WA House COG - Committee Meeting
(November 18, 2021) - UW ADAI Update

Cannabis Concentrate with Smoke
[ Event Details ]

University of Washington researchers spoke about recommending policies regarding high THC cannabis concentrates ahead of a legislatively mandated report on the subject.

Here are some observations from the Thursday November 18th Washington State House Commerce and Gaming Committee (WA House COG) Committee Meeting.

My top 3 takeaways:

  • Two UW ADAI researchers discussed their upcoming report on potential policy responses to health risks associated with tetrahydrocannabinol (THC) concentrates.
    • Committee Chair Shelley Kloba welcomed Susan Ferguson, a UW Associate Professor of Psychiatry & Behavioral Sciences and the UW ADAI Director, and Beatriz Carlini, an Affiliate Associate Professor of Public Health (audio - 2m, video). Ferguson said Carlini would lead the presentation but she remained “available for questions” (audio - 1m, video).
    • Carlini told legislators she led the “cannabis research and education program at ADAI” and said she would give a “proviso update on the developing policy solutions in response to the public health challenges of high THC potency cannabis.” She promised to review the mandate given to the institute, the progress to date, and future steps in completing the contract (audio - 16m, video, presentation) 
      • A provision in Section 215(55) of the 2021-23 operating budget directed the creation of a contract with UW ADAI “through [the] Health Care Authority to...explore policy solutions in response to the public health challenges” posed by “high THC.” The contract required “an initial report summarizing the progress to date,” she noted, saying researchers were “40 days [out from] this report.”
      • Carlini called attention to a decision by UW ADAI staff to “not include medicinal cannabis, we are talking here about non-medical, commercial cannabis.” As researchers “recognize medicinal users have specific needs,” she stated that health concerns around higher cannabinoid concentration products “[do] not apply in this case” and were left out of “our scope of work.” She then highlighted the research brief UW ADAI officials prepared.
      • Carlini found the UW ADAI review of potential policy responses would be “a natural next step in terms of work [beginning] in 2020” with a consensus statement that represented “the initiative of Health Care Authority...through the Washington Prevention Research Subcommittee.” The statement was authored by UW and Washington State University (WSU) experts “with” Washington State Liquor and Cannabis Board (WSLCB), Washington State Department of Health (DOH), and Washington State Health Care Authority (WA HCA) staff; and Liz Wilhelm, formerly of Prevention Works in Seattle (Prevention WINS), a community-based alcohol and drug use prevention coalition.
        • According to Carlini, over six months the group “analyzed the data in terms of cannabis concentration and health risks” before publishing the statement and the research brief. She said they’d concluded that “there was a clear, dose-response relationship where the highest the THC content was in cannabis products the higher the risk of encountering adverse health effects,” with impacts especially concerning “for young users and people with preexisting mental health conditions.”
        • Additionally, Carlini relayed that researchers looking at data from Washington state claimed “that the harms seems to be more likely to” disproportionately affect “marginalized populations like low-income and minorities, in part, because [these] products tend to have a lower cost,” a more “discrete nature,” and because of “glamorization through social media and the effect of advertising.”
      • She explained that the contract hadn’t funded new research, but the “evidence was documented previously” so researchers could “use our skills as scientists to develop policy solutions in response to the public health challenges.” Several policies “that were proposed and adopted in North America” were identified, she indicated, but had not been expressly recommended by UW ADAI staff yet.
      • Carlini discussed the outreach conducted to “stakeholders and experts,” telling lawmakers her goal was finding “common ground and consensus” on which recommendations to forward. Carlini reported that stakeholders were being sorted into “different types” and received different engagement methods to “bring a fair assessment” of policy approaches before researchers determined final recommendations. They contacted 42 organizations and 120 individuals, she added, and “although not considered stakeholders because they are sovereign nations,” outreach had included leaders in tribal governments. Carlini said the interviews and surveys included “cannabis consumers---both medical and non-medical---mental health advocates, mental health patients, historical marginalized groups, health experts...health care agencies, prevention agencies” and cannabis sector “farmers, processors, retail, lobby organizations, and immediate, dedicated, and [ancillary businesses] funded by cannabis industry.”
      • Carlini listed policy options being surveyed by UW ADAI:
        • “Taxation based on THC Potency
        • Prohibit certain product types
        • Regulate or prohibit marketing
        • Limit total THC in a single purchase
        • Require serving size
        • Cap on THC concentration
        • Require minimum CBD content
        • Regulate packaging or labeling”
      • Carlini talked about how stakeholders were engaged in a “two-step approach, and the main common denominator of [these] two steps is that basically we are gonna listen, listen, and listen.” The listening would be done “first through interviews, about 35 to 40 people will be selected,” Carlini stated, specifically those “with lived experience, or representing collected interests of people with lived experience that may have experienced problems with high THC products.” From there, she said researchers would use “concept mapping” which featured individuals “having to choose policies,” a “participatory approach that is very equitable in the sense that everybody can give anonymous input and allows for ample participation.” At that point, researchers’ role was to be in “the background, synthesizing data that we collect and analyzing areas of convergence of possible consensus in terms of policy,” Carlini observed, as stakeholders rated “how important, feasible, and equitable are the different policies suggested.”
      • The final phase involved organizing the ratings, said Carlini, so that “stakeholders [were] telling us what is important to them, what’s feasible to them, what’s equitable to them.” She promised that stakeholder work would continue as it was “the bulk of the work that we are doing” along with evaluating proposed or enacted policies on cannabis concentration “taking place in North America.” Moreover, Carlini said that UW ADAI researchers planned to “dive more into the local assessment of what is happening” in Washington, like “acute health events” as well as “a possibility of the informal market then start producing” unregulated cannabis concentrates, leading to “fires and explosions.” She indicated researchers would also look at “mental health events that happen in our community."
  • Two questions posed by committee members pertained to the impact of cannabis concentrate regulations on the legacy market and outreach UW ADAI staff were conducting.
    • Kloba inquired whether the policies under consideration included “criteria” to weigh the “impact on the illicit market.” Neglecting to do so would be “antithetical to what you’re trying to do if any regulation we do on the legal market pushes people into the unregulated market,” she said (audio - 3m, video) 
      • Carlini agreed, saying “it's our hope that our...suggestions and recommendations are going to be made are really not as ADAI,” but instead “facilitating the voice and the considerations of Washington stakeholders.” She intended to “organize different opinions and find areas of consensus through analysis of data” to find “go zones,” or places of consensus, versus divisive policy options. Carlini acknowledged potential impacts on the “illicit market...has been a very common argument.” Though no one “can totally guess what will happen,” Carlini planned to look for “examples in other places and also see what experts and stakeholders consider in terms of possible effects.”
    • Assistant Ranking Minority Member Kelly Chambers, also a legislative appointee to the Washington State Legislative Task Force on Social Equity in Cannabis (WA SECTF), asked if lawmakers “can help distribute...or participate in, or share with our constituents,” the research surveys. Carlini replied that researchers intended to use an “online survey process” and that Chambers could reach her by email for the purpose of “sending people our way” as prospective stakeholders (audio - 1m, video).
    • Kloba looked forward to “partnering with” UW ADAI to “tackle this problem and come up with some good solutions.” She concluded cannabis concentrate regulation was “not an easy issue to resolve, but it’s absolutely necessary that we do” (audio - <1m, video).

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