PUEBLO, Colo.—It’s a common story across America: A city loses its main employer, usually a manufacturing company with well-paying, blue-collar jobs (that often go to China). The city’s economy crumbles, and those who can move out, do.

Decades later, and looking peeling-paint tired, the city hasn’t managed to recover, but drugs have found a permanent home.

In Pueblo, Colorado, the manufacturer was a steel plant beleaguered by a market crash in the 1980s and worker strikes in the 1990s. And one drug was given a red-carpet welcome.

For years, Pueblo has been looking for industries to revive its economy, and when recreational marijuana was legalized for retail sale in Colorado in 2014, many saw it as the answer. More people would be employed and the tax money would go to schools and infrastructure.

The county commissioner at the time, Sal Pace, went all-in on the industry, promoting Pueblo as the “Napa Valley of cannabis.” Pueblo is situated 100 miles south of Denver, with a population of around 160,000 people.

Marijuana grow operations and dispensaries sprung up quickly and now employ around 2,000 people, Pace told Colorado Politics in September. According to employment website Indeed.com, the majority of dispensary jobs in Colorado pay $12 to $15 per hour.

Pace said about half of the commercial construction in Pueblo County since 2014 has been related to cannabis.

“The cannabis boom in Pueblo is real and sustainable, and we’re well positioned to be a national cultivation hub after federal legalization,” Pace told the publication.

So far, 11 states have legalized retail marijuana and four others—New Jersey, Arizona, Montana, and South Dakota—are considering it. Marijuana is still an illegal, Class 1 drug according to federal law.

View From the ER

Two emergency room doctors in Pueblo see a different side of the equation and say the deleterious effects of cannabis legalization far outstrip any benefits.

Dr. Karen Randall, who trained in pediatrics and emergency medicine, spent years as an ER doctor in Detroit, but Pueblo turned out to be a whole other level.

“It’s like a horror movie,” she told The Epoch Times. Every shift in the ER brings in a patient with cannabinoid hyperemesis. In layman’s terms, that means someone is screaming and vomiting uncontrollably. The sound is wretched and apocalyptic. It’s caused by chronic cannabis use, usually high-potency products, and it stops when the person stops using cannabis.

Then there’s the psychosis.

“I was in Detroit for 18 years and the cannabis psychosis here is worse than anything I saw in Detroit,” Randall said. “They’re very violent. The combination of this high potency THC and meth just creates this incredibly violent person.”

THC (tetrahydrocannabinol), the main psychoactive ingredient in today’s marijuana products, is now being extracted to reach a potency of more than 80 percent. In the 1990s, the average potency of a joint was around 4 percent THC.

Dr. Brad Roberts said he’s seeing more and more patients with psychosis who have no previous psychiatric history and are testing positive only for THC.

“There’s no PCP. There’s no amphetamines. There’s no alcohol. The only thing that comes up positive is cannabinoids. And they’ll admit that they did dabs right before it happened,” he said. “The ones I see that are true psychosis are teenagers—so 17, 18, 19.”

Dabs are a method of taking concentrated THC, usually through a vaping device or a glass rig. The concentrate is most commonly made by using butane to extract THC from the cannabis plant, and then it’s further processed to strip the butane out. Other forms of butane hash oil include waxes, shatters, and budders—which are similar, but have different textures.

Recently, a teenager “yelling incoherently” was brought into the ER with three police officers, five EMS personnel, and three security staff holding him down, Roberts said. The young man had been running along the middle of the street waving a metal rod at cars.

“I gave him 10 milligrams of intravenous Versed—after he had had 5 mg of Haldol, 50 mg of Benadryl, and 2 mg of Ativan [all sedatives]. And it hadn’t put him down. And he had been tased twice by the police,” Roberts said.

The teen later told Roberts he had been smoking concentrated cannabis waxes. Only cannabis showed up on his drug screen.

Roberts and Randall are trying to sound the warning bell on the negative effects marijuana legalization has had on their community and provide information that politicians might not be considering when faced with the legalization decision.

Since legalization in Colorado, Randall and Roberts have seen an increase in all drug use, not just marijuana. Methamphetamine use is up 143 percent, opiates are up by 10 percent, and cannabis is up by 57 percent, according to data from the ER drug screens over the past seven years.

“If you pump a community full of drugs, you’re going to have to expect everything that’s associated with them. You’re going to have to expect the crime, addiction,” Randall said.

“If you listen to what the industry says, we should be rolling in money because we’ve got about 50 dispensaries and we have over 100 legal grows. … And so if you think about just that number, this community should be thriving, we should be rolling in dough.

“And we’re not. We’re the canary in the coal mine. Our kids are failing, our kids are using drugs more. I can’t find health care for them. I can’t find rehab, I can’t find places to put the kids in foster care.”

The Healthy Kids Colorado survey for 2019 showed that 20.6 percent of high school children in Colorado had used marijuana in the previous 30 days.

“While smoking marijuana remained the most frequent method of use in 2019, smoking decreased as dabbing significantly increased as the second most common method of marijuana consumption among high school students,” the survey report stated. Vaping has also become more common.

The survey report concluded, “These are concerning trends since marijuana products associated with these methods of consumption often contain high concentrations of THC.”

Recently, two children younger than 14 ended up in the ER with Randall after each had ingested half of a candy bar that contained 500 mg of THC. Randall said the kids obtained the product from a buyer via Snapchat.

“We’re losing this generation,” she said. “What I see … is the kids either smoke themselves, or they become the parents’ caretaker, they take care of their parents who are smoking—using drugs and drinking. And I don’t know which is sadder—you have an 8 year old that’s giving you the medical history of the parent, or the kid’s using.”

Roberts said he believes the marijuana black market, prior to legalization, was a safer option, as the highly concentrated products now developed by chemists and botanists weren’t prevalent. “There is no part of this that is safer—it’s more frequently used, it’s higher potency use, and there are now all these different ways to use it,” he said.

In the ER, he asks his patients about smoking, drinking, and drug use, and said he’s “amazed” at how many people are smoking five or six joints a day. Or they’ll tell him, “‘I take a hit on the bong when I wake up, I usually go home for lunch and take a couple hits,’” he said.

“Almost 100 percent of the people that use, use daily.”

Both Roberts and Randall say at least one-third of what they see in the ER on a daily basis is solely related to drug issues.

Many patients don’t believe it when the doctors tell them it’s their marijuana that’s causing their hyperemesis or psychosis.

“They always say, ‘It’s not the cannabis. Pot is good for you,’” Randall said, “because it’s been portrayed as super benign—it’s healthy for you, it’s natural.”

Roberts said the last patient he told threw his papers on the floor and stormed out of the room.

Both have received threats, including death threats, for speaking out about the dangers of cannabis. They blame the strengthening cannabis industry lobby.

“They don’t want me to talk about the dangers of cannabis because they want everyone in the world to think it’s wonderful and thriving,” Randall said.

Pueblo City Mayor Nicholas Gradisar said his main concern with the Pueblo cannabis industry is minors using cannabis, which is more readily available now.

“Obviously, it’s illegal to sell or give marijuana to minors. Nobody thinks that’s a good idea,” he said. “There’s some people that shouldn’t use it, because they have that addictive personality—just like they shouldn’t use alcohol. And the high-potency THC, it’s sort of a dosing issue.”

He said the edible cannabis products now must include a dosing recommendation on the packaging. “Obviously you get people that think they know better and they don’t abide by that. But those are decisions that individuals make. Like I say, hopefully, those are adult individuals and not children.”

Tax Revenue

The cannabis industry, by ensuring the city receives some tax revenue, has placed itself in a position in which it’s hard to roll things back, Roberts said.

Gradisar said the city’s eight cannabis retail stores generate about $100,000 a month in taxes for the city.

“So economically, it’s been a benefit to the city,” Gradisar told The Epoch Times. “The costs in terms of law enforcement efforts have been negligible. When you compare them [cannabis retail stores] to bars, there’s just no comparison to the number of calls or the incidents that take place in those establishments.”

Gradisar said the increased issues with black market marijuana were a surprise, but law enforcement has been working to snuff it out.

Roberts and other concerned citizens tried and failed in 2016 to opt Pueblo out of retail marijuana.

“How is the city motivated to now cut that out?” he said. “It was a great business plan: ‘Let me give a little bit of my profits to the city, that way the city will never shut me down. And the more I can make the city dependent on me, I’m safe.’”

Both doctors say the extra medical costs alone should be a deterrent.

Dealing with a case of cannabinoid hyperemesis costs around $5,000 in the ER, Randall said. At least $3,500 of that is for a CT scan. Her ER sees on average one patient a day with the affliction, which adds up to about $1.8 million per year.

But, she said, most patients are on Medicaid, which means the medical care is federally subsidized, so local governments don’t need to account for the whole medical cost.

Statewide, Colorado collected $262.9 million from the regulated marijuana industry in fiscal year 2019, which made up 1.7 percent of the state’s overall tax revenue. K–12 schools received $102.2 million for school construction and school funding, an amount equivalent to 39.5 percent of total marijuana revenues.

The apportionment of state funds disbursed to Pueblo was about $706,000.

Additionally, in fiscal 2019, Pueblo received local taxes related to cannabis sales and licensing totaling more than $7,849,000. Of that, $796,650 was spent on its college scholarship program. Other expenses it covered included $1.3 million to health expenses, $833,730 for animal control, and $520,000 toward an art center.

Gradisar said the city is exploring the idea of expanding the industry by allowing hospitality rooms for the consumption of cannabis. But not much has moved forward yet, with the pandemic stymying progress.

“Cannabis has been around a long time, and I’m a fan of regulated cannabis—that we regulate it, we tax it, we control it,” he said. “And I think we’ve done a pretty good job in terms of putting those regulations in place.”

Number on Medicaid

A high proportion—about 41 percent—of Puebloans are on Medicaid. The county population is just under 170,000, according to census data, and 70,500 are on Medicaid.

The proportion has increased from 2010 when around 34 percent were on Medicaid.

“There is no way to absorb that kind of cost on a continuum,” Randall said. She said many people moved to the area for cannabis, but they brought their chronic illnesses into an already poor community. Ads in the local newspapers suggest a myriad of illnesses that cannabis can alleviate or cure.

“This community just kind of absorbed a whole bunch of people … who moved here to cure their diabetes with pot—which isn’t happening. And so in addition to all the problems that pot causes itself, we have all these people who moved here for the cure. Everybody’s looking for that miracle, and then they come into the ER with tremendous problems.”

Randall said it’s also difficult to attract medical providers to the area with such a large proportion of the population on Medicaid. “You can’t sustain a practice like that,” she said.

All but 4 of the 36 physicians in Randall and Roberts’s group live in Colorado Springs or Broadmoor, where the crime rate is lower and the schools have a better reputation.

Roberts, who grew up in Pueblo, has pledged to stay and do what he can to improve the city. He believes the way to turn things around is through education “to the point that people won’t use.”

He likens the issue to Big Tobacco, in that it took decades for people to understand that tobacco use was causing serious health issues and to make changes. “Same with opiates. Everybody was put on opiates, and if we didn’t give somebody opiates for their pain, we were bad doctors. And that’s how it was for years and years and years—until it got bad enough. And then when it gets bad enough, there starts to be change,” Roberts said.

“I think cannabis will do the same thing; it will eventually get bad enough. I don’t know where that bad enough is, but it’ll get bad enough that the pendulum will swing back.”

Meanwhile, he said, it’ll be “a bleak outlook” for many. “With cannabis, once you’ve damaged your brain and you develop schizophrenia, I probably can’t fix that. So there’s a certain number of people who are going to have mental health disorders,” he said.

Finding a Sober Workforce

While the doctors say the medical and social impacts haven’t yet reached the nadir, a local businessman says other areas are trending back up.

Pueblo native Ryan McWilliams has seen the best and worst of the city, but remains eternally optimistic about its future.

McWilliams, an engineer, employs dozens of people across multiple businesses in Pueblo.

His main challenge now is finding a sober workforce and attracting more skilled workers to the area.

Prior to 2014, before cannabis retail dispensaries and grow operations began popping up everywhere, McWilliams said 15 to 20 percent of possible hires were denied due to drugs or alcohol.

“Today, I think it’s well over half, it’s well over 50 percent,” he told The Epoch Times.

“Our biggest issue with marijuana has been the lack of skilled workforce we can get. And almost zero unskilled workforce these days can pass a drug test, because they’re all testing hot for marijuana.”

McWilliams said he hires people for jobs ranging from general labor to skilled labor and construction, up to engineering. He works with the railroad industry, transportation companies, the aircraft industry, and cities.

“We don’t want to hire alcoholics, just like we don’t want to hire potheads. There’s no difference to me as an employer,” he said. “It impacts their workmanship, it impacts their safety, it impacts my safety.”

McWilliams said his company has a zero-tolerance policy, but some employers he knows have stopped drug testing their employees because they’re desperate for workers.

“They’re saying, ‘If we do test, we’ll lose half of our workforce, or a quarter of our workforce, and we’re already short-handed,’” he said. “So it’s created an issue where, for society in general, we’ve lowered our standards all the way across the board.”

McWilliams has a vision to create positive opportunities in Pueblo and help provide the economic drivers that the region still needs.

“This was not utopia. But at the same time, it was never at the level or at the magnitude that it is today, the volume of problems and the severity of problems is far worse than it was prior to legalization of marijuana,” he said.

One of his projects is to repurpose the old meatpacking plant that stood empty and broken, with around 150 homeless people living in it, when he took over. It’s now in the beginning stages of becoming a business and social hub in Pueblo.

“I’m currently pulling money and projects from other places—from London to Seattle to rural Georgia. I’m pulling money out of those projects, and closing down those projects, and pulling it to Pueblo, Colorado, because I think the upside here is so much bigger than it is everywhere else,” he said.

In August, the city announced that EVRAZ Rocky Mountain Steel is undertaking a multimillion dollar upgrade and putting in a new long-line rail manufacturing facility. The project is expected to create 1,000 jobs.

Wind tower manufacturer Vestas has a manufacturing facility in Pueblo. And the city is having discussions about new housing developments.

“There is no reason that the United States today should not have the capability to make absolutely everything we need,” McWilliams said.

As marijuana legalization expands to other states, Pueblo’s problems will be alleviated somewhat, McWilliams predicts.

“Marijuana is always going to be here, but it’s always going to be everywhere else. And the good part about Colorado now, and Pueblo, is we went through it, and just like this town has always done, we weathered the worst of the storm in that whole social experiment,” he said.

“My view is, we try to manage it the best we can. And we just outnumber those negative effects with positive companies coming in and positive influence and economic growth.”

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