Dispatches from the 2019 North American Cannabis Summit


Public health officials, researchers, physicians, policy makers, and other stakeholders are gathered in Los Angeles this week for the 2019 North American Cannabis Summit, a three-day conference where they will discuss federal and local policies, public health and safety, emerging research and data, and social equity programs in the United States, Canada, and Mexico.

Cannabis Wire will provide coverage from Monday through Wednesday, so check back for more all week.

Here are snapshots from Tuesday, Day 2 (see below for Day 1):

What legalization lessons have we learned from Colorado?

In a session entitled, “Everything We Messed Up. And How We Fixed It,” Andrew Freedman and Lewis Koski recalled their experiences with the legalization of adult use in Colorado.

Freedman, who served as Colorado’s first Director of Marijuana Coordination, emphasized the unexpected rise in violence related to homegrows. Initially, the state allowed people to home grow up to 99 plants. Very quickly, said Freeman, hundreds of pounds of Colorado cannabis were diverted to states like Florida, where the price per pound was substantially higher. The homegrows policy also led to an increase in violence in rural part of Colorado. “There really was a story of two different worlds,” said Freedman. While those in major cities were able to purchase cannabis in “safe, comfortable, clean” shops, those in rural counties saw an uptick in homicides and an increased presence of organized crime.

Freedman, who now consults for other jurisdictions, said that he and fellow policy makers failed to ask themselves: “Hey, is this going to be something that gets exploited?” Since recalibrating its policy, Freedman shared, homicides specific to homegrows in Colorado have gone down.

Freedman also remarked on California’s recent approval of statewide delivery, which he described as a “policy nightmare.”

“What you’ve essentially done,” he said, “is that everybody’s doorstep is now a point of sale.”

“I think there is solidly-written regulation behind that,” Freedman concluded, “but the ability to enforce and monitor that you are keeping up with those regulations is a really serious conversation that needs to happen between the state and locals.

Regulating cannabis may not reduce violence in Mexico

In a session on cannabis use in Mexico, María Elena Medina Mora, chief director of the Ramón de la Fuente National Institute of Psychiatry, said that while she sees the link between cannabis prohibition and violence in the country, legalization will likely not yield a decrease in bloodshed.

Medina Mora said the Mexican Senate is weighing a bill to regulate cannabis that underscores the role of “the prohibitionist policy that Mexico adopted during the last two administrations.” According to the text of the bill, this policy has become manifest in the “conflict known as the ‘War against narcotrafficking,’” which has generated two consequences that point to its failure, namely “the hardening of violence in every corner of the country and the criminalization of vulnerable sectors of society.”

Those who favor legalization, said Medina Mora, understandably point to this relationship. However, she cautioned, because organized crime is very flexible (“they can go from one drug to another, to human trafficking, to oil”), putting an end to prohibition will not solve Mexico’s problem with violence. Latin American drug policy experts like Zara Snapp have acknowledged organized crime’s ability to adapt. Still, they argue that while cannabis regulation is not a panacea, it can serve as a point of departure for addressing the effects of prohibition. The bill in question, for instance, also points to people who have been incarcerated for simple possession.  

When it comes to opioid addiction, cannabis is not a “silver bullet”

Day two of the conference wrapped up with a keynote address on the role of cannabis in the evolving opioid epidemic, led by Rosalie Liccardo Pacula, co-director of RAND’s Drug Policy Research Center and co-principal investigator of the think tank’s Opioid Policy Tools and Information Center.

In it, Liccardo Pacula said that though studies indicate that cannabis may be effective for chronic pain management, there is no clinical evidence on whether the co-administration of opioids and cannabinoids decreases the development of opioid tolerance. “Advocates who want to make a case for their cause, use cannabis as a silver bullet,” said Liccardo Pacula. “If there was clear evidence, I’d jump right on it,” she added. “I have a family member addicted to opiods. This is a personal issue to me. That said, there are effective medications out there, and I would hate to see a policy debate about a potential-possibly-maybe drug take over the dissemination of drugs that are known to be effective at tackling this problem. Let’s have a discussion about the benefits of cannabis— but let’s not mix it up with the opioid crisis.”

Here are snapshots from Monday, Day 1 (originally published January 29):

When it comes to cannabis employees, there’s a lack of data on workplace safety

During a session on the health and safety of cannabis workers, Marc Schenker, professor of Public Health Sciences and Medicine at UC Davis and founder of the university’s Migration and Health Research Center, indicated that while the California cannabis industry employs an estimated 200,000 full-time workers (not counting part-time employees), there are no large studies of this population. Moreover, because many of these workers are undocumented, obtaining representative health data is a challenge.

To gauge workplace safety, Schenker said, researchers infer from other agricultural data, which points to allergen, chemical, and microbiological exposure; musculoskeletal disorders like tendonitis and carpal tunnel syndrome; and physical hazards that range from cuts and abrasions to compressed gas explosions.

Cat Packer, the executive director of the Los Angeles Department of Cannabis Regulation, was in the audience. “Have you identified any equipment to mitigate some of the concerns you’ve brought up?” she asked Schenker, referencing workplace hazards. In response, he listed a number of items, including n95 respirators. “But those things are often expensive,” he said, “and if you have a small producer, they might cut corners.”

Then, Schenker added: “Everyone is concerned about Big Marijuana, but, you know, they are often subject to more oversight.”  

Schenker also pointed to changes post-legalization. For instance, historically, California’s “trimmigrants” have been foreign vacationers, college students, and young working professionals. Recently, the industry has turned toward labor contractors in processing facilities, often with older female workers (a notable change, said Schenker, given that most cannabis production occurs in small, remote, rural locations in northern California, where there have also been registered cases of sexual assault and sex trafficking).

A glimpse into effects of secondhand cannabis smoke in apartment buildings

Later, Peggy Toy, who directs the Health DATA (Data. Advocacy. Training. Assistance.) program at UCLA’s Center for Health Policy Research, shared preliminary findings of a citywide evaluation that aims to determine whether Los Angeles should implement a cannabis-free policy in multi-unit housing. Launched in April 2018, the study, which will conclude in June 2020, will ultimately survey 4,800 tenants and 200 landlords across 12 City Council districts. So far, 4 out of 10 owners/managers who’ve been interviewed support a policy that bans all types of smoke (cannabis and tobacco), while 2 out of 10 favor one that prohibits tobacco but not cannabis (or, at least, allows cannabis for medical reasons). Among landlords who favor a total ban, said Toy, several said that it would be difficult to selectively enforce smoking policies. Notably, 4 out of 10 landlords said they would not support any type of smoke-free policy, as it would undercut their renter pool.

Another study, sponsored by the University of Washington’s Alcohol & Drug Abuse Institute, examined the cannabis industry’s advertising violations between 2014 and 2018, as identified by civil society and authorities. A public records request to the Washington State Liquor and Cannabis Board indicates that, overall, the most common types of violations relate to outdoor advertisements, lack of mandatory warnings, and distribution of giveaways or coupons. Violations reported by Washington residents underscored a concern with content appealing to minors or promoting cannabis’ “curative or therapeutic effects.”

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