October 30, 2024 – A new report on high-potency cannabis by the California Department of Public Health raises important concerns for the cannabis community. The report blames high-potency products for a rising incidence of cannabis use disorder (habitual overuse), cannabis psychosis, hyperemesis syndrome, emergency room visits, and frequent use by youth under 21.
The report makes several key recommendations aimed at reducing access to high-potency products. While some of them are reasonable, others are objectionable and anti-consumer in the view of Cal NORML—in particular prohibiting high-potency concentrates, flowers, and hashish—a measure likely to make consumers turn to more dangerous illicit alternatives.
The CDPH report was written by an “independent scientific committee” that did not include a single medical cannabis physician, user, or industry expert, but did include the Public Health Institute, a group that receives funding from the state tobacco tax and regularly lobbies against pro-consumer cannabis policies at the state and local levels.
While the CDPH report assumes that high potency is a key culprit in problematic cannabis use, this is not necessarily true in all cases. For example, if smokers adjust their dose downward to compensate for higher potency, they can reduce their exposure to harmful smoke toxins. High doses are also helpful for certain patients with dire medical conditions.
Although the relation between potency and cannabis misuse is not clear-cut, it is true that average cannabis potency has risen substantially in recent years to 20–24% THC, while the number of emergency room visits due to cannabis in California has likewise risen appreciably.
Upon review of the report, Cal NORML takes issue with a number of the CDPH’s key recommendations, as follows.
CDPH RECOMMENDATIONS AND CAL NORML COMMENTS:
(1) Prohibit cannabis product advertising on billboards, or any other general public-facing advertising.
COMMENT: Cal NORML has opposed previous proposed bans on cannabis billboards for retailers insofar as they help inform motorists where to find dispensaries. Advertisements for particular product brands are however less useful, though they are allowed in the case of alcohol (but not tobacco). Contrary to claims of public health advocates, advertising is unlikely to prompt use by minors, since they can’t buy products on the legal market.
(2a) Limit manufacture and sale of high-THC products; specifically, concentrates for inhalation (e.g. dabs, wax, shatter) with THC content above 60%.
COMMENT: Cal NORML strongly opposes potency caps. High-potency inhalables offer harm reduction benefits to users, since they reduce the amount of smoke they need to consume to get high. High-potency concentrates (80-90% THC) are especially useful in vape pens, most of which are designed to deliver modest doses of THC per puff, akin to a typical joint, without generating harmful smoke. Lower-potency vape concentrates need to be diluted with other chemicals that can pose health hazards of their own.
(2b) Prohibit the sale of cannabis flower with THC content above 25% and prohibit the infusion of additional psychoactive cannabinoids into flower or pre-rolls.
COMMENT: It is unclear whether flowers labeled 30 – 40% THC accurately reflect the dosage of their contents. Users often find them difficult to distinguish from 20% varieties. Infused pre-rolls are apt to be overpowering for many users, and should be clearly marked so as not to be confused with regular joints,
(3) Consider establishing a Quebec-style public monopoly on cannabis sales, particularly in jurisdictions that have not yet legalized sales.
COMMENT: Establishing state cannabis stores would be a daunting, costly and legally challenging task, especially for a state that has a poor record of managing public services efficiently. Competition is always preferable to a state monopoly.
(4) Restructure state excise taxation on adult-use cannabis to be proportional to the milligrams of THC in the product.
COMMENT: At first glance, a good case can be made for taxing products on the basis of their intoxicating potential—beer, wine and liquor are taxed differently according to their alcohol content. However, this is not so straightforward in the case of cannabis because adjustments have to be made for the delivery route. For instance, a standard joint contains ~100 – 200 milligrams of THC, but most of it is lost in the process of smoking. In contrast, a comparably strong edible will contain just 10-20 mg THC. It doesn’t make sense to tax joints at ten times the rate of edibles.
(5) Ensure that the cannabis tax is maintained to keep revenue in line with the goals established by AB 195 (the 2022-2023 legislative commitment to replace revenue lost from the cultivation tax).
COMMENT: The revenue goals established by AB195 are high and should not be considered sacrosanct. If the state wants to raise more revenues for public health programs funded by cannabis, it should consider raising the alcohol tax.
(6) Require plain packaging for all cannabis products. At a minimum, this should apply to high potency products.
COMMENT: Cal NORML has opposed previous legislation that would unreasonably prohibit pictures on product labels, but would support efforts to improve product labeling of potency, contents and dosage instructions, and to reduce wasteful, non-recyclable packaging.
The CDPH report includes numerous other, unobjectionable recommendations, many of which have already been implemented in current law, such as limiting edibles to 10 mg per unit, prohibiting promotion that is appealing to children, funding public education about high-potency cannabis, tracking hospital reports of negative outcomes from high-potency cannabis, etc.
Stay tuned: Cal NORML will be closely watching the next session of the legislature to see what kind of bills are introduced in response to the CDPH recommendations.
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