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State medical cannabis board considering cap on percentage of THC in dispensed products; questions, opposition delay decision

MORGANTOWN – The state Medical Cannabis Advisory Board is considering a proposal to limit the THC content of dispensed cannabis products to 10%.

The proposal stirred opposition and questions among members at the board’s Thursday meeting, and opposition from the public. So the proposal has been referred back to the workgroup that initiated the proposal for further study and more public comment.

Board member Dr. James Berry, chair of WVU’s Department of Behavioral Medicine and Psychiatry, and director of addiction services at the WVU Rockefeller Neuroscience Institute, proposed the cap.

He told board members that the Health and Medical Workgroup heard a presentation from an addiction psychiatrist who said the medical evidence supports THC potencies of only 10% or less, while higher concentrations contribute to a number of public health concerns including suicide, depression, anxiety and addiction.

THC is the main psychoactive ingredient in cannabis. For recreational users, it produces the high.

Adam Goers, senior vice president of Corporate Affairs for Columbia Care, which operates the Cannabist dispensaries in West Virginia, said THC and other cannabanoids in medical cannabis form an “entourage effect” used to treat the medical issues approved under the state’s medical cannabis program.

Jason Frame, director of the state Office of Medical Cannabis, said THC levels vary from product to product. THC percentage in flower may range from the low teens to the mid 20s, and the lower 30s at the highest.

Concentrates, he said, may be as high as 90%. State code limits the total amount of TCH sold per visit, but not the percentage in any product.

According the the OMC, the program has 12,855 approved medical cannabis patients, 104 registered physicians, nine growers, five processors and 30 dispensaries. As of Sept. 2, sales were $11.68 million, with 1,442 pounds of cannabis sold in 198,406 individual items. The industry supports about 2,000 direct and indirect jobs.

Board member Rusty Williams, who is the board’s patient advocate, disagreed with Berry. He watched the presentation, he said, and it was out of date, drawing on data from 2007. That information has been debunked by research from various institutions and the board has voted down this proposal before.

Williams also said that none of the six physicians on the board have taken the training to certify patients for the program and so aren’t familiar with how it works.

Berry said that he doesn’t know what certifying physicians are doing to follow up and monitor their cannabis patients. As with opioid prescribers back in the mid-2000s, “They might not even be seeing the problems. Those of us seeing the problems are in the addiction and psychiatric world.”

Board member Jesse Forbes said they haven’t yet heard from the cannabis industry on how the proposal might affect it. He suggested taking no action on the proposal during Thursday’s meeting so the workgroup can gather more current data and public comment.

The board agreed to that and will take up the proposal again at its next meeting – the date has not been announced.

Industry advocates told The Dominion Post that the 10% figure is an artificial threshold. Potency is not the right thing to look at, but instead how does the patient get the correct amount of active ingredient.

Columbia Care contacted The Dominion Post about the proposal. Goers watched the Zoom meeting and talked about the proposal afterward.

The arbitrary limit is not based on science or the judgment of the doctor and patient, he said. Medical cannabis is a means to keep people off the black market and off of opioids.

“If a proposal like this were to move forward, it would just be a non-science-based, backward trajectory to the great progress West Virginians have made,” he said.

In manufactured products, he said, patients will be forced to consume medically unnecessary fillers to get the required effect. With flower products, there would be unnecessary vaporizing of plant material.

“These types of decisions should be made between the physician and the patient, and not to be arbitrarily done,” he said, “The only beneficiaries of this would be the illicit market. The losers would be patients not being able to get medicine that they and their doctors have found to be able to effectively treat them.”

Also, he said, medical cannabis isn’t covered by insurance. Forcing people to buy more product may cause them to turn back to opioids and benzodiazepines that are covered and would cost them less.

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