Liquor Control Board to adopt limits on types of marijuana infused products to be produced

Limits on the types of food or drink that may be produced by marijuana businesses are expected to be adopted by the Liquor Control Board tomorrow.  The proposed language (see 4A Handout 2 from the April 23 Board meeting) states:

"To reduce the risk to pubic health, food defined as potentially hazardous . . . may not be infused with marijuana . . . Any food that requires refrigeration, freezing, or a hot holding unit to keep it safe for human consumption may not be infused with marijuana."

Policies that limit the types of products sold are beneficial for public health.  A recent American Journal of Public Health article notes:

"Both the alcohol and tobacco industry have developed products that are particularly appealing to youths.  Examples include candy and gum cigarettes, alcohol pops, and wine coolers.  It seems valuable to impose restrictions on marijuana products targeting youths similar to those imposed on the alcohol and tobacco industry.  Although it may be impossible to think in advance of every possible product that could appeal to youths, examining current products would be a useful place to start.  The medical marijuana industry already sells THC-infused chocolate bars, peanut butter cups, Rice Krispies treats, hard candies, and lollipops."

Adopting rules that ban the production of marijuana-infused lollipops, Rice Krispies treats, gummy candies, and goldfish-shaped crackers, among other products that resembled foods usually eaten by children, could help decrease the risk to child and adolescent health.

Cuts to substance abuse treatment coincide with cuts to substance use prevention

Earlier this week, a Seattle Times opinion piece describes how  “ . . .Washington’s nationally lauded chemical-dependency treatment community is in critical condition, and it is fading fast.”

“Just this month, a 41-year-old inpatient treatment center in Madrona and a detoxification facility in Everett are closing. Other facilities are teetering on the brink, downsizing, merging or shedding jobs to stay above water. Recovery Centers of King County is losing $20,000 a month on outpatient care.”

“It’s gotten so bad, so quickly, that state regulators are scrambling to ensure some smaller rural counties don’t lose their sole treatment facility. I’ve heard it described as the state’s most serious crisis in chemical-dependency treatment in a generation.”

Toward the end of the article, a treatment provider points out that many of the patients in her detox center (which is closing) are young.  “When she looks around the facility, 'It looks like high school.' Prescription painkillers and heroin are surging, and hook the young. 'They look like babies.'"  Even prior to current cuts in treatment funding, the majority of Medicaid-eligible adolescents who needed substance abuse treatment were not able get the help they needed. 

This is a particularly bad time to lose treatment providers because painkillers and heroin are not the only drugs for which adolescents and young adults seek help.  In fact, marijuana is the primary drug for which adolescents seek treatment and it is about to become much more available throughout the state.   Teen marijuana use rates are expected to increase.   

During the marijuana legalization debate, proponents of I-502 promised increased funding for substance abuse prevention and treatment.  Not only has promised funding not yet materialized, but funding has been cut for both.  In addition to treatment funding cuts, the statewide Community Mobilization Program, a science-based prevention program, was eliminated from the state budget in 2013.  Efforts to get funding back into the state budget failed.  In his opinion piece, Jonathan Martin writes about the state legislature and treatment funding: “Unbelievably, I hardly heard a peep about this in the three-month legislative session, let alone a proposed fix.”  The same can be said about prevention.  Not a peep. 

Regulate nicotine and marijuana products to prevent youth use

An article in the latest edition of the American Journal of Public Health suggests that it is important for pubic health policies for preventing youth marijuana use to be instituted as soon as possible in states like Washington.  Policies should be adopted before an industry with significant lobbying power is fully established.  The article states, “The lesson for marijuana may be to establish authorities’ rights to impose regulations from the outset because of how difficult it can be to expand regulator scope” after an industry is well established. 

The Food and Drug Administration’s recent announcement that they plan to regulate e-cigarettes, devices that vaporize liquid nicotine products, provides a perfect example.  As the Campaign for Tobacco Free Kids notes, “Three years after first announcing plans to do so, the Food and Drug Administration today has finally issued a proposed rule to begin regulating electronic cigarettes, cigars and other tobacco products not currently under its jurisdiction . . . It is inexcusable that it has taken the FDA and the Administration so long to act." 

Barriers to regulation

According to a New York Times article about the FDA’s proposed regulations, “Thursday’s release of the blueprint — which is hundreds of pages long — is sure to set off a frantic lobbying effort in Washington as affected industries try to head off the costliest, most restrictive regulations.”

“Members of the Smoke Free Alternatives Trade Association, one of the e-cigarette industry trade groups, descended on Washington in November, and reported holding nearly 50 meetings with congressional officials to help them “learn more about the negative impact inappropriate regulation could have on this nascent industry,” the group said in a statement.”

“The industry has several trade associations, and a number of them have met with Obama administration officials about the regulations over the past several months, according to public records and industry group statements.”

Before a similar industry is established for marijuana, Washington State regulators would be smart to act now to adopt policies for marijuana based on what has been proven to prevent youth alcohol and tobacco use.  According to the Campaign for Tobacco Free Kids, the delay in e-cigarette regulations "has had serious public health consequences as these unregulated tobacco products have been marketed using tactics and sweet flavors that appeal to kids, and their use has skyrocketed.”

Skyrocketing use of marijuana vaporizers

Just like the use of nicotine vaporizers has skyrocketed among teenagers, the use of marijuana vaporizers has also skyrocketed among teenagers according to state officials. "Right now in Washington, if you are in mid twenties and younger, you prefer hash oils and vaporization as opposed to smoking," said Randy Simmons, Program Director for I-502 for the Washington State Liquor Control Board in a recent KOMO News story.

Regulating e-joints

Among the FDA’s proposed regulations is a ban on selling e-cigarettes to minors, a regulation that the King County Board of Health adopted in 2010.  The sale of marijuana vaporizers to minors could be banned on a statewide level and online.  Like the ban on e-cigarette sales to minors, such a regulation would be one way to reduce the number of minors who try and regularly use what is erroneously seen as a safe way to use marijuana.

Seattle Times calls for marijuana prevention programs

Last week, a Seattle Times editorial stated that teen marijuana use prevention efforts should start now.  "Washington instead is waiting for the spring of marijuana tax revenue to gurgle up and fund prevention efforts. That’s a mistake," the editorial says.

In fact, many substance abuse prevention strategies can be implemented without funding.  As yesterday's post explains, policies supporting public health should be adopted before the new marijuana industry is fully up and running.  Several public health prevention strategies can be put in place by key institutions in our state without prevention-specific funding.

• Local jurisdictions can strictly enforce the ban on public consumption of marijuana.  
• Products attractive to children and teens can be prohibited.
• Statements supporting limits on the number of marijuana stores can be made by public officials.  
• Tighter restrictions on advertising can be adopted.  

The idea that substance abuse prevention is all about implementing school-based programs or mass media campaigns is outdated.  (Though, there is nothing stopping the Seattle Times from forming a private-public partnership and running marijuana prevention ads pro bono right now.)  Yes, those elements of teen drug use prevention are important, but to be most effective they need be part of a comprehensive strategy that addresses the many individual and community factors that contribute to marijuana use among minors.

Public health regulations for marijuana

An article published in the April 17, 2014 edition of the American Journal of Public Health discusses why public health regulations are needed when establishing a legal commercial marijuana system. 

Based on research findings for preventing teen alcohol and tobacco use, the authors suggest implementing the following regulations for an emerging marijuana market:

• Keeping prices artificially high;
• Restricting and carefully monitoring licenses if a state monopoly is not established;
• Limiting the types of products sold;
• Limiting marketing;
• Restricting public consumption. 

Limiting outlet density: public health benefits

The Washington State Liquor Control Board marijuana rules limit the amount of marijuana retailers that may open in communities.  Twenty-one stores will be allowed in Seattle, which is in line with how many liquor stores were in Seattle prior to privatization.  Limiting outlet density is a proven way to reduce underage drinking and other public health harms associated with alcohol.  The article elaborates by stating, “ . . . studies from various disciplines converge in showing a strong positive relationship between alcohol outlet density and alcohol misuses as well as unintentional injuries and crime.  The evidence is so strong that several national and regional health organizations . . . have included recommendations related to licensing restrictions in prevention plans.”

Limiting outlet density: Saving tax dollars

The article goes on to say, “Keeping the number of licenses small also helps control the cost of regulating these new businesses and enforcing compliance (because there are fewer entities to oversee).  Fewer licenses make it easier for the government to keep close records on each licensee, making it easier to discover anomalies in their books that could indicate diversion to underground markets.”

Limiting products sold

Since it is difficult to expand regulations once a market is fully established, the authors suggest that products attractive to youth be strictly limited from the get-go.  “If governments wait to try to impose such product restrictions or leave the industry to regulate itself, the outcome could be problematic, as profit motive will likely dominate decisions rather than consumer safety.”  Both the alcohol and tobacco industries make products that are attractive to youth including sweet-flavored cigarettes, nicotine products, and alcohol.   Currently, marijuana rules in our state do not ban sweet-flavored or other products that may be attractive to youth. 

Restricting public consumption

The authors promote limiting public consumption of marijuana based on studies about youth tobacco use and restrictions on public tobacco use.  “ . . . Clean indoor air laws targeting public places that youths tend to congregate . . . are associated with reduced initiation and self-reported use of cigarettes among children and adolescents.  Even broad workplace clean indoor air laws . . . have been shown to influence the smoking behaviors of youths by influencing antismoking norms.”  While the use of marijuana “in view of the public” is against Washington State law, it remains to be seen how the law is interpreted by local jurisdictions and enforced.  In Seattle, public use of marijuana results in a verbal warning for the first violation and a $27 fine after that. 

How to reconcile two legal marijuana systems

Recreational marijuana goes on sale legally in Washington this summer.  During this year's legislative session, state lawmakers failed to agree on how to reconcile the state’s unregulated medical market with its regulated recreational market.  Hear what Senator Jeanne Kohl-Welles and others have to say about it in the April 4 edition of City Inside/Out.

WA Court of Appeals: Local ordinances can ban medical marijuana gardens

Earlier this week, the Washington State Court of Appeals affirmed the City of Kent’s authority to prohibit medical marijuana collective gardens from operating in the city.

After Kent adopted an ordinance prohibiting collective gardens throughout the city, challengers sued, arguing that state medical marijuana legislation permitted collective gardens throughout the state, thus Kent could not exclude collective gardens from its zoning districts.

This week, the court of appeals affirmed a lower court decision and found that statute does not legalize the use of medical marijuana.  Therefore, medical marijuana use, including the establishment of collective gardens, was not legalized. In its decision, the court wrote, “ . . . collective gardens are not legal activity. The Ordinance, by prohibiting collective gardens, prohibits an activity that constitutes an offense under state law. As it prohibits an activity that is also prohibited under state law, the Ordinance does not conflict with the MUCA” (Medical Use of Cannabis Act).