WSLCB - Board Caucus
(April 25, 2023) - Summary

WSLCB - Board Caucus (April 25, 2023) - Summary - Takeaways

An update on the 2023 legislative session hinted at a potential special session to revise a Blake bill on drug use and treatment, then staff discussed input on the medical cannabis system.

Here are some observations from the Tuesday April 25th Washington State Liquor and Cannabis Board (WSLCB) Board Caucus.

My top 2 takeaways:

  • Director of Legislative Affairs Marc Webster talked about last minute developments around drug policy and budget support for managing environmental pesticides in the legislative session, plus bills signings and interim work for WSLCB staff.
    • Webster expressed excitement that the “2023 legislative session is officially over and he could offer “my first interim presentation” since joining WSLCB (audio - <1m, video).
    • SB 5536 - “Concerning controlled substances, counterfeit substances, and legend drug possession and treatment” (audio - <1m, video)
    • Washington State Office of the Governor (WA Governor) Signing Ceremonies (audio - 1m, video)
      • Webster explained that two agency request bills—one modifying the social equity program (SB 5080), and another on tetrahydrocannabinol (THC) product regulation (SB 5367)—had been delivered to Governor Inslee’s staff and said there would in-person signing ceremonies after social distancing restrictions related to the coronavirus pandemic were implemented for 2020 bill signings, “and I'll be up on the hill for one of those today.” He added the number of attendees at signings was limited, “I think bill sponsors can name five people, and agencies could name three.”
    • Budgets (audio - 1m, video)
    • Interim Work (audio - 1m, video)
      • Reflecting on the support from the board he’d received when pushing their legislative agenda, Webster asked to speak with board members soon about “what worked well, what worked less well, and how best to get your input into the policies…before we put together our budget request and legislative agenda” for 2024 in the fall. He looked forward to getting “input from that new research department…how does that flow in and impact what we want to do?”
      • Board Chair David Postman agreed on the need for interim collaboration between the board and staff dealing with policy or legislative development. He also complimented the difference Webster made in moving their priorities: “our agency request legislation” had changed, “but I felt like those bills were treated with respect.” Postman added Board Member Ollie Garrett in when praising the agency lobbying push for SB 5080, which he felt “went better than I thought it could, maybe would…it was better than in the past.” He complimented the “great job of staff and board member working together” with Inslee’s team and legislators. “And the THC bill is almost like this afterthought, whereas that's such a complicated bill, [that] was so hard last year,” observed Postman. Webster added this meant “a lot of work in rulemaking to come,” and Postman remarked “we asked for that right? But can't complain about rulemaking for our own bills” (audio - 3m, video).
    • Implementation Dashboard (audio - <1m, video)
      • An “implementation dashboard to look at all of the work that the legislature has tasked us with,” like participation in task forces and work groups, was being set up by Policy and Performance Manager Jessica Dang. Webster indicated, “I'll be working with her, and I really can't wait to show you what we come up with.”
      • Board Member Jim Vollendroff inquired if a similar dashboard had been developed at the agency before. Postman told him it was a new approach, and both members voiced their support for the plan, and “look forward to seeing what that looks like” (audio - 1m, video).
  • Staff shared a “Medical Cannabis Industry Review” touching upon retail medical cannabis endorsements, patient outreach, work with other agencies, and continued collaboration with the International Cannabis Policy Study (ICPS).
    • Director of Policy and External Affairs Justin Nordhorn introduced how he and Public Health Education Liaison Mary Segawa "encountered a very proactive individual" through the Washington State Department of Health (DOH) who was completing a capstone project as part of graduate study and “really wanted to look at some of the medical cannabis issues in the state.” He explained they’d helped the staffer “craft and create some of the surveys that she was implementing” as well as “figure out what…type of issues that we wanted to get at.” Nordhorn mentioned that since they’d previously relied on research from the ICPS at the University of Waterloo, Segawa would present on incorporating their feedback after he highlighted “opportunities for further exploration around the medical program” (audio - 2m, video).
    • Nordhorn talked about the capstone project which included surveys of medical patients at stores and online; and their outreach to other state agencies inside, and outside, Washington state (audio - 8m, video).
      • “This was a controlled survey for the student that was able to interact with people at [12] different retail locations” in western Washington, said Nordhorn. Although ”it wasn't as broad-based as far as geographies that we would love to see,” he noted how “she expanded it to a digital survey to try to get a higher representation of respondents.” According to Nordhorn, after a survey period from “November of 2022 through the beginning of January 2023,” the capstone project “ended up with a total of 267 participants.”
        • “73% of those folks that responded said they were aware of a medical cannabis program,” Nordhorn remarked, but “just because they're aware doesn't mean that they're fully knowledgeable” and public education about the existing program would be beneficial. The “194 of those 267 that said that they were aware” were asked additional questions, indicated Nordhorn. 
        • 16% of the respondents “held medical authorizations, but only six people out of all of those,” or “just over 2% of all respondents, were actually registered patients” in the DOH authorization database. He felt this “really shows a…disconnect for the patients in that particular area.”
        • 56% of respondents also were “saying that they would qualify for the medical program yet choose not to engage,” along with 39% who indicated they had a qualifying medical condition. Nordhorn interpreted this as “a very low level of participation” in the status quo medical system.
      • “Drilling down” into why people aren’t engaging with the program, Nordhorn had learned “the number one response was that I didn't see the benefit. The [lack of sales and use tax] in the stores [was] not significant enough for participation and talking with patients over the years they also see some risks involved” that weren’t “outweighing any benefits of that program.” After that, the most frequent answer was that the medical system was “too time consuming,” he said, since stores had a variety of cannabis products for people over 21 anyway, or getting the authorization was “too expensive, and that comes into that medical cost.” Products preferred by respondents were similar to what the board had previously heard about Washington consumers in 2022, Nordhorn reported, primarily “flower and edibles.”
      • As for “where they want to get their information,” he remarked that “about two thirds” expressed not being “comfortable speaking to their health care providers.” However, when questioned “about where do you prefer to get your medical cannabis information, the top one was ‘from their medical provider,’” Nordhorn told board members, followed by seeking information “through the website, and I think that has to do with the confidentiality, being able to access it on your own time not having to go in and…pay a cost.” He wanted to improve the informational offerings available in these areas, and claimed that in collaborating with DOH officials, he’d learned “they're going through some rule development” for medically compliant product “that we're going to be providing feedback” on. Additionally, Nordhorn announced that the medical program lead at DOH, Shannon Angell, was getting involved in the medical cannabis committee for the Cannabis Regulators Association (CANNRA). He was impressed by the Utah Department of Health and Human ServicesCenter for Medical Cannabis, noting they had lots of information, though “when you look at…a seven-page publication from them, the first five pages are all disclaimers and” warnings, “but I think that's appropriate for folks to understand.” Nordhorn argued “some balanced information on the website could be an opportunity for us…to look at that.”
      • When asked about their ability to find medically compliant cannabis, the “overwhelming answer" from respondents was that it wasn’t available, relayed Nordhorn. He was aware of only “three producers out of…over a thousand” that were producing medically compliant product. He wanted to incentivize more companies to get into that market, but knew there were “added costs for production” which made it difficult. With mandatory pesticide testing adopted in March 2022, Nordhorn believed that “narrows that gap” between adult use and medically compliant items, and DOH personnel were willing to “look at maybe, even, medically compliant product in a different way.” Cannabis had to be “earmarked at the growing stage” to be medically compliant, and couldn’t then be sold under adult use product standards. If a licensee was “getting towards the end stage and creating your final product if there were opportunities…to designate it at that point, you may have some more flexibility in your business operations.”
      • “The last thing that was called out” was cost, Nordhorn commented, “it was…pretty close in that, but…just over half the people were saying no, they couldn't afford the products and…a number of folks who have qualifying conditions may not necessarily have the same level of employment and those types of things.”
    • Segawa highlighted relevant data from an ICPS report they’d received which involved several questions about medical cannabis that were posed between September and November 2021 that included “almost 1,800” respondents from Washington (audio - 4m, video).
      • Among all respondents, “25% self-identified as a medical user only,” she reported. Almost the same proportion asked their physician about qualifying, “24% had, and of those who sought approval 38% were refused” and “9% had a recommendation in the past 12 months.”
      • When asked why they sought out cannabis as medicine, Segawa explained that for mental health “about 39% said ‘for anxiety,’ about 30[%] ‘for depression,’ and 18% for ‘PTSD or traumatic events;’ those were the top three.” The most frequent physiological conditions people reported using medical cannabis for was “‘pain’ 38%, ‘problem sleeping ‘about 30%, and ‘headaches or migraines’...28 and a half percent.”
      • Stressing that ICPS had a lot of other data, Segawa noted “their report for 2022 should be coming out by the end of May, so we're gonna have brand new data on this shortly.” She wanted a better sense of the most popular product types, consumption patterns, product sources, their “perception of that access,” plus the levels of THC and cannabidiol (CBD) most frequently sought by patients.
      • Segawa’s ambition was for the capstone project and ICPS information to help staff “zero in more on the preferred products…used by those who are using for medical purposes” and then figure out how to increase accessibility of those products in the medically compliant market.
      • In September 2021, WSLCB arranged contract K1522 with the University of Waterloo to access data from Washington state, a research report, and additional analysis by ICPS Lead Researcher David Hammond, a School of Public Health Sciences Professor who’d studied the Canadian cannabis market. His work was brought up by the board and he was a keynote presenter at the University of Washington Addictions, Drug, and Alcohol Institute (UW ADAI) Symposium on High-THC Cannabis in Legal Regulated Markets.” Hammond subsequently presented research on the Washington cannabis market to board members in November 2022.
    • Nordhorn lauded Segawa for working “with [ICPS] on modifying and clarifying some of the questions that we would like to ask…based on the previous survey we were actually able to fine tune some of those.” He was “excited about seeing the data that's coming out towards the end of May” and anticipated another survey “coming up in the next year” (audio - 1m, video).
    • Ready to get better feedback on how to improve medical cannabis, Postman considered “the findings in the capstone” to match up with other complaints: “People don't see the benefit enough, there's some risks to it, it's too time consuming.” He didn’t believe the existing system was “being fully utilized" and that there were steps both WSLCB and DOH staff could take “to help that.” However, even pushing the existing program more wouldn’t address all those concerns, Postman observed, “some of that is inherent in the program” which prompted him to wonder “does that mean you need a different program?” He recognized that there was “clear” legislative intent and they were bound to carry out the program, but “I read those results and I see why people aren't more engaged in the existing system, that we're not doing everything…hope we can spend some time…the second half of this year trying to figure out what we could do, just by policy.” Postman summed up that “everything we can possibly do we should do,” and “encourage [DOH leaders] to do as well” (audio - 2m, video).
    • Nordhorn mentioned “prioritization of rule projects, particularly because of all the legislation that's passed,” was underway. This included the “endorsement project, and there's also advertising and looking at what's gonna create a better value to the patient,” he noted. Nordhorn mentioned that staff were seeking “where can we actually capitalize the most to add value to the patients?” (audio - 1m, video)

Information Set