WSLCB - Executive Management Team
(December 9, 2020) - Public Health and Prevention

WSLCB’s leading substance use prevention staffer provided their first in-depth update in months, pushing back against temporary policy allowances and raising public health concerns.

Here are some observations from the Wednesday December 9th Washington State Liquor and Cannabis Board (WSLCB) Executive Management Team (EMT) meeting. Today we cover Public Health Education Liaison Sara Cooley Broschart’s update.

My top 2 takeaways:

• Broschart was a leading voice for substance use prevention in the agency’s consideration of public health, and was the key coordinator between prevention advocates and the WSLCB in recent years.
  • Broschart discussed the 2019 Healthy Youth Survey (HYS) at length with board members in January 2020. She explained that “prevention services in the state of Washington are based in communities through coalitions, and there’s over 80” adding, “most of the work is being done locally.”
  • Broschart outlined other partnerships she’d been involved with on behalf of the agency:
    • The Youth Marijuana Prevention Education Program (YMPEP) which Broschart said was mostly funded by the Dedicated Marijuana Account.
    • The Washington State Prevention Enhancement Policy Consortium which created a five-year strategic plan for Substance Use Disorder Prevention and Mental Health Promotion. Broschart called the document an “amazing read.”
    • The Washington Impaired Driving Advisory Council (WIDAC), a program of the Washington Traffic Safety Commission (WTSC)
    • The University of Washington Alcohol and Drug Abuse Institute (UW ADAI)
    • The Washington State Health Care Authority (WA HCA) Behavioral Health and Recovery Division (BHRD) Community Prevention and Wellness Initiative (CPWI) which Broschart explained represented most of the community coalitions in the state.
    • Drug Free Communities (DFC) Coalitions which were funded by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).
    • At the time, Broschart planned to “reach more of them in 2020” as her “vision for the program” was to “build prevention and public health engagement in our rulemaking process.” She aimed to “achieve parity” so that “we’ve got as many prevention and public health voices in the room as we do other stakeholders.”
  • In the fall of 2019, Broschart was at the forefront of the WSLCB response to the vaping-associated lung injury (VALI) health scare and represented WSLCB when the Washington State Board of Health (SBOH) initiated rulemaking to ban vitamin E acetate from vapor products on March 11th.
  • Broschart had been on maternity leave before returning to work October 1st according to remarks from Board Chair Jane Rushford on September 1st. At that time, Cannabis Observer reported that a policy tracking spreadsheet from the agency's COVID - Legal/Policy/Rules team showed that Broschart and staff at the Washington State Department of Health (DOH) as well as the WA HCA BHRD inquired about “data on alcohol and marijuana sales to use as an indicator of use, and to forecast the adverse behavioral health effects due to the COVID-19 pandemic” on May 22nd. The document noted the request was “resolved quickly by Sara and Brian [Smith, Director of Communications].”
  • Other recent public health and prevention-focused events Cannabis Observer has tracked include:
    • Staff from WA HCA hosted a webinar on “Impacts of Marijuana Legalization in Washington” on September 29th.
    • A University of Washington professor led a webinar on the “Pharmacology of Cannabis” on October 29th.
    • WA HCA organized the 2020 Washington State Prevention Summit on November 4th which included a session titled “A Couple of Things About Cannabis.” During that session, presenters released “Cannabis Concentration and Health Risks,” a report which described research around the question “is high potency cannabis use safe for the citizens of Washington State?” A follow up webinar on that presentation, “The More the Merrier? THC Potency in the Legalization Era,” was planned for December 17th.
    • WSLCB Policy and Rules Manager Kathy Hoffman hosted an advocacy and rulemaking webinar to train public health representatives and prevention advocates on November 12th, and noted Broschart was advancing a youth use prevention message with the Cannabis Regulators Association (CANNRA).
    • Staff from the Washington Poison Center (WAPC) organized a webinar titled “Let's Talk Cannabis: A Capacity-Building Training for Influential Adults” on December 9th. 

• Broschart reviewed public health and prevention activities by the agency while sharing selected research and external communications (audio - 13m).
  • Broschart began her presentation summarizing “the input we’ve been getting from prevention/public health communities since the onset of Stay Home, Stay Healthy,” the proclamation from Governor Jay Inslee addressing the coronavirus pandemic. She wanted to inform the Board ahead of the 2021 legislative session about the “top level highlight[s]” of several “really robust policy discussions” she had participated in with stakeholder groups.
  • Broschart acknowledged the fiscal strain on the agency as well as on many WSLCB licensees due to COVID-19 restrictions, saying it was “obvious to me and to most of our public health community members. So, they just want to be sure, I think, overall, that public health impacts” were considered to avoid anticipated “unintentional consequences” from the agency's coronavirus response.
  • “We definitely need to listen to science," Broschart said of policy decisions, “and again, LCB’s been great at doing that.” She stated "the research is clear about the impact of increasing access and availability of alcohol.” While the “newness” of legal cannabis made comparable research “less extensive,” she nonetheless argued that “these lessons can likely be applied to cannabis” as well.
  • Broschart explained that the American Public Health Association (APHA) “has weighed in” against the loosening of alcohol regulations in the wake of the pandemic. Broschart said it was a “really big deal” as APHA represented some of the “foremost” experts on the COVID-19 crisis. She then mentioned a study from Alcoholism: Clinical and Experimental Research which found “the most drinking and the most problem drinking that we’ve seen since [alcohol] prohibition” had been identified prior to COVID-19. Broschart shared APHA’s view that those from communities “already disproportionately burdened by the pandemic” were likely to “be more impacted by” negative outcomes.
    • In their news release, APHA President Lisa Carlson was quoted as saying the public health community “should be squarely at the table in policy discussions around alcohol regulations in general, and certainly during the pandemic.”
    • The Journal of the American Medical Association (JAMA) published a study on “Changes in Adult Alcohol Use and Consequences During the COVID-19 Pandemic in the US” on September 29th.
  • Broschart told the group she’d invited Boston University Professor David Jernigan and Beatriz Carlini, a UW School of Public Health Affiliate Associate Professor, to speak to WSLCB Policy and Rules staff “about the public health consequences” stemming from the pandemic. She shared information on the “consequences” of temporary alcohol allowances given financial and emotional pressures members of the public experienced throughout the year. Broschart said researchers had “looked at other disasters to analyze the impacts of these kinds of stresses on alcohol use” and had urged agency leaders evaluating whether to make some allowances permanent to keep harms in mind when “considering their continuance.”
  • She reported that Jernigan provided data suggesting “increases in violence and domestic violence” in addition to child abuse in the short term with “long term consequences” like greater alcohol dependence/use by “women, older adults, racial/ethnic minorities” all groups that she said were “at times disproportionately impacted with negative” outcomes from alcohol use. Broschart conveyed that health officials “realize we're not going to be able to revert back to life as we know it” in a number of ways “and this would be one of them.” The cumulative impact of temporary allowances amounted to "turning the dial up across many" different issues of access, she argued.
  • Broschart next talked about “correspondence with LCB” and showed a list “of all the different groups that we have heard from at LCB since April.” The list included:
    • King County YMPEP
    • Washington Association for Substance Abuse and Violence Prevention (WASAVP)
    • Olympic Educational Service District 114 YMPEP
    • Okanogan County Community Coalition
    • WHY Coalition and “several of the CPWI coalitions” through the Athena Forum at WA HCA
    • Mary Segawa, who held the Public Health Education Liaison position at WSLCB before Broschart, “sent a note.”
      • Following her departure from WSLCB, Segawa became an independent consultant and educator for public policy and substance use disorder prevention. She worked with the Northwest Prevention Technology Transfer Center (NW PTTC) to facilitate webinars, including “Activating Communities for Change” and “Advocacy Essentials for Prevention Practitioners.”
      • Segawa recently collaborated with Oregon Health Authority Principal Researcher Julia Dilley to develop “A Prevention Practitioners' Toolkit to Understanding R10 State Cannabis Policies and Regulations” for NW PTTC. The toolkit consists of six documents which describe “the current status of HHS Region 10 state retail cannabis regulatory frameworks and specific policies, highlighting their relevance for prevention” in Washington, Oregon, Idaho, and Alaska.
  • WSLCB hosted a prevention roundtable in June where “many individuals brought up” concerns about the temporary policies Broschart described. She noted two more virtual prevention roundtables were scheduled for December 17th and 18th.
  • Broschart added that “Prevention Voices is a new, statewide advocacy group that has formed, in many ways, to address this issue.” Broschart shared a document from Prevention Voices with agency leadership which she felt described “what the concerns really are from the prevention community.” Beyond “negative consequences” from increased use were projections of “increased social and healthcare costs” like more drug treatment spending “down the line.” Broschart said the group had concerns about both alcohol and cannabis allowances including “enforcement issues” such as age verification. 
    • Prevention Voices hosted an organizing webinar in early July and has asked staff from the Washington State Legislative Information Center (LIC) to help train advocates in early January to participate in the upcoming virtual legislative session.
  • While Prevention Voices applied a heavy “youth lens” to their recommendations, she noted that Jernigan and Carlini had “concern across the population” around increased substance use. She repeated her observation that “as the social norms shift" in the direction of alcohol being “normative...the science does show that youth use generally goes up." Broschart claimed experts were finding problems around “third party delivery, and delivery in general, that have shown that improvement is needed” and pointed to a May 28th member advisory from the National Liquor Law Enforcement Association (NLLEA) as evidence the group was against permanent delivery policies.
    • The advisory recommends agencies like WSLCB “encourage its licensee community to follow best practice protocols for home delivery and curbside pickup.” 
    • On August 27th, NLLEA’s weekly update said of delivery and to-go service: “struggling restaurants say it’s a lifeline, letting them rehire bartenders, pay rent and reestablish relationships with customers. But others want states to slow down, saying the decades-old laws help ensure public safety.”
  • Rushford thanked Broschart, saying it was “important to keep these perspectives and this discussion in front of us” when attempting to help struggling businesses while keeping a “guardrail” in place supporting “public health and prevention” (audio - 1m).

Information Set