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Since Missouri legalized marijuana in 2018, Dr. Bob Batterson has noticed a change in attitudes.
The Children’s Mercy Hospital psychiatrist more often hears from parents wondering if cannabis could help their child’s anxiety, autism or OCD.
“I tell them there are no studies,” said Batterson, the medical associate director of the hospital’s Division of Developmental and Behavioral Health. “A lot of hype, but no studies.”
And even if Children’s Mercy allowed its doctors to prescribe weed (it doesn’t), Batterson wouldn’t know what dose to recommend. He also couldn’t say which patient might experience a marijuana-induced psychotic episode or other serious reaction.
No one could.
Years of federal prohibition and the resulting limits on research mean the science about marijuana is skimpy at best. Public health experts say that should trigger caution in a world where legal marijuana is increasingly accessible and more widely consumed.
“There has been relatively little research on cannabis,” said Steven Teutsch, who chaired a year-long study for the National Academies of Sciences, Engineering and Medicine about the impact legal cannabis is having on public health. “Many of the benefits are often over-promoted and are iffy in many cases. And the harms are often not fully appreciated.”
Despite a well-known and largely accepted narrative that marijuana is safe and not addictive, the reality — especially when people consume greater and stronger amounts of the drug — is often different, health experts said.
Some 30% of cannabis users report having a physical dependency on the drug, according to the U.S. Centers for Disease Control and Prevention. Scientists believe the drug could hurt brain function, heart health and can lead to impaired driving. It also correlates with social anxiety, depression and schizophrenia.
The federal government, which Teutsch said has “ largely been missing in action in all of this,” needs to step in with campaigns to educate the public, with model legislation to help states regulate the drug and with research funding to study health effects — good and bad.
Marijuana rules to protect health up to the states
Eliana Kinzer
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Missouri Business Alert
Missouri saw a surge in cannabis-focused events, like the Mid-Mo Canna Expo, after the legalization of recreational marijuana, helping drive the state past $1 billion in cumulative cannabis sales.
Marijuana is still illegal at the federal level, and classified by federal law as a Schedule I drug, defined as a highly addictive substance with no known medical use. Hearings on a proposal to reclassify it as a Schedule III drug will begin in January.
That change would remove barriers — and free more money — for research that could give doctors a better understanding of the health effects of all those gummies, pre-rolled joints and THC-spiked drinks at your neighborhood dispensary.
It also could pave the way for more drug development. To date, the U.S. Food and Drug Administration has only approved three drugs related to cannabis.
Some experts also contend that Congress needs to undo federal law adopted in 2018 that allowed hemp products containing THC (tetrahydrocannabinol), the primary psychoactive compound in cannabis, to be sold in gas stations and grocery stores, free from regulatory oversight.
Under the current system, every state with legal weed takes a different approach to the drug.
California became the first to legalize medical marijuana in 1996. And Colorado and Washington led the way in legalizing recreational pot in 2012.
In the years since, only a handful of states, including Kansas, have resisted passing some level of legalization. Missouri voters adopted a constitutional amendment allowing medical marijuana use in 2018, and one legalizing recreational weed in 2022.
The state has a responsibility, said Dr. Heidi Miller, chief medical officer for the Missouri Department of Health and Senior Services, to make sure people know the risks that come with marijuana.
“Cannabis has multiple potential therapeutic effects, but also potential adverse effects,” she said. “We need to inform the public of what we know and what we don’t know.”
Missouri has budgeted $2.5 million (less than 0.2% of what people in the state spend on weed in a year) for a public information campaign to get this message out.
Miller said the campaign, which is in early planning stages and not yet scheduled, should warn vulnerable populations — young people, pregnant or breastfeeding women and people with a personal or family history of mental illness — about the risks of getting high.
It should also alert people, she said, that the marijuana they may have smoked a few decades ago has little resemblance to the potent variety sold at dispensaries.
The stuff sold today may have four times more THC. And that doesn’t include concentrates, which can have THC levels reaching 90%.
“Clearly, the adverse effects are going to be heightened, the higher the potency,” Miller said. “We can’t assume that all cannabis is safe because it’s, quote, natural. We also want folks to understand that cannabis is potentially addictive.”
More people are using cannabis
Carlos Moreno
/
KCUR 89.3
Cannabis flowers in a jar sit on the counter at Fresh Green Dispensary in Waldo. If the recreational cannabis amendment passes in Missouri, a wider variety of products could become available through vendors.
Since sales began in Missouri four years ago, the Division of Cannabis Regulation says more than $3 billion has been spent on cannabis products in the state. In fiscal year 2024, recreational sales, referred to as “adult use,” reached $1.16 billion, while medical weed sales totaled just under $166 million.
As in other states that have legalized cannabis, use of the drug is on the rise.
Dutchie, a technology company whose software powers the payment platforms and other backend systems in dispensaries, reported that on the Wednesday before Thanksgiving — known in the industry as “Green Wednesday” — average orders in Missouri dispensaries jumped 18% above a regular Wednesday to more than $84.
The number of people using the drug, which experts said will only continue to rise, is raising alarms.
A November 2023 report from the Substance Abuse and Mental Health Services Administration found that 61.9 million Americans — 22% of those 12 and older — reported using cannabis in the past year. More than 13 million 18 to 25 year olds — 38% — said they’d used the drug. The same was true for 11.5% of 12 to 17 year olds.
As people consume marijuana more frequently and in higher doses, anecdotal stories related to health problems are becoming more common. They include reports of cannabinoid hyperemesis syndrome, a gastrointestinal condition that leads to bouts of vomiting and intense pain, and instances of cannabis-induced psychosis, a mental illness that can lead to violence and suicide.
“They didn’t legalize old school hippy weed,” said Aubree Adams, a Colorado mother whose son became psychotic after using marijuana. “We’re dealing with a really hard drug.”
Every day, Adams said, the organization she founded to educate the public about the dangers of marijuana use, receives inquiries from a handful of families across the country dealing with issues related to marijuana use.
Her organization, Every Brain Matters, is pushing for potency caps on the marijuana being sold in the United States; an end to the sale of edibles, which often look like candy; and a ban on sugary-flavored vapes.
Adams also wants it to be illegal for marijuana companies to market products as medicine that have not been approved for medical use. States need to be out front telling the public the truth, she said.
“I don’t know why we have to sugar coat things and play politics,” she said. “Tell them the truth. Tell them the science.”
Her son is 24 now. He’s come in and out of sobriety since first getting into trouble “dabbing” highly concentrated marijuana when he was 15. She believes he would be fine if he hadn’t used the drug.
“My son fights for his mental well being on a daily basis,” she said.
Adams wants other parents to know the potential risks. And she wants adolescents and young adults — who she believes are a primary target of marijuana companies — to realize what they might be getting into. Doctors say that developing brains are more vulnerable to problems
“This is not a soft drug,” she said. “This is a hard drug that can change your brain chemistry.”
Lack of federal oversight
But getting meaningful regulatory change in an industry that lacks federal oversight is difficult.
Under the current system, every state has its own set of rules about everything from how cannabis products are packaged, tested and sold to what training the budtender at your local cannabis store needs to have. States decide who can buy cannabis, how much someone can buy during a certain period and how potent weed can be.
The states also oversee what’s in the marijuana, including setting maximum levels for contaminants like heavy metals and pesticides. Missouri’s Cannabis Division established rules based on the amendments voters adopted.
The state has licensed 10 private laboratories, which marijuana producers hire to test products for compliance with state rules. Cannabis regulators also are opening a “reference laboratory” by mid-2025 to verify those results.
Because the state legalized weed later than other states, it adopted standards that are among the most stringent in the country, said Anthony David, chief operations officer with Green Precision Analytics, a private marijuana testing lab in Kansas City. Before opening the lab with three partners, he grew marijuana in the Pacific Northwest.
“Cannabis that Missourians are smoking,” he said, “is safer than probably anywhere in the world.”
The National Academies of Sciences’ report on cannabis and public health, which was commissioned by the CDC and the National Institutes of Health, recommended several policy changes states could make to protect the public.
Those include things like limiting the potency of marijuana (Missouri has no such limit), and restricting retail hours at dispensaries. While Kansas City limits how late a dispensary can stay open, the state does not, and some weed shops in neighboring communities offer 24-hour-a-day drive-thrus. Other suggested policies from the report involve implementing strategies to protect kids. In short, they want cannabis products to be controlled much like alcohol and tobacco.
“Almost every state does something right, but there are a lot of things they don’t do,” Teutsch said. “We advise the states to look at what was done for tobacco and alcohol because there’s many years of experience there implementing policies that have a public health focus.”
David G. Evans, a New Jersey attorney representing people who claim they’ve been harmed by marijuana, also believes there is wisdom to be gained from what unfolded in the tobacco industry.
He contends that the legal system needs to step in where regulators have failed. Evans is suing marijuana companies for harming clients and marshalling lawyers across the country to do the same. He hopes the legal actions will bring public awareness about risks of marijuana and rein in the industry.
“The marijuana industry is low-hanging fruit,” Evans said. “They’ve been allowed to be reckless. They’ve not been controlled, not disciplined. And the state governments have played right along with them. Now there’s starting to be a reckoning.”
This story was originally published by The Beacon, a fellow member of the KC Media Collective.
Copyright 2024 KCUR 89.3
“}]] Years of federal prohibition and the resulting limits on research mean the science about marijuana is skimpy at best. Missouri has budgeted $2.5 million for a public information campaign about the health risks of marijuana use. Read More
