Adult Use Cannabis Health Advisory Committee Minutes 05/16/2023

Illinois Adult Use Cannabis Health Advisory Committee Meeting

• Grace Hou - Secretary, Illinois Department of Human Services
• Dr. Sameer Vohra - Director, Illinois Department of Public Health

• Bi-Annual Meeting Pursuant to Public Act 101-0027
• Date & Time
• Tuesday, May 16, 2023
• 2:00 P.M. -3:30 P.M.

MINUTES

1. Call to Order
   1. Secretary Hou called the meeting to order at 2:04 P.M.
2. Welcome
   1. Secretary Hou
      1. Secretary Hou welcomed everyone to the seventh committee meeting. Secretary Hou mentions that there will be a few presenters today: Nathaniel Steinfeld, Deputy Cannabis Regulation Oversight Officer, DFPR and Venkatesan Natarajan, University of Illinois at Chicago (UIC); Rafael Rivera Chief of Staff, IDHS/SUPR; Douglas Smith, University of Illinois Urbana-Champaign; James A. Swartz, University of Illinois at Chicago; and Director Sameer Vohra.
      2. iSecretary Hou introduced Director Vohra. Director Vohra thanked Secretary Hou for the introduction. Director Vohra stated that he will save his remarks for his presentation later in the meeting.
3. Roll Call and Introductions
   1.  Secretary Hou asked Brian Pacwa to complete the roll. Mr. Pacwa confirmed that a quorum was met for this meeting.

Public Members

1. Samantha Alonis
2. Laura Carrillo
3. Robert Connor
4. Dana Franceschini
5. Laura Garcia
6. David T. Jones
7. Lance King
8. Amanda Lake
9. Ryan Lantrip
10. Venkatesan Natarajan
11. Brian Pacwa
12. Sarah Pointer
13. Lee Ann Reinert
14. Douglas Smith
15. James Swartz
16. Ashley Thoele
17. Amaal Tokars
18. Mark Wheeler
19. Rafael Rivera
20. Nathaniel Steinfeld

• IV. Approval of Minutes and Agenda
  • a. Secretary Hou acknowledges that a quorum has been reached. The committee moved to approve the meeting minutes.
• V. Chairperson's Remarks
  • a. Secretary Hou reminds everyone that the charge of the Illinois Adult Use Cannabis Health Advisory Committee is to discuss and monitor changes in drug use data in the State of Illinois and emerging financial and medical information relevant to the health effects associated with cannabis use. The committee also provides recommendations about public health awareness campaigns and messages based on drug use data. Research shows that cannabis use has potential health benefits for people managing chemotherapy side effects and those experiencing insomnia and chronic pain.
  • b. However, as we continue to learn about the benefits of cannabis used in specific settings and with specific populations, we must also learn about the negative health outcomes associated with cannabis use disorder. A recent National Institute on Drug Abuse study found that young men with cannabis use disorder were at an increased risk of developing schizophrenia. The study analyzed detailed health records spanning five decades and representing more than six million people in Denmark to estimate the fraction of schizophrenia cases that could be attributed to cannabis use disorder on a population level. Researchers found strong evidence of an association between cannabis use disorder and schizophrenia among men and women, though the association was much stronger among young men. Using statistical models, the study authors estimated that as many as 30% of cases of schizophrenia among men aged 21-30 might have been prevented by averting cannabis use disorder. Further research is needed to validate these findings. However, still, the study highlights the importance of exploring cannabis use across genders, ages, and racial and ethnic groups and the importance of awareness campaigns that help stop the development of cannabis use disorder.
  • c. Secretary Hou indicated that a link to the study will be posted in the chat box: https://nida.nih.gov/news-events/news-releases/2023/05/young-men-at-highest-risk-schizophrenia-linked-with-cannabis-use-disorder
  • d. Lastly, Secretary Hou states that we must continue to work together to address the stigma and access challenges surrounding the compassionate use of medical cannabis. No one in Illinois should struggle to access their prescribed medication.
  • e. Secretary Grace Hou turns the meeting over to Dr. Sameer Vohra, MD, JD, MA, IDPH Director
• VI. Update on Health Effects- Dr. Sameer Vohra, MD, JD, MA, IDPH Director
  • a. Dr. Vohra thanks Secretary Hou and appreciates the Secretary for outlining the charge of this committee: (1) monitoring the changes in drug use data, (2) thinking about the emerging science and medical information relevant to the health effects associated with cannabis use (3) using information, both data and other, as well as anecdotal stories from the committee and people in our communities so we can provide recommendations and provide the right, culturally effective awareness campaigns and messages. There is still a lot for us to learn about the adult use of cannabis, but there is also we do know. For instance, particularly for medical cannabis and the impact that it makes on providing relief and improving challenging issues with pain management. Dr. Vohra has spoken with James Champion to understand these compelling stories.
  • b. Dr. Vohra is hoping to move through the data that they are finding through their databases around what they see across the state in terms of cannabis, such as some of the challenges and reasons for its use which are noted in the hospital data such as ED visits associated with cannabis use. Part of this presentation is to re-cap some of the timeline and where we have gotten to the state to reach the point that we are now in May 2023. This presentation will focus on the legalization and program timelines and medical cannabis and opioid alternative program data. Opioids are not the right or most effective pain management therapy for many individuals, and medical cannabis allows for the opportunity to create an opioid alternative program. The presentation will also focus on the Illinois Behavioral Risk Factor Surveillance System (BRFSS) data (adults) and Illinois syndromic surveillance (SyS) ED visit counts.
    • i. Dr. Vohra mentioned that thanks to advocates, many of whom are on this committee, the first big step in Illinois to cannabis legalization was in August 2013 when the Medical Cannabis Pilot Program (MCPP) was signed into law. Medical sales of cannabis began in late 2015, which created the opportunity to learn from medical cannabis and to get to the point that we could get to adult-use cannabis. In July 2016, the possession of adult-use cannabis was decriminalized. In August 2018, the Alternatives to Opioids Act was signed, which created the Opioid Alternative Pilot Program (OAPP). In June 2019, Gov. Pritzker signed into law the adult-use cannabis program, then recreational. January 2020 is when adult use recreational marijuana sales began in Illinois.
    • ii. Dr. Vohra provided data on the MCPP and OAPP programs. Within the number of qualifying patients for MCPP and OAPP in 2022, the largest group for MCPP was 48% for non-terminal patients and 36% for caregivers of patients. The OAPP program accounts for 12% of the total qualifying patients between MCPP and OAPP. There are nearly 5,000 healthcare providers active in both of those programs. The number of qualifying patients by fiscal year for MCPP and OAPP shows that more patients have been able to qualify for MCPP. The height of qualifying for MCPP was in 2021. There was a dip in 2022, and they are trying to understand the rationale. For OAPP, there was a dip in the number of qualifying patients for 2020 and 2021, but the number increased to 1,390 patients that qualify for the program as of FY 2022.
      • 1. Dr. Vohra provided a chart of the large number of diagnoses and eligible diagnoses under MCP and OAPP. This shows the importance of how this therapy in MCPP and OAPP affects individuals with several different diseases that span across different organ systems. This also shows the importance of engaging a variety of providers to show them this is a great therapy for them to use and that patients know that medical cannabis is available to them. We want to ensure that the public health campaigns depict that many diseases are eligible for these programs. Dr. Vohra presented a list of the leading and top qualifying conditions. Top qualifying conditions include chronic pain, post-traumatic stress disorder (PTSD), migraines, osteoarthritis, fibromyalgia, cancer, spinal cord disease, neuropathy, irritable bowel syndrome (IBS), and rheumatoid arthritis. Many of these conditions cause severe pain, and having medical cannabis allows for the benefit of these health effects.
    • iii. Dr. Vohra provided data on the Illinois Behavioral Risk Factor Surveillance System (BRFSS) data (adults). This includes data from 2018-2020. Among Illinois users, non-medical reasons are the most common reason for adult use. Approximately 30% of individuals use it for medical and non-medical reasons, 20% for medical reasons, and 50% for non-medical use. In 2018, adult use was higher in Cook County than in the rest of the state, although all regions provide comparable data now. In 2020, adult use was 11% in Cook County, 9% in the collar counties, and 8% for the rest of the state.
    • iv. Dr. Vohra provided data on the Illinois syndromic surveillance (SyS) ED visit counts. In terms of cannabis-related disorders and emergency visits by gender, from July 2022 through March 2023, there are larger numbers of visits for males versus females. The largest age bracket for emergency visits is within the 21-44-year-old group. In terms of the monthly count of Illinois cannabis-related ED visits between July 2022 and March 2023, the biggest peak occurred in March 2023, and they are still trying to determine why this is the case.
      • 1. The major reasons for ED visits included cannabis-induced hyperemesis (increased vomiting), shortness of breath, behavior and mental signs, anxiety, intoxication, pain, injuries, or suicide attempts. In terms of reasons for an ED visit by age group, for individuals between 0 to 4 years old, drug intoxication was noted in 1 in 4 cases. For those 5 to 17 years old, gastrointestinal symptoms were noted in 1 in 4 cases. For those 18 to 44 years of age, GI (vomiting and nausea), as well as mental and behavioral symptoms, seemed to be the biggest factors. The aforementioned were also prominent for the 44 to 64 and 65 and older age groups. 5% of ED visits were among preschool children who had ingested cannabis products, including vaping, edibles, and flower. Ongoing parent education on the safe storage of cannabis and the unregulated THC products available is warranted. Suspected suicidal cannabis exposures reported to US poison centers from 2009-2021 show an increase throughout the years regardless of age group, with the most notable rise during and after the pandemic, particularly with children and females.
  • c. Dr. Vohra opened the floor for questions.
    • i. Latasha Nelson inquired if there is any information pertaining to health equity in terms of medical licenses for getting cannabis by race.
      • 1. Dr. Vohra does not have information available, and he will make a note to answer the question later.
    • ii. Dr. Aks, inquired if the ED visits were just for cannabis or if polysubstance was involved for the adult population, as Dr. Aks sees a lot of polysubstance through his job in the ED.
      • 1.  Dr. Vohra stated that polysubstance use was not controlled for. How things are coded and brought to them does not always provide a nuanced picture of what we see. Polysubstance exposure is something that should be thought about for education campaigns, as well as something that we should think about globally. There could be other things included in substances depending on where individuals are getting the substance from. This is something that we must educate the public on.
    • iii. Kevin Rynn commented on the way that these things are stored, such as up and away from children in a kitchen, yet children are still seeing this as a food product, and they end up in the hands of kids.
    • iv. Marco Jacome asked what are the speculations that attributed to the high peak in ED visits in March 2023
      • 1. Dr. Vohra indicated that this might be something open to the group to understand what they see in practice. It may be seasonal effects. Dr. Vohra stated that if others have other ideas from what they see in their communities or clinically, that it would add value to this question, they can certainly comment.
    • v. Kelly Judge Goldberg asked if Dr. Vohra could contextualize the note about breastfeeding that only 4 in the 1,811 noted breastfeeding in triage notes.
    • Dr. Vohra stated that they are trying to understand how they relate cannabis exposure to babies and preschool children. As they were analyzing the data, there were only 4 in the 1,811 in that 0 to 4 age group that noted cannabis use while breastfeeding. This is to tease out if there is a connection between child poisoning and use among breastfeeding women.
    • Ms. Goldberg stated it's a controversial topic within the medical cannabis community. It also crosses over racial issues as women may not want to provide that information as it puts them in a tough situation.
    • Deputy Director Alonis included in the comments: Only about 1/3 of infants are still breastfed up to 12 months in Illinois, and less than 1/3 are exclusively breastfed through 6 months, so the low number of cases related to breastfeeding doesn't surprise me.
    • vi. Nate Steinfeld inquired if these numbers include Delta 8, which is unregulated THC products. He asked if this was the health effects of any type of cannabis, including Delta-8. From what Mr. Steinfeld has seen and heard, he stated that he sees an uptick in unregulated products.
    • Dr. Vohra stated that he was doing a deeper dive to learn about Delta 8, and Jim Champion may have more comments. It is hard for them to tease this data out, but it is a great point.
    • Mr. Champion commented that he also wondered if the overdose data includes Delta-8. He has seen products in which the packages look the same, and he was wondering, especially for the children, if the overdose data includes delta 8. Mr. Champion stated that it is scary how much companies make these products look like the real thing and how they are marketed directly to children. It is an unregulated industry that he hopes we can do something about.
    • vii. Deputy Director Alonis asked if the shifts correlated to changes in COVID restrictions over time.
      • 1.  Doug Smith stated it might be a post covid rebound.
• VII. Adolescent Cannabis Use Among Youth in ZIP codes with Medical Dispensaries -Douglas Smith, Professor and Director of the Center for Prevention Research and Development (CPRD), University of Illinois at Urbana-Champaign
  • a. Dr. Smith provided information on the Illinois Youth survey (IYS) study he conducted using 2018 data. They were particularly interested in youth in areas with medical cannabis dispensaries using more cannabis than youth not in areas of dispensaries.
    • i. In terms of cannabis laws and adolescent use, a lot of early research uses coastal states, which can be problematic. They are also using state-wide estimates of substance use. Something that differentiates their study is that IYS asks youth to report zip codes, and they can reasonably match how close they live to dispensaries. IYS is completed every other spring in even years. This study uses the weighted sample, which represents all kids across Illinois for 8th, 10th, and 12th graders. This study has 162 participating schools. More information can be found at http://iys.cprd.Illinois.edu.
    • ii. The measures used were self-reported zip codes on the IYS and matched to zip codes of medical dispensaries. Sales data confirmed that the dispensaries were operational before January 2018. Youth self-reported the past year and past month cannabis use. They controlled for gender, race, free and reduced lunch, grade, region, and zip code size because some counties are very large.
    • iii. Dr. Smith provided a graph depicting adolescent cannabis use in the past month and the past year over time from 2011-2018, when medical cannabis legislation was passed, and licenses issued. There have not been major changes throughout this time period.
    • iv. The main findings show that youth that lived in a zip code with a dispensary were less likely to use cannabis in the last 30 days for grades 10 and 12. Within the past year, cannabis use was lower for 12th graders that lived in a zip code with a dispensary. There is no significant effect for 8th graders. Youth living in the suburbs depicted even lower cannabis use if they lived in a zip code with a medical dispensary. The presence of medical dispensaries appears to have not increased adolescent substance use through 2018. However, it is still early. At the time of this study, only 55 dispensaries were operational, but if you look at California studies, there are hundreds of medical dispensaries.
    • v. Dr. Smith indicated that it is important to keep in mind that zip codes are an imperfect measure of proximity to dispensaries, only self-report data was used. Causality is difficult due to the cross-sectional nature of the study.
    • vi. Dr. Smith indicated that it is still critical to monitor this. Some of the newer forms of cannabis are particularly needed to track, such as Delta-8. He would like to do a follow-up study with concentrates and other forms of cannabis that are more accessible if you live close to a dispensary. Doug notes that in Monitoring the Future in 2022, 50% of high school seniors used alcohol in the past year, and approximately 1 in 5 used cannabis in the past year. This declined during the pandemic years and has not yet rebounded. It will be interesting to see if this changes over time when more data becomes available.
  • b. Secretary Hou opened the floor up for questions.
    • i. Dr. Tokars inquired what were the particular questions in IYS that they measured off.
      • 1. Dr. Smith stated it included: in the past 30 days, how many days did they use cannabis, and then they dichotomized the variable into a yes or no indicator.
    • ii. Chief of Staff Rivera commented, as far as the rebound effect, that is what folks are scared about since we saw rates go down during the pandemic. So, we are still all waiting to see if there will be a rebound effect. He asked Dr. Smith if he had any idea if there would be a rebound effect and if there was anything that has been depicted in the literature thus far.
      • 1. Dr. Smith said he could answer the question but would be speculating. In IYS in 2022, schools were still reeling from the pandemic. They still had difficulty recruiting schools due to teacher shortages and CPS strikes. School districts were still challenged, so, they don't have great data. Substance use among teens is a social activity, so, if teens are separated from their friends and at home, they have less access. As teens are around peers more, then it would make logical sense to see a rebound effect.
    • iii. Dr. Zachary Marcus, a pediatrician, stated that he takes care of young adults in college health, typically individuals between 18-35 years old. He is aware of the sensitive period in which the younger initiation, then there is an increased risk of psychosis. His suggestion is to look at in future research, and anecdotally he has seen, that there has been a great impact on the 18-25-year-olds. He is curious if the impact on 18-25-year-olds has been greater than for those at younger ages and if initiation within the young adult age group poses similar issues for increased risk of psychosis.
      • 1. Dr. Smith stated that this comment dovetails with Dr. Vohra's presentation. There were many hospitalizations in the 18- age group. So, he wonders if most people within that group are within the 25-30 age range. Youth that have an earlier age of onset may put them at risk for polysubstance use, which increases the risk of hospitalizations. Within the IYS, there was a small percentage of people using opioids that were also polysubstance users.
    • iv. Deputy Director Alonis stated that she is thinking about health equity and regional health equity, and she is wondering if there is a correlation for youth that are in areas that have dispensaries are lower because it is a predominately white and wealthy neighborhood. Deputy Director Alonis inquired if the study controlled for this factor.
      • 1. Dr. Smith stated that they are planning to merge IYS with income mobility data, which ranks all zip codes in terms of income mobility. They have interesting findings that he will send to Deputy Director Alonis. Dr. Smith thinks that they may have a way to analyze what she is suggesting, but it requires an additional data source.
• VIII. Cannabis Research Institute- Nathaniel Steinfeld, Deputy Cannabis Regulation Oversight Officer (CROO), DFPR; Venkatesan Natarajan, University of Illinois at Chicago (UIC)
  • a. Mr. Steinfeld introduced himself as a part of the CROO team. He focuses on research and data and helps support the State connect to different data sources across state government, as well as support the need for cannabis research across the market. A part of his job, he has been working with DPI, which is a branch of the University of Illinois system. They are close to having an actionable plan to conduct research on cannabis across all our public universities to inform this commitment and influence government policies across the board. Mr. Steinfeld introduced Mr. Natarajan to talk about the idea of what the Cannabis Research Institute is and what the next steps are.
  • b. Mr. Natarajan introduced himself as the Director of Research at the Discovery Partners Institute.
    • i. They will be building a research institute that will break ground next year. The institute will be situated under the DPI. There are 3 pillars of research priorities:
    • Social equity impacts: social equity programs, medical cannabis access, diversity, equity, and inclusion (DEI)
    • Medical and health effects: medical and clinical research on effectiveness, the intersection between cannabis and other drugs, teen use
    • Agricultural crop management: the Agricultural School at the University of Illinois Urbana-Champaign has a large cannabis program looking at crop size. The institute will help support extraction technologies. process innovations, environmental improvements, and relationship to industrial hemp.
    • ii. The primary institute activities will be broad and interdisciplinary and include research as the primary activity, but it will also affect education, training, and advisory to the city, state, legislative, and federal bodies.
    • iii. The goals of the center include:
    • Becoming a national center of excellence for cannabis research
    • Provide reliable information to address key questions for the State related to cannabis.
    • Build trust among stakeholders, including policymakers, community leaders, and industry representatives, by convening workshops and learning sessions.
    • Establish collaborative networks to strengthen social equity programs and encourage scholarly collaborations and innovation across different disciplines and sectors.
    • iv. Mr. Steinfeld stated that it is critical for them to keep in mind the equity of research and make sure they have collaborative teams. They want to ensure they are connected to community colleges and training programs to make this top-level research actionable and useable. There is much need for research to explain the questions we all have related to cannabis, but this research must be focused on forward-thinking, and equity centered.
    • v. Mr. Natarajan indicated that broadly, there is limited funding at the federal level for cannabis research. For NIH funding, cannabis receives some modest levels of funding, such as 390 million in 2022. Comparatively, alcohol and tobacco are much higher. He thinks the differences can be broadly offset by state-level funding.
    • vi. There are some cannabis institutes across the country that they have been in touch with. For instance, California has many different cannabis institutes the agricultural institute is at UC-Davis, the medical institute is at UC-Irvine, and the social equity is at UC-Berkely. Within Illinois, they are trying to create a comprehensive institute, and the first in the Midwest to do so with these three pillars, particularly focusing on social equity.
    • vii. Illinois is positioned to be a national leader in cannabis research through the work of CRI. It is meant to be a partnership between the city, state, and University of Illinois system. The institute was announced in December of 2022 by Governor Pritzker and Mayor Lightfoot. They are currently going through the hiring process of hiring a Director for CRI to ensure that they are staffing the institute with the necessary research expertise. They plan to work with community members, build interdisciplinary teams, and house data repositories to inform the State and the public about cannabis.
      • 1. Mr. Steinfeld stated that the equity lens requires public funding and support. What has worried Mr. Steinfeld about some other institutes in other states is that they are heavily funded by the industry.
    • viii. DPI is in talks with the city and the state for potential funding for the institute and build-out after two years.
• IX. Data Collection Update: Dr. James Swartz, University of Illinois at Chicago
  • a. Dr. Swartz stated that he wants to provide an update on the data sources he uses for the report. After about two years, he now has permission for almost all the datasets; however, there are a couple of issues this year with a few datasets. The National Survey on Drug Use and Health, which is heavily relied on for the report, pulled their 2020 data because they believed that with the COVID pandemic, they did not have a representative sample. So, they did not want people to compare 2020 to other years. They have not posted 2021 data yet. As such, Dr. Swartz may have to use canned reports, which may limit him in some of the analyses that he can do. Additionally, after a long time of trying to request raw data for MCPP/OAPP, he will not have permission to obtain access to this data. The intent was to match the data from both programs with PMP data to do an analysis to see if people previously on opioids that converted to MCPP or OAPP had reduced their use of opioids. However, Dr. Swartz was told that after legal review, he was not able to gain access because the restriction is actually baked into the statute, which states that "this confidential list may not be combined or linked in any manner with any other list or database." PMP was approached by the CDC to put together a multi-state study to look at this same issue, and we hoped to participate in the multi-site study. It looks like unless this statutory limitation changes down the road, then this is not possible in the near future. This was written in the statute because cannabis at the federal level is still illegal. So, there was concern that this information could be used if policies changed at the federal level about actively going after people to charge them with an offense.
  • b. Dr. Swartz wants to mention a few studies that have come to his attention. As part of what he does is review the research coming out, and he tailors his analyses to how this is presented in Illinois. One study that Dr. Swartz wanted to mention is the study that Secretary Hou presented on early in the meeting, regarding the study in Denmark. Dr. Swartz stated that the study mentions the association between cannabis use and schizophrenia, but then they make claims that one-fifth of cases could be prevented. This claim goes beyond association, and their analyses don't really support that. He looked at the study to see if they looked at someone starting cannabis at time 1 and if they were more likely to use it at time 2 and 3, but he did not find any indication of this in the study. He cautions putting too much emphasis on this study and their conclusions about a causal connection between cannabis and schizophrenia. Dr. Swartz presented another study that looked at all 50 states and did not find statistically significant differences in the rates of psychosis-related diagnosis or prescribed anti-psychotics for states with medical and recreational cannabis compared with states with no such policies. This highlights that this information is in flux. Furthermore, Dr. Swartz presented a study that came out this past year on traffic fatalities. The authors concluded that states who legalized earlier experienced larger traffic fatality increases. So, since Dr. Swartz has access to the data in Illinois, he wanted to determine if there is a similar association within the state of Illinois. In Illinois, the number of fatalities in Illinois with the driver testing positive for cannabis. The number of fatalities has increased, as has the number of positive tests related to fatalities. However, as a proportion of the fatalities, the percentage has not changed. It was 10% in 2018 and has remained around 8% from 2019-2021. So, we have not seen the same thing happen in Illinois yet that was indicated within this traffic fatalities study. Dr. Swartz stated that polysubstance use is quite common. In terms of traffic fatalities in Illinois, drivers have 2 times the likelihood of also testing positive for stimulants, MDMA, and tranquilizers. The one drug that was not more likely was opioids. Overall, we must be cautious about research conclusions because as you look further into the research, there is more to the story. We need to also look at polysubstance use among people using cannabis.
  • c. Secretary Hou stated that there is a message in the chat from John inquiring if there is any new data on Gateway theory for cannabis.
    • i. Dr. Swartz indicated that a paper he read most recently showed that there was no effect, but he has not seen anything else recently. One paper he read was that if there was any effect that it was rather small, but most of the research has been negative about cannabis being a gateway to other drug use.
• X. Secretary Hou requested that attendees write in the chat any public comments they may have during Chief of Staff Rivera's presentation that can then be addressed at the end of the meeting.
• XI. Update on the Public Education Campaign: Rafael Rivera- Chief of Staff, IDHS/SUPR
  • a. Chief of Staff Rivera indicated that we have a small think tank with Dr. Doug Smith, Dr. James Swartz, Nate Steinfeld, and himself. So, he wanted to thank those individuals that put thought into what we see within these studies.
  • b. Chief of Staff Rivera wants to provide an update on the public education campaign regarding addressing the issue of childhood poisoning. He is working with the Division of Early Childhood on processes and reviewing messaging to bring awareness to childhood cannabis poisoning. Their team is exploring distributing lockable stash bags. They are working with Prevention First as their vendor.
  • c. They also reached out to the Bureau of Maternal and Child Health to gauge their interest in partnering with the safe storage pilot initiative. They are focusing on marketing materials and the distribution of stash bags. They are working closely with CROO, especially Nate Steinfeld, to identify dispensaries and advocacy groups that would be open to the distribution of free stash bags as a strategy to reduce childhood poisoning. Rafael held up a stash bag to show what they looked like. They will provide these in different venues targeting people purchasing cannabis or young parents. When we talk about cannabis and childhood poisoning, the best thing to do is lock up weed, particularly edibles. So, a lot of the public awareness campaign efforts will be targeted toward locking up cannabis. The stash bag is a smell-proof bag, so dogs cannot smell it. There is a combination lock so parents can lock items in it.
  • d. Secretary Hou opened the floor to any remaining questions.
    • i. Dr. Nelson, who is an OB/GYN, inquired if we are noticing any effects of cannabis use among kids which mothers used while pregnant.
    • ii. Chief of Staff Rivera and Dr. Swartz have not seen any research thus far. Dr. Doug Smith speculates it is too early to answer that question.
• XII. Secretary Hou thanks everyone for their time.
• XIII. Meeting adjourned at 3:31 P.M.