Interdisciplinary Approaches to Informing State Cannabis Policy

Transcription

1 Interdisciplinary Approaches to Informing State Cannabis Policy Nicholas C. Peiper, PhD, MPH Getting in the Weeds: An Emerging Issue in State Health Policy National Academy for State Health Policy #NASHPCONF17 October 24, RTI International is a registered trademark and a trade name of Research Triangle Institute.

2 Conflicts of Interest None to declare. This work was funded through a Strategic Investment Fund (SIF) at RTI International. 2

3 Overview Current State Policies New Products and New Effects Retail Perspective Big Data Broad Data Future Directions 3

4 The November 2016 Ballot Medical: 29 states Adult Use: 8 states + D.C. 2 in 3 adults live in a medical state 1 in 5 adults live in an adult use state 4

5 New Products Legalization has led to an explosion of new products, with a wide range of potency. 5

6 New Effects I was out for a good, I want to say 24 hours. Denver focus group participant The oil and the wax lasts so much longer. One puff of that is a head changer, if that s all you want. San Francisco focus group participant Geez, I didn t mean to do this. Seattle focus group participant 6 I do edibles at least twice a week, strong edibles. Because I like the high. San Francisco focus group participant

7 Public Health and Safety Issues Unexpected highs Drugged driving Inexperienced users Delayed effects Mislabeled or tainted products Product inconsistency 7

8 RTI Colorado Survey Nine months after the January 1, 2014, start of retail sales (634 people who used cannabis in the past year): 71% had tried a new product 54% had used an edible 55% got more high than expected 8

9 Trying New Products, Edibles & Unexpected Highs 100% 90% 80% New Product Trial and Unexpected Highs 70% 60% 61% 50% 40% 43% 30% 20% 10% 0% Tried a new product Got More High than Expected Did not try a new product Trying new products and edibles were associated with greater odds of an unexpected high 9 New product trial (aor=2.13, p<0.001) Edible use (aor =1.56, p<0.05)

10 Retail Perspective 10

11 RTI Dispensary Survey (N=158) Have you ever received any formal training or certifications to be a budtender? 56% answered yes Never/Rarely 5% Sometimes 23% Sometimes 12% Often 41% Always 31% Always 27% Often 61% 11 Label Disclosure for Edibles Risk Disclosure for Edibles

12 Dispensary Internet Behaviors Types of posts in the past 30 days among dispensaries with a social media account (73%): 77% New Products/Storefront 52% Scientific/Medical Report 72% Coupons/Promotions 30% Delivery Services 12

13 Big Data: Twitter 13

14 Broad Data: Oregon BRFSS 1 Cannabis Use Subtypes (N=378) Subtype 1 (12.9%) Subtype 2 (7.4%) Subtype 3 (62.7%) Subtype 4 (16.9%) Smoke Ingest Vape Other Cigarettes Binge Alcohol 14

15 Broad Data: NSDUH 40% Daily Cannabis Use Among Recreational and Medical Users 35% 30% 25% 20% 15% 10% 5% 0% Recreational Medical 15

16 Policies to Prevent Product Contamination/Protect Consumers Inventory Tracking Pesticide Testing Ingredient List Expiration Date Denver-based MMJ Edibles Recalled Over Pesticide Concerns CO, WA, OR, AK each require inventory tracking and pesticide testing AK does not require an ingredient list OR does not require an expiration date

17 Policies to Prevent & Manage Delayed Effects of Edibles CO, WA, OR, AK each enacted drugged driving laws and require warning labels WA, OR, AK s laws were in place on the first day of sale: CO enacted drugged driving and warning label requirements 6 months after edibles first went on sale

18 Thank you! Nicholas C. Peiper, PhD, MPH Behavioral Epidemiologist Behavioral & Urban Health Program RTI International