State and local marijuana regulators, industry stakeholders and advocates and opponents of legalization took part in a two-day session hosted by the National Academies...

State and local marijuana regulators, industry stakeholders and advocates and opponents of legalization took part in a two-day session hosted by the National Academies of Sciences, Engineering and Medicine (NASEM) this week, sharing their perspectives on evolving cannabis policies.

This marked the second NASEM Committee meeting for its “Public Health Consequences of Changes in the Cannabis Policy Landscape” series. In September, the conversation featured representatives of several federal agencies who weighed in on the subject.

For this week’s round, many of the participants had direct experience regulating marijuana markets at different levels of government. That included cannabis regulators from California, Hawaii, Maryland, Missouri and Oklahoma, who talked about the successes and shortcomings of their individual experiences navigating the rapidly changing industry.

California Department of Cannabis Control (DCC) Director Nicole Elliott said that, her state has developed a “pretty robust market” with “a lot of complexities” since legalization was implemented about six years ago.

“We’re starting to see a little bit more stability in our market,” she said. “We are starting to see some consolidation in our market as well, although we have a significant amount of competition in this market.”

One of the key issues that she said California is still working to address is “the persistent illegal market,” which is partly due to the fact that the state has “historically produced a lot of cannabis for the rest of the United States” and also the patchwork of local rules that has left regulatory gaps that illegal operators continue to serve.

Missouri, on the other hand, is “fairly new to the game as these things go,” Amy Moore, director of cannabis regulation at the state’s Department of Health and Senior Services (DHSS), said. She noted that Missouri marijuana sales recently reached a $1 billion milestone, saying it’s a “pretty active, regulated market.”

“Even in our adult-use law, which really integrated itself into the medical-use law, there’s very explicit focus on public health here,” Moore added. “So that runs throughout our rules.”

Michele Nakata, supervisor of the Hawaii Office of Medical Cannabis Control and Regulation, recognized that the state was “very slow to open our dispensary system” under its medical marijuana program, and lawmakers “chose to be a lot more restrictive” compared to other states. That “makes it a lot easier to do our jobs, especially with limited resources,” she said.

But “there’s a lot of things that that we are looking forward to fixing,” Nakata said. And as the legislature prepares to consider an adult-use legalization proposal that the attorney general’s office recently unveiled, she said, “we’re ready—we’re trying to ramp up and be prepared for that.”

Each of the officials represent states that are also members of the Cannabis Regulators Association (CANNRA), an independent organization aimed at coordinating efforts to implement cannabis policy changes.

CANNRA is able to provide on-the-ground perspective about what’s “actually happening” in state marijuana markets, “as opposed to what may be on the books and statute or regulation,” Will Tilburg, the organization’s president who also serves as acting director of the Maryland Cannabis Administration (MCA), said at the National Academies event.

Local cannabis regulators also shared their insights on a separate panel on Wednesday. They represented Denver, Detroit, Grand Rapids and Seattle.

One of the questions that was put to the group was how participants view the role of the marijuana industry in their markets and in their experience as regulators.

Kim James, director of Detroit’s Office of Marijuana Ventures & Entrepreneurship, said that industry stakeholders are “involved in every aspect of what’s going on,” and she characterized the relationship as somewhat hostile, stating that business interests have filed around 100 lawsuits against the city over various regulations.

“Every time we do an ordinance or new change, we get sued by the industry because they disagree” with primarily health-related rules, she said. “It’s always about business interests and making sure that they can preserve their market share in their place.”

Molly Duplechian, executive director of Denver’s Department of Excise and Licenses, said there’s an important “dichotomy between addressing the public health and safety but also creating regulations that allow for the growth of the market and the growth of the industry.”

When presented with different regulatory options, she said it’s key to ensure that “we have all the different stakeholders at the table—so we have the industry talking about how it impacts their business and their bottom line or their processes, but also having the public health voices at the table, too. I think it’s really important to just balance that out.”

Industry organizations also participated in the NASEM event, with representatives from the National Cannabis Industry Association (NCIA), Natural Products Association, National Craft Cannabis Coalition and US Pharmacopeia discussing how different regulatory models affect marijuana businesses, pricing and product trends and compliance issues.

Michael Cooper, co-chair of NCIA’s policy council, emphasized that while the industry might have a seat at the table in affecting marijuana laws, he doesn’t think the “sway” cannabis reform has in legislatures “is because of the industry lobbying.”

“It’s because Americans want these products, and they would prefer to have them produced by a regulated entity,” he said, citing recent polling showing overwhelming public support for cannabis legalization.

On Thursday, there was one panel featuring international officials, including a representative of Canada’s top health agency and experts at major universities in Australia, Chile, Spain and Uruguay. They talked about issues such as “trends in product use, purchases in legal or illicit markets, prices, and exposure to ads” in their respective countries, as well as lessons that the U.S. could take from their experiences.

Another Thursday panel brought together advocates and experts on diametrically opposed sides of the marijuana reform debate.

Cat Packer, director of drug markets and legal regulation at the Drug Policy Alliance (DPA), said that she recognized that one of the goals of the NASEM cannabis sessions is to inform future policy recommendations, and she said it was her hope that “those recommendations would be for the government to develop and implement a national plan to study and address the harms and disparities associated with cannabis policy—not just cannabis and cannabis use.”

“I say this in part because I know that, as a country, we are not the best at admitting mistakes, and that has consequences,” she said. “We are also struggling with having conversations about race. That also has consequences.”

“I know that this particular committee’s scope is focused specifically on cannabis,” Packer said. “But I think it’s also important to note that this is in a context of larger drug enforcement and drug prohibition. Prohibition has had a long, racist history and I hope that folks are developing policy research agendas with a real emphasis on studying the racist origins of cannabis policy.”

Peter Grinspoon, a cannabis specialist at Massachusetts General Hospital, offered a science and medicine perspective on the issue, pointing out for example that physicians generally “are very confused about about cannabis.”

“The data is very contradictory and there are all kinds of obstacles we have to overcome,” he said, adding that with such strong majority support for medical cannabis access, “I think doctors should at least be able to have that intelligent, non-stigmatizing, non-judgmental conversation with their patients.”

On the other side of the spectrum, Kevin Sabet of the prohibitionist group Smart Approaches to Marijuana (SAM), opened by dismissing the medical cannabis movement as “an idea created in a PR boardroom, not in a lab.” Marijuana has been further popularized, he argued, by industry messaging that leverages “celebrity endorsements” and “Santa Claus” and marijuana gummies that make consumption “fun and cool.”

Sabet said that the marijuana industry is not only “mimicking” large alcohol and tobacco companies, but they are “actually getting investments from them.”

The ad hoc NASEM cannabis committee is ultimately expected to take all of these perspectives and develop “recommendations for strengthening a harm reduction approach, which would minimize harms, of various regulatory models, including but not limited to social, employment, education, and health impacts” and also issues recommendations on “policy research for the next 5 years.”

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Photo courtesy of Chris Wallis // Side Pocket Images.

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