Commentary

Dr. Catherine Antley: THC limits in cannabis concentrates are essential

This commentary is by Catherine Antley, M.D., a community physician in South Burlington. 

The recent article on THC limits in cannabis concentrates leaves out the important fact that Vermont law currently includes a 60% cap on THC in solid concentrates. 

Thankfully, lawmakers in the Vermont House have listened to the science, and they are working to keep the high THC concentrates cap in H.548. The intent of Act 164 as passed and as sold to Vermonters is that the commercial sale of cannabis is "for the purpose of public health and safety.”

What is new is the Cannabis Control Board’s push for these dangerous products before the market in Vermont is even off the ground. These are not products used by the “casual” cannabis consumer.  In the 1990s, the average THC content in marijuana flower was less than 4%. It is now about 15% — and we’re talking about products with a potency of up to 80 or 90% THC. 

What do we know about these products? The science is settled that they are dangerous, especially for the development of severe mental illness.

The chair of the Vermont Cannabis Control Board testified last month, "I recognize that these concentrates are dangerous ... they are dangerous ... they are dangerous, you know … there are long-term negative health consequences of consuming high THC concentrates." 

A dot the size of a grain of rice of concentrate is “dabbed” using a nail and blow torch at temperatures around 500 to 700 degrees.  The products are so powerful, people report developing a dependence immediately.

Thousands of Colorado families and individuals have been affected by the harms of THC marijuana concentrates and have contacted their representatives. Lawmakers also watched firsthand as psychosis, schizophrenia and addiction developed in their families, who, to quote Dr. Robin Murray, “would be well but for their cannabis use.” Colorado Rep. Judy Amabile testified about her son. Colorado’s attorney general also testified on alarmingly increasing Colorado youth use and need for consumer protection and eventually a 2021 bill resulted in mandatory warnings on THC marijuana concentrates. The bill also allocated $3 million alone for a scoping review of the all the quality peer-reviewed literature on high THC concentrates; results due in June 2022. 

By law, Colorado purchasers of THC cannabis concentrates must now be warned that use may lead to "psychotic symptoms … mental health problems … uncontrolled and repetitive vomiting … and … physical and psychological dependence.” Cannabis is now the drug most often found in completed teen suicide in Colorado. The Colorado warning includes a telephone number for the suicide hot line. See our 2022 Vermont Statehouse testimony on high THC concentrates here.

While controlling the illicit market is cited as a reason to lift the Vermont THC caps, there is no convincing evidence that lifting the THC caps will decrease the illicit market on the products. Where there are no caps, like California and Colorado, the illicit market has increased.

In Quebec, high THC concentrates are capped, and the use of prohibited (illicit) products like high THC concentrates is lower as compared to neighboring Canadian provinces without THC concentrates caps.

This is logical. With a high THC cap, these products are not produced legally to then be diverted to the illegal market and they are not promoted as safe through legal advertising to the public 21 and older.

It is now understood that high THC concentrates act as an environmental health risk for severe mental illnesses like psychosis or schizophrenia in a city or locale, just as we know that lead is an environmental risk factor for low IQ or air pollution is a risk for lung disease.

So why is the Cannabis Control Board pushing for these products now? Maybe because the cannabis industry, like tobacco and opioid, wishes to create the most highly addictive product. "Dependence is good for the bottom line " as Beau Kilmer, Vermont Rand report author testified to the Vermont Senate finance committee in 2016, predicting then that industry would create new products and strategies to increase dependence, regardless of the harms.

Vermont physicians, nurses and mental health providers, already overwhelmed by a pandemic and a Vermont mental health crisis, will be left taking care of the increase in psychosis, schizophrenia, suicidality, unrelenting vomiting with resulting kidney failure, dehydration, seizures and dependence (addiction). Many mental health harms of cannabis THC concentrates are sadly irreversible.  To help prevent mental illness and addiction, I only hope that by the time you read this, the cap will still be in place.


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