The medical cannabis edibles market is experiencing unprecedented growth across the globe, including in other states besides Maryland where cannabis has been legal for longer. Smaller product developers should brace themselves for stiff competition. Major food and beverage corporations have their eyes on this space and are jumping in. Those who have already dipped their toes into the water include Anheuser Busch, Coca-Cola, Constellation Brands and Molson Coors.
William Tilburg and the Maryland Medical Cannabis Commission are working to safely bring edibles to market in Maryland, a state where one percent of the population is a medical cannabis patient. As director of policy and government affairs for the Maryland Medical Cannabis Commission (MMCC), Tilburg is charged with overseeing the process for writing the regulations for food products with cannabis in them, or, edibles.
During Maryland’s most recent legislative session, the General Assembly passed House Bill 17 as emergency legislation, which included clarification of cannabis edible products. Why were edibles considered an emergency? “Patients had been advocating for edibles as a safe method of cannabis administration,” says Tilburg.
The pitch to legislation was that the majority of the market right now in Maryland is smoked or vaped products, which have known potential health harms. Edibles would provide a safer method of administration.
In addition, there is increasing evidence that edibles are distinct in how they affect a patient in two ways: 1) there is a lower peak high from the THC; and 2) the effect is more extended than with smoked or vaped products. If you think about traditional pain relievers such as Aleve, they are often advertised as lasting 12 hours rather than eight. The idea is that a patient will have a longer lasting pain relief and lower peak effect.
Dispensaries report that the average medical cannabis patient in Maryland is about 50 years old. This reflects a large elderly population who are using medical cannabis for chronic pain and other conditions. Those individuals are less likely to want to smoke or vape medicine, so edibles provide another option, says Tilburg.
House Bill 17 was prefiled in November 2019 by Delegate Cheryl D. Glenn . To prepare for the hearings, the MMCC conducted assessments of the 30-ish states where their medical cannabis programs include edibles. They reviewed the laws and talked with legislators in those jurisdictions to learn about enforcement and pitfalls to avoid. These conversations with other regulators have been key and have helped inform how the regulations are worded.
The MMCC is taking pains to address potential issues like child access and the dangers of cannabis. Early adopter states such as Colorado and California have navigated concerns with dosing of products and child access to them. When they adopted legalization, they didn’t have proper restrictions in place, and they saw increases in poison control calls and ER visits, particularly for edibles. There are federal standards for child-resistant packaging so that children aren’t able to open a package but adults can. There will be required written warnings as well as pictures on the packaging to deter children. Servings will be clearly marked to help adults avoid overconsumption and help them understand what amount is appropriate. There will also be restrictions on the amount of THC and cannabis that can be in a product. Patient information material will be developed to help people understand the benefits and risks.
The idea is to prepare for potential adverse events in order to prevent them. The MMCC’s policy committee has engaged a cross section of groups in writing the regulations, such as the Maryland Poison Center, public health professionals, cannabis experts, attorneys, lab experts and other stakeholder groups. “We think these steps should have a positive effect to avoid what happened in other states,” says Tilburg. The commission prioritizes stakeholder engagement; meetings are open to the public and public comments are welcome.
Perhaps the biggest roadblock for edibles is that we don’t yet understand how cannabinoids are absorbed into the bloodstream when ingested. Cannabinoids don’t dissolve in water; they dissolve in fat. Since water and oil don’t mix, producers have to get creative with special emulsion techniques. Those techniques may have health risks. Other issues include edible products with a bad aftertaste and limited shelf life.
Many medical cannabis dispensaries in Maryland already sell products that seem like they should be considered edibles – gummies, chews, troches. How did those products come to market if edibles weren’t yet legalized? According to Tilburg, the initial statute did not define medical cannabis or cannabis products, but the MMCC statute did. Previously there were three categories: usable cannabis such as flower products, medical cannabis concentrates and infused products, which included anything that is a food, beverage or gum. Troches and medicated chews were previously put into the “infused” category with pharmaceutical and dietary supplements. The new statute creates a new category for edibles. This change shifts some products to another category. The MMCC issued a clarifying bulletin on May 13, 2019.
“The goal is to provide a safe and effective medical cannabis program where patients can access the product and consume it safely,” says Tilburg.
The hope is for the regulations to take effect by the end of 2019 or early 2020. The process is lengthy, with many opportunities for stakeholders to provide comments. “The way we have success is with businesses engaging in the rule-making process,” says Tilburg. He encourages those in the industry to come to meetings or send in written comments if they can’t attend in person. Anyone in the industry can also sign up to receive email and text updates.
Kelly Swan is a writer, communicator and storyteller in the Baltimore area.