Cannabis Research Review Board Meeting – January
by DAVID M. JOLLEY, J.D.
The Department of Health and Human Services’ Cannabis Research and Review Board (CRRB) held their monthly meeting last Tuesday (Jan 10). The meeting was held virtually only, but was open to the public. There was no meeting in December.
The Board consists of the following members:
Katherine Carlson, M.D., M.S. (Board Chair)
Matthew S. Mclff, M.D. (Board Vice Chair)
Perry G. Fine, M.D. (Immediate Past Chair)
Brian Zehnder, M.D.
Jennifer L. Norris, M.D.
Michael Moss, M.D.
Misty Smith, Ph.D.
As stated in the statute, the purpose of the CRRB is to review available research related to the human use of cannabinoid products. Specifically, the CRRB evaluates the safety and efficacy of cannabinoid products and expanded cannabinoid products in terms of:
medical conditions that respond to cannabinoid products;
dosage amounts and their medical forms; and
interactions between cannabinoid products, expanded cannabinoid products, and other treatments.
Cannabis Exposures– Dr. Moss
Dr. Moss started the meeting with a slide show presentation on what U.S. poison centers have reported about people who either call the poison center or go to the emergency room after taking too much cannabis. In adults, this usually results in anxiety and panic attacks, whereas most children just become exceedingly tired and sedated. In either case, death is exceedingly rare (if not non-existent).
In his slide presentation, Moss showed how states that have legalized cannabis (such as Colorado Michigan and Massachusetts) there has been a large increase in the number of children going to the emergency room after taking cannabis. These have predominately been from edibles. There was a similar jump in pediatric cases in Canada after legalizing edibles. Poison centers saw an increase in these cases among older adults as well (>50). Utah isn’t that different, which saw a sevenfold increase in cannabis exposure from 2015-2020.
Moss noted how we saw an increase in cases even before medical cannabis was legalized in Utah, which probably means it came from out of state, but there’s no way to know for sure.
Dr. McClff made an analogy to cars and car accidents, pointing out how we saw a big increase in deaths from car accidents after cars became so prevalent. While we can’t ban cars entirely, we can make them safer through regulations, much like we should with cannabis.
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Dosage guideline discussion – Sarah Ponce
There was considerable discussion on the creation of dosing guidelines for Utah cannabis patients. The current guidance document is over two years old. While Board members Ponce and Dr. Norris are still working on a revising the guidelines, Dr. Fine suggested and made a motion that in the interim, they use the dosing guidelines and diagrams laid out in an article from 2021 in the Journal of Cannabis Research.
The motion was approved with no one opposed.
DHHS Updates – Rich Oborn, CMC Director
Legislative
Oborn talked about a bill being proposed in the next legislative session starting in a week. HB0072 (Medical Cannabis Governance Revisions) moves most oversight and regulation of medical cannabis pharmacies and couriers from the Department of Health and Human Services to the Department of Agriculture and Food; In addition, the bill creates a “Medical Cannabis Policy Advisory Board.”
Controlled Substance Database
Oborn gave an update on integrating cannabis card holders’ information into the Controlled Substance Database, where any medical provider could look up an see if a patient’s purchase history from dispensaries in Utah. Not surprisingly, this is opposed by many patients and privacy rights advocates.
U of U Research Update
Oborn also said they are finalizing a contract with the University of Utah to measure patients’ experience with the medical program here.
In addition, Oborn stated the number of cardholders in the state increased 45% from the last year; the total number of QMPs increased by 6%; and Utah dispensaries made 15,100 deliveries in rural areas of the state—an whopping increase of 462% from 2021.
Public Comments
Public comments were limited to 2 minutes. Here is a summary of those comments.
Zac Newel King (patient/TRUCE) who lost his wife to an Ambien overdose, said education is the key. King was prescribed Ritalin in the past and had a horrible experience on it, whereas on cannabis, he hasn’t had any negative side effects. King stressed how there have been zero deaths from cannabis, unlike these pharmaceuticals, and we need to focus more on organic medicine (like cannabis). King also stated his opposition to a state database of cannabis users as discussed during the meeting.
Dr. Mark Viner, M.D., a psychiatrist in Nevada, disagreed, saying not all cannabis use is entirely safe and having a database is important. Viner also thinks some of the dosage guidelines could have too much THC for older patients.
Zachary Chase (patient/TRUCE) said he watched her mom’s best friend go through cancer and die, which completely wrecked his mom. He believes there are too many restrictions in Utah with few products in the dispensaries, stating, “If we can’t find the products we count on, where do we go?”
Christine Stenquist (President, TRUCE) said the problem with dosing guidelines is CBD is not allowed in the Utah pharmacies. She stressed we need to “recodify what’s in place” in order to do this and work with the MJ Freeway, which is a cannabis technology and consulting company, offering cloud-based, seed-to-sale, cannabis compliance software for cannabis businesses in other states, including retail, delivery, wholesale, cultivation, and manufacturing. In addition, Stenquist wanted a follow-up to her question about the board’s authority to ban or regulate the synthetic cannabinoids showing up in Utah’s cannabis program.
Kyle E. (TRUCE) suggested that dosage should be considered during new patient consultations with pharmacists, based on their current medications.
Angel Perez (patient) asked why there weren’t any follow-ups to the last meetings public comments. Specifically, she wanted to know why some products like seltzers have been removed from the pharmacies.
Public Comments Follow-up
In response to the comments, Oborn attempted to address some of these concerns, saying the board does not have the authority by statute to regulate the state’s medicinal cannabis. This lies with the legislature, according to Oborn. This is what led to the ban on certain products, like seltzers.
This opened up a wider discussion among the board members about what they can and cannot do about the synthetic cannabinoids (or adulterants) showing up in Utah’s supply, and whether these would be considered “poisonous.” Apparently, under Utah law, something must be considered “poisonous” in order for it to be banned. Since there isn’t any data or studies that show these synthetic cannabinoids are poisonous, they are basically considered safe, and can’t be banned.
Of course, as Dr. Fine pointed out, this contradicts the normative practices in pharmacology and medicine, where a lack of data is not proof of its safety.
An agenda and slides presented during the meeting can be found here.
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