Cannabis "potency" is colloquially used to refer to the concentration (%) or dose (mg) of tetrahydrocannabinol (THC)—the primary psychoactive and intoxicating constituent of the cannabis plant—present in cannabis or cannabis products. The potency of legal herbal cannabis currently sold in California is now five to ten-fold the level found nationally in cannabis studied in the 1970s and 80s. A wide range of manufactured solid and liquid chemical extract products of up to 99% THC are now sold as vaping liquids, shatter, waxes, or other concentrates or are used in edibles.
There is a pattern of increasing risk with increases in THC concentration: the higher the levels of THC in cannabis and cannabis products, the higher the risk of experiencing adverse events and cannabis use disorder. Use of high-potency cannabis may also be especially harmful for certain populations, including people under the age of 26 whose brains are still maturing, those who are pregnant and their infants, and people with a personal or family history of mental health conditions or substance use disorders.
This report was prepared by a committee of scientists and medical experts who were convened by the California Department of Public Health in response to a Resolution of the Department of Cannabis Control's Cannabis Advisory Committee and a Governor's Directive to provide an analysis of the problem of increasing potency of cannabis and cannabis products and formulate recommendations to address it. Dr. Lynn Silver, director of PHI's Getting it Right from the Start program, served as co-chair of the committee and is an author of the report.
Top Ten Recommended Policies by Likely Greatest Impact on Adverse Outcomes, in Order
1. Prohibit cannabis product advertising on billboards or any other general public-facing advertising
2. Limit the manufacture and sale of high-THC products. Specifically a) prohibit the sale of liquid and solid concentrates for inhalation (e.g. dabs, wax, shatter) with THC content above 60% and implement careful oversight of allowable vehicles and diluents to ensure safety; b) Prohibit the sale of cannabis flower with THC content above 25% and prohibit the infusion of additional THC (or other psychoactive cannabinoids) into flower or pre-rolls; and c) Limit edible products to a maximum of one 10 mg THC dose per physical piece or liquid beverage container (excluding tinctures).
3. Consider testing, promoting, or facilitating a Quebec-style public monopoly approach to cannabis sales, particularly in jurisdictions that have not yet legalized cannabis sales.
4. Restructure state excise taxation on adult-use cannabis to be proportional to the milligrams of THC in the taxed product, applicable to all cannabis products. Ensure that the restructuring maintains or increases cannabis tax revenue in line with the goals established by Assembly Bill 195 (the 2022-2023 legislative commitment to replace revenue lost from the cultivation tax cut by 2026).
5. Enforce existing laws and regulations that prohibit products that are attractive to children and restrict flavored additives in inhaled cannabis products.
6. Prohibit the use of added flavors (including fruits, mint, menthol, vanilla, chocolate, spices, and other common food flavors) in inhaled products, whether natural or synthetic. Additionally, prohibits language and images that could lead consumers to believe the product has flavors other than those of cannabis.
7. Strengthen regulations with clearer, evidence-based criteria for identifying and prohibiting packaging, marketing, and advertising characteristics that appeal to children and youth.
8. Fund and implement public education campaigns on the risks of high-potency cannabis, including mental health risks. Allocate additional funds from Tier 3 of cannabis tax revenue (without reducing the Elevate Youth program) to the CDPH, totaling $10 million or more per year beyond their current allocation. These funds should be used to enhance high-quality cannabis prevention education campaigns, including those focused on high potency messaging, as well as supportive formative research and testing of messaging. Prioritize campaigns addressing use during pregnancy, drugged driving, and education for youth and seniors.
9. Fund and ensure the tracking and regular reporting of negative health outcomes associated with high-potency products in California hospitals, emergency rooms, and ambulatory care settings. This should include documenting the type and potency of marketed products. Additionally, incentivize increased screening to more clearly document the product type used in clinical services and poison control cases.
10. Require plain packaging for all cannabis products. At a minimum, this should apply to high-potency products, including flowers with THC content above 20%, inhaled products exceeding 35% THC, and edibles containing more than 10 mg of THC per individual piece or liquid container, if permitted.
To read the full report, click here.
Source: Public Health Institute