The state's top health official is weighing new regulations to ensure that users of medical marijuana snacks and drinks know when to stop.
Will Humble said he may require dispensaries to certify that an employee has discussed with the customer the effects of the product being bought. Humble, the state's health director, said he exploring the use of what might be called “secret shoppers” to ensure that customers are being told what they need to know to remain safe.
Humble said Arizona laws and regulations already require dispensary “agents” to talk with customers. He conceded it's likely that medical marijuana buyers have been pretty much left on their own to discover how much they needed to inhale, whether smoking or “vaping” it, to get the effect they wanted.
“It goes straight from your lungs into your bloodstream, right to your brain,” Humble said. “So it's easier to self-regulate in that regard.”
Humble said edible forms of medical marijuana are the best from a health perspective, as they don't require inhaling all the fumes.
“But they're much harder to regulate the dose,” he said. “So you have a bigger opportunity with edibles to overdose on the medical marijuana because you continue to eat either a brownie that was more potent than you realized or more brownies than you probably should have.”
Humble said by the time someone feels the effects of the chemicals, it's too late to do anything about it “because it's already in your blood.”
This really wasn't much of an issue in Arizona before a March court ruling involving a 5-year-old Mesa boy, a medical marijuana patient, whose parents said he needed a tincture made from an extract.
Maricopa County Attorney Bill Montgomery had argued the law allows use only of the plant itself and requires any food product to actually have pieces of the plant, a restriction that limited the kinds of edibles produced. The judge said Montgomery was off base and gave the go-ahead for extracts — and all the products that could be made from these concentrates.
There are existing requirements that products list the amount of marijuana it took to produce a product, but Humble said they are probably not helpful in preventing an overdose.
The reason is that nothing in Arizona law requires that products be tested — and labeled — for the level of active ingredients. That includes not only the psychoactive ingredient tetrahydrocannabinol that gets people “high” but also cannabidiol, another compound in marijuana which has medical effects but without the feeling of being "stoned.''
“No two lemon bars are actually created equal,'' Humble said.
“One might be from a strain that's really high in THC but almost no CBDs,” he said. “Others would be really high in CBDs and hardly any THC.”
And that, he said, is why the dispensary agents need to be chatting with their customers, particularly those picking up edibles.
“They're supposed to talk to them about what the marijuana does,” he said of existing rules. And it even requires discussion of “self-management,” with patients urged to keep track of their experiences in a notebook “so they can do a better job of self-regulation at home.”
Humble said his staffers are supposed to identify themselves when they inspect a dispensary. So there's no real way to tell what happens at the counter on a day-to-day basis.
That's where the possibility of a “secret shopper” comes in. So Humble is reviewing the law to see if he can do that now or would need a change in the voter-approved law — one that could be made by the Legislature only on a three-fourths vote of both the House and Senate.
At this point, it does not appear the dealers will raise objections to expanded regulations. Andrew Myers, executive director of the Arizona Dispensaries Association, said proponents of medical marijuana have a selfish reason to want to prevent patients from overdosing.
“The biggest risk of people having too much cannabis is really that they're not going to use it again,” he said. And Myers said that, in many cases, patients are not “effectively educated.”
Myers said he also sees no problem with undercover inspections “as long as it's a fair and equitable system,” one in which the dispensary operators have a voice in crafting.
Attorney Ryan Hurley, who represents some dispensary owners, said he concurs with Humble's concern that there may be a need for actual testing of products.
“There's no way to assure that the dose in one edible is going to be consistent with the dose in the same brand in the same type of product,” he said.