Nearly 10 years after Colorado voters approved adult use cannabis, in 2012, the state industry could see a major overhaul if a push to regulate the state’s strong cannabis products is successful.
A new bill in Colorado aims to curb cannabis consumption by minors, educate consumers about the rising strength of cannabis products, and collect data about hospital visits that might reflect cannabis consumption.
On Tuesday, the bill, HB21-1317, was at the top of a “most accessed bills” list on the legislature’s home page. At the start of Tuesday’s hearing, more than 200 people had registered to testify on the bill, which is sponsored by Representatives Alec Garnett and Yadira Caraveo and Senators Chris Hansen and Paul Lundeen.
There were recurring themes during the hours of testimony, which was at times tear-filled: youth use and consequences of their consumption of the strongest THC products, and, more broadly, the need for better education around those products. Those opposed to the bill included patients, or the parents of patients, who need products with higher THC content for efficacy and, in some instances, cost-effectiveness.
In the late evening, the bill cleared the House Public & Behavioral Health & Human Services committee in a unanimous vote. On Tuesday, Colorado Attorney General Phil Weiser thanked the bill sponsors for their work on the bill and noted that his office will continue to work with lawmakers and stakeholders to “further improve this bill and Colorado’s regulation of marijuana.”.
“The rise of teenage use of high-THC-concentration marijuana presents a critical public health threat that demands action,” Weiser wrote.
Colorado has, at times, come under scrutiny for its cannabis regulations. New York Times columnist Maureen Dowd made internet waves when she went to Colorado in 2014 and consumed so much of a chocolate edible that she thought she’d died. While she faced relentless ribbing from cannabis consumers who pointed out that she clearly overconsumed, Dowd started a conversation about potency that informed both cannabis policy and education.
HB21-1317 would reduce how much cannabis a customer can purchase to 8 grams and, starting next January, concentrates would only be sold in a “package containing one gram separated into no less than 10 equal-portioned amounts.” This provision prompted several people to testify about how this could increase costs for businesses, consumers, and patients, as well as about sustainability with so much plastic waste expected with additional packaging.
Several provisions also appear aimed at curbing “looping,” or the practice of visiting multiple shops to purchase more than the legal limit with the goal of resale. The bill, for example, would require records of real-time purchase data, rather than end-of-day dumps that can provide a loophole for those seeking to loop. It would also require medical and adult use shops to display a notice at point of sale “regarding the criminal penalties associated with marijuana diversion,” and literature on overconsuming concentrates.
The bill aims to collect data specifically about “high-potency THC marijuana and concentrates.” For example, if passed as written, the Colorado School of Public Health would be required to conduct a systematic review of existing research on cannabis and cannabis products with higher concentrations of THC. It would also establish a “scientific review council” that would make recommendations to Colorado’s General Assembly. Finally, a campaign would follow, geared toward educating the public about how these stronger products could affect a “developing brain and mental health.”
On the mental health note, the bill would also require medical professionals to take a mental health history when documenting other types of health history of patients seeking medical cannabis.
The 18-20 age group is a clear focus of the bill. The legislation tightens up medical cannabis rules for people over 18 but under 21, the legal age of consumption, by requiring that two doctors sign off on a condition that requires medical cannabis, and at least one of those doctors “must explain the possible risks and benefits of the medical use of marijuana to the patient.”
The bill would also ban advertising that is “specifically directed to those ages 18 to 20 years old and requires medical and retail marijuana concentrate advertising to include a warning regarding the risks of medical marijuana concentrate overconsumption.”
The bill would also lead to a slew of changes to patients’ medical cannabis recommendations, and several patients testified that they were upset that they were left out of the process.
For example, medical practitioners would have to “certify” their medical cannabis “authorization with the state’s Department of Public Health and Environment, and some of the accompanying information that the bill “requires” are: the “THC potency level of medical marijuana being recommended; the dosage form; the daily authorized quantity;” and “directions for use.”
It’s worth noting that scientific literature has pointed to medical professionals’ unease with their level of knowledge about medical cannabis. McMaster University in Canada conducted a qualitative study between January and October 2019, published in April in the Canadian Medical Association Journal Open, that focused on phone interviews with Ontario-based family physicians. Researchers noted three themes: “reluctance to authorize use, concern over harms and lack of practical knowledge,” concerns over lacking scientific evidence, and broadly, the gaps in education, for example, about the potential for “exacerbation of mental illness.”
“Despite the increasing availability of medical cannabis, family physicians expressed reluctance to authorize its use because of lack of knowledge and concerns regarding harms,” researchers concluded. “Family physicians may benefit from guidance and education that address concerns they have surrounding medical cannabis”
On Tuesday, there was extensive testimony from people who treat people struggling with substance use, or their parents. There was an emphasis on minors who had what they described as “psychotic episodes” after consuming strong THC concentrates, and the dependence from which some struggled to break free.
Will Brown, 17, said that he used “high concentrate THC” products that resulted in mental health problems. He bought the concentrates, he said, from dealers who bought cannabis products from legal dispensaries.
Tammy Wollbrinck, of the Colorado Association of School Nurses, spoke in favor of the bill and detailed some of her experience as a registered nurse in a high school setting since the late 1990s.
“The early days of marijuana, with its THC levels of 2-7%, are long gone,” Wollbrinck said. “Many of the symptoms that I see are very reminiscent of the care of patients suffering from cocaine-induced heart attacks during my emergency days.”
Senator Kevin Priola testified as, he said, “a parent.” He laid out that his son struggled with “marijuana addiction” for five years, starting at the age of 14, and he asked that his colleagues pass the bill and “be open to amendments to strengthen it.”
“We’ve learned we’re not alone, through conversations with other parents, at sporting events and schools,” Priola said.
Members of the cannabis industry spoke both in support and against the bill, often proposing suggested amendments.
Dean Heizer, executive director and chief legal strategist for LivWell Enlightened Health, and chair of the Marijuana Industry Group, the largest trade association in Colorado, took a nuanced approach.
“I support the policies of this bill. We have an amended position on this bill,” Heizer said, adding that he supports research and “tightening down on looping. We support tightening down on potential diversion.”
“What we don’t support is non-data-based regulation like potency limits and potency caps. And I’m glad we landed where we are today because we’re having a conversation instead of a battle,” Heizer said.
Chuck Smith, CEO of DixieBrands and board chair of Colorado Leads, a cannabis business alliance, said he “appreciates” the aims of the bill as they relate to reducing youth access to cannabis, but pointed out areas for improvement.
“We also want to ensure that the new requirements of the bill, which are meant to reduce access to minors and provide additional information for patients and consumers, can be properly operationalized by the industry,” Smith said.