Cannabis Research Review Board Meeting – November
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 (Nov 8). The meeting was held virtually only, but was open to the public.
The Board consists of the following members:
Katherine Carlson, M.D., M.S. (Board Chair)
Matthew S. Mciff, 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.
Synthetic and Derivative Cannabinoids - Brandon Forsyth (UDAF)
Brandon Forsyth, Ph.D from the Utah Dept. of Agriculture and Food (UDAF) began the meeting with a slide presentation answering some questions he had received from the board regarding synthetic and derivative cannabinoids that have been showing up in Utah’s medical cannabis supply. In his presentation, Brandon explained the various processes and extraction methods used to turn cannabis flower into a concentrate. The most common method in Utah (and the country) is ethanol extraction followed by “short path distillation,” which has also been the most common source for unknown and/or synthetic cannabinoids showing up recently and causing concern among Utah patients.
Brandon also presented a slide showing which synthetic/derivative cannabinoids have been detected in Utah’s medical cannabis products and to what degree. Cannabis flower had the least (none) derivative cannabinoids of the three different types tested, followed my “Low Cannabinoid Final Products” (e.g., gel cubes, tinctures, liquids, and topicals) and “Concentrates” (e.g., vape carts and dabs) which had the highest amount of delta-6a, 10a, and delta-10, all of which are not naturally occurring. However, Brandon didn’t think the data (as a whole) is statistically significant, but believes a few products out there are keeping the average high, which should be looked into further.
In another slide presented, Brandon showed an example of a “hemp” vape cartridge (meaning it wasn’t sold through the medical program) that had a large number and variety of synthetic or unknown cannabinoids detected. Not being part of the medical program, these products are much less regulated and have lower quality control. Brandon believes these derivative cannabinoids would be found in other states’ medical cannabis supply that uses the same extraction methods (discussed earlier).
Following this presentation, there was considerable discussion by the board about their authority to ban (or disallow) these synthetic and derivative cannabinoids that have been showing up. Brandon stated that the UDAF is not a public health body and not in a position to ban certain substances, but can only test for the derivatives.
When asked whether the DHHS could prohibit these cannabinoids, Rich Oborn (DHHS) stated current law requires that they have evidence of a particular ingredient or cannabinoid having a harmful effect on a patient before they can take any action. It is unclear what statute Rich was referring to, but a plain reading of Utah Code 4-41a-701 (Cannabis and cannabis product testing) would suggest otherwise. As stated in the statue, “the department may make rules to:
(a) determine required adulterant tests for a cannabis plant product, cannabis concentrate, or cannabis product;
(b) determine the amount of any adulterant that is safe for human consumption;
(c) establish protocols for a recall of cannabis or a cannabis product by a cannabis production establishment.”
Rich acknowledged other states have been able to regulate and limit these types of products better, but this is something only the Utah legislature can and should do, according to him. Rich did point out legislation recently passed that requires Utah medical cannabis products have a label listing all their cannabinoids. Of course, this gives little comfort for patients who don’t have the time or knowledge to read through all ingredients of a particular product before purchasing it. For this reason, board member Perry Fine suggested the cannabinoids of products also be listed on the Center for Cannabis website. In addition, Fine stated it’s not up to the board to interpret the statute, which is why legal counsel is needed to do so.
Public Comments
Public comments were limited to 2 minutes. Here is a summary of those comments.
Kelly Lake (patient/TRUCE) wanted to know how much weight these departments are giving to experts who have addressed this issue, and what to do (or how to return) bad products that contain “hot hemp.”
Clinton Young (patient) wanted to know if cannabis regulations have any impact on the cost of cannabis for patients.
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Christine Stenquist (President, TRUCE) pointed out that despite earlier claims, the UDAF and DHHS do have the authority by statute (above) to regulate and/or ban certain products deemed unsafe for human consumption. Stenquist emphatically stated the board “can’t continue to pass the buck onto others and to take responsibility for what [authority] the legislators have given to the departments.” Stenquist also noted how every doctor on the board has said this is not how you practice medicine, and how patients are spending a lot of money and deserve better representation from these agencies.
Mark Viner, M.D. suggested both the patient and prescriber review a CoA (Certificate of Analysis) together prior to purchasing so they can compare the major and minor cannabinoids within and determine whether the cannabis is more hemp-derived.
Zac Newel King (patient/TRUCE) would like to see dispensary websites have full panel CoAs listed for each product, which should all be organic and clean. In addition, Zac thinks we should get rid of the QMP model and make medical cannabis more affordable in the state.
Drew Howells (Utah Veterans for Medical Cannabis) says he has a hard time reading the small print on labels that lists any derivatives and would like to know which agency is responsible for the safety of these cannabis products.
Chirine Touati (patient advocate, TRUCE) said she had to stop purchasing products containing any synthetics at the advice of her doctors. Like others, she wants to know who will take responsibility and “clean up the program.”
Lezli Engelking (Founder, FOCUS) pointed out the whole process of creating a cannabis isolate is by definition, isolation, so there really shouldn’t be any “leftovers” if there are better controls, like we see in the food and pharmaceutical industries, which require rigorous testing before putting a product on the shelves.
Emily Tucker (patient/TRUCE) reemphasized Christine’s comments and places blame at the feet of DHHS and UDAF. She would also like to see more discussions like this on the science and processes involved.
Kristen Larsen (patient/TRUCE) spoke to the financial pressure she experiences as a patient in Utah, recently paying $50 for an eighth cannabis. She also said (because of poor product quality) she walks out of a dispensary feeling more sick than when she entered, and doesn’t undertand why she can’t return bad products that made her sick.
An agenda and slides presented during the meeting can be found here.
A video of the meeting can be viewed here.
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