DEA Could Reclassify Marijuana To A Less Restrictive Category – A Drug Policy Expert Weighs The Pros And Cons

BY CHRIS MEYERS

ADJUNCT PROFESSOR OF PHILOSOPHY,

GEORGE WASHINGTON UNIVERSITY

The Drug Enforcement Administration announced in early 2024 that it would act on President Joe Biden’s call to reclassify marijuana, moving it from the tightly controlled Schedule I category that it has been in since 1970 to the less restrictive Schedule III status of the Controlled Substances Act. That triggered a long process of hearings and reviews that will not be completed until after the presidential election in November.

The news drew strong reactions from critics: 25 Republican lawmakers sent a letter to Attorney General Merrick Garland protesting any changes to federal marijuana laws. They argued that the decision “was not properly researched … and is merely responding to the popularity of marijuana and not the actual science.”

As a philosopher and drug policy expert, I focus on assessing arguments and evidence rather than politics or rhetoric. So, what are the arguments for and against rescheduling cannabis?

Scheduling under the Controlled Substances Act

The Controlled Substances Act places each prohibited drug into one of five schedules based on known medical use, addictive potential and safety. Schedule I drugs – which, along with marijuana, also includes heroin, LSD, psilocybin, ecstasy (MDMA) and quaaludes – is the most restrictive category.

Schedule I substances cannot be legally used for any purpose, including medical use or research, though an exception for research can be made with special permission from the DEA. The criteria for inclusion in the Schedule I category is that the substance has a high potential for abuse, is extremely addictive and has “no currently accepted medical use.”

Schedule II, which is slightly less restrictive than Schedule I, includes drugs that are addictive and potentially unsafe but also have some accepted medical use. These include strong opioids such as fentanyl, as well as cocaine, PCP and methamphetamine. Though they are still tightly regulated, Schedule II drugs can be used medically with a prescription or administered by a licensed physician.

Schedule III is much less restrictive and is intended for substances with legitimate medical use and only moderate risk of abuse or dependency. This category includes low-dose morphine, anabolic steroids and ketamine.

Schedule IV – which includes the sedative Valium, the weak opioid tramadol and sleep medicines such as Ambien – is even less restrictive.

The least restrictive category is Schedule V, which includes cough syrups with codeine and calcium channel blockers such as gabapentin and pregabalin. All scheduled drugs require a doctor’s prescription and can be distributed only by licensed pharmacies.

What rescheduling would mean for marijuana

The push to reschedule is largely to make federal laws consistent with state medical marijuana programs that – as of October 2024 – are legal in 38 states plus the District of Columbia.

Moving marijuana to Schedule III would not change its legal status in states where it is banned. It would make marijuana legal at the federal level but only for medical use. Recreational use would still be federally prohibited, even though it is currently legal in 24 states plus Washington.

Rescheduling, however, might not make medical marijuana any easier for patients to access and could even make it much harder for some. Currently, getting a medical marijuana card is quite easy in most states. In Washington D.C., where I live, patients can self-certify.

f marijuana is reclassified as Schedule III, medical marijuana programs will have to start requiring a doctor’s prescription, just like with all other scheduled substances. And it could be distributed only by licensed pharmacies, which would put medical dispensaries that are now selling it without a license from the Food and Drug Administration out of business.

Rescheduling, however, would give medical marijuana legitimacy as a bona fide medicine. And the intent of the move is to increase access, even if it is unclear how rescheduling would achieve that.

So, assuming that rescheduling would have the intended effect of expanding access to medical marijuana, should it be rescheduled?

Medical uses of marijuana

Though there are three criteria for Schedule I in the Controlled Substances Act, the DEA in fact relies on only the medical use criterion. This was the basis of the DEA’s proposal to reschedule marijuana. The fact that almost 75% of Americans live in a state with a medical marijuana program suggests that marijuana has an accepted medical use.

More importantly, Schedule III of the Controlled Substances Act already includes dronabinol, which is delta-9 THC, the active ingredient in marijuana. Although dronabinol is synthesized in the lab rather than extracted from the cannabis plant, it is the exact same molecule. The FDA approved THC in the form of dronabinol in 1985 for treating anorexia caused by HIV/AIDS as well as nausea and vomiting due to chemotherapy. Placing marijuana in the same schedule as its primary active ingredient makes a lot of sense.

Another argument in favor of rescheduling is that it would open up new opportunities for medical research into marijuana’s effects, research that is currently hampered by its Schedule I status. This work is critical because the system of cannabinoid receptors through which marijuana causes its therapeutic and psychoactive effects is crucial for almost every aspect of human functioning.

Research has shown that cannabis is effective not only in treating nausea and AIDS but also chronic pain and some symptoms of multiple sclerosis.

There is also good evidence that marijuana can help treat other conditions, including Lou Gehrig’s disease (amyotrophic lateral sclerosis, or ALS), glaucoma, irritable bowel syndrome, insomnia, migraine, post-traumatic stress disorder and Tourette syndrome. Keeping marijuana in the Schedule I category severely hampers research that might establish more effective treatments for these conditions.

Balancing risks and benefits

Those opposed to rescheduling cite possible health risks associated with marijuana consumption. Heavy use is linked to an increased risk of developing schizophrenia. However, the increased risk of schizophrenia from cannabis use is comparable to that caused by watching excessive television, eating junk food or smoking cigarettes.

Long-term marijuana use can also lead to sleep problems and diminished visuospatial memory. It can also cause gastrointestinal trouble, such as cannabis hyperemesis syndrome, which is characterized by nausea, vomiting and abdominal pain. The symptoms, while extremely unpleasant, are temporary and occur only after consuming marijuana. The condition disappears in people who stop using.

Marijuana use can also be addictive. According to the Centers for Disease Control and Prevention, about three out of every 10 regular marijuana users meet the diagnostic criteria for cannabis use disorder.

All of the concerns above are legitimate, though it is worth noting that virtually no effective medicine is free from undesirable side effects. And although marijuana can be habit-forming, it is not as addictive as alcohol, tobacco, oxycodone, cocaine, methamphetamine or benzodiazepines. None of those other drugs are categorized as Schedule I, and alcohol and tobacco are not scheduled at all.

Unlike most other prescription medications, marijuana use is associated with many benefits. For example, in states where marijuana has been legalized, worker’s compensation payments have fallen by an average of 21% among people over 40. Researchers think that this is because marijuana helps workers better manage chronic pain. The use of marijuana for pain management also helps to reduce dependency on opioids. One study found that U.S. counties with one or two marijuana dispensaries had an average of 17% fewer opioid-related fatalities compared with counties with no dispensaries.

Research also shows that marijuana use can help to prevent Alzheimer’s by blocking the enzymes that produce amyloid plaques. It also shows promise for reducing a person’s risk of developing Type 2 diabetes by helping the body regulate insulin and glucose levels.

All of these benefits add up to marijuana users having an overall lower rate of premature death than nonusers.

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How Cannabis And Psilocybin Might Help Some Of The 50 Million Americans Who Are Experiencing Chronic Pain

BY KEVIN F. BOEHNKE

ASSOCIATE PROFESSOR OF 

ANESTHESIOLOGY,

U NIVERSITY OF MICHIGAN

The U.S. Drug Enforcement Agency announced in late April 2024 that it plans to ease federal restrictions on cannabis, reclassifying it from a Schedule I drug to the less restricted Schedule III, which includes drugs such as Tylenol with codeine, testosterone and other anabolic steroids. This historic shift signals an acknowledgment of the promising medicinal value of cannabis.

The move comes in tandem with growing interest in the use of psilocybin, the active component in magic mushrooms, for treatment of depression, chronic pain and other conditions. In 2018 and 2019, the U.S. Food and Drug Administration granted a breakthrough therapy designation to psilocybin, meant to expedite drug development given that preliminary studies suggest it may have substantial therapeutic value over currently available therapies for treatment-resistant depression and major depressive disorder.

Both of these developments represent a dramatic change from long-standing federal policy around these substances that has historically criminalized their use and blocked or delayed research efforts into their therapeutic potential.

As an assistant professor of anesthesiology and a pain researcher, I study alternative pain management options, including cannabis and psychedelics.

I also have a personal stake in improving chronic pain treatment: In early 2009 I was diagnosed with fibromyalgia, a condition characterized by widespread pain throughout the body, sleep disturbances and generalized sensory sensitivity.

I see cannabis and psilocybin as promising therapies that can contribute to bridging that need. Given that an estimated 50 million Americans have chronic pain – meaning pain that persists for three months or more – I want to help understand how to effectively use cannabis and psilocybin as potential tools for pain management.

Cannabis versus other pain medications

Cannabis, also known as marijuana, is an ancient medicinal plant. Cannabis-based medicines have been used for at least 5,000 years for applications such as arthritis and pain control during and after surgery.

This use extended through antiquity to modern times, with contemporary cannabis-based medications for treating certain seizure disorders, promoting weight gain for HIV/AIDS-related anorexia and treating nausea during chemotherapy.

As with anything you put in your body, cannabis does have health risks: Driving while high may increase risk of accidents. Some people develop cyclical vomiting, while others develop motivation or dependence problems, especially with heavy use at younger ages.

That said, lethal overdoses from cannabis are almost unheard of. This is remarkable considering that nearly 50 million Americans use it each year.

In contrast, opioids, which are often prescribed for chronic pain, have contributed to hundreds of thousands of overdose deaths over the past few decades. Even common pain medications like nonsteroidal anti-inflammatory drugs, such as ibuprofen, cause tens of thousands of hospitalizations and thousands of deaths each year from gastrointestinal damage.

Furthermore, both opioids and nonopioid pain medications have limited effectiveness for treating chronic pain. Medications used for chronic pain can provide small to moderate pain relief in some people, but many ultimately cause side effects that outweigh any gains.

These safety issues and limited benefit have led many people with chronic pain to try cannabis as a chronic pain treatment alternative. Indeed, in survey studies, my colleagues and I show that people substituted cannabis for pain medications often because cannabis had fewer negative side effects.

However, more rigorous research on cannabis for chronic pain is needed. So far, clinical trials – considered the gold standard – have been short in length and focused on small numbers of people. What’s more, my colleagues and I have shown that these studies employ medications and dosing regimes that are far different from how consumers actually use products from state-licensed cannabis dispensaries. Cannabis also causes recognizable effects such as euphoria, altered perceptions and thinking differently, so it is difficult to conduct double-blind studies.

Despite these challenges, a group of cannabis and pain specialists published a proposed guideline for clinical practice in early 2024 to synthesize existing evidence and help guide clinical practice. This guideline recommended that cannabis products be used when pain is coupled with sleep problems, muscle spasticity and anxiety. These multiple benefits mean that cannabis could potentially help people avoid taking a separate medication for each symptom.

Traditional hurdles to studying cannabis

Since the Controlled Substance Act was passed in 1970, the federal government has designated cannabis as a Schedule I substance, along with other drugs such as heroin and LSD. Possession of these drugs is criminalized, and under the federal definition they have “no currently accepted medical use, with a high potential for abuse.” Because of this designation and the limits placed on drug manufacturing, cannabis is very difficult to study.

State and federal regulatory barriers also delay or prevent studies from being approved and conducted. For example, I can purchase cannabis from state-licensed dispensaries in my hometown of Ann Arbor, Michigan. As a scientist, however, it is very challenging to legally test whether these products help pain.

Reclassifying cannabis as a Schedule III drug has the potential to substantially open up this research landscape and help overcome these barriers.

The emerging role of psychedelics

Psychedelics, such as psilocybin-containing mushrooms, occupy an eerily similar scientific and political landscape as cannabis. Used for thousands of years for ceremonial and healing purposes, psilocybin is also classified as a Schedule I drug. It can cause substantial changes in sensory perception, mood and sense of self that can lead to therapeutic benefits. And, like cannabis, psilocybin has minimal risk of lethal overdose.

Clinical trials combining psilocybin with psychotherapy in the weeks before and after taking the drug report substantial improvements in symptoms of psychiatric conditions such as treatment-resistant depression and alcohol use disorder.

Risks are typically psychological. A small number of people report suicidal thoughts or self-harm behaviors after taking psilocybin. Some also experience heightened openness and vulnerability, which can be exploited by therapists and lead to abuse.

There are few published clinical trials of psilocybin therapy for chronic pain, although many are ongoing, including a pilot study for fibromyalgia conducted by our team at the University of Michigan. This treatment may help people develop a healthier relationship with their pain by eliciting greater acceptance of it and decreasing rumination often related to negative thoughts and feelings around pain.

As with cannabis, some states, such as Colorado and Oregon, have decriminalized psilocybin and are building infrastructure to increase accessibility to psilocybin-assisted therapy. One recent analysis suggests that if psychedelics follow a similar legalization pattern to cannabis, the majority of states will legalize psychedelics between 2034 and 2037.

Challenges ahead

These ancient yet relatively “new” treatments offer a unique glimpse into the messy intersection of drugs, medicine and society. The justifiable excitement about cannabis and psilocybin has led to state policies that have increased access for some people, yet federal criminalization and substantial barriers to scientific investigation remain. In the years ahead, I hope to contribute toward pragmatic studies that work within these difficult parameters.

For example, our team developed a coaching intervention to help veterans use commercially available cannabis products to more effectively treat their pain. Coaches emphasize how judicious use can minimize side effects while maximizing benefits. Should our approach work, health care providers and cannabis dispensaries everywhere could use this treatment to help clients in chronic pain.

Approaches like these can supplement more traditional clinical trials to help researchers determine whether these drug classes offer benefit and whether they have comparable or less harm than current treatments. As our society connects to the rich history of healing using these ancient drugs, these proposed changes may offer safer and substantive options for the 50 million Americans living with chronic pain.

This article is part of Legal cannabis turns 10, a series examining the impact of a decade of recreational cannabis use.

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What Marijuana Reclassification Means For The United States

Marijuana plants are seen at a secured growing facility in Washington County, N.Y., May 12, 2023. The U.S. Drug Enforcement Administration will move to reclassify marijuana as a less dangerous drug, a historic shift to generations of American drug policy that could have wide ripple effects across the country. (AP Photo/Hans Penninl, File)

BY JENNIFER PELTZ AND LINDSAY WHITEHURST

WASHINGTON (AP) — The U.S. Drug Enforcement Administration is moving toward reclassifying marijuana as a less dangerous drug. The Justice Department proposal would recognize the medical uses of cannabis, but wouldn’t legalize it for recreational use.

The proposal would move marijuana from the “Schedule I” group to the less tightly regulated “Schedule III.”

So what does that mean, and what are the implications?

WHAT HAS ACTUALLY CHANGED? WHAT HAPPENS NEXT?

Technically, nothing yet. The proposal must be reviewed by the White House Office of Management and Budget, and then undergo a public-comment period and review from an administrative judge, a potentially lengthy process.

Still, the switch is considered “paradigm-shifting, and it’s very exciting,” Vince Sliwoski, a Portland, Oregon-based cannabis and psychedelics attorney who runs well-known legal blogs on those topics, told The Associated Press when the federal Health and Human Services Department recommended the change.

“I can’t emphasize enough how big of news it is,” he said.

It came after President Joe Biden asked both HHS and the attorney general, who oversees the DEA, last year to review how marijuana was classified. Schedule I put it on par, legally, with heroin, LSD, quaaludes and ecstasy, among others.

Biden, a Democrat, supports legalizing medical marijuana for use “where appropriate, consistent with medical and scientific evidence,” White House press secretary Karine Jean-Pierre said Thursday. “That is why it is important for this independent review to go through.”

IF MARIJUANA GETS RECLASSIFIED, WOULD IT LEGALIZE RECREATIONAL CANNABIS NATIONWIDE?

No. Schedule III drugs — which include ketamine, anabolic steroids and some acetaminophen-codeine combinations — are still controlled substances.

They’re subject to various rules that allow for some medical uses, and for federal criminal prosecution of anyone who traffics in the drugs without permission.

No changes are expected to the medical marijuana programs now licensed in 38 states or the legal recreational cannabis markets in 23 states, but it’s unlikely they would meet the federal production, record-keeping, prescribing and other requirements for Schedule III drugs.

There haven’t been many federal prosecutions for simply possessing marijuana in recent years, even under marijuana’s current Schedule I status, but the reclassification wouldn’t have an immediate impact on people already in the criminal justice system.

“Put simple, this move from Schedule I to Schedule III is not getting people out of jail,” said David Culver, senior vice president of public affairs at the U.S. Cannabis Council.

But rescheduling in itself would have some impact, particularly on research and marijuana business taxes.

WHAT WOULD THIS MEAN FOR RESEARCH?

Because marijuana is on Schedule I, it’s been very difficult to conduct authorized clinical studies that involve administering the drug. That has created something of a Catch-22: calls for more research, but barriers to doing it. (Scientists sometimes rely instead on people’s own reports of their marijuana use.)

Schedule III drugs are easier to study, though the reclassification wouldn’t immediately reverse all barriers to study, Culver said.

WHAT ABOUT TAXES (AND BANKING)?

Under the federal tax code, businesses involved in “trafficking” in marijuana or any other Schedule I or II drug can’t deduct rent, payroll or various other expenses that other businesses can write off. (Yes, at least some cannabis businesses, particularly state-licensed ones, do pay taxes to the federal government, despite its prohibition on marijuana.) Industry groups say the tax rate often ends up at 70% or more.

The deduction rule doesn’t apply to Schedule III drugs, so the proposed change would cut cannabis companies’ taxes substantially.

They say it would treat them like other industries and help them compete against illegal competitors that are frustrating licensees and officials in places such as New York.

“You’re going to make these state-legal programs stronger,” says Adam Goers, an executive at medical and recreational cannabis giant Columbia Care. He co-chairs a coalition of corporate and other players that’s pushing for rescheduling. It could also mean more cannabis promotion and advertising if those costs could be deducted, according to Beau Kilmer, co-director of the RAND Drug Policy Center.

Rescheduling wouldn’t directly affect another marijuana business problem: difficulty accessing banks, particularly for loans, because the federally regulated institutions are wary of the drug’s legal status. The industry has been looking instead to a measure called the SAFE Banking Act. It has repeatedly passed the House but stalled in the Senate.

ARE THERE CRITICS? WHAT DO THEY SAY?

Indeed, there are, including the national anti-legalization group Smart Approaches to Marijuana. President Kevin Sabet, a former Obama administration drug policy official, said the HHS recommendation “flies in the face of science, reeks of politics” and gives a regrettable nod to an industry “desperately looking for legitimacy.” Some legalization advocates say rescheduling weed is too incremental. They want to keep the focus on removing it completely from the controlled substances list, which doesn’t include such items as alcohol or tobacco (they’re regulated, but that’s not the same).

Paul Armentano, the deputy director of the National Organization for the Reform of Marijuana Laws, said that simply reclassifying marijuana would be “perpetuating the existing divide between state and federal marijuana policies.” Minority Cannabis Business Association President Kaliko Castille said rescheduling just “re-brands prohibition,” rather than giving an all-clear to state licensees and putting a definitive close to decades of arrests that disproportionately pulled in people of color.

“Schedule III is going to leave it in this kind of amorphous, mucky middle where people are not going to understand the danger of it still being federally illegal,” he said.

___ Peltz reported from New York. Associated Press writer Colleen Long in Washington contributed to this report.

Cannabis Legalization Has Led To A Boom In Potent Forms Of The Drug That Present New Hazards For Adolescents

BY TY SCHEPIS

PROFESSOR OF PSYCHOLOGY

TEXAS STATE UNIVERSITY

Eventually, most adults reach a point where we realize we are out of touch with those much younger than us.

Perhaps it is a pop culture reference that sparks the realization. For me, this moment happened when I was in my late 20s and working with adolescents in school settings to help them quit smoking. When other drugs would occasionally come up, I didn’t understand some of the slang terms they used for these drugs. Many people may have that feeling now when the topic of cannabis comes up – especially in its different and newer forms.

As a professor of psychology, I focus my research on substance use in adolescents and young adults. A major change during my time in research is the legalization and explosion of cannabis availability across the U.S.

There are arguments for and against increasing legalization of cannabis for adult use in the U.S., but expanded access to legal cannabis also may have unintended consequences for adolescents. These consequences are compounded by the increasing potency of some cannabis products.

A shifting landscape

I use the word “cannabis” since it refers to the plant from which the drugs are derived. It also serves as a catch-all term for any substance with chemical compounds from cannabis plants and addresses concerns that the word marijuana has some long-standing racist overtones.

Cannabis now comes in a larger variety of forms than it used to. When most people over 40 think of cannabis, they imagine its dried form for smoking. This cannabis was not particularly strong: The average THC concentration of cannabis seized by the Drug Enforcement Agency in 1995 was 4%, while it was roughly 15% in 2021.

In addition to the smoked form, some might remember an edible form, often baked into a dessert like a brownie, or hashish, which is derived from more potent parts of the cannabis plant.

Today there are many different cannabis concentrates that have high levels of THC, typically ranging from 40% to 70%, and more than 80% in some cases, depending on the method of extraction.

These include oils that can be vaporized by vape or dab pens, waxier substances and even powders.

How cannabis derivatives interact with the brain

THC and cannabidiol, or CBD, are the most common chemicals in cannabis. Each one interacts with the brain in different ways, producing different perceived effects.

CBD does not produce the same “high” that THC does, and cannabidiol may have benefits as a medication for severe epilepsy, as well as other potential but as yet unproven medical uses. The differences between THC and CBD come from how they interact with cannabinoid receptors – the proteins onto which these drugs attach – in the brain and body.

However, CBD can also make people sleepy, alter mood in unintended ways and cause stomach upset. Never use a CBD product without consulting a physician.

The changing nature of cannabis products

THC is the chemical most strongly associated with the high from cannabis. By increasing the amount of THC, concentrated products can increase blood levels of THC rapidly and more strongly than nonconcentrates such as traditional smoked cannabis.

Cannabis concentrates also come in many different forms that range from waxy or creamy to hard and brittle. They are made in a variety of ways that may require dry ice, water or flammable solvents such as butane.

The myriad names for cannabis concentrates can be confusing. Concentrate names include “budder,” which refers to a yellowish paste like frosting; “shatter” is made similarly to budder but comes in a thin, brittle and translucent form; there’s also “wax” or “crumble,” which confusingly is not waxy but is more like a powdery or grainy substance; and “keef” or “kief,” which is powdery in nature and derived from the most potent parts of the cannabis plant. It is similar to hashish.

The names change regularly and can vary by guide or from person to person. It is best to ask what a term means from an open and curious place than to act as if you know all the terminology.

Many concentrates are vaporized and inhaled. Vaporizing is different than smoking, as vaporizing heats the concentrate until it becomes a gas, which is inhaled. Smoking involves burning the compound to produce an inhaled gas.

Many who vaporize concentrates call it “dabbing.” This refers to the dab of concentrate to heat, vaporize and inhale.

Another way to vaporize cannabis concentrates is to use a vape pen. Vape pens are sometimes also called dab pens, depending on the local terms.

Cannabis use and adolescents

One of the reasons why young people are drawn to these sorts of products is that vaping or dabbing the concentrated form makes it easier to hide cannabis use. Vaping cannabis does not create the typical smell associated with weed.

A 2021 systematic review found that past-year cannabis vaping nearly doubled from 2017 to 2020 in adolescents - jumping from 7.2% to 13.2%. A more recent study in five northeastern U.S. states found that 12.8% of adolescents vaped cannabis in the past 30 days, a more narrow time frame that suggests potential increases in use. In addition, a 2020 study found that one-third of adolescents who vape do so with cannabis concentrates.

Cannabis use by adolescents is scary because it can alter the way their brains develop. Research shows that the brains of adolescents who use cannabis are less primed to change in response to new experiences, which is a key part of adolescent development. Adolescents who use cannabis are also more likely to experience symptoms of schizophrenia, struggle more in school and engage in other risky behaviors.

The risks of cannabis use are even greater with concentrates because of the high levels of THC. This is true for both adolescents and adults, with greater risk for symptoms of schizophrenia such as hallucinations and delusions, mental health symptoms and more severe cannabis use.

The best analogy is with another drug – alcohol. Most people know that a 12-ounce beer is much less potent than 12 ounces of vodka. Cannabis in smoked form is closer to the beer, while a concentrate is more like the vodka. Neither is safe for an adolescent, but one is even more dangerous.

These dangers make early conversations with kids about cannabis and cannabis concentrates critically important. Research consistently shows that expressing disapproval of drug use makes adolescents less likely to start drug use.

Start these conversations early – ideally before middle school. You can find some helpful online resources to guide the conversation.

While these conversations can be uncomfortable, and you can look like the out-of-touch adult, they can be a major step toward preventing adolescents from using cannabis and other drugs.

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Many People Think Cannabis Smoke Is Harmless − A Physician Explains How That Belief Can Put People At Risk

Public perceptions of the safety of cannabis determine how it is used and regulated. Jamie Grill/Tetra images via Getty Images

BY BETH COHEN

PROFESSOR OF MEDICINE

UNIVERSITY OF CALIFORNIA, SAN FRANCISCO

Though tobacco use is declining among adults in the U.S., cannabis use is increasing. Laws and policies regulating the use of tobacco and cannabis are also moving in different directions.

Tobacco policies are becoming more restrictive, with bans on smoking in public places and limits on sales, such as statewide bans on flavored products. In contrast, more states are legalizing cannabis for medical or recreational use, and there are efforts to allow exceptions for cannabis in smoke-free laws.

These changes mean an increasing number of people are likely to get exposed to cannabis smoke. But how safe is direct and secondhand cannabis smoke?

I am a primary care doctor and researcher in a state where cannabis is now legal for medical and recreational use. My colleagues and I were interested in how opinions about tobacco and cannabis smoke safety have been changing during this time of growing cannabis use and marketing.

In our survey of over 5,000 U.S. adults in 2017, 2020 and 2021, we found that people increasingly felt that exposure to cannabis smoke was safer than tobacco smoke. In 2017, 26% of people thought that it was safer to smoke a cannabis joint than a cigarette daily. In 2021, over 44% chose cannabis as the safer option. People were similarly more likely to rate secondhand cannabis smoke as being “completely safe” compared with tobacco smoke, even for vulnerable groups such as children and pregnant women.

Despite these views, emerging research raises concerns about the health effects of cannabis smoke exposure.

Do opinions on cannabis match the science?

Decades of research and hundreds of studies have linked tobacco smoke to multiple types of cancer and to cardiovascular disease. However, far fewer studies have been done on the long-term effects of cannabis smoke. Since cannabis remains illegal at the federal level, it is more challenging for scientists to study.

It has been particularly hard to study health outcomes that may take a long time and heavier exposure to develop. Recent reviews of research on cannabis and cancer or cardiovascular disease found those studies inadequate because they contained relatively few people with heavy exposure, didn’t follow people for a long enough time or didn’t properly account for cigarette smoking.

Many advocates point to the lack of clear findings on negative health effects of cannabis smoke exposure as proof of its harmlessness. However, my colleagues and I feel that this is an example of the famous scientific quote that “absence of evidence is not evidence of absence.”

Scientists have identified hundreds of chemicals in both cannabis and tobacco smoke, and they share many of the same carcinogens and toxins. Combustion of tobacco and cannabis, whether by smoking or vaping, also releases particles that can be inhaled deep into the lungs and cause tissue damage.

Animal studies on the effects of secondhand tobacco and cannabis smoke show similar concerning effects on the cardiovascular system. These include impairments in blood vessel dilation, increased blood pressure and reduced heart function.

Though more research is needed to determine the risk of lung cancer, heart attacks and strokes posed by cannabis smoke, what is already known has raised concerns among public health agencies.

Why do opinions on cannabis matter?

How people perceive the safety of cannabis has important implications for its use and public policy. Researchers know from studying cannabis and other substances that if people think something is less risky, they are more likely to use it. Opinions on cannabis safety will also shape medical and recreational cannabis use laws and other policies, such as whether cannabis smoke will be treated like tobacco smoke or whether exceptions will be made in smoke-free air laws.

Part of the complexity in decisions about cannabis use is that, unlike tobacco, clinical trials have demonstrated that cannabis can have benefits in certain settings. These include managing specific types of chronic pain, reducing nausea and vomiting associated with chemotherapy and increasing appetite and weight gain in those with HIV/AIDS. Notably, many of these studies were not based on smoked or vaped cannabis.

Unfortunately, though Googling cannabis will return thousands of hits about the health benefits of cannabis, many of these claims aren’t supported by scientific research.

I encourage people who want to learn more about the potential benefits and risks of cannabis to talk to health care providers or seek sources that present an unbiased view of the scientific evidence. The National Center for Complementary and Integrative Health has a good overview of studies on cannabis for treatment of a variety of medical conditions, as well as information about potential risks.

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US Regulators Might Change How They Classify Marijuana. Here’s What That Would Mean

FILE - Marijuana plants are seen at a growing facility in Washington County, N.Y., May 12, 2023. The Health and Human Services Department has recommended removing marijuana from a category of drugs deemed to have “no currently accepted medical use and a high potential for abuse.” The agency advised moving pot from that “Schedule I” group to the less tightly regulated “Schedule III.” The decision is up to the Drug Enforcement Administration. (AP Photo/Hans Pennink, File)

BY JENNIFER PELT

NEW YORK (AP) — The news lit up the world of weed: U.S. health regulators are suggesting that the federal government loosen restrictions on marijuana.

Specifically, the federal Health and Human Services Department has recommended taking marijuana out of a category of drugs deemed to have “no currently accepted medical use and a high potential for abuse.” The agency advised moving pot from that “Schedule I” group to the less tightly regulated “Schedule III.”

So what does that mean, and what are the implications? Read on.

FIRST OF ALL, WHAT HAS ACTUALLY CHANGED? WHAT HAPPENS NEXT?

Technically, nothing yet. Any decision on reclassifying — or “rescheduling,” in government lingo — is up to the Drug Enforcement Administration, which says it will take up the issue. The review process is lengthy and involves taking public comment.

Still, the HHS recommendation is “paradigm-shifting, and it’s very exciting,” said Vince Sliwoski, a Portland, Oregon-based cannabis and psychedelics attorney who runs well-known legal blogs on those topics.

“I can’t emphasize enough how big of news it is,” he said.

It came after President Joe Biden asked both HHS and the attorney general, who oversees the DEA, last year to review how marijuana was classified. Schedule I put it on par, legally, with heroin, LSD, quaaludes and ecstasy, among others.

Biden, a Democrat, supports legalizing medical marijuana for use “where appropriate, consistent with medical and scientific evidence,” White House press secretary Karine Jean-Pierre said Thursday. “That is why it is important for this independent review to go through.”

SO IF MARIJUANA GETS RECLASSIFIED, WOULD IT LEGALIZE RECREATIONAL POT NATIONWIDE?

No. Schedule III drugs — which include ketamine, anabolic steroids and some acetaminophen-codeine combinations — are still controlled substances.

They’re subject to various rules that allow for some medical uses, and for federal criminal prosecution of anyone who traffics in the drugs without permission. (Even under marijuana’s current Schedule I status, federal prosecutions for simply possessing it are few: There were 145 federal sentencings in fiscal year 2021 for that crime, and as of 2022, no defendants were in prison for it.)

It’s unlikely that the medical marijuana programs now licensed in 38 states — to say nothing of the legal recreational pot markets in 23 states — would meet the production, record-keeping, prescribing and other requirements for Schedule III drugs.

But rescheduling in itself would have some impact, particularly on research and on pot business taxes.

WHAT WOULD THIS MEAN FOR RESEARCH?

Because marijuana is on Schedule I, it’s been very difficult to conduct authorized clinical studies that involve administering the drug. That has created something of a Catch-22: calls for more research, but barriers to doing it. (Scientists sometimes rely instead on people’s own reports of their marijuana use.)

Schedule III drugs are easier to study.

In the meantime, a 2022 federal law aimed to ease marijuana research.

WHAT ABOUT TAXES (AND BANKING)?

Under the federal tax code, businesses involved in “trafficking” in marijuana or any other Schedule I or II drug can’t deduct rent, payroll or various other expenses that other businesses can write off. (Yes, at least some cannabis businesses, particularly state-licensed ones, do pay taxes to the federal government, despite its prohibition on marijuana.) Industry groups say the tax rate often ends up at 70% or more.

The deduction rule doesn’t apply to Schedule III drugs, so the proposed change would cut pot companies’ taxes substantially.

They say it would treat them like other industries and help them compete against illegal competitors that are frustrating licensees and officials in places such as New York.

“You’re going to make these state-legal programs stronger,” says Adam Goers, an executive at medical and recreational pot giant Columbia Care. He co-chairs a coalition of corporate and other players that’s pushing for rescheduling.

Rescheduling wouldn’t directly affect another pot business problem: difficulty accessing banks, particularly for loans, because the federally regulated institutions are wary of the drug’s legal status. The industry has been looking instead to a measure called the SAFE Banking Act. It has repeatedly passed the House but stalled in the Senate.

ARE THERE CRITICS? WHAT DO THEY SAY?

Indeed, there are, including the national anti-legalization group Smart Approaches to Marijuana. President Kevin Sabet, a former Obama administration drug policy official, said the HHS recommendation “flies in the face of science, reeks of politics” and gives a regrettable nod to an industry “desperately looking for legitimacy.”

Some legalization advocates say rescheduling weed is too incremental. They want to keep focus on removing it completely from the controlled substances list, which doesn’t include such items as alcohol or tobacco (they’re regulated, but that’s not the same).

National Organization for the Reform of Marijuana Laws Deputy Director Paul Armentano said that simply reclassifying marijuana would be “perpetuating the existing divide between state and federal marijuana policies.” Minority Cannabis Business Association President Kaliko Castille said rescheduling just ”re-brands prohibition,” rather than giving an all-clear to state licensees and putting a definitive close to decades of arrests that disproportionately pulled in people of color.

“Schedule III is going to leave it in this kind of amorphous, mucky middle where people are not going to understand the danger of it still being federally illegal,” he said.

___ Associated Press writer Colleen Long contributed from Washington.

Mounting research points to health harms from cannabis, THC and CBD use during pregnancy, adolescence and other periods of rapid development

BY HILARY A. MARUSAK

Cannabis is a widely used psychoactive drug worldwide, and its popularity is growing: The U.S. market for recreational cannabis sales could surpass US$72 billion by 2023.

As of early 2023, 21 U.S. states and the District of Columbia have legalized cannabis for recreational use for people age 21 and up, while 39 states plus the District of Columbia have legalized it for medical use.

The growing wave of legalization and the dramatic increase in cannabis potency over the past two decades have raised concerns among scientists and public health experts about the potential health effects of cannabis use during pregnancy and other vulnerable periods of development, such as the teen years.

I am a developmental neuroscientist specializing in studying what’s known as the endocannabinoid system. This is an evolutionarily ancient system found in humans and other vertebrates that produces natural cannabinoids such as THC and CBD.

Cannabis and its constituents interact with the body’s endocannabinoid system to product their effects. THC and CBD are the most commonly known cannabis extracts and can be synthesized in a lab. My lab also studies the risks versus potential therapeutic value of cannabis and cannabinoids.

People often assume there’s no risk when using cannabis or cannabinoids during vulnerable periods of life, but they’re basing that on little to no data. Our research and that of others suggests that cannabis use during pregnancy and adolescence can present myriad health risks the public should be aware of.

Cannabis use during pregnancy

More and more pregnant people are using cannabis today compared with a decade ago, with some studies showing that nearly 1 in 4 pregnant adolescents report that they use cannabis.

Many cannabis-using people may have not known they were pregnant and stopped using when they found out. Others report using cannabis for its touted ability to ease pregnancy-related symptoms, like nausea and anxiety. However, studies do not yet confirm those health claims. What’s more, the potential harms are often downplayed by pro-cannabis marketing and messaging by dispensaries, advocacy groups and even midwives or doulas.

In addition, physicians and other health care providers often are not knowledgeable enough or don’t feel well equipped to discuss the potential risks and benefits of cannabis with their patients, including during pregnancy.

While research shows that most people who are pregnant perceive little to no risk in using cannabis during pregnancy, the data show there is clear cause for concern. Indeed, a growing number of studies link prenatal cannabis exposure to greater risk of preterm birth, lower birth weight and psychiatric and behavioral problems in children. These include, for example, difficulties with attention, thought, social problems, anxiety and depression.

Cannabis and the developing brain

When cannabis is inhaled, consumed orally or taken in through other routes, it can easily cross through the placenta and deposit in the fetal brain, disrupting brain development.

A recent study from my lab, led by medical student Mohammed Faraj, found that cannabis use during pregnancy can shape the developing brain in ways that are detectable even a decade later.

We used data from the National Institutes of Health Adolescent Brain Cognitive Development Study, which is the largest long-term study of brain development and child and adolescent health in the U.S. It has followed more than 10,000 children and their families from age 9-10 over a 10-year period.

Through that analysis, we linked prenatal cannabis exposure to alterations in functional brain networks in 9- and 10-year-old children. In particular, prenatal cannabis exposure appeared to disrupt the communication between brain networks involved in attentional control, which may explain why children who were exposed to cannabis in utero may develop difficulties with attention or other behavioral issues or mental disorders as they develop.

While alcohol abuse has steadily declined among adolescents since 2000 in the U.S., cannabis use shows the opposite pattern: It increased by 245% during that same period.

Data reported in 2022 from the Monitoring the Future survey of over 50,000 students in the U.S. found that nearly one-third of 12th grade students reported using cannabis in the past year, including cannabis vaping. Yet only about 1 in 4 12th grade students perceive great harm in using cannabis regularly. This suggests that many teens use cannabis, but very few consider it to have potential negative effects.

Cannabis use during adolescence

Research shows that the adolescent brain is primed to engage in high-risk behaviors such as experimenting with cannabis and other substances. Unfortunately, owing to ongoing brain development, the adolescent brain is also particularly susceptible to the effects of cannabis and other substances. Indeed, many neuroscientists now agree that the brain continues to develop well into the second and even third decade of life.

In line with this vulnerability, research shows that, relative to those who did not use cannabis during adolescence, those who started using it during adolescence are at increased risk of developing depression, suicidal ideation, psychosis and reductions in IQ during adolescence and adulthood. Neuroimaging studies also show residual effects of adolescent cannabis use on brain functioning, even later during adulthood.

Reading beyond the label

Despite common misconceptions that cannabis is “all natural” and safe to use during pregnancy or adolescence, the data suggests there are real risks. In fact, in 2019, the U.S. surgeon general issued an advisory against the use of cannabis during pregnancy and adolescence, stating that “no amount … is known to be safe.”

Cannabis may be harmful to the developing brain because it disrupts the developing endocannabinoid system, which plays a critical role in shaping brain development from conception and into adulthood. This includes neural circuits involved in learning, memory, decision-making and emotion regulation.

While much of this research has focused on cannabis use, there is also other research that comes to similar conclusions for THC and CBD in other forms. In fact, although CBD is widely available as an unregulated supplement, we researchers know almost nothing about its effects on the developing brain. Of note, these harms apply not only to smoking, but also to ingesting, vaping or other ways of consuming cannabis or its extracts.

In my view, it’s important that consumers know these risks and recognize that not everything claimed in a label is backed by science. So before you pick up that edible or vape pen for stress, anxiety, or sleep or pain control, it’s important to talk to a health care provider about potential risks – especially if you are or could be pregnant or are a teen or young adult.

READ ORIGINAL STORY HERE

New California Law Prevents Employers From Taking Action Against Employees Based Solely On Cannabis Use Away From Work

JD SUPRA

BY CONNOR, ERIKA RASCH, PAYNE & FEARS ATTORNEYS

Drug screenings form a routine part of many hiring processes, but a new law may require employers to review this practice. The law, AB 2188, signed by Gov. Gavin Newsom on Sept. 18, 2022, amends the California Fair Employment and Housing Act (FEHA) to prohibit employers from discriminating against workers in hiring, termination, or any term and condition of employment, solely because the worker consumes medical or recreational cannabis outside of the workplace.

The law, which goes into effect Jan. 1, 2024, adds California to an increasing list of states enacting workplace protections for state-legal cannabis use outside of[AD1] the workplace. It will prohibit employers from, for example, penalizing or terminating an employee for admitting to using cannabis while off duty and away from work, or refusing to hire a candidate for failing a drug screening test, if that test detects past use as opposed to active impairment.

AB 2188 does nothing to change the requirement that employers maintain drug- and alcohol-free workplaces, nor does the law give employees license to possess, be impaired by, or use cannabis while on the job. Additionally, employers may still base employment decisions on results from tests that detect active impairment.

Impact on Testing

AB 2188 allows employers to continue to utilize drug testing, so long as the methods used do not screen for “nonpsychoactive cannabis metabolites.” Employers should take note that most drug tests currently relied on, however, do exactly that.

When cannabis is consumed, metabolites of the psychoactive molecule THC are circulated and stored in cells throughout the body. Testing issues arise because these metabolites remain psychoactive for, at most, a few hours but remain present in the body in a nonpsychoactive form for up to several weeks (or longer in the case of chronic users). Because most current tests simply detect the presence of any cannabis metabolite, they fail to distinguish between psychoactive and nonpsychoactive metabolites as the law requires.

Exceptions and Prohibitions

AB 2188 contains several exceptions, including for employers in the building and construction trades, certain federal employers or contractors, or positions requiring a federal government background check or security clearance.

Employer Takeaways

Employers should review their company policies respecting cannabis use and, if necessary, bring them into alignment with AB 2188. If employers utilize drug screening, they also should review the screening method used to ensure that it detects psychoactive THC metabolites or impairment, and not merely the presence of nonpsychoactive metabolites.

Californians May Soon Be Free Of Dreaded Employer Weed Tests

BY SHEILA MCCLEAR

California could become the seventh state in the country to protect workers who smoke pot—in their off hours, not on the job, of course

Those seeking gainful employment in the Golden State yet constantly find themselves stymied by intrusive pre-hire pot tests, relief may soon be yours—that is, aside from the relief from your two-joint-a-day habit.

According to the Los Angeles Times, California could be the seventh state in the country to protect workers who smoke pot—in their off hours, not on the job, of course—from job discrimination.

Assembly Bill 2188, passed Tuesday by the state Senate, would “amend the state’s anti-discrimination laws and the Fair Employment and Housing Act to prevent companies from punishing employees who use cannabis outside work and test positive for the drug.”

Currently, in pre-employment drug screenings, a person can test positive in a hair or urine sample, meaning that they can currently test as “under the influence,” even if they have not smoked marijuana in the past several days or even weeks.

The new law would prevent employers from punishing employees who fail such tests. However, it still allows employers to use other methods, like saliva analysis, to determine whether or not an employee is high at a particular moment.

The bill is now headed to Governor Newsom, and he has until the end of September to decide whether to sign it into law. If he signs, the law would go into effect Jan. 1, 2024.

However, exclusions would still apply, such as employees in building and construction trades, federal contractors and employees who receive federal funding, as well as “federal licensees who are required to maintain drug-free workplaces.”

In an open letter to legislators, the California Chamber of Commerce opposed the legislation, calling the bill a “job killer” because it would “create an unprecedented, protected class for marijuana users and undermines employers’ ability to provide a safe and drug-free workplace” under state law.

However, the law clearly protects off-job use of marijuana only.

Labor unions, like United Food and Commercial Workers Local 324, say that employees should have the freedom to do what they want outside of work—especially since recreational cannabis has been legal in California since 2016.

“Using outdated cannabis tests only causes employees to feel unsafe and harassed at work, it does not increase workplace safety,” Matt Bell, secretary-treasurer for the UFCW 324, told the Times.

The other states that protect workers who enjoy cannabis are Connecticut, Montana, Nevada, New Jersey, New York and Rhode Island.

SOURCE: LOS ANGELES MAGAZINE

Survey Shows Boom In Marijuana Vaping Among School Kids

In this April 11, 2018, file photo, a 15-year-old high school student uses a vaping device near the school's campus in Massachusetts. According to a study released on Wednesday, Dec. 18, 2019, about 1 in 4 high schoolers said they had vaped nicotine at least once in the previous year. But vaping marijuana grew more quickly: 1 in 5 high schoolers had done it at least once the year before. (AP Photo/Steven Senne, File)

BY MIKE STOBBE

NEW YORK (AP) — About 1 out of 5 high school students in the U.S. say they vaped marijuana in the past year, and its popularity has been booming faster than nicotine vaping, according to a report released Wednesday.

“The speed at which kids are taking up this behavior is very worrisome,” said Dr. Nora Volkow of the National Institute on Drug Abuse, the federal agency that pays for the large annual teen survey.

Electronic cigarettes and other battery-powered vaping devices mostly heat a liquid containing nicotine into a vapor that’s inhaled, In recent years, they have been increasingly used to vaporize THC, the chemical that gives pot its high.

The University of Michigan survey asks students in grades 8, 10 and 12 across the country about smoking, drinking and drugs. About two-thirds of this year’s 42,000 participants were asked about vaping marijuana.

Vaping nicotine is still more popular: about 1 in 4 high schoolers said they had done it at least once in the previous year. But vaping marijuana grew more quickly: 1 in 5 high schoolers had done it at least once the year before.

About 1 in 7 high school seniors this year were considered current users of marijuana vaping — they had vaped in the month before they took the survey. That’s almost doubled from 1 in 13 the year before.

Overall, marijuana use — in all its forms — is holding steady. It’s not clear if students are switching to vaping or continuing to use other forms as well, said Richard Miech, who oversees the survey.

Daily marijuana use rose in both middle school and high school kids in 2019, and “if you want to be a daily marijuana user, vaping makes it easier,” he said.

It’s odorless and slips easily into a pocket. “You can just kind of graze on that all day,” he said.

The survey is in the Journal of the American Medical Association, which also published results of a different survey in 2018 that showed an increase in marijuana vaping among middle and high school students.

Both have limitations: the surveys rely on what kids say, and it does not include teens who are not in school. Federal and state laws ban minors from using marijuana recreationally, and prohibits sale of vaping products to kids

The Michigan survey was conducted earlier this year, before reports of a surge in cases of vaping-related lung damage, mostly in teens and young adults who used black-market THC products.

Volkow said the illnesses “may scare some teenagers away” from vaping marijuana.

The survey also found most other forms of teen drug use are flat or declining, including alcohol, ecstasy, heroin, cocaine, and meth. An exception was LSD, which has been increasing in 10th and 12th graders. About 3.6% of high school seniors said they’d dropped acid in the previous year.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

CALIFORNIA: Almost 1 Million Illegal Marijuana Plants Seized

An illegal marijuana grow site in Sierra Nevada contained about 6,000 plants and traces of the pesticide carbofuran, officials said. Image: Kent Nishimura/Los Angeles Times

BY PATRICK MCGREEVY

LOS ANGELES TIMES
Three years after Californians decided to legalize and license marijuana farms, law enforcement raids this year seized nearly 1 million pot plants from illicit grows in the state, a jump from last year highlighting that the black market remains a persistent problem.

The just-concluded growing season saw the state's main enforcement program conduct 345 raids of illegal grow sites throughout California and the eradication of 953,459 marijuana plants, up from 254 raids last year that seized 614,267 pot plants, state Atty. Gen. Xavier Becerra said Monday.

Law enforcement agencies working together in the Campaign Against Marijuana Planting program arrested 148 people and seized 168 weapons during this year's raids, up from 52 arrests and 100 firearms confiscated during last year's growing season.

"Illegal cannabis grows are devastating our communities," Becerra said. "Criminals who disregard life, poison our waters, damage our public lands, and weaponize the illegal cannabis black market will be brought to justice."

Growing marijuana was legalized by Proposition 64, which was approved by California voters in 2016. State residents 21 years and older could immediately grow up to six plants for personal use, while larger farms were required to get a state license starting Jan. 1, 2018, pay taxes and license fees and track every plant harvested and sent to pot shops.

But illegal pot farms have continued operating — California is the largest supplier of marijuana to the rest of the country and it is illegal to sell cannabis outside the state from licensed California farms. A new study by the research group New Frontier Data estimates that California produces 58% of the cannabis grown in the United States.

Becerra said the black market persists in part because criminal growers can sell marijuana more cheaplythan licensed growers because they don't pay fees and taxes, or meet the costly environmental standards, that are required of licensed cultivators.

"The illicit cultivation of marijuana continues to be a major problem in California," said Douglas Herrema, the manager of the Palm Springs field office for the U.S. Bureau of Land Management.

Since 1983, the Campaign Against Marijuana Planting program has targeted illegal cannabis grows on public land across the state. The program is a collaboration between the state Department of Justice, the state Department of Fish and Wildlife, local police agencies and federal agencies including the U.S. Forest Service.

CAMP is the state's main coordinated enforcement effort, while other agencies have separately raided and seized illegal marijuana grows.

The California National Guard provides air support, including helicopters, that helps agencies including the federal Drug Enforcement Agency spot and get to remote grow sites, said William D. Bodner, special agent in charge of the DEA's Los Angeles office.

"These illegal marijuana grows destroy wildlife and wreak havoc on our land and water, ultimately impacting the communities where we live," Bodner said during a Monday press conference with Becerra in Los Angeles.

Many of the illegal growing operations are the work of Mexico-based drug trafficking organizations in remote areas including national forest lands, officials said.

Gangs that operate illegal pot farms can be violent. Last month, an El Dorado County sheriff's deputy was killed in a shootout with illegal growers at a site in Somerset in Northern California, the attorney general noted.

Law enforcement raids often find illegal farms that have dammed or diverted public streams and dumped dangerous pesticides including carbofuran, methyl parathion and aluminum phosphate, Becerra said.

"Those grows threaten our public safety and our public health and our environment," Becerra said, noting that this year's raids occurred in 35 of California's 58 counties.

©2019 the Los Angeles Times

Visit the Los Angeles Times at www.latimes.com

Distributed by Tribune Content Agency, LLC.

Lung Illnesses Send Chill Through US Marijuana Vape Market

In this photo taken Sept. 20, 2019, David Alport, owner of the Bridge City Collective marijuana dispensary in Portland, Ore., goes over sales numbers with the store's general manager Cameron Moore. The company has seen a 31% decrease in its sales of vaping products in the past two weeks. “It’s having an impact on how consumers are behaving,” said Alport. “People are concerned, and we’re concerned.” (AP Photo/Gillian Flaccus)

BY GILLIAN FLACCUS, JENNIFER PELTZ

PORTLAND, ORE. (AP) — Vaping products, one of the fastest-growing segments of the legal marijuana industry, have taken a hit from consumers as public health experts scramble to determine what’s causing a mysterious and sometimes fatal lung disease among people who use e-cigarettes.

The ailment has sickened at least 805 people and killed 12. Some vaped nicotine, but many reported using oil containing THC, marijuana’s high-inducing ingredient, and said they bought products from pop-up shops and other illegal sellers. The only death linked to THC vapes bought at legal shops occurred in Oregon.

Amid the health scare, the amount of the legal pot industry’s revenue that comes from vape products has dropped by 15% nationwide, with some states, including Oregon, seeing decreases of more than 60%.

Health officials in California, home to the world’s largest legal marijuana marketplace, this week issued an advisory urging people to stop all forms of vaping until a cause is determined. Massachusetts, which like California allows so-called recreational use of marijuana by people 21 and older, went further than any other state, issuing a four-month ban on vape sales.

Vaping THC is popular for those desiring quick high without the smoke that comes from lighting up joints. Marijuana companies are trying to boost the public’s confidence by promoting that their vaping products are tested by the government, demanding ingredient lists from their vendors and in some cases pulling items from shelves. Some also are scrambling to get liability insurance.

Still, many have seen notable declines in sales in the few weeks since the health scare emerged on a national scale.

“It’s having an impact on how consumers are behaving,” said David Alport, owner of Bridge City Collective in Portland, which in two weeks saw a 31% drop in sales of vape cartridges that hold the oil that vaporizes when heated. “People are concerned, and we’re concerned.”

In the United States’ booming legal cannabis market, vaping products have exploded in popularity. In roughly two years, they have grown from a small fraction of overall sales to about one-third, with $9.6 billion in sales between 2017 and 2019, according to New Frontier Data, an economic analysis firm that tracks the industry. About one-fifth of U.S. cannabis consumers report using them.

New Frontier found a 15% decline in the market share for vape sales nationwide during the first week of September and saw no rebound in data collected through Sept. 18. At the state level, New Mexico, Massachusetts, Nevada and Montana all saw drops of one-third or more, while California fell by 6%.

Oregon, which announced its death at the beginning of the month and said it was from a vape purchased at a regulated dispensary, saw one of the biggest drops in market share for vape revenue — 62%, said John Kagia, the firm’s chief knowledge officer.

Yet as vape sales sink, some retailers report sales of other cannabis products going up. Bridge City Collective, for example, saw its usually lackluster edible sales increase about 40 percent the same week vaping sales plummeted. Consumers also are showing more interest in the dried flower used in joints.

Analysts are watching to see if vape sales erode further after the U.S. Centers for Disease Control and Prevention announced Thursday that the number of suspected vaping-related illnesses had grown by 52 percent in the past week.

“This is a very, very fast-moving issue, and it will likely be a couple more weeks, if not months, before we understand the impact it’s really had on the retail ecosystem and on consumers’ attitudes,” Kagia said prior to the announcement.

Doctors have said the illnesses resemble an inhalation injury, with the lungs apparently reacting to a caustic substance. So far, no single vaping product or ingredient has been linked to the illnesses.

Health officials in New York are focusing on vitamin E acetate, a viscous solution that’s sometimes added to marijuana oils. Retailers in some markets are pulling products from their shelves that contain that and other additives. Other companies have proactively released public statements saying their vape oils contain only pure THC.

Medicine Man, which operates five retail outlets in Colorado, announced Thursday it has stopped selling vape products with propylene glycol or vitamin E acetate.

“The decision to take this particular product off our shelves was significant, as the confidence and trust of our consumers is paramount to our core values,” Medicine Man President and Chief Executive Officer Sally Vander Veer said. “Hopefully the rest of the industry will also conclude that removing these cannabis products with the chemical additives under scrutiny from the market is in the best interest of consumers and all of us as operators.”

In Illinois, a message board for medical marijuana patients banned posters from sharing home vape recipes.

“I just do THC. No flavor additives. I won’t even take that chance,” said Lisa Haywood, a medical marijuana card holder who lives outside Chicago and follows the board for advice and support.

State regulators track the cannabis sold to consumers but don’t monitor what additives are in marijuana oil vapes. That’s led states to begin discussions of how to tighten restrictions on vaping products even as retailers themselves try to determine which of the products on their shelves contain so-called cutting agents.

“We haven’t evolved our system that far to think about what we would test for in those products. A lot of these additives were conceptual at the time when the (marijuana legalization) law passed and the program came into place,” said Steve Marks, executive director of the Oregon Liquor License Commission, which oversees the state’s cannabis industry.

“Figuring that out is part of the evolution that we have to do as a consumer protection agency,” he said.

Hilary Bricken, a Los Angeles-based attorney whose firm specializes in cannabis business law and regulatory issues, said the legal marijuana industry is moving so fast that many states are “literally making this up as they go,” and the vaping scare has stripped away the sense of security that consumers get from buying from a licensed dispensary.

The vaping crisis will undoubtedly hasten tighter regulation at the state level and force the industry to patrol itself better to avoid crippling lawsuits, she said. The idea of more regulation unnerves some medical marijuana.

If there’s a ban, “what does it do for all these people who have been seeing relief? ... It is going to really impact patients and the industry that we’ve fought” to create, said Melanie Rose Rodgers, a Colorado medical cannabis patient and leader of the state’s chapter of Americans for Safe Access, which advocates for medical marijuana patients.

Bobby Burleson, an analyst with Toronto-based investment and financial services company Canaccord Genuity, said the initial problems for the vape segment of the cannabis industry should moderate, and the health scare may in the end help the legal marijuana industry.

The crisis “should ultimately accelerate the shift away from the black market for cannabis products in the U.S.,” he said.

Flaccus and Peltz, who reported from New York City, are members of AP’s marijuana beat team. Follow