Researchers warn of mental health risks of highly potent cannabis

Researcher Beatriz Carlini clicks on a few of the websites of local cannabis retailers before finding what you’re looking for.

Its screen displays a yellow sticky substance, similar in appearance to raw honey, or as the product’s marketing calls it, “Cake Batter”.

The substance is a highly concentrated form of cannabis called dap, which is produced by extracting the psychoactive compound THC from the cannabis plant. It is usually vaporized and inhaled using a bong-like device, but often includes a blowing torch.

Strong cake mix. Its label reads 65% THC.

Carlini, an acting assistant professor in the Institute on Addiction, Drugs and Alcohol at the University of Washington School of Medicine, says the product’s THC concentration is “relatively low” in the broad, legal world of high potency products, or dabs. While the average cannabis flower has about 20% THC, some cannabis plants sold in Washington contain up to 90%.

Products like these set off alarm bells for clinicians and a group of research scientists in the Pacific Northwest, who see the widespread availability of antilipids and other highly concentrated substances as a quiet but growing threat to public health, especially among young adults and teens. Lawmakers are considering new regulations, such as a THC cap or a higher tax on powerful products. However, retailers and suppliers point out that these products are already illegal for those under the age of 21, and warn that bans or increased taxes on certain products could spur the growth of an illegal market that would be very difficult to monitor and control.

When cannabis was legalized for recreational use in Washington beginning in 2014, cannabis extract, which contains concentrates, was extracted. About 9% of the market. Concentrations now make up 35%, according to 2020 data from Washington State Liquor and Hemp Board.

“This is a case of product development trumping science and politics eclipsing,” Carlini said. “No one knew we were legalizing this.”

Industry leaders argue this, saying that a variety of products – including more powerful ones – are part of the natural evolution of the market.

“These products were envisioned,” said Pearl Bryson, executive director of the Seattle-based nonprofit The Cannabis Alliance. “In a mature market, you will notice an increased use of concentrates on the flower.”

Research on highly concentrated products—also referred to as wax, resin, or breakouts—remains limited in the United States, mainly due to Federal government Thoroughly regulates cannabis research.

But scientists point out that new Evidence from studies in adults linking high-potency THC to an increased risk of psychosis—and an increased risk of psychosis. The development of psychosis years ago Than to be expected in people at risk for this condition. psychosis It involves a loss of contact with reality, and symptoms can include delusions and hallucinations.

While it’s unclear how high potency THC affects young people, especially in the long term, a A large body of research Links frequent cannabis use in young adults to psychotic symptoms. Anecdotally, pediatricians here have reported an increased number of teens in emergency rooms experiencing psychotic episodes, confusion and severe vomiting, called cannabis hyperemesis syndrome.

Whether such products should be regulated – and how to do so – raises complex questions for policy makers.

Just so far Vermont And the Connecticut Ceilings included high concentrations of THC in cannabis legalization bills – both at 60% THC. California is considering legislation requiring cannabis producers to include a label warning of potential mental health consequences and other risks.

If Washington moves to regulate THC concentrations, the state will become a testing ground for what happens when the state cracks down on the cannabis industry after it is legalized. In 2021, Carlini and a group of researchers received $500,000 from lawmakers to study potential regulatory actions; Their report was due to be submitted to the Washington State Health Care Authority on September 30, and is expected to be made public at the end of December.

“We will be the first country to do something after that [the state] Shoreline Democrat Lauren Davis, who proposed the two THC-cap bills that failed to get out of the committee in recent legislative sessions, said Representative Loren Davis, a Shoreline Democrat; Bill proposes capping THC concentrated at 10%suggest the other 30% cap.

Davis, who describes the state’s cannabis industry as a “failed experiment,” said she intends to propose new legislation based on the researchers’ findings.

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“Time bomb”

Researchers face an uphill message battle: Historically, the US government’s “Reefer Madness” campaign of disinformation and the war on drugs has raised serious public doubts about anti-cannabis rhetoric.

But scientists caution that the emerging data is worrisome.

The majority of teens in the Northwest do not use cannabis, but among those who do, they are increasingly reporting the use of molasses and other alternatives to smoking. According to the 2021 Washington Youth Health Survey, about 33% of 12th graders in Washington who use cannabis report having consumed it. And in Oregon, a portion of young cannabis users have jumped and report cannabis use 26% to me 36% From 2017-2019.

we Poison Control Center data indicate Cannabis-related calls rise while the poison center Calls go down Inclusive. When people with cannabis-related concerns were called, they were more likely to contact poison centers after using processed cannabis products such as molasses than using plant-based cannabis.

Julia Daily, an epidemiologist at the University of Wisconsin, who presented the data at a symposium in September that drew more than 150 scientists and others, said.

Almost everyone interviewed acknowledged the need for further research on highly effective products and their relevance to mental health consequences in young people. There is an inherent lag in understanding the relationship, because the factors that contribute to serious mental illness are many and can worsen over years.

Existing studies do not include results from people using the kinds of highly potent products that are now available: The bulk of the research is in products that contain about 10% THC according to US government research rules, notes Dennis Walker, a clinical psychologist and research professor at UW. And there are no studies proving a direct causal relationship between high potency THC and psychosis, mainly because people experiencing a direct relationship would be unethical.

“The industry has used this as a reason to do nothing,” Carlini said.

Pediatricians say they are already witnessing what happens when young people with low tolerance to THC try very strong products. Some end up having a psychotic episode or have temporary cognitive impairment, such as problems with simple motor tasks, finding words, or remembering something they were just told. Others who have developed tolerance to products with a high THC content seek help after severe episodes of vomiting, dehydration, stomach pain, and symptoms of Acute Mental Syndrome.

“Do people really see this or are we just blowing smoke in here? I totally see it,” said Dr. Cora Bronner, M.D., professor of pediatrics at the University of Wisconsin and a physician at Seattle Children’s Hospital. “I see her at least three or four times a week,” noting that she points out To more young people for cannabis use disorder than it did five years ago, but that demand now outstrips the available resources.

At a 2021 state legislative hearing on the issue, Dr. Beth Ebel said some young people are so high up when they arrive at the emergency room that they appear to have a traumatic brain injury.

“Approximately a third of children age 12 and older who I care for at a trauma center have cannabis involved in their injury,” said Ebel, a Harborview pediatrician.

Mental health resources from The Seattle Times

what is happening now?

The question of how concentrates should be handled relates to whether state regulations would encourage a more dangerous black market. Policy makers are considering several options, including raising age limits or marketing restrictions on high potency products, imposing higher taxes, adding THC limits and launching more aggressive public health awareness campaigns.

Industry and consumer experts have campaigned vigorously against Davis’ proposals for a THC cap and continue to argue that the new restrictions will lead to worse public health outcomes as unregulated products may contain pesticides or dangerous additives.

“Our highest priority is a safe, quality-controlled market that keeps products away from children,” Vicki Kristofferson, executive director and lobbyist at the Washington Cannes Business Association, which represents producers and retailers across the state, wrote to the Seattle Times. . “Returning to embargo policies poses a threat to an open and transparent sector and inadvertently supports the illicit market, which operates in the dark.”

Ramsay Doodar, who works at a cannabis dispensary and leads a consumer advocacy group called Patients for Reasonable Cannabis Policy, said retailers are already enforcing strict rules that prevent people under the age of 21 from buying cannabis.

The next step is to use a portion of those billions of tax revenue [generated by the cannabis industry] To focus on education and prevention.” He added that adults should be held accountable when they give or sell cannabis to minors.

Jonathan Colkins, a professor at Carnegie Mellon University in Pittsburgh, said: Analyze the cannabis market in Washington In association with the non-profit RAND Corporation.

If the state decides to regulate, he said, it should “start small, until we find out what kind of restrictions can be lifted without creating an illegal market.” And that’s in part to see if the Washington state government has the backbone to enforce a ban. “

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