In its first five days of legalization, over $10.8 million worth of adult-use recreational marijuana was sold in more than 271,000 transactions statewide, including at the Collinsville facility that serves this area. 

That number may continue to increase as the year goes on, as Illinois is scheduled to award up to 75 additional dispensary licenses, which will be announced May 1. 

It was against this backdrop the Monroe County Coalition for Drug-Free Communities held its first meeting of 2020 and first of the post-legalization era in Illinois. 

The coalition spent the meeting hearing a presentation on recreational marijuana from Stacie Zellin, a community educator from the National Council on Alcoholism and Drug Abuse in St. Louis. 

The NCADA is a nonprofit that focuses on prevention harms from substance use through education, primarily in schools. The organization mainly operates in eastern Missouri.

The NCADA’s official position on recreational marijuana is that it can get behind decriminalization but not commercialization because it is concerned that will lead to more youth use. 

“This goes back to some very basic prevention ideas,” Zellin said. “We want to protect these developing brains as long as possible.” 

As with the nonprofit’s position, Zellin’s presentation brought nuance to much of the discussion surrounding recreational marijuana by providing data. It also sought to address what happens next. 

A key point Zellin emphasized was that the marijuana of 2020 is much more potent than the cannabis of yesteryear. 

She said the tetrahydrocannabinol level in cannabis in the 1970s was about 1-2 percent. 

THC is the compound in marijuana that gets the user high. 

In 2019, vaping products containing THC had levels ranging from 15-30 percent. Additionally, a butane hash oil exists with a THC level of 80 percent. 

Zellin said that contrasts with public perception of cannabis, which has gradually become more accepting. 

“These products do not match that perception,” she said. “As the products have changed, our perceptions of harm and safety have not. And not only has perception of harm with the products not kept up, it’s actually decreased.” 

Zellin said the increasing potency of marijuana has also contributed to drawbacks from the drug. 

In the short term, the effects can include euphoria, anxiety and slower reaction time, while long-term impacts may include decreased memory and psychological problems. 

She said those issues are not new, but have been drastically exacerbated by the potency of marijuana products. 

On a broader level, Zellin said recreational marijuana could lead to negative public health outcomes.  

Based on data from other states with legal cannabis, Illinois could see an increase in emergency room visits, mental health issues, automobile crashes and crime as a result of legalization. 

But Zellin said none of those are guaranteed because the data is inconclusive. 

“I’m going to have a really hard time talking about some of these public health outcomes because sometimes the data is either not there or it’s conflicting,” she explained. “With any data point and the story that it tells, sometimes that story can be modified depending on what a person wants to say.”

Zellin cited a 2019 national survey of about 500,000 people as an exemplar of that. 

That survey found problematic use among children ages 12-17 was 25 percent higher in states with legal recreational marijuana. That increase, however, meant only 2.72 percent of children had that problem, compared to 2.18 percent. 

The study also showed use among adults, problematic and otherwise, increased after legalization, which Zellin said made sense. 

“Most marijuana users are going to use less than 100 times in their life,” she said. “There is a small portion of marijuana users who are the heavy users, and they are very heavy users. It’s just like alcohol: there’s a lot of people who drink a little and there’s a few people who drink a lot.” 

Zellin also pushed back against a key talking point of those for legalization: tax revenue. 

She argued the money made from cannabis-related taxes is often relatively insignificant compared to the problems those funds are meant to address. 

In Illinois, the state estimated it will receive about $375 million from the marijuana industry in 2024. That would mean only $37.5 million would go to the state’s multi-billion dollar backlog of unpaid bills. 

“We’re not confident about making the case for revenue,” Zellin said. “Revenue isn’t necessarily a positive thing associated with the sale of these products.”

With all that in mind, Zellin said the two key responses to legalization are surveillance and education. 

She said surveillance, which in this case means data collection, is crucial for understanding the effects of legalization. 

“We really can’t respond to a public health threat if we don’t know that the public health threat exists,” Zellin noted. 

In terms of education, Zellin said the priority should be determining its focus. 

“Does this come down to public information and campaigns,” she asked. “Does this come down to informing? And then what does that level of information look like? Do we take a harm reduction approach? ‘People are going to use, so let’s advise them how to do it.’ Which areas do we focus on? Do we segment different age groups, different populations?”

That is an issue the coalition, which saw county commissioner candidates George Green and Duane Langhorst in attendance, will look to address in Monroe County.