The Week Ahead
(November 9, 2020)

WA HCA - DBHR - Washington State Prevention Research Subcommittee - Cannabis Concentration and Health Risks - Cover

DOH and SBOH would present their legislative agendas and WSLCB would undertake training for prevention community advocates while endorsing concerns about “high potency cannabis.”

Here’s a look at cannabis-related policymaking events on Cannabis Observer’s calendar in the week ahead.

Monday November 9th

On Monday at 9:30am PT, the Washington State Board of Health (SBOH) Board Meeting was scheduled to occur.

  • [ Event Details ]
  • During the regularly scheduled Washington State Department of Health (DOH) update, and in addition to the latest information on COVID-19, staff planned to present details on the Department’s legislative priorities, budget requests, and potential budget cuts. Three potential budget cuts are noteworthy:
    • “Reduce marijuana prevention and education media campaign.” The Department suggested leaving $2,622,000 in the Dedicated Marijuana Account (DMA) which would otherwise be appropriated to the agency. $18,200,000 would be allocated.
    • “Merge tobacco-vape and marijuana prevention units.” Five full-time employees (FTEs) would be let go saving $1,932,000.
    • “Reduce Washington Poison Control GF-S expenditures.” The Washington Poison Center (WAPC) is a non-profit organization which receives substantial funding from the DOH and undisclosed private donors. The Department has proposed cutting $424,000 from their support for WAPC’s work, leaving $2,831,000 budgeted.
  • The Board will also consider a resolution honoring outgoing Secretary of Health John Wiesman, who has served in that role leading the DOH since his appointment by Governor Jay Inslee in April 2013.
  • Later in the afternoon, the Board planned to review its own legislative agenda for the 2021 session.
    • No documents were provided in advance, although the Board’s legislative statement for the 2019-2020 biennium was provided for review. During the last session, the Board listed “Preventing Smoking and Vaping” fourth amongst fifteen foci stating: “In August 2016, the Board adopted Resolution 2016-01 to increase the age of purchase for tobacco and vapor products from age 18 to 21. During the 2019 legislative session, EHB 1074 passed, which raised the legal sales age for tobacco and vapor products from 18 to 21. The Board supports strategies to prevent marketing, sales, and use of tobacco, e-cigarettes, smokeless tobacco, and marijuana to youth, including a flavored vapor and tobacco products ban and adding additional authority for product bans and allowing recalls. In response to the 2019 nationwide outbreak of vapor lung illness and injury, the Board would support legislation that improves regulation of Washington’s vapor product industry including requiring vapor ingredient disclosure and lab testing for vapor products, requiring signage regarding health risks, removing the pre-emption of vapor product retail licensing, allowing for product bans and recalls, and instituting nicotine limits.”
    • During the Board’s last meeting on October 13th, members hosted a public hearing on proposed rules to more permanently prohibit use of vitamin E acetate in all vapor products before voting to adopt the rules as final. A legislative ally of the Board, Representative Gerry Pollet, dialed in to share his perspective that "many public health professionals applaud the ban" but "feel very strongly that this ban may not go far enough." He claimed to cite an article published in The Lancet in August, stating: "Other ingredients (terpenes, medium chain triglycerides) as well as vitamin E acetate, including diacetyl, and other chemical flavorings, heavy metals, or e-liquid thermal decomposition products might contribute to the development of EVALI." He concluded, “This is not the be all end all and that further work is needed to ban flavors that have serious potential for harming lung tissues, especially that in youth” (audio - 4m).
  • Finally, the Board will consider opening an investigation into multiple complaints received about Spokane Regional Health District (SRHD) Administrator Amelia Clark in connection with the firing of SRHD Health Officer Bob Lutz---a member of the SBOH. The procedural complaint alleges “that Dr. Lutz was removed from his position with neither an opportunity for a public hearing, or a full meeting and vote of the SRHD Board of Health.”
    • In July, we noted that Lutz issued a “Civil Health Hold” to detain a non-compliant COVID-19 patient in the downtown Spokane County jail for ten days.
    • At publication time, over 12 “batches” of written comments had been received by the Board in connection with the SRHD action.

On Monday at 10am PT, the Washington State Liquor and Cannabis Board (WSLCB) COVID Legal/Policy/Rules Meeting was scheduled to recur.

  • [ Event Details ]
  • Agency staff leadership, Board Chair Jane Rushford, and Assistant Attorney General Bruce Turcott convene multiple times per week via webinar to discuss policy-related questions raised in the context of the pandemic.
  • Originally having met daily every work day, the schedule of meetings was shifted to 3x per week (M, W, F) on June 10th.
  • It’s Cannabis Observer’s understanding that the cadence for these internal meetings has been further stepped down, but we have not yet been able to confirm the current schedule.

Tuesday November 10th

On Tuesday at 10am PT, the weekly WSLCB Board Caucus was scheduled to recur.

  • [ Event Details ]
  • At publication time, no cannabis-specific items were listed on the agenda and no rulemaking updates were planned due to the cancellation of the regularly scheduled Board Meeting.

Wednesday November 11th

On Wednesday, State facilities would be closed in recognition of Veterans Day.

The WSLCB COVID Legal/Policy/Rules Meeting was cancelled.

The bi-weekly WSLCB Board Meeting was cancelled.

The weekly WSLCB Executive Management Team (EMT) meeting was cancelled.

Thursday November 12th

On Thursday at 1pm PT, a WSLCB Webinar on Advocacy and Rulemaking was scheduled to occur.

  • [ Event Details ]
  • The event announcement posted on the Washington State Health Care Authority (WA HCA) Athena forum “for substance abuse prevention and mental health promotion professionals and volunteers” states: “Kathy Hoffman, Policy and Rules Manager, from the Washington State Liquor and Cannabis Board will highlight how rule making occurs and how coalitions can get involved in the rule-making process.  Participants will understand how rules are developed and influenced by advocates. Additionally, the presentation will address marketing advertising regulation and enforcement, accessing data sets and ways to advocate within the LCB rule adoption process. Please share with community prevention and public health partners who are interested in learning how advocates can and do play an active role in the adoption of rules at the LCB.”
  • Last week, WA HCA hosted the annual Washington State Prevention Summit, intending to “[bring] together those working to promote mental health and to prevent substance abuse, violence and other destructive behaviors in their communities and integrate these efforts with primary health care.” WSLCB was the leading “Gold Sponsor” for the event.
  • On the second day of the Summit on Wednesday November 4th, Northwest Prevention Technology Transfer Center (NW PTTC) Co-Directors Kevin Haggerty and Brittany Cooper presented a workshop on “A couple of things about cannabis.”
    • In addition to their respective academic roles at the University of Washington and Washington State University, Haggerty and Cooper are also Co-Directors of the WA HCA Department of Behavioral Health and Research (DBHR) Prevention Research Subcommittee (PRSC). At publication time, Cannabis Observer was unable to locate an official public website for the PRSC which could helpfully document its members, history, and purpose. However, the subcommittee is referenced frequently online amongst academic curriculum vitae and citations as well as prevention community documents.
    • Following the failure of HB 2546 (“Concerning the potency of marijuana products”) to be advanced beyond its policy committee public hearing in late January, the PRSC “invited a work group of researchers to better understand the scientific evidence of the health and behavioral risks are of high potency cannabis use” in March. 11 researchers joined the effort organized by Bia Carlini of the University of Washington Alcohol and Drug Abuse Institute (UW ADAI).
    • On September 15th, during the Washington State House Commerce and Gaming Committee (WA House COG) work session on “Cannabis potency policy considerations,” Carlini’s presentation focused on “High Potency Cannabis” wherein she described the formation and goals of the PRSC work group. At the time, she indicated the work group’s goal was development of a “consensus statement on health risks of high concentration cannabis.” Carlini said the group “departed” from an approach which would “check if the science really backs what we have been perceiving as work in the community.” Instead, the group planned to assert “that high potency cannabis is more detrimental to health than lower potency, so there is a dose-response relationship.”
    • Last week, Haggerty and Cooper presented the work group’s report publicly for the first time, titled Cannabis Concentration and Health Risks: A Report for the Washington State Prevention Research Subcommittee (PRSC).”
      • Cannabis Observer extends its thanks to Jim MacRae for obtaining and sharing a copy of the report.
    • The report is structured as a “Consensus Statement” followed by a collection of ten research summaries by the work group members (only Haggerty did not contribute a research topic). The ten articles and their authors:
      • “Epidemiology of Adult Cannabis Users in Washington State who Dab, Eat, or Vape Cannabis” by Caislin Firth
      • “High Potency Cannabis, Residues and Contaminants” by Bia Carlini
      • “High Potency Cannabis Flower and Concentrates: Self-administration Patterns in the Real World” by Carrie Cutler
      • “Exposure to Cannabis Products reported to US Poison Control Centers, 2017-2019” by Julia Dilley
      • “Traffic Safety and Cannabis Potency” by Dale Willits
      • “Cannabis Use Disorder and High Potency Cannabis” by Denise Walker and Jason Kilmer
      • “THC Potency and Onset of Psychotic Disorders” by Michael McDonell
      • “Impact of Cannabis Use and Potency during Adolescence” by Nephi Stella
      • “Cannabis Use during Pregnancy” by Celestina Barbosa-Leiker
    • The report concludes with 12 suggestions for “Moving Forward - A brief research agenda,” stating: “Research available to date documents that THC content in cannabis products contributes to adverse health effects in a dose-response manner. This increased risk imposed from using higher potency cannabis products is particularly concerning for young users and those with certain pre-existing mental health conditions. To further our understanding on the impact of high-THC content cannabis products, more research is needed.”
    • In addition to the academic researchers, the front page of the report credits and indicates it was created “With” the following individuals:
      • Sara Cooley Broschart, WSLCB Public Health Education Liaison
      • Trecia Ehrlich, former WSLCB Research Consultant
      • Kristen Haley, DOH Health Services Consultant 3
      • Christine Steele, WA HCA DBHR
      • Liz Wilhelm, Prevention WINS

Friday November 13th

On Friday at 10am PT, the WSLCB COVID Legal/Policy/Rules Meeting was scheduled to recur.