Marijuana has been legal in Arizona for quite some time — voters approved medical use back in 2010 and recreational in 2020. While we generally consider it safe and not addictive, new reporting from outlets like The New York Times show, that’s not always the case for everyone.
While most people aren’t going to experience any problems with cannabis, we’re learning more about the negative reactions some people have as time goes on.
Dr. Bryan Kuhn, a pharmacist and clinical toxicologist with Banner’s Poison & Drug Information Center, says much of them stem from confusion over dosages and the unregulated, but still intoxicating, versions of the drugs you can buy outside of dispensaries.
Dr. Bryan Kuhn, a pharmacist and clinical toxicologist with Banner’s Poison & Drug Information Center,
Full conversation
DR. BRYAN KUHN: The more you make some product available to the general public, the more likely we’re going to start to see increased use, increased cases, and, you know, unfortunately some increased issues from these types of exposures and even preceding the legalization in 2020 for recreational cannabis products, we had already started seeing an increase both locally and nationally. We’d seen an increase in the numbers of calls and cases reported to the 55 poison centers across the United States.
Our calls seem to have more or less plateaued in the last couple of years. So in 2023, 2024, we saw somewhere in the neighborhood of about 400 to 500 calls coming into our poison center, and probably the most expected trend, if you will, were the increased calls related to children getting into these cannabis products. These are products that don’t always give you the clear indication that they are indeed cannabis containing and so whether it’s a child finding a cookie, a brownie, a gummy bear, what have you, or an adult just unwittingly finding you know, these products are around the house, we started to see this increase in the call volume at our center even before the legalization of recreational cannabis products in 2020.
LAUREN GILGER: OK, so you mentioned kids and sort of accidental, you know, kids eating an edible kind of thing being one of the top problems that you see. But let me ask you also just about this issue of dosages, like, are there calls from adults who just do not know how much THC they’re ingesting?
KUHN: Yes, and we have a couple of things that need to be sort of sussed out in this entire process because we can get cannabis products from the licensed dispensaries that are part of the Arizona Dispensary Association in the state that have to adhere to prescribed rules that were promulgated in the 2020 Prop. 207 passage.
These rules indicated what type of packaging, labeling requirements had to be in place, what sort of dose limitations and total dosage in a package, and we find that there are in sort of that camp of cannabis calls that the history or the information tends to be pretty reliable from what the caller is able to give us.
But then we have the products that fall outside of what was in the farm bill of 2018 and Prop. 207 and 2020 that allowed for, let’s call it the psychoactive hemp-based products. So this would include Delta 8, Delta 10, THC products, CBD products. So in that sort of second camp we have far less reliability with respect to the potency, quality and purity of the product that we are getting phone calls on. It makes it a little bit more challenging to predict when and to what extent or the severity with which we’ll expect to see sort of the kind of anticipated clinical effects.
GILGER: Yeah, that makes sense. So these intoxicating hemp products are becoming an issue at your level as well. We expect maybe to see some legislation on that, I think at the Capitol this year, right, like looking at whether or not these should be regulated here. They’re regulated in some states, but you don’t know exactly what you’re getting.
KUHN: Indeed, indeed, and you know, ultimately, you know, the farm bill was pretty narrowly defining what was able to be sold by dispensaries, and it was very specific that it was going to be this Delta 9 THC product, which tends to be the poster child psychoactive compound you find in the cannabis plant, but it’s really only one of several 100 different compounds that you find in the cannabis.
You have the analogs like Delta 8, Delta 10, and really all that delta and the number designation means is it’s the same compound just in a slightly altered form. And so we find it doesn’t always have a sort of a 1-to-1 equal potency with the Delta 9. We generally expect like Delta 8 to have about half the potency of Delta 9, but it’s still, if you take, you know, an equipotent dose of the Delta 8, it will result in the same sort of clinical effects as Delta 9.
GILGER: Interesting. OK, so that’s one issue you’re seeing. What about when it comes to this dosage question even for, you know, more regulated cannabis products in the state? Like, is it, is it like somebody who has never used marijuana is getting themselves sick because they don’t know what they’re taking or they took more than they should, or is it more like people who use every day can see problems?
KUHN: So the new user of the product, let’s, let’s be honest, I mean when it comes to the dosage from products you can buy at a dispensary, they are typically limited to having a total of 100 mg per package and the typical dosage unit you’re going to find is a 10 mg gummy, let’s say.
So it becomes very imprecise when you bite off a half or a quarter of that gummy to get your 2.5 or 5 mg dose, if that was your intended dose. And so you know this very imprecise dosing and dosing that might be predicated off of someone else’s use history or experience might be more or less than what you are willing to tolerate.
GILGER: I wonder what you think of the regulation we have set up and and if there are things you think should be done to help people understand this better as they use it.
KUHN: I mean, that’s a fantastic question and, and certainly, you know, there are regulatory issues that could be in place that standardize any cannabis product, whether it’s a CBD, CBG, CBN, THC product across head shops and dispensaries. There’s, you know, but those gears tend to move more slowly than just becoming an informed consumer on our own end. So you know, having a discussion with your personal physician or even those at the dispensaries, this is their product. They want a consumer who comes back to buy quality products.
So, you know, ask the pertinent questions that exist in your mind to those from whom you’re purchasing the product from. But also, you know, poison centers, physicians, medical professionals can all weigh in. You know, we all might come with our biases, but you know, if you’re asking for objective information, hopefully you’re going to receive an objective answer to your question.
H/T: www.kjzz.org
