WIDAC - Council Meeting
(July 11, 2024)

Here are some observations from the Thursday July 11th Washington Impaired Driving Advisory Council (WIDAC) Council Meeting.

My top 3 takeaways:

• Requirements around cannabis products with high levels of tetrahydrocannabinol (THC) had been an increasing focus of public health researchers, State regulators, and cannabis sector representatives.
  • Following in the footsteps of previousiterations, HB 2320 (“Concerning high THC [tetrahydrocannabinol] cannabis products”) was passed by lawmakers and signed on March 29th. The law incorporated a mandate to the Washington State Department of Health (DOH) on store signage about risks of high THC items—most commonly cannabis concentrates—industry training, and requested a DOH public educational campaign with input by Washington State Liquor and Cannabis Board (WSLCB) representatives.
    • Washington State Health Care Authority (WA HCA) was required to issue a request for proposals (RFP) on a “contract to develop and implement guidance and health interventions for health care providers, certain patients, and for other uses, with reports.” However, the supplemental operating budget signed the same day allocated $328,000 in fiscal year (FY) 2025 using language that would either require WA HCA to contract with the University of Washington Addictions, Drug, and Alcohol Institute (UW ADAI) for that work.
    • UW ADAI leaders convened a symposium on “High-THC Cannabis in Legal Regulated Markets” in September 2022, and a webinar on “Addressing the Risks of High THC Cannabis: The Public Health and Legislative Saga” in April 2023. At publication time, the organization had opened registration for a second symposium regarding “Cannabis, Schizophrenia, and Other Psychotic Disorders: Moving Away from Reefer Madness Toward Science” on September 19th.
    • WSLCB employed a Public Health Education Liaison who served as a unique hub between interests in the substance prevention and public health fields and acted as an agency representative for groups such as WIDAC. After Board Member Jim Vollendroff joined in May 2022 with a history in behavioral health and recovery, he brought attention to legislation on high THC products. Earlier in 2024, he inquired if the subject had been addressed in closed meetings with public health and prevention leaders. In a June 12th discussion about potential 2025 legislation, Vollendroff noted he’d “talked to [HB 2320 sponsor Representative Lauren] Davis about this, but I anticipate the high THC concentration products will come up in some fashion.”
    • In October 2023, WIDAC heard a presentation on the Traffic Safety Statewide Survey which covered public attitudes on cannabis and driving. The council’s last meeting was on April 11th.
  • In an attempt to find consensus on policy options for high THC products, WSLCB had hosted two focus groups on the topic with cannabis sector representatives on June 26th and July 10th. At the latter event, Vollendroff and Public Health Education Liaison Kristen Haley reflected on the sometimes combative language and oppositional posturing cannabis representatives received from some public health interests. She observed it would “turn down the temperature a little if folks could just have better tone and terminology” on the topic of high THC regulation.

• Washington State Liquor and Cannabis Board (WSLCB) Public Health Education Liaison Kristen Haley briefed about “Understanding the Impacts of High THC” where she addressed risks with the products, steps agency staff had already taken on the matter, and what they would be doing ahead of the 2025 legislative session (audio - 15m, presentation).
  • Haley described her “charge” from WIDAC leaders to “talk primarily about some high THC concentration listening sessions that we've been hosting at LCB with partners.” Stressing that she was a “health educator” rather than a trained researcher, she contextualized the “sequence of questions that I've been experiencing from partners or the general public” where “first is always like, well, what are you talking about? What is high THC?” There was a “pragmatic answer” for the existing cannabis market that health officials and researchers had begun to “coalesce” around which was “starting at or equivalent to 35% THC.”
    • However, Haley indicated the “other answer” was that “high THC is anything at or above 10%. And that's because a lot of the scientific literature actually shows that the dose response starts at the 10% high THC products, meaning that at just 10%, you start seeing…higher risk of psychosis, or more addiction or other things.”
    • Her impression was regulators “can't necessarily regulate around that 10% because the market is just…so skewed toward higher THC products.” She noted that policy options such as capping THC content at 10% or changing tax rates above that point would affect almost all products “so it just pragmatically doesn't make sense.”
  • Under the assumption that high THC items were 35% or higher, Haley reported this was “basically concentrates and anything that's derived from concentrates” like vapor products and most cannabis edibles. She continued, stating “right now, genetically, flower can't be higher than 35% THC, which is the other reason why [the common definition was] coalescing at that space.” However, “in the past flower was kept at a much lower percentage,” Haley argued, anticipating “the market will continue to innovate, and that we will continue to see genetically modified versions that increase that cap.”
  • The final question Haley often heard was “how did we get here?” She explained that although average THC content had been increasing prior to states like Washington legalizing the adult use market, in 2021 the “average THC in products was 21%. But the highest on the shelves right now is 95%...that's a big gap…from 1995 to what we're seeing today.”
    • Increasing THC levels in cannabis had been reported as a research concern as far back 1980, however prohibition had a poor track record in both accurately monitoring potency before then, or in stopping increases in substances’ concentration.
  • While not everyone who consumed cannabis used high THC products, “and not everyone who consumes high THC products has adverse effects,” she claimed that the probability of adverse effects were “significantly higher when someone is consuming a high THC cannabis product.” Haley credited WSLCB Research Specialist Tyler Watson for a chart of 10th grader responses from the Healthy Youth Survey (HYS) which showed changes in the amount of the group who reported using various cannabis products, including a “1,340% jump from 2014 till now” in use of vapor products. As most of these items had high THC, she argued their use “increases the risk not only for the developing brain but that third thought point…high THC products exacerbate risk for cannabis use disorder; psychosis or schizophrenia; and cannabis hyperemesis syndrome.” She also pointed out “being able to drive safely after using a high THC product decreases significantly. People shouldn't be driving at all after using but if they are using these higher THC products, it increases the risk.”
    • Haley discussed the issue of psychosis or schizophrenia diagnoses in the focus group on June 26th after a participant noted that the criteria for the conditions were very different despite the terms being used seemingly interchangeably by some public health interests. At the time, she commented she wanted “to check in with some of the ADAI folks and some other researchers and see if maybe that's a messaging piece,” since even “as a trained health educator with a science degree, it's hard to interpret some of those findings.” 
    • On March 13th, Watson led the first official presentation of 2023 HYS results to the WA HCA Prevention Research Collaborative as then-WA HCA Prevention Research and Evaluation Manager.
  • Referring to comments from WTSC staff that “about a third of cannabis plus alcohol drivers in fatal crashes were aged 16 to 25 in 2023,” she wouldn’t “draw a line that says…people are using high THC and then they're driving with alcohol and cannabis and then they're dying in fatal crashes, or they're killing others during fatal crash events. But I, I do want all these things to live in the context together.”
  • Turning to what WSLCB leaders had been doing, Haley pointed out some of the impacts of HB 2320 as well as limitations like the lack of funding for a DOH education campaign. She explained how DOH counterparts were “looking at their budget and trying to shift around so that they can fund a campaign that's specific to high THC.” She described focus groups at WSLCB as “listening sessions” on the subject of high THC for cannabis sector representatives, calling the events a “strategic evolution” beyond regular closed prevention roundtables agency staff had hosted for several years. Haley relayed that public health and prevention representatives had met with WSLCB officials three times regarding cannabis concentrates, with another meeting in the works. Besides the two cannabis sector focus group events, she promised a third was being planned, and “people are open to having maybe quarterly sessions where…we talk and explore some of these possible solutions together.” Her next move would be a “hybrid call” with a limited number of selected advocates for each group.
  • “Historically, we have not all always gotten along super great,” acknowledged Haley, which she perceived as creating “roadblocks to actually implementing policy that we all can agree is keeping our roads safer, keeping our kids healthier, keeping people who use cannabis safer and healthier when they do that.” The dialogue so far had been “illuminating,” she told the group, and “potential strategies that are coming up…in all of these conversations, public education is a huge one.” Budtender training and additional research had come up, but Haley also stated “maybe changes to packaging and labeling, maybe doing some shifts to the tax structure.” Others had proposed “age gating, which would mean for certain products, you'd have to be 25 to purchase those products,” though she cautioned “not everyone is in favor of that. So I think that's still up for discussion.” Product potency caps were another divisive policy, as when imposing limits on how much THC was in a product, “there is risk in all of these leading people to more of the black market. But that's why we're doing these listening sessions to explore what's available to us, what's reasonable.”
    • Davis, sponsor of HB 2320, previously sponsored bills to institute new age restrictions on concentrates.
  • Wrapping up, Haley added that there were separate listening sessions being facilitated by WSLCB focused on alcohol product placement. She then noted that there would be another event scheduled on August 7th about a “LCB hosted data dashboard,” and that anyone with an interest in participating could contact her at Kristen.Haley@lcb.wa.gov. “There are ways for you to report violations if you're out in the community and you see a hemp-derived THC product at a non regulated store,” she concluded, “let us know about that, that's illegal.”

• Attendee comments centered on potential rules for alcohol placement, but Haley also encouraged council members to send her photos of cannabinoid products they’d encountered in their communities.
  • Edica Esqueda, WTSC Impaired Driving Program Manager, thanked Haley who she described as “tenacious” in her work at WSLCB. Haley then asked that anyone encountering high THC cannabis or hemp products send pictures to her so they could be added to Haley’s “library of those images." She suggested it helped regulators to know where products were being sold whenever possible, as this had been "happening across the board,” and they wanted enforcement against the items to be "more equitable" rather than targeting particular jurisdictions or stores (audio - 3m).
    • The day before, Haley had agreed with cannabis sector interests that there was an "elephant in the room of online sales” for hemp consumables being accessible to those under 21.