Spokane Regional Health District could teach Department of Health how to deal with marijuana and pregnancy

Nobody is more passionate about their patients than public health nurses, especially those working in maternal and child health programs.

They are always seeking ways to educate and inform on a shoestring budget. So when Jolene Erickson, a Lincoln County public health nurse, received an email with a message from Washington state Health Secretary Dr. John Wiesman, attempting to head off concerns about a new drug prevention video, she was appalled at how the money was spent.

Initiative 502, which legalized marijuana in 2012, requires the state to support education programs with “medically and scientifically accurate information about the health and safety risks posed by marijuana use.” I-502 did not dictate specific target populations for outreach.

For Erickson, with 24 years of experience working with mothers and babies, it’s a question of numbers.

“We’ve heard point-blank from pregnant women they’re using marijuana for nausea early in pregnancy. They equate legal with safe and it isn’t. Where’s the money going?”

Pregnant women were not a priority population in the 2015-17 budget for the $15 million the Washington State Department of Health received from the dedicated marijuana account.

But DOH did fund five pilot projects at $100,000 each, targeting culturally marginalized youth. Grantees included the American Indian Health Commission for Washington State, Asian Pacific Islander Coalition focusing on Seattle and four other West Side communities, Gay City Health Project in Seattle, Center for Multicultural Health in Pierce and King counties, and El Centro de la Raza in Yakima.

Videos were produced as part of short-lived social marketing campaigns. DOH was only able to provide links to three of the five publicly funded projects. The Asian-Pacific Islander production focused on questions about marijuana, and could be used for conversations with teenagers across the state. Spokane-based consultant Kauffman & Associates worked with urban Indian youth in Seattle and Spokane to develop drug awareness videos speaking to Indian youth anywhere.

But local drug prevention educators agree the video produced by the Gay City Health Project lacks a prevention message and reinforces negative stereotypes. DOH claimed the video carries an “indirect marijuana prevention message as it raises issues of systemic discrimination.”

There’s indirect, and then there’s invisible. The video was part of an outreach campaign to about 2,000 Seattle youth, according to DOH.

Erickson has been grateful for access to campaign materials prepared by the Spokane Regional Health District as the regional DOH contractor.

The SRHD’s popular Weed To Know campaign provided posters and information cards distributed through Spokane’s 34 licensed marijuana retailers, funded under a DOH contract. Weed To Know focuses on educating adults to be role models of responsible use for youth, with three simple messages focused on knowing the law and three on harm reduction.

But health care providers still had questions about marijuana use by women who are pregnant, breast-feeding and parenting. DOH was still silent on maternal child health and marijuana use.

Women were arriving at the hospital for delivery reeking of marijuana. The five northeast Washington counties including Spokane have been working hard to bring down rates of maternal smoking nearly twice the state average and four times the King County average. One more thing to smoke wasn’t helping.

Outreach to the pregnant, breast-feeding and parenting population would have made a great pilot project but still wasn’t a DOH priority population. SRHD stepped up and found local funds to plug the gap. The expanded Weed to Know – Baby and You campaign launched in June of this year. Paige McGowan, health program specialist in the SRHD Marijuana, Vaping Device and Tobacco prevention program, said the “community response has been phenomenal.”

Materials have been distributed through WIC offices, local hospital and health care systems, and shared with public health agencies nationally and in Canada. Yet DOH has expressed no interest in evaluating the program for statewide use, saying “DOH does not evaluate our partners’ work.”

DOH should. Without evaluation there is no learning. It’s OK for a pilot project to turn out poorly. And it’s OK to lean on Eastern Washington success.