WA House COG - Committee Meeting
(December 2, 2022)

Friday December 2, 2022 8:00 AM - 10:00 AM Observed
Washington State House of Representatives Logo

The Washington State House Commerce and Gaming Committee (WA House COG) considers issues relating to the regulation of commerce in alcohol, tobacco and cannabis, as well as issues relating to the regulation and oversight of gaming, including tribal compacts.​

Work Session

  • "Update on Cannabinoid Product Regulation and Enforcement and Summary of Research on High-THC Concentration Cannabis"
https://app.leg.wa.gov/committeeschedules/Home/Documents/30199

Observations

A WSLCB briefing on cannabinoid regulation charted activity leading up to 2023 request legislation including an investigation of a licensee engaged in synthesizing cannabinoids.

Here are some observations from the Friday December 2nd Washington State House Commerce and Gaming Committee (WA House COG) Committee Meeting.

My top 3 takeaways:

  • A panel of Washington State Liquor and Cannabis Board (WSLCB) officials talked about the agency grant of authority as it related to oversight of synthesized THC and an Enforcement investigation into the practice, followed by an update on policy development, rules, and agency request legislation on the matter for 2023.
    • Kloba said the committee was ready to hear an “update on cannabinoid product regulation and enforcement” from WSLCB officials (audio - 1m, video). 
    • Justin Nordhorn, WSLCB Director of Policy and External Affairs, noted staff changes underway at the agency, in particular the retirement of Director of Legislative Relations Chris Thompson who would be succeeded by Marc Webster. He conveyed that the panel from the agency would “present on not only the THC [tetrahydrocannabinol] program, but also some of the enforcement issues, our authority issues, as well as our agency request legislation that we are going to be asking for [next] year” (audio - 2m, video).
      • WSLCB board members planned to recognize Thompson as well as departing Chief Financial Officer Jim Morgan at the Wednesday December 7th board meeting.
    • Nordhorn called attention to the “minimal” amount of authority the agency had around hemp products, compared to their general powers (RCW 66.08) and cannabis oversight abilities (RCW 69.50). “So, when you're looking at production, and processing, retail sales, and transportation issues across the state, we have the scope of regulatory oversight in these particular areas,” he stated. Whereas for hemp, Nordhorn said, “we have no…regulatory oversight or authority in hemp unless it's coming into the I-502 [initiative 502] system as an additive” which activated “authority over that particular product on the testing and safety standards” (audio - 2m, video, presentation).
    • WSLCB Enforcement and Education Director Chandra Wax—formerly Chandra Brady, who “just recently got married”—-elaborated on the limits of WSLCB power to regulate production and sale of THC synthesized through conversion of cannabidiol (CBD) extracted from hemp beyond I-502 licensees (audio - 2m, video).
      • After joining the agency in February 2021, Wax reported that staff made her “aware of some possible synthetic THC entering the marketplace,” including comments from people “seeing edibles and other products in the retail stores that included this synthetic THC.”
      • A review of “public safety and regulatory authority” was conducted before Nordhorn’s team released an April 2021 policy statement “saying that that is not allowed.” Wax indicated an enforcement bulletin distributed that May let “our retailers know that that was something that could not be done within the 502 marketplace, and then in July, we followed up with an interpretive statement.”
      • She noted there’d been “some folks in the marketplace, specifically some processors, that didn't agree with that interpretation and chose to continue manufacturing that product” as she turned to the Westside Cannabis Captain, Joshua Bolender, to offer details of a prominent violation investigation.
    • Bolender spoke about his work in the cannabis enforcement unit, where in June 2021 staff “received a number of complaints that were unique” and officers were unaccustomed to investigating. These complaints were “that a particular cannabis producer/processor was manufacturing THC from hemp derived CBD” which he said staff conducted “quick research on” (audio - 4m, video).
      • An investigation began into allegations “that this was criminal conduct and that it was unfairly competing with other licensed cannabis businesses,” Bolender told the committee. Officers found that there was a licensed processor which had been “synthesizing both delta-8[-THC] and delta-9-THC,” comparing the practice to “spinning straw into gold.” He explained how “there was very little cannabis coming into the business, but in our traceability system it appeared that there was a lot of cannabis coming out of it,” which their investigation found was “synthetic THC.”
      • Bolender reported that the process to synthesize cannabinoids included “using carcinogenic chemicals, or solvents, and it required manipulation of traceability data because there wasn't much cannabis coming in but a lot of it was going out.” Enforcement officers had determined it was “both an administrative and a criminal violation to do this,” he remarked.
      • Sharing a photo of the “GEMS Machine” at the facility, Bolender commented that “a lot of…laboratory instruments and chemicals” had been employed to “to synthesize the CBD into THC. So, this isn't normal extraction that we're used to seeing.” When synthetically created, THC “is typically a schedule one controlled substance,” he said. Bolender explained that WSLCB officers “seized over 800 pounds of synthetic THC, and then we seized hundreds more pounds of synthetic THC that had been sold to other cannabis licenses by this licensee.”
    • Though not specifically named throughout the presentation, the timeline and details align with a July 2021 administrative violation notice (AVN) alleging four violations by licensed processor Unicorn Brands LLC regarding the company’s conversion of CBD into synthesized THC.
      • Unicorn Brands Owner Peter Saladino filed an appeal, but reached a settlement that the company “shall not use its license to produce or manufacture Delta-8 THC, Delta-9 THC, or any similar synthetically-produced THC from any hemp-based sources in the State of Washington unless explicitly authorized by a subsequent change in state law.”
      • The Enforcement Evidence Report identified a “Chromatography Multi-Column Filtration Device ‘GEM’ machine” which applied methanol and water to an input solution that ”the GEM machine then separates the solution into two parts labeled as the following:
        • a) product-the desired ∆ 9 THC and some ∆ 8 THC, and
        • b) recycle-the unreacted CBD used again for separation.”
      • Find out more from the WSLCB:
      • When speaking before the Cannabis Alliance on October 1st, Kloba talked about how the settlement was a sign WSLCB was exercising their authority “to enforce the fact that it's prohibited under current rules and law in the regulated market.” At that time she mentioned that the agency may need additional power to “do enforcement outside of the regulated market.”
    • Kathy Hoffman, WSLCB Policy and Rules Manager, talked about overlapping rules, outreach, and legislative responses “concerning the regulation of THC products” underway at WSLCB (audio - 6m, video).
      • Following the 2022 legislative session after lawmakers didn’t pass cannabinoid regulation bills from WSLCB or others, Hoffman described how agency staff continued “hosting deliberative dialogue sessions and a month later we began exploring what we could accomplish by rule within our current statutory authority.” She mentioned the dialogues were “around the question ‘what might we determine is, or is not, impairing’” and featured panels of “scientists who informed our work for our legislation previously, our law enforcement partners, and our public health and prevention partners.” Hoffman communicated some themes that came into focus:
        • “​​The science on what is or is not impairing, or intoxicating beyond what we already know about alcohol is not settled, and all three panels agreed on this.”
        • “We learned that creating a chemical framework and attempting to draw a bright line between what is impairing or not depends on how cannabinoids bind to receptors, and how strongly they bind, and this varies from person to person.”
        • “We also learned that over time the burden has shifted to regulators proving product risk, rather than manufacturers proving product safety, and we confirm that some of the known hemp-derived compounds have not been studied in humans.”
        • “All cannabinoids produced for human consumption that fall within a certain THC threshold” needed to be under “regulatory authority to assure safe manufacturing processes.”
        • “We should focus on risk, rather than what cannabinoids are or not impairing,” which led to the establishment of the WSLCB Cannabinoid Science Work Group, which had its inaugural meeting the day before on December 1st.
      • According to Hoffman, rulemaking served “to determine whether creating new or amending existing definitions might address public health risk associated with production and processing of cannabis products” and involved a July 28th listen and learn session on draft conceptual rules.
        • She conveyed staff findings that “the definitions cannot be extended in rule based on a variety of factors, but primarily lack of statutory direction,” as well as cannabis industry concern “about agency overregulation of cannabis concentrates produced and sold in the I-502 system.” Moreover, “confusion continues to exist around…what agency regulates hemp-derived products, and what agency regulates cannabis products,” she added.
        • All of this gave staff the impression that the rulemaking process wouldn’t be “productive in terms of further conceptual development, and we ultimately withdrew the CR-101” on September 14th, Hoffman remarked.
      • All of this, she said, helped to “inform our proposed legislation” for 2023, where the agency wanted to “create a safe pathway, or route for manufacturing, if the product will be consumed by humans” with the goal of synthesized cannabinoids “no longer being available in the hemp marketplace, but products like hemp seed and milk having a pathway to the market as food products.”
      • Hoffman wrapped up with an acknowledgement that “words like ‘impairing’ or ‘intoxicating’ may be more appropriate in law or rule related to motor vehicle operation, and that moving either of these words into product regulation on any level becomes vague very quickly.”
    • Nordhorn reviewed the development of agency request legislation on cannabinoid regulation for 2023, which he relayed had been approved by the Governor’s Office the previous day (audio - 9m, video).
      • He acknowledged that unpassed 2022 legislation on the matter “was very large, cumbersome, and confusing, especially with some of the terminology that…we were building in.” Following the session, Nordhorn explained they’d continued outreach to stakeholder groups, finding “underlying concerns and interest points from each side of those, and we came to a very good understanding of these, and then we drafted our proposal for this year.”
      • The revised request bill language had scaled “it way back into a few particular areas” of public health and safety, with Nordhorn specifying youth access and control over “products with THC…very commonly accepted as the impairing product. So, this year's legislation, we're boiling it down to regulating THC and then any…hydrocarbon that's coming off of that…such as hexahydrocannabinol (HHC).” As well as clear age restrictions, Nordhorn talked about increased education so  “businesses in the open market can understand what's legal and what's not legal to sell.”
      • The request bill would include “an option to change delta-9 to all THC” as the law had stated that “THC concentration” was specifically defined based on the amount of delta-9-THC, Nordhorn said. In addition to removing the reference to delta-9-THC, he brought up WSLCB staff working with officials at the “State Crime Lab on some of this concept so…we can make sure that this type of language doesn't impede their ability to test on their investigations.”
        • A February 4th fiscal note for the last WSLCB request bill on cannabinoid regulation included estimates from staff for the Washington State Patrol that updated equipment, laboratory methods, and personnel or training to conduct accurate product tests for compounds beyond delta-9-THC would cost $1,655,000 for first year costs and $127,000 annual ongoing costs.
      • Nordhorn then mentioned the bill would offer a way to regulate online sales of cannabinoid items, comparing it with WSLCB online alcohol regulation. “Alcohol is considered alcohol when it reaches one half of one percent alcohol by volume,” he said, and “anything above that, age restricted and regulated, anything below that it's on the open market.” With cannabis, Nordhorn commented that their request bill would propose “no more than one milligram of THC in a particular unit, and no more than three of those units in a package.” This was because they’d seen research indicating “no observable negative impact at the two and a half milligram level,” he explained. Not wanting children to get access to any product “that can get you high, or come close to a product that an adult should purchase” led to the three milligram package limit, below which would be a “hemp consumable,” and above which would be a “cannabis consumable.”
      • The legislation would also alter mentions of the ‘dry weight’ concentration of THC, with Nordhorn elaborating that “dry weight usually only refers up until harvest and so once you start converting it, and concentrating it, it doesn't have the same equations.”
      • “We're also trying to incorporate a little bit of consumer safety into this particular bill,” Nordhorn told lawmakers, because regulators recognized “there's a lot more growing interest in synthetics.” So, “if folks are utilizing any type of synthetic CBD,” he stated, “if it's a synthetic cannabinoid, we want that to be on the package so that the consumer can understand what they’re purchasing.” He compared this to “a disclaimer for peanut allergies.” 
      • The last component of the bill Nordhorn highlighted was “a very clear licensing requirement” in order to make sure online sellers “will have to adhere to the same standards” as any in-state manufacturer. This “would give local law enforcement as well as our folks an opportunity to try to intervene and curb that activity from happening online if they're exceeding these types of thresholds” in products.
      • By focusing on youth access and what needed to be regulated to manage that, Nordhorn asserted there was “some fairly positive support for this, and even from those who opposed it last year.”
  • Two questions about the WSLCB response to synthesized cannabinoids tackled the economics behind the practice, along with the risks such items might pose.
    • Chambers wanted to know “is the Delta 8 cheaper to produce?” (audio - 1m, video)
      • Nordhorn considered that a fair description “because it's unregulated, there's not manufacturing practices that are overseen for that and you're taking, basically your CBD, and converting and utilizing some acids, and creating that delta-8.”
      • Chambers followed up to see if there was consumer demand “because it's widely available in other states that are selling it.” He concurred the products were available in many states and Washington wasn’t “the only state struggling with this particular challenge.” He thought there were “29 states that have banned some of these products and then others are trying to regulate it.”
    • Wylie was curious about what a focus on “risk” meant in the WSLCB presentation, where it was mentioned as a deliberative dialogue theme (audio - 2m, video).
      • “There's a couple different risk factors that we're looking at,” Nordhorn answered, citing:
        • “Risk of folks selling product that they're not aware of what's in the product”
        • “Risk of the youth acquiring that product because it's unregulated and…easy to access”
        • “Risks involve the consumer and we're hearing anecdotally…from stories that consumers only realize that they are consuming something that was impairing after they started consuming it” leading to potential “traffic safety” issues.
    • Kloba included that she knew members were eager to start “reading that bill, and getting all the detail[s] involved.”
      • Legislative pre-filing of bills began on Monday December 5th ahead of the session which was scheduled to begin on January 9th, 2023.

A cannabis regulatory expert spoke to the committee about cannabinoid regulation, including research, media reporting, federal statistics, and legislative efforts outside of Washington state.

Here are some observations from the Friday December 2nd Washington State House Commerce and Gaming Committee (WA House COG) Committee Meeting.

My top 3 takeaways:

  • Schauer briefed the committee on “National Trends and State Updates on Regulating Intoxicating Hemp-Derived Products,” addressing research, state level policy, and federal action on the issue (audio - 14m, video, presentation).
    • Following a WSLCB panel, Schauer promised to touch upon “updates to the science to adverse event reporting and really to what other states are doing.” She made clear that CANNRA was a “nonpartisan nonprofit organization that exists to convene, support, and educate cannabis regulatory agencies,” with “more than 40 States and US Territories in our membership.” The organization was “primarily funded by membership dues, and we're an affiliate of the Council of State Governments,” Schauer added. She then gave “a quick disclaimer” that she had no “industry funding to disclose and this presentation doesn't necessarily represent official opinions of CANNRA or any of the states with whom I work.”
    • Stating that concerns over delta-8-tetrahydrocannabinol (delta-8-THC) had expanded to “really become an alphabet soup" including “a ton of different molecules that have come out that are being derived from hemp,” she named:
    • Available product types had “changed a bit,” she told the committee, going from “a lot of edible and vaping products” to also have “marketing of dabs on the hemp derived product landscape.” Schauer noted a “bit of a bump…in smokeable products that look like a cigarette” but turned out to be ”hemp plant matter and then it's sprayed with…delta-8 extract.” Moreover, many items were packaged to look “very similar to the products that we see in the regulated adult use cannabis space.”
    • Schauer quickly reviewed the process of extracting cannabidiol (CBD) from hemp plants: “you add acids, heat, and solvents to convert that CBD extract into other cannabinoids, some of which are found in nature, some of which are not and which we know very little to nothing about.” Mentioning the general lack of regulation around hemp derived products, she stressed there were many solvents that could be used “some of which are much more dangerous than others.” Schauer relayed that researchers were starting to “publish in the peer-reviewed academic literature some of the composition of…these hemp-derived impairing products,” highlighting several examples:
    • Lacking better understanding around “byproducts and adulterants being used in…these delta-8 and similar products," Schauer blamed an absence of federal regulation of the products. With “adverse event reporting continu[ing],” she showed media mentions of warning and poisonings, like a “case in Virginia where a four year old allegedly consumed a large amount of Delta 8 gummies and died.”
    • Schauer then shared how the U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) “have recently updated National Poison Center data, they looked at data between January 1st, 2021 and February 2022. I want to mention up front, this is certainly an under-report of adverse effects” as it only counted “people that knew what they had consumed and took the time to call a poison center and report on that.” Schauer showed statistics on the “more than 2,300 exposure cases” reviewed:
      • “41% involved pediatric patients less than 18 years of age
      • 40% involved unintentional exposure to Delta-8 (and 82% of these
      • unintentional exposures impacted pediatric patients)
      • 70% of cases required health care facility evaluation, 8% of those resulted in admission to critical care (45% of patients requiring evaluation were pediatric patients)
      • One pediatric case was coded with a medical outcome of death”
    • Finding that federal action on the issue was muted due to the schedule 1 status of cannabis, Schauer said the response was so far “limited to issuing a few warning letters to companies with egregious violations particularly purporting medical benefit of products” although “they have a data acceleration plan to collect more data.”
    • Schauer found there were “two major issues that states are facing in regulation, one is how to deal with these chemically derived impairing cannabinoids…the other is how to deal with impairing amounts of delta-9-THC that is legally allowed in products that meet the hemp definition per the farm bill because hemp is defined on a dry weight basis.” She explained, “in a plant that may not be a lot of THC. But by weight, in gummies, or a chocolate bar, or a beverage, you can pack a lot of THC into that.” Schauer pointed to a December 2021 paper from the Oregon Liquor and Cannabis Commission (OLCC) that had a chart that “really shows how much Delta 9 THC you can legally have in these products and how that compared to the Oregon market at the time that they presented these data to their legislature.” OLCC staff found “three, four times the amount of delta-9-THC in a chocolate bar, way more than that in a beverage,” she remarked.
    • The subject matter could be challenging “for non-scientists,” Schauer said, and there wasn’t scientific consensus “on how to define impairing and intoxicating…what synthetic means,” how best to define cannabinoids “not found in nature,” and “what to do about full spectrum products. People that say they want a lot of cannabinoids in their products along with the CBD, those types of products can have high levels of THC and how do we classify those. And then what to do about biosynthetically derived cannabis that's coming from yeast or algae.” With Washington having “different agencies regulating hemp and cannabis,” Schauer found the emerging commercialized compounds “lack safety data and profiles so legislation that seeks to just…name the list of molecules that we’re concerned about quickly becomes outdated.”
    • Schauer highlighted several state policy responses:
      • “Oregon – HB 3000 (2021)  Gave broad regulatory authority to OLCC to regulate impairing hemp-derived cannabinoids, set THC limit per serving in hemp (2mg/serving, 20mg/package). Recent task force to review regulations made to date.”
      • “Michigan – HB 4517 (2021)  Gave CRA [Michigan Cannabis Regulatory Agency] authority to set a limit of THC in products, requires licensing from CRA for sales of Delta-8 and other forms of THC.
      • Nevada - SB 49 (2021)  Broadly defines THC (D8,9,10, THCO) and requires a license and approval from NV CCB [Nevada Cannabis Compliance Board] to make or sell Delta-8.”
        • According to Schauer, Michigan and Nevada had “somewhat similar approaches…to Oregon.”
      • “Colorado – SB22-205 (2022)  Created a taskforce to make recommendations to regulate intoxicating hemp and THC products. Report with recommendations due to legislature Jan 1.
      • Virginia – HB 30 (2022)  Task force to analyze industrial hemp extracts and other substances containing THC intended for human consumption. Draft report was delivered on Nov. 8th” and its final report on November 14th.
        • State task forces were also popular approaches, she said, “in some cases those task forces were extremely diverse,” like Colorado, while Virginia “was more science-based.” In Virginia, “their draft report was unable to reach consensus on” many of the challenges she’d named, while Colorado’s group “had the same challenges…they've not been able to get much further than the legislatures did in discussion.”
      • Minnesota – HB 3595 (2022)  Legalized consumable hemp-derived products up to 5mg THC/serving, 50 mg/package with no purchase limits, and no required licensing.”
        • “Many have called the legalization scheme in Minnesota ‘adult use hemp’,” Schauer remarked, resulting in what she termed “an unregulated adult use approach, and the types of products that you can buy on the hemp market in Minnesota are probably very similar to adult use products that you would find in many states.”
    • Summing up her impressions of the varied approaches, Schauer said there were “some that I would argue are working better than others. This does continue to be a challenging area, CANNRA’s put together some resources” that “can be good primers” for those unfamiliar with the topic.
  • WA House COG Chair Shelley Kloba thanked Schauer for the presentation and signaled her approval of WSLCB engagement with CANNRA (audio - 1m, video).
    • Kloba appreciated knowing that Washington regulators weren’t “the only ones who are struggling with this…I like to think that Washington leads on a lot of things and I hope that we can continue to really make sure that product safety and minimizing risk is important” .
    • She then endorsed the “time that our LCB folks spend engaging with CANNRA. I think that's an important investment.”

Informed by a small survey of stakeholders, a researcher producing a legislative report recommended officials reduce the availability and use of high-concentration cannabis products.

Here are some observations from the Friday December 2nd Washington State House Commerce and Gaming Committee (WA House COG) Committee Meeting.

My top 3 takeaways:

  • University of Washington Addictions, Drug, and Alcohol Institute (UW ADAI) Research Scientist Bia Carlini, leader of the Cannabis Education and Research Program (CERP), reviewed the history of the report and health risks associated with highly concentrated cannabinoid products before members asked about consumer self-titration.
    • First, Carlini made clear that “what we are presenting here is not related to cannabis as a medicine. We strongly believe that cannabis as a medicine is a matter that should be decided by individuals and their health care providers. And also, it does not include unregulated products which had been discussed by” Washington State Liquor and Cannabis Board (WSLCB) representatives before her remarks. Her study of high-concentration tetrahydrocannabinol (THC) products had “been focusing on this product both in terms of the health risk and also what Washington's stakeholders think about products that contain very high concentration of THC” (audio - 2m, video, presentation).
    • Regarding health implications, Carlini noted the consensus statement involved 11 researchers including herself who looked at “research evidence around cannabis concentration,” finding the “greater the potency of cannabis products, the greater the likelihood of adverse health effects…we tried to give examples” throughout the document of “why that is” (audio - 3m, video):
      • “Are high THC products more likely to cause…cannabis use disorder?…We conclude that, yes more THC you have in a product more likely you have the chances of individuals having a really hard time living without consuming on a regular basis the cannabis products…despite of consequences on their family lives, social life, professional life, and…their own health.”
      • “We also look at evidence around who are the people that consume high THC products, we were particularly concerned with inequality and disparities on this matter. And in Washington State we could see that young adults…from 21 to 24, 25, before their brains are completely developed” as well as “people who report mental health challenges and did not have the chance to have higher schooling, and have a lower income, were more likely to consume this high THC products.”
      • “We also were very curious about people being able to adjust their own dose. Should we really be concerned? I mean people may use a very strong product but just titrate, or regulate, and use less, and we could see that the evidence is it depends a lot. Right now, we have very reasonable research showing that healthy people and regular consumers are in fact able to control and regulate their own dose, healthy people mean both mentally and physically, so the researcher is available to show that initially, but there is no data showing that people that struggle with mental health conditions or physical disabilities can do that.”
      • Chair Shelley Kloba asked Carlini if that meant adults could consume less of a high-concentration product, and “might consume less of it than if [they] had a lower THC concentrated product…Sort of adjusting so that I get to the mental state that I'm looking for.” Carlini stated this was “possible if the person [was] healthy, physically and mentally, and if they are already regular consumers.” She stressed it was “not the case from the general population of consumers…and this is initial data that has been documented by Dr. Carrie Cuttler…so [it] is not to be generalized by all consumers.” Carlini further observed that it was “hard to guide policy based on this assumption because this assumption is only possible for a particular set, minority set of consumers” (audio - 1m, video).
      • Representative-elect Chris Stearns wondered "how many people are able to” self-titrate their cannabis consumption. Carlini believed a “very, very small amount of people can do that…around ten or 20%, maybe, of consumers are able to do that because they have been using cannabis regularly.” She additionally noted, during “research…you screen out any people that have issues of mental health and physical disability. So, for these people, which is a tiny amount of people, they can adjust. So for all purposes, to think about policies…this small portion of people it's hard to generalize for, you know, everybody” (audio - 1m, video).
    • Carlini indicated that researchers had also looked at whether “THC potency associated, or related to, the onset of psychotic disorders such as schizophrenia.”Their data indicated the “higher the intake of THC…the more likely that people would develop a psychotic disorder,” she commented (audio - 3m, video).
      • Carlini thanked Kloba for being among legislators attending the UW symposium, highlighting a presentation on "Cannabis Use and Psychiatric Comorbidity: Epidemiology and Association with High-Potency Cannabis Products" by Deborah Hasin of Columbia University. Hasin found that “as you increase the potency of cannabis and the frequency of use you have a very important increase on the risk of developing psychosis,” as well as higher odds of relapse if a consumer “had one episode but not fully developed psychosis,” as well as a “higher risk of not succeeding in treatment.” Carlini said Hasin had called it “reasonable to conclude that today's very high potency cannabis products…confer even a greater risk of psychosis” since her study was “based on considering high-concentration” to be cannabis with THC of “more than 10% and we know the high concentration here is more around 67%.” Carlini’s impression was that Hasin’s findings were “one public health reason” in favor of limiting access to high-concentration items.
  • Carlini then went over a survey of stakeholders that had been conducted to gauge the feasibility and impact of policy options on high-concentration cannabis products before reviewing the statutory and regulatory changes UW ADAI researchers were recommending.
    • “Science is always incomplete, and we invite people to prove us wrong if that's the case,” said Carlini, before describing how researchers had taken a step beyond the “strong evidence” in their consensus statement by conducting a survey on the topic with Washington stakeholders. She described how this had been done through a 2021 budget proviso allocating $500,000 to the WA HCA for UW ADAI “to develop policy solutions in response to the public health challenges of high tetrahydrocannabinol potency cannabis.” Their goal was “to find common ground amongst stakeholders” (audio - 6m, video).
      • Carlini went over the process of conducting the survey, providing information similar to her presentation during the symposium on how respondents self-identified their primary roles, which were divided up into:
        • “Community members, we included prevention advocates, social justice, youth centered organizations, parents of youth”
        • “Professionals from healthcare providers, law enforcement, government agencies, and researchers”
        • “Cannabis advocates that were people that report working [in], being representatives…lobbying professionals, press, consumers and of course…owners of different businesses”
      • Next, Carlini reviewed the concept mapping process by which policy ideas were vetted and organized. An initial cohort of survey respondents suggested policy ideas, she explained. Redundant suggestions, or comments on “medicinal cannabis or delta-8-THC” were removed, and Carlini said the 46 remaining policy options were then ranked by a new cohort of participants based on what they believed was the feasibility and positive impact of each option. Mentioning the demographics of the respondents, she indicated 106 participants engaged in the first stage of concept mapping, and 160 participants ranked the vetted policy options in the second phase, though Carlini mentioned that because this was done anonymously “we cannot assure how many of them were the same” participants in both surveys. There had been concerns that “more than half would be King County only,” but the replies came from around Washington, including a “reasonable, even participation too, of the stakeholders’ big groups.”
        • Carlini’s presentation named the number of respondents for six of 29 counties in Washington, showing the state’s three most populous counties were undersampled according to federal census data at time of publication:
          • King County: 29.1% of population, 23% of respondents
          • Pierce County: 11.9% of population, 4% of respondents
          • Snohomish County: 10.7% of population, 3% of respondents
          • Thurston County: 3.8% of population, 16% of respondents
          • Spokane County: 7% of population, 6% of respondents
          • Whitman County: 0.6% of population, 8% of respondents
    • Talking about the results of the survey, Carlini said that the first question had been “what is your concern about high THC in Washington state. Because we didn't want to then be creating a problem that…we researchers are really concerned, and nobody really cares.” After participants saw a website from UW ADAI that “included a description of the problem, links to additional resources, and a list of the stakeholder groups being asked to participate,” their average response was a concern of 3.8 out of 5, with Carlini reporting that concerns ranged from 1.4 among industry participants, while “researcher and government employees are over four in terms of their concern” (audio - 8m, video)
      • Carlini organized the 46 policy options provided into eight groups subdivided by color, albeit a different configuration than her UW ADAI presentation of the same options:
        • Advertising Restrictions and Age Restriction options, were “pretty much preventing the initiation of use”
        • Taxation; Product and purchase caps; Ban High-THC Products, and Licensing options “related to trying to decentivize [sic] or minimize the use of this products”
        • “Empower the consumer and public with information”
        • “There were several answers too, that was ‘laws and regulations are perfectly fine as they are’ that we called the ‘Do Nothing area.’”
      • Expressing an interest in a “go zone” of stakeholder supported ideas, Carlini’s presentation named “Empower consumer/public with information,” “Advertising Restrictions,” “Taxation,” and “Product and purchase caps” as close to, or reaching a consensus among respondents as more impactful and feasible than not.
        • She mentioned that the cannabis advocates group felt “that [it's] very feasible to do nothing and would have a positive impact,” and that group only supported advertising restrictions for high-concentration products which were already in statute.
        • Carlini noted that Product and Purchase Caps were seen as “research backed, evidence based” and high impact, but a “little low” on feasibility.
        • Backing for taxation changes on cannabis items with “more than…35%” THC was “not very marginal.” Increasing taxes on items with more than 10% THC failed to reach the go zone of stakeholder support, she added, finding “high support on taxes…mostly c[a]me from professionals, healthcare professionals, researchers, and government workers.”
        • Improving informational offerings to consumers was the most popular option (“people loved the idea,” Carlini remarked). She called out responses to some specific ideas:
          • “Warning labels” and “readable labels”
          • “Place public health messages at point of sale”
          • “Maintain availability, but teach ‘a dab will do’”
            • Carlini emphasized “professionals and communities” were “less enthusiastic about this option. It just stays here because of the support of the cannabis industry to do that.”
        • Additional public guidance was also popular, with Carlini’s presentation options grouped as “Earmark cannabis tax for PSAs/ads and social media campaign explaining risks” and “Education in schools and community centers.”
    • Carlini talked about recommendations UW ADAI would make to legislators after incorporating the survey into their consensus statement along with “research evidence” from “North American contacts.” The published draft report featured details “on what has been done up to September” of 2022, even as “none of the policies implemented have been ever evaluated” making them “tangential to our recommendations” (audio - 3m, video).
      • Carlini claimed the survey results showed concern over high-concentration products “for non-medical use, and they support policy changes,” whereas support “to do nothing” was “very, very low.”
      • Several policy options were also “also backed by science and research,” she said, including consumer education, “age-gating, and tax increases proportional to THC content.”
      • She noted that Cannabis Observer had published an observation on an earlier draft of the UW ADAI report the day before her presentation, making her “more than willing to answer any questions you may have about them since now they are in the public domain.” She concluded by thanking her team of researchers, participants, “advisory group members,” and Polygon, Inc for conducting the concept mapping.
      • While the final legislative report was due to be submitted by December 31st, at publication time it was not available on the WA Legislature website nor the UW ADAI website.
  • Legislators had a variety of questions around the published draft report including justifications for the recommendations, potential impacts, and outreach conducted.
    • Kloba noted that respondents in the professionals category “were one of the categories who felt that taxation was a viable choice, but I was wondering…if they had any awareness of the taxation study that LCB did several years ago finding that it didn't seem very feasible?” (audio - 3m, video)
      • Carlini credited Kloba as the legislator that “put forward this idea of having also a proviso to analyze a taxation as an option,” but Carlini asserted that “taxation works for alcohol, tobacco, and [unhealthy] foods really well.” She considered the feasibility study from 2019 to have been focused “on a whole economic outlook, and marginally on public health” while UW ADAI’s goal was to center public health concerns.
      • Kloba commented that “when the rubber hits the road implementation is also a very important concern, so implementability…is key.”
    • Then Kloba inquired about advertising, noting that because WSLCB Director Rick Garza was present, he could share an “overview of advertising regulations as they currently stand” (audio - 3m, video).
      • Garza felt that because there had “been so many changes that you've made over the years,” naming billboard restrictions, he would have to review before being able to share an accurate overview.
      • Policy and Rules Manager Kathy Hoffman joined the discussion to say the board had opened advertising rulemaking in August 2022, the first potential revision “since 2018.” She termed it a “complex area,” particularly since “there are challenges with respect to…constitutional freedoms” around what businesses were allowed to claim. Garza clarified for Kloba that the existing advertising rules on billboards permitted “product…to be advertised and the stores.”
    • Representative Melanie Morgan asked “when the researchers were doing their research in determining…high potency leading to the addiction, was there any comparison to addiction and harms that are caused by alcohol and nicotine? And then, were these research done on different cultural groups” to assess the impact on the “harms and the addictions” (audio - 3m, video).
      • “Research…has been done in different ways,” Carlini explained, but their work focused on comparing cannabis flower and “other more concentrated products.” She argued that other research had been done, but “the user of solely cannabis is a very, very, very rare event” and “most…people consume cannabis plus other products.” In particular, “most people that consume cannabis are…very likely to be tobacco users, are very likely to also consume alcohol,” she insisted. Carlini also believed that regardless of what recreational drugs an individual used, “people that struggle the most with discrimination in society are way more likely to become addicted, or to develop a use disorder, than people that are mainstream and have…decision power, and privilege.”
    • Representative Kelly Chambers returned to the topic of psychotic disorders, inquiring “how can somebody know that they're at risk? Is it...a family history, a diagnosis…certain types of diagnosis?” (audio - 2m, video)
      • Calling mental health “somewhat of a mystery” for professionals and society, Carlini deemed the concept an “intersect[ion] of genetic makeup and environmental conditions, and cannabis is one of these environmental conditions.” She alleged “any other mental health condition, some genetic makeup” could potentially “trigger…a psychotic episode.” However, most research in the field involved those “already hospitalized, or already having the chronic foundation psychotic disorders,” with Carlini indicating schizophrenia was the most studied such condition, though it remained “relatively rare, around one to three percent of people will develop” it.Case control studies compared “people that are already struggling with the disease…and compare with similar people that are not, and you go back in time and you look if they have used cannabis and which potency…in their near past.”
    • Kloba wanted to know if causation of mental health conditions could be established; “maybe there's a little bit of a chicken and an egg problem” since “sometimes undiagnosed mental health disorders” motivated people to be “self-medicated by various substances” (audio - 2m, video).
      • “The only way we could do research on causation,” argued Carlini, was getting a “randomized” group of subjects “then see what happens, do an experiment.” Such subjects would be tracked by researchers for “one to two decades” which she assumed would show those using cannabis “are way more likely to have…schizophrenia, or psychotic disorders, than people that have not.” She knew lawmakers wouldn’t “legislate over people[s’] genetic makeup, but you could legislate over a trigger of this genetic makeup…on not letting this, throughout the years, to trigger psycho[tic] development.”
    • Representative-elect Kristine Reeves hoped to better understand “correlation between the utilization of the substance and its adverse impacts on what I would characterize as underrepresented, or historically marginalized and challenged communities.” She asked Carlini to review the “demographic data in your research in terms of highest impact to particular subsets of the community,” while also addressing “any research outstanding…that shows a correlation between the demographic impacts based on those subsets of the population, and adverse childhood experiences” (ACEs audio - 4m, video).
      • First, Carlini called for “more funds [so] we can work on the granular level of the questions that are being made,” as “adverse childhood experiences is not a variable that has been measured.” She did allow that any “marginalized communities” were at higher risk for substance use disorders “because that's a way they found, most likely to cope with the way society treated them.” Carlini was open to researching the factor specifically in the future.
      • Reeves asked if UW ADAI “would have the capacity” to look at ACEs if requested. Carlini replied that they would before making clear the topic had been studied, but it was “not as clear” whether high-concentration cannabis products impacted the odds of developing use disorders relative to ACEs.
      • Kloba noted she favored more cannabis research funding “because we have fantastic institutes” in UW and Washington State University (WSU).
    • Representative-elect Clyde Shavers asked about the “supply and demand situation, or dynamic. Are consumers demanding greater concentrations of THC, or is it industry…through their entrepreneurship…experimenting with higher concentrations?” He asserted there was some question over whether “using cannabis really lead[s] to other use of harder drugs.” Referencing the cannabinoid briefing earlier in the work session by WSLCB staff, Shavers wondered if their growing market share was the result of consumers after a “better high…and potentially could that lead to other drug use?” (audio - 3m, video)
      • Finding the cannabis sector to be a “very very efficient industry that is keen on innovating,” Carlini asserted this pattern was “typical of industries of any kind that are oriented to grow and make a profit.” She suggested cannabis companies “started experimenting with what was already available” and began making new products.
      • She pointed a finger at social media platforms for being “rampant with advertising, true influencers, and…associating cannabis with very positive” or “desirable lifestyles. Of course consumers start demanding the products.”
      • Carlini noted that “in 2014, [concentrates] were barely seven percent of the market, now they are around 34 to 40% of the market.” She couldn’t be sure whether new product offerings, or a consumer demand for them, was driving the change in consumption, but remained focused on how “these products are not safe for consumption, and they are…exposing people to health risks… particularly people…with a less than privileged life. And we need to do something about it.”
    • Stearns asked about input on the report from sovereign tribal governments across Washington, the majority of which had cannabis compacts with the state (audio - 2m, video).
      • “We cannot consider them stakeholders; they are sovereign nations so they are our partners, not stakeholders,” established Carlini. Through the WA HCA tribal liaison and a “Dear Tribe letter," she reported that tribal governments were contacted and researchers achieved “some connection.” She encouraged any policy change around high-concentration cannabis products to include a chance for tribes to “give their opinion.” Carlini described how UW ADAI staff “​​put our cards out and didn't get too much direction” from tribes, “of course, I think they're interested and they should become partners on negotiating a solution [in] this area.”

Engagement Options

In-Person

O'Brien Building, 15th Avenue Southwest, Olympia, WA, USA

House Hearing Room C

Livestream

https://www.tvw.org/watch/?eventID=2022121071

Information Set