Day 3 Hearing Recap for Kansas Medical Marijuana SB560.

As advocates for medical marijuana and adult-use marijuana, it would be easy to go into today's hearing and react to every objection - but it would not be advocacy. It would be my own bias manifesting negatively and defensively. To truly advocate for something means acknowledging the good and the bad and having adult conversations to find solutions and compromise to the "dark reality" so many refuse to acknowledge in the light of all of the benefits of cannabis. I am not going to recount every testimony so that you can target the statements of individuals. I am going to give you the overall consensus of their concerns. Their real concerns.

There are many valid concerns that the physicians and law enforcement expressed today. They are doing what some of us refuse to do and are looking into the worst-case scenarios. They're forced to do this because they see them. Every day. We don't

There are no dosage guidelines, no consistency with effects. No real way to enforce the laws because there's no way to measure the current level of intoxication based on dosage - because a person's tolerance varies, and one dose may not impair one person, while completely impairs another. It's the "wild west" of medicine.

Who among us has smoked and felt paranoia or panic? Be honest. ✋ Who has felt that edible or dab hit a little too hard and had to lay down? ✋

Anyone denying they've never felt a moment of negative effect from cannabis use is lying to themselves or simply doesn't remember. Now - are these what people would think of as "major side-effects" when we have pharmaceutical commercials with symptom precautions listed by an auctioneer in the background? Heck no! These are the minor league compared to our everyday pain and they pass quickly. But that is not how a physician or law enforcement officer sees it. A problem that's a problem - is a problem.

As proponents, we often say "Well, we can't cap the THC levels because different people with different tolerances will require increased amounts." Or "We need all forms of use available because it affects people differently." We acknowledge that what's right for one user, isn't always right for another. These are our valid and truthful defenses. They are also the same reasoning and defenses used by the opponents today - it does affect everyone differently, and they are seeing an increase in the negative effects as THC levels rise in medicinal and recreational products. Every medical professional today noted a diminishing return, if you will, in the medical benefits of cannabis after a peak of 10-15%.THC. That perhaps we're discovering that there is a point where too much IS too much that we would not have known if not for the emergence of concentrates and strains specifically bred to increase THC. They are saying "Absolutely, yes - cannabis has health benefits, and has been safely used for thousands of years - but not with these man-made levels of THC." These genetically modified buds aren't the "natural medicine" we're accustomed to and fighting for. They even explained that we see this phenomenon in other medicines as well. As dose and potency increase, the adverse effects are increasingly likely and become worse. Over-the-counter medicines such as Ibuprofen are beneficial at small doses but can cause great damage at high dosages and prolonged use. Ulcers and stomach issues are often reported.

And while we may not think of them this way, the paranoia, anxiety, "greening out" we experience are all symptoms of THC overdose. And while cannabis doesn't directly kill you, they have seen instances where the panic it has induced has caused heart attacks, and the paranoia has caused suicides. And that while these instances used to be few and far between - they're becoming more common as the levels of THC available are increasing. These correlations are clear and increasing enough that they are concerned. As THC levels increase they are also seeing a parallel increase in mental disorders associated with long-term use. And while you may be like me and immediately say "I use it to help my mental disorders!", and dismiss them, it's enough of a concern that Colorado overwhelmingly passed Bill 21-1317 into an Act in June of last year to further study how these effects should dictate future regulations. Those studies will conclude on July 1st, 2022. It's easy to shrug them off and say "Well, there's a lot going on in the world, these mental issues are just life right now." - and we would not be wrong, but if they are able to draw a clear line of causality over the past decade or so between the increase and exposure to high doses of THC not seen before in mankind's history and mental health episodes - it's worth taking the ounce of caution to listen.

They aren't wrong - THC levels available have risen dramatically since people have been allowed to openly grow and play with genetics. This study ends in 2014 and we hadn't even hit 14% yet. Less than 10 years later we're seeing plant matter up around 40% and concentrates, "THC diamonds" that are 99% pure THC. If it was going to be sprinkled sparingly like salt - diluted and on its own, that's one thing - but people are layering this with waxes, kief, and plant matter - or dabbing it straight.

As an avid user and proponent, even I have to step back and think sometimes when I see these products and videos of users on social media - "Damn, that's some overkill". And if your tolerance is that high, perhaps it's time for a T-break, or micro-dosing to get that back under control. I even personally find that use of concentrates raises my tolerance faster. Some of these new products are not being used responcibly.

At least with flower, changing strain and terpene profile can be enough of a change that it helps with your tolerance reset. But the closer you get to 100% THC, the less of the other beneficial ingredients, cannabinoids, and terpenes you're getting. You're losing the "entourage effect" that makes cannabis beneficial. You may as well be getting Marinol - a pill of synthetic THC, in which case you wouldn't need medical marijuana. Dr. Eric Voth stated in his testimony "If you want to legalize cannabis use for people - do it, but leave medicine out of it." when discussing how medical cannabis is used as a predicate for recreational marijuana. That we essentially "test the waters for legalization" using medicine as a patsy. And I can't disagree with his observation. Every state with medicinal cannabis does eventually go to recreational - or will. So, even when we're asking for medical marijuana - what is it we really want? We want everyone to have access that can find relief in cannabis. We want those with illnesses to be able to use marijuana for its proven medical benefits. So why not skip the medical middle man? Just legalize. Give everyone access. Dr. Elizabeth Stout referenced the "Paradox of Prohibition" (shown below) which is a graph that is based on decades of studies that show you get the least amount of public harm when you legalize with strict regulation. Medical cannabis would fall between "prohibition" and "decriminalization and harm reduction". It leaves recreational use unregulated which feeds the black market and increases public health risk -especially with today's THC concentrations and the high risk of mold in large grows.

This brings us to the officers.

They just want to keep the public safe. They're worried about traffic incidents and vehicular fatalities, they are the ones that have to respond to find your loved one scared, injured, or worse. They are the ones on the line that need to know when and how to tell the difference between a legal possession - or illegal possession of cannabis to protect cardholders' rights. They need to know how to decipher the level of intoxication of a cannabis user on the road to keep the public safe.

Law Enforcement likes clear-cut rules to follow - which is why they also want pharmacy-like specificity when dealing with prescribed cannabis. What should be in that bag? What is a 30 day supply? What is the prescription on intake for this particular patient? How can we guarantee that the product in the bag is a legally dispensed product? What are the safety features on the ID card that will enable us to ensure it's a valid card? Will there be a database available to us 24/7 so when we have a suspect that forgot their card we can validate them? How will unused medicine be discarded at an end of life situation for a cardholder?

These are all valid questions that enable or prevent them from doing their job. Many of the law offices also just straight out don't have the equipment to test products or people properly and these things are not addressed in the bill.

When it came to legal repercussions it was the physicians who wanted to remove the portions of the bill that protect the recommending doctor from malpractice suits. They all believe that if negative effects were to occur due to improper dosing or lack of follow-up with the patient, the doctor should absolutely be at fault. However, Dr. Voth stated later that he wouldn't want to be sued for recommending a vaccination - which is a bit contradictory to his statements toward cannabis doctors, and opiate doctors who have "created addicts".

He also stated that in all of his years of medicine and careful patient monitoring, he has never personally created an addict. He fears that marijuana physicians will be lax due to the perceived safety of the plant in conjunction with the abuse of the medical cannabis system to gain recreational access.