WSLCB - Work Group - Cannabinoid Science - Public Meeting
(April 4, 2024)

Here are some observations from the Thursday April 4th Washington State Liquor and Cannabis Board Cannabinoid Science Work Group (WSLCB - Work Group - Cannabinoid Science) Public Meeting.

My top 3 takeaways:

• Legislators concerned with the health impacts of high tetrahydrocannabinol (THC) products passed a law requiring regulators from agencies such as WSLCB to further define the products in order to provide more detailed sales data for a mandated legislative report.
  • In October 2023, work group members published a report on “Detectable Levels of THC and Cannabis Product Safety.” They last met in December 2023.
  • Following passage of HB 2320 (“Concerning high THC cannabis products”) on March 29th, WSLCB was tasked with tracking “data on the amount of products sold under the three broad categories (usable cannabis, cannabis concentrates, and cannabis-infused products), the average THC concentration, the average milligrams of THC per unit sold, and the range of THC concentration in both usable cannabis and cannabis concentrates.” This information was to be put into a legislatively mandated report “due by Nov. 14, of 2025.”
    • The University of Washington Addictions, Drug, and Alcohol Institute (UW ADAI) had been one of the most prominent State institutions in favor of further regulating cannabis concentrates and ‘high THC’ products which researchers with the organization defined as those with over 35% THC.
      • UW researcher and Cannabis Education and Research Program (CERP) Director Bia Carlini was among researchers quoted in a May 23rd New York Times article on the mainstream popularity of cannabis among American adults. Carlini called it “disheartening” that a May 2024 study suggested there’d only been a slight decline in frequent alcohol use as cannabis had become more popular. She and others interviewed for the story connected this to cannabis concentrates, though the survey question in the research didn’t specify product type people used.

• Work group members talked about how to define “high THC” and serving sizes but, besides an increased focus on public education, a consensus proved elusive.
  • Research Manager Sarah Okey explained that their focus on policies for THC was an attempt to answer if there was “a way to create a definition of high THC and justify that definition of high THC?” She said the issue was “receiving a lot of increased attention recently across various stakeholders, public health professionals, researchers, regulators, both within Washington and across the United States” (audio - 3m, video - WSLCB).
    • Okey told attendees a “primary point of discussion” had been that “higher THC [wa]s associated with greater risks relative to lower THC,” and that health risks could be higher for those with “developing brains, youth, young adults, adolescents, those with underlying health problems, like people who have a family history with psychosis, or who have mental or physical health problems as well.” But there’d also been “research looking at medical, medical and therapeutic effects of higher versus lower THC,” she noted, and the topic was rife with nuance, including “THC concentrations, route of administration, how many, how frequently you're using, there can be a lot of variations.”
    • Okey suggested one study “actually looked at over 450 studies that examined higher versus lower THC, and they found that there was so much variability on the methodology of high versus low THC.” She described a need to look at policy alternatives “or where research needs to focus.”
  • Okey’s first question was whether attendees thought “creating a definition of high THC [wa]s feasible?” (audio - <1m, video - WSLCB).
    • Jessica Tonani, Verda Bio CEO, encouraged caution in defining “high THC” as she considered unsafe dilution of some concentrates to be a distinct risk. “Is it feasible for somebody to just put a number” in place to mean ‘high THC’, she asked, “it probably is, but is that the best for safety? I think that's one of the biggest questions in my mind is, how do we enable people access to, to safe products? And without creating more safety hurdles?” Tonani speculated that if 50% concentration was defined as “high THC and banned or something like that…what other dilutents would people put in those to meet that threshold?” Although she felt “in general, concentrated floral material is, from an inhalation perspective, relatively safe,” there were compounds that could be added such as “vitamin E acetate and different things in vape carts, that is not safe.” Tonani wondered if there were “mechanisms that we approach this via tax or different mechanisms that don't put people into situations that they're creating products that may have larger health issues than the ones that we're trying to tackle” (audio - 3m, video - WSLCB).
    • Sarah Murray, former Catholic Charities Eastern Washington Community Programs Manager, felt distinguishing based on product type might work, offering that concentrates could be considered “high THC” while cannabis flower wouldn’t be. “I tried to steer [patients] away from concentrates because drinking hard liquor is worse for you than having one beer,” she explained. Murray suggested recommending a product type rather than focusing on the percentage of THC as “I want to try to help people not just go for the one that's gonna get them high, but the one that's going to help them the most.” She called this a “substance based way” to regulate cannabis products. Okey agreed that considering all cannabis concentrates to be “high THC” had been a standard used in some research, and “if you know theoretically, you have the same amount of THC in one product versus another product, flower versus concentrates would there be differences in like, risk and safety profiles as well?” Murray also liked the idea of “guiding legal users to what is going to give them the…safest and most pleasurable and avoiding kind of risks associated with that” (audio - 3m, video - WSLCB).
    • University of South CarolinaSchool of Medicine Columbia Postdoctoral Fellow and researcherTaylor Carter, shared that his animal studies used the equivalent of “2000 milligrams injected” and from a “toxicology standpoint” considering THC content on a “per serving” basis might be better than total cannabinoid content to achieve a beneficial health impact. Moreover, he stated that from a “health perspective, a lot of things potentially considered high THC don't necessarily have a physiological harmful impact” (audio - 4m, video - WSLCB).
      • Carter believed this was “letting [consumers] know that this is a stronger product, and potentially keeping them from…the mental side effects that would come along with a high THC dose.” Taylor had seen research articles where “devices…that can kind of mirror a breath” in order to “measure how much THC is being consumed per vape puff…most of the vape pens they tested were between nine and 16 milligrams of THC per puff.” He pointed out that in a paper Okey cited in an email to member, “they noted that when the users were using concentrates, they took half the number of puffs, and they were allowed to consume as much as they wanted. And there's another study they referenced in their discussion that they saw the same thing.”
      • Carter noted there were receptors in the lungs “that basically can signal that you've consumed a lot of a product.” With some evidence of consumer self-titration where “higher THC product may result in less usage,” he felt “if the little bottle said…’50 servings are within this,’ maybe that person would be conscious and be like, ‘Oh, I'm not supposed to consume half of this product in one sitting.’”
    • Ryan McLaughlin, WSU Department of Integrated Physiology and NeuroscienceAssistant Professor and Washington State University Center for Cannabis Policy, Research, and Outreach (WSU CCPRO) researcher, argued that “we're just initially starting to talk about smoking versus vaping,” however from a “health standpoint for users edibles was the one that induces the most emergency room visits and is most likely to induce overdose and that has [to do with consumers’] inability to self titrate.” For McLaughlin, THC wasn’t “always the bad guy, but…it certainly can be,” adding that his wife Carrie Cuttler, also a researcher and professor, “hasn't measured THC quantity, or concentrations, per se…she doesn't see any greater cognitive impairing effects from people that are using concentrates versus flower” (audio - 2m, video - WSLCB).
      • Cuttler had called for greater cannabis research in an April 18th article from the Inlander. She also presented on “Acute Effects of High Potency Cannabis Flower and Concentrates on Cognition" during a 2022 UW ADAI symposium. 
    • Spoke Sciences Chief Regulatory Officer and Vice President of ChemistryBrad Douglass argued it might “be more feasible and perhaps effective to define high THC in terms of the amount of THC consumed or used over a period of time, rather than by defining it based on the product that THC is in.” Okey compared this to a common formula used to gauge adult blood alcohol content (BAC), and felt that Douglass meant “providing guidelines based on [how] your level of risk increases based on if you're using X, Y or Z amounts during the day or throughout the week.” He confirmed this interpretation, saying the guidance would be “more instructive to folks that are looking to minimize the risk” (audio - 4m, video - WSLCB).
      • Murray relayed that when assisting older medical cannabis patients she found many of them preferred cannabis edibles with definitive serving amounts to inhaled products. She thought if patients “take it at night and they wake up and they're dizzy, then they know…that more is not…going to be good for them.” Murray speculated that cannabis labeling could do more to emphasize “this many servings per package. If you take half the package, you're going to be pretty drunk or whatever,” and that this arrangement could be more beneficial to a “layperson.”
      • Tonani observed that cannabis concentrates such as kief were centuries old, and “there are certain ways that people have consumed this plant and not seen some of the issues.” She suggested public education might prove the most feasible way to help general “understanding how much of something that people should consume and not necessarily…the format that it's being delivered in.”
  • While alcohol was “all liquid,” Okey noted the numerous ways people could ingest cannabis, with the size of “puff” varying between individuals. As a result, she said it “seems very complicated" to define servings across product types (audio - 2m, video - WSLCB).
    • Carter indicated some experiments had simulated breathing to arrive at their measurements, and was dubious of the potential to test every cannabis product. Instead, he said “over time, there could be [an] equation that summarizes it pretty well, based on the viscosity of the liquid, based on THC content, you can…determine what the average puff would be.” Beyond the difficulty of finding a formula, “anytime you come up with…an equation or anything, people are going to figure out a way to get around it,” Carter added.
  • Okey wanted to clarify if there was “a method of determining the serving size right now” (audio - 13m, video - WSLCB).
    • Murray described participating in a project where they looked at “100 milligrams of flower. And three of those four times a day is like a ceiling limit…because when people are smoking more than that, in my experience, they're not really getting any effect after that as much as they're getting like side effects more than anything, but like that's totally unverified and I didn't use a tool to measure that.” Lab testing of blood THC concentration was possible, she indicated, but “I don't know if there's literature out there that [showed] you're impaired after this number.” Murray theorized this number could be used similar to BAC when it came to labeling cannabis serving size.
    • McLaughlin explained the problem with this was “we often want to equate blood levels of THC with intoxication or impairment, but…blood levels actually don't really correlate with cognitive…impairment, it's brain levels of THC that you really need.” He had concerns over “trying to draw too many relationships with alcohol, because…cannabis and alcohol are just an entirely separate beast that we can't just say that a concentrate is the same as” drinking liquor, “it's very different, in my opinion, just based on the pharmacokinetics.”
    • David Gang, WSU CCPRO Director and professor at the WSU Institute of Biological Chemistry, claimed “a number of states had had some values on the laws on the books that were based on values of blood levels. Most of those had been removed, because they found that they were just not able to demonstrate any…correlation to actual impairment function.” He noted factors like liver function and body mass index (BMI) could alter cannabis impact on consumers. Alcohol consumption also had compounding physiological factors, “but it's a lot more consistent in these broad categories,” he said. Gang felt researchers needed more time to identify a "quantifiable marker" that "connects a person's impairment." He claimed that while there was “hype” around potential solutions to this, “it's really not going to lead to something that's really applicable in the field, or even in a clinical setting. So it is a really big problem.”
    • Tonani argued this had been a problem for lawmakers looking at cannabis regulation and finding that “it's not necessarily the product by design is enabling, like everybody to have an issue.” She regarded it as an “educational deficit” that by focusing on “high THC” some consumers who were more sensitive to impairment or misusing cannabis were hearing a message that product type was the problem. Tonani wondered “how do we address the issue, which may not be just defining what high THC is?”
    • McLaughlin continued to find education being more important than determining THC limits since “we don't really have the science to back up that even…having ‘high THC’ in and of itself, is going to be more deleterious in terms of mental health or cognitive health outcomes.” Until that was clearer, “I always feel like when we're trying to put a cap on things, or we're trying to prevent people from using things, it just creates alternatives for them to go and bypass the regulations,” he said. “I think just now that we have so many more people using it…we really need to emphasize just trying to teach people and educate people about what these harms actually are and what we know and what we don't actually know yet,” argued McLaughlin. He also felt, “we can't just make legislation based on something that we kind of have a hunch on.”
    • Gang stipulated the issue with education was finding a “lowest common denominator" where consumer education reached those groups most at risk would take the advice seriously. “Little kids aren't going to be educated on this," he warned, noting youth access had been a top concern for legislators.
    • Tracy Klein, Washington State University (WSU) Vancouver Associate Professor and WSU CCPRO Assistant Director, acknowledged “the State is a little bit conflicted about what its role is in terms of education.” Although officials had established a medical cannabis consultant program, Klein wasn’t aware of “any kind of evaluation of the, what that role should be, was it effective. Was the education that people were getting, did it do anything?” She had participated in a 2020 study which looked at consultants’ knowledge along with medical practitioners, and suggested any consideration of the State’s role in cannabis education should include them.
    • Carter pointed out that peanut butter could be a lethal product to those with peanut allergies, “yet we still allow peanut butter to be sold in stores.” Despite the extreme risk a product could pose to those with “genetic mutations,” he said among the overall population “long term toxicities [were] not that high.” Carter argued, if “we're looking at it from…the potential role in schizophrenia…there are some things out there where a small group is susceptible in a way that other people are not.”
  • Based on the discussion, Okey acknowledged that a definition for “high THC” might not be feasible, particularly if it was meant to articulate potential risks. Defining serving size was similarly challenging, she added. Nonetheless, Okey also picked up how "education is super important" as well as tracking frequency of cannabis use over time (audio - 2m,  video - WSLCB).

• Regarding cannabis product stability, members had few safety concerns but agreed that proper storage and some additional education could be useful.
  • Okey referred to a rulemaking petition accepted by WSLCB on March 13th which dealt with labeling a cannabis product’s harvest or processing date, claiming it had brought more attention to product quality and safety. “And within the past several months, there's also been questions and conversations about how various environmental factors like packaging and light can impact the cannabis product’s stability across time and degradation,” she remarked. Okey encouraged work group members to consider “what might be the best steps to move forward with this” (audio - 1m,  video - WSLCB)
  • The first question posed by Okey was what “initially comes to mind in terms of the biggest factors to pay attention to” for product stability (audio - 2m, video - WSLCB).
    • Tonani offered "potential concerns" based on the type of item but stressed the central issue was cannabinoid degradation. While declining cannabinoid content didn’t compromise product safety, she said it “becomes a question of whether the consumers are getting what they want and storage conditions.” Both cannabis flower and edibles could be stored for long periods of time, Tonani added, but “the difference becomes…food safety concerns and, and exploration of other ingredients and things like that in edible formats.” Overall, there were “mainly the microbial concerns.”
  • Okey drilled in on product stability issues around cannabis flower (audio - 3m, video - WSLCB).
    • Emphasizing this was mostly about how cannabis was stored, Tonani suggested that flower which was “cured properly” could last a "couple years" if kept in a cooled and dark environment.
    • Douglass also felt degradation wasn’t a problem beyond the “microbiological concerns” Tonani had mentioned. He hadn’t seen pesticide or heavy metal content being impacted and, absent a safety concern, didn’t think results on the certificate of analysis (COA) from testing a product would change significantly. Douglass reiterated the main impact on products during storage was “cannabinoid to concentration across time.”
  • When prompted to consider storage factors, Murray alleged untrimmed flower on a stem could be stored “forever,” but how licensees actually stored their cannabis was what mattered. She advised having regulators consider licensee storage, preferably in a "closed, unlit spot.” Tonani specified that heat, light, and humidity were common factors in determining microbial growth in plants. Gang seconded this, and stated “cool, dark, and dry is always best for everything…cannabinoids are going to break down into things that are less active, more benign over time” He noted that storage issues were more of a food safety concern (audio - 3m, video - WSLCB).
    • Specifying that some medical cannabis patients had raised questions about "how fresh their products are,” Tonani asked if there was a requirement for freshness or harvest date to be labeled. Director of Policy and External Affairs Justin Nordhorn replied that it was optional, but the rulemaking mentioned by Okey was proposing it be mandatory. Tonani felt that by including that information, a consumer could weigh the overall freshness of cannabis items when deciding whether to buy them. Murray commented that if she had confidence in how cannabis was stored she wouldn’t see a problem. Klein offered that in Oregon, retail cannabis staff “can't pull products based on dates. They're just supposed to sell them in order. So there's no option to…look at that date” (audio - 3m, video - 
  • Contemplating consumer education, Okey wondered if harvest dates or storage information were things a consumer would want to know (audio - 2m, video - WSLCB).
    • Murray felt a consumer would want to know if cannabis storage had been in compliance with WSLCB regulations.
    • Tonani encouraged having disclosure of storage conditions be an “opt-in” choice for businesses, letting them decide whether consumers would benefit from the certainty of knowing cannabis had been properly stored.
  • When it came to product stability of cannabis concentrates, Okey was curious if there were any different storage concerns (audio - 3m, video - WSLCB).
    • Klein mentioned topical products, “if they're losing efficacy…to me, that is a regulatory issue if people are continuing to sell something that's supposed to be effective.”
    • Douglass understood concentrates to be more stable and have similar environmental and storage needs to cannabis flower. He acknowledged the concerns around freshness and efficacy, but wasn’t aware of additional hazards related to concentrate storage.
  • Okey relayed her impression from the discussion that there were no safety concerns around cannabis product stability provided they were properly stored. She mentioned that providing additional information around harvest date or storage conditions might be useful to consumers (audio - 1m, video - WSLCB).