Study Examines Current State Regulations, Public Health Risks of Growing Medical and Recreational Marijuana Market

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A new study urges state and federal regulators to take a closer look at the health and safety risks of the growing medicinal and recreational cannabis market.

“Cannabis regulation is unlike any agricultural product, food, or drug in the United States. Currently, there are no nationwide guidelines based on conventional risk assessment methodologies or knowledge of patient susceptibility. to the medical use of cannabis,” said lead author Max Leung, assistant professor at Arizona State University in the School of Mathematical and Natural Sciences.

“As a result, our research team conducted the first in-depth study to examine 3 primary concerns: 1) the current contaminant regulatory landscape at the state level, 2) the identification of cannabis contaminants of concern in samples and 3) exploration of all patient populations that may be susceptible to contaminants.”

The cannabis market has grown significantly over the past decade to become a $10 billion industry by 2017, $50 billion by 2026, and over the past year around 55 million users. Currently, 15 states have legalized medical cannabis, but little attention has been paid to its implications for chemical exposure and consumer safety.

At the federal level, cannabis is still listed as an illegal substance. This limits the efforts of several federal agencies to assess and mitigate the public health risk of cannabis contamination. Currently, cannabis is neither federally regulated as an agricultural, food, or pharmaceutical product, so the USDA does not monitor its growth nor does the FDA consider it a drug.

So how does a cannabis user know that what they are putting into their body is safe? “There is surprisingly little information on the level of contamination in cannabis products sold in this country,” Leung said.

Without any federal guidance, it was left entirely to the states to craft a patchwork of cannabis regulations and policies. “Individual legalized states and DC make their own rules with huge variances,” Leung said.

From their study, Leung and colleagues found that as of May 2022, 36 states and the District of Columbia had listed a total of 679 cannabis contaminants listed as regulated in medical or recreational cannabis. Most of these contaminants were pesticides (551, including 174 subcategories of insecticides, 160 herbicides and 123 fungicides), followed by solvents (74), microbes (21), inorganic compounds (12), mycotoxins (5) and 16 classified as “other.”

“What was interesting was that many of the pesticides in this document were very unlikely to be used in the cultivation and processing of cannabis,” Leung said. These pesticides included chlorpropham (a plant hormone that prevents sprouting of potatoes), oxytetracycline (an antibiotic), and norflurazon (an aquatic herbicide to control Hydrilla).

“What also alarmed us was that the US EPA tolerance document and individual jurisdictions also listed a total of 42 legacy pesticides that were no longer registered for agricultural use in the United States. , such as dichlorodiphenyltrichloroethane (DDT), chlordane, lindane and parathion.

As for the amount of contaminant levels, there were great inconsistencies from state to state. different state jurisdictions have shown significant variations in regulated contaminants and action levels of up to four orders of magnitude.

How often has this been a problem? The research team also extracted data testing records from cannabis flower and extract samples produced in California, the largest state cannabis market in the United States. Their sample data represented approximately 6% of California’s legal production in 2020-21.

“As required by the California Medical and Adult Cannabis Safety and Regulation Act, all cannabis and cannabis-based products on the legal California market must be tested for 68 pesticides, four inorganic substances, 20 solvents, six microbes and five mycotoxins,” says Leung.

“Cannabis manufacturers must submit their products – including cannabis flowers and cannabis-based products such as edibles, concentrates and other consumables – to a state-licensed cannabis testing laboratory. All Products must be certified for compliance testing before they can be sold legally. Products that fail to meet state regulatory levels in compliance testing are subject to recalls.”

They recorded an overall failure rate of 5.1% for the California cannabis samples, which included an average of the failure rate of 2.3% identified for flowers and 9.2% for extracts in the California samples. Insecticides and fungicides were the most common categories of contaminants detected, with boscalid and chlorpyrifos being the most common. Contaminant levels have fallen below regulatory action levels in many legalized jurisdictions, indicating a higher risk of contaminant exposure.

Finally, Leung’s team looked at reports of medical cannabis use published by state-level public health agencies from 2016 to 2021. Currently, there are 37 U.S. medical cannabis programs and nearly 100 eligible medical conditions listed by these programs.

“Cannabis and cannabis products are often marketed as alternatives to standard medical treatments,” Leung said. “As such, medical cannabis has the potential to expose susceptible patients to harmful contaminants.”

“Immunocompromised patients with cancer and HIV, women of childbearing age, and patients with seizures and epilepsy are among those most susceptible to the health risks of pesticides and microbial contaminants that can be found in cannabis,” added Leung.

The majority of patients were prescribed medical cannabis for pain relief (799,808 patients), followed by post-traumatic stress disorder (164,383 patients), spasticity associated with multiple sclerosis or spinal cord injury. spinal cord (78,145 patients), cancer (44,318 patients), and epilepsy (21,195 patients).

“Our findings have two important implications for public health,” Leung said. “First, the scattered approach to state-level regulations can confuse cannabis manufacturers and discourage compliance while subjecting cannabis users to a higher level of exposure to contaminants in some jurisdictions. Second, being Given the current state of cannabis contaminant regulation in the United States, it is unclear whether the health benefits of cannabis use outweigh the health risk of exposure to cannabis. contaminants transmitted by cannabis.”

To help better inform the public and policy makers, Leung recommends further surveys to examine safety considerations in susceptible patient populations across all medical conditions.

“The progression and prognosis of many qualifying conditions can be worsened by exposure to contaminants found in cannabis,” Leung said. “This study demonstrates an urgent need for a unified regulatory approach to mitigate the public health risk of cannabis contamination at the national level.”

The study, “Comparison of State-Level Regulations for Cannabis Contaminants and Implications for Public Health,” was published online Sept. 14 in the peer-reviewed journal Environmental Health Perspectives.


People who use medical cannabis are also more likely to use nicotine


More information:
Comparison of state-level regulations regarding cannabis contaminants and public health implications, Environmental Health Perspectives (2022). DOI: 10.1289/EHP11206

Provided by Arizona State University

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