a comparable site based on enrollment size, racial/ethnic breakdown, and regional proximity. For reference, during the 2021-22 academic year, all four Nevada County sites reported a cumulative enrollment of 3,001 compared to 2,900 at the comparable sites. No drastic changes in enrollment numbers were reported for either the Nevada County or the comparable sites from the 2017-18 to the 2021-22 academic year. 19 RAYS program coordinators approved the selection of these comparable sites. Differences in these suspension counts between Nevada County schools and comparable sites were examined to inform the evaluation of the potential impact of RAYS on the number of disciplinary incidents over time. Pretest and posttest survey data was exported and converted to Microsoft Excel® files from the Qualtrics PlatformXM® online survey database. Using the randomly assigned passphrases, indoor grow facility each respondent’s pretest and posttest data was linked to analyze behavioral outcome changes from pretest to posttest. Descriptive analytical methods were employed to tabulate counts and percentages for each question response option at pretest and posttest. To evaluate changes in enrollee knowledge, perceptions, and behaviors, the percentages of participants who selected each response option for each question were compared from pretest to posttest. All percentages reported are of the total pretest and posttest survey sample . RStudio© statistical software was used to conduct all analyses while Microsoft Excel® was used to tabulate all activity and case-level data.Table 4 provides a breakdown of all RAYS activities implemented from May 2021 to January 2023. Data in each column presents the total number of exposures for each activity by attendee type – student, staff, administrator, parent, and “other”. The majority of student exposures was through informational presentations as these events reached a broader range of students, not just the youth advocates and students enrolled in RAYS. Exposure counts are reported in place of participant counts as some individuals may have attended multiple sessions or events of the same activity type. Therefore, the counts presented in Table 4 may reflect duplicate exposures to a specific activity.The findings reported here should be interpreted with caution given that these results are from an intermediate evaluation.

All findings are preliminary and should not be considered as a comprehensive assessment of the RAYS program. Additionally, due to a small pretest and posttest survey sample size, data may not be inclusive of all students who participated in the RAYS program. Overall, a total of 21 out of the 48 participants who exited RAYS during this evaluation period submitted a matched pair of pretest and posttest survey responses, equating to an approximate 43.75% response rate. Discussions with program coordinators revealed unanticipated logistical challenges with ensuring all students who exited RAYS submitted both pretest and posttest survey responses. Nonetheless, current protocols are being revised to increase pretest and posttest survey response rates. Despite these limitations, the findings reported here may provide insight into the potential individual-level impacts of the RAYS program on select variables of interest.Differences in student responses to questions on self-responsibility and personal awareness from pretest to posttest are found in Table 5. The proportion of students who strongly agreed or somewhat agreed with statements on self-responsibility did not significantly change from pretest to posttest. There was a slight increase in the percentage of students who agreed that before they do something, they think about how it will affect the people around them; however, agreement levels for other statements remained the same or did not change drastically.Table 6 presents the percentage of students at pretest and posttest who reported using a substance in the last 30 days. Out of the 21 students, 52.38% reported having used a marijuana product in the last 30 days at pretest whereas 38.1% said they had recently used marijuana at posttest. A similar reduction was seen with the proportion of students reporting past 30-day vape use, with 66.67% of students reporting using a vape with nicotine or just flavoring at pretest and 38.1% at posttest. There was a slight decrease in the percentage of students who said they had drunk alcohol, with 19.05% reporting past 30- day alcohol use at pretest and 9.52% at posttest.To measure changes in awareness of resources prior to and after going through RAYS, students were prompted to indicate how much they agreed with statements on identification of services and resources at their school. Table 8 reports the proportion of students who either somewhat agreed or strongly agreed with statements on student self-efficacy of being able to identify mental health and substance use services. There was a slight increase in the percentage of students who believed they could name at least one person or place that they could go to for support with mental health-related issues with 90.48% saying they could at pretest and 95.25% at posttest. Awareness of support or resources for substance use-related issues also increased, with 71.43% saying they would be able to name a place or person at pretest and 90.48% at posttest. When asked if they would be able to refer a friend or classmate to such services, 71.43% said they would be able to at pretest and 85.71% at posttest.To assess overall student experiences in RAYS, participants were prompted with both quantitative and open-text questions at posttest. Table 9 presents the proportion of students who either somewhat agreed or strongly agreed with statements regarding RAYS. Of the 21 participants who exited RAYS between August 2021 and January 2023, 80.95% believed that the program helped them to think about how their substance use affects others. The majority of students found the resources provided through RAYS to be available when they needed them. Additionally, 80.95% said that they would recommend the program to others.Students were also asked what they liked and disliked about RAYS and what they would change about the program via open-text questions. Overall, enrollees expressed their appreciation for the education received through RAYS, with some students highlighting their preference for substance use education in lieu of traditional forms of punishment.