Cannabis Culture Reshaped By Stronger Products and Proliferation of Legalization

As more states move to legalize marijuana, a widening array of products—many with higher concentrations of THC and backed by aggressive marketing—have rapidly changed the nation’s cannabis culture.

At the recent Cape Cod Symposium on Addictive Disorders, LaTisha Bader, PhD, chief clinical officer at Women’s Recovery in Denver, Colorado, delved into emerging trends regarding cannabis use, potency, and marketing practices, as well as the impacts of today’s cannabis products on users’ mental and physical health.

Ahead of her session at the Symposium, Dr Bader spoke with Addiction Professional about cannabis-related developments within the past 5 years, how currently available products have a more impact on users’ health than cannabis products of the past, and how public health policies, public perception, and consumption trends are being reshaped.

Editor’s note: This interview has been edited for length and clarity.

Addiction Professional: What new trends are we seeing regarding cannabis products and the marketing practices that are being used to promote them?

LaTisha Bader: The product has made a pretty good boom within the last 3 to 5 years. Anything that we could have created with cannabis, we have. … What we're seeing is that we have figured out how to put cannabis in everything from morning to night, [and] from toothpaste and face wash. We can put it on our bodies, we can put it in our bodies, we can literally insert it into ourselves now. You name it, we have figured out a product to make from that.

That boom happened pretty quickly, from when we first industrialized cannabis and then started putting out products through dispensaries. As soon as we moved from that drug dealer dark market, where you were just mostly moving flower and concentrates, now there's shelves to fill, and so, we fill them. We’ve turned it into candles, we've turned it into clothing. There's CBD-infused socks.

What we've seen with products is that it's moved into very intimate places within our home, within our purse, within our hygiene. [Another] trend that we're seeing in the most recent years is taking a lot of those products and really continuing to up the potency.

AP: With all that in mind, what impacts are we seeing that cannabis with regards to physical and mental health? And are there differences in the effects that are being produced by the cannabis products of today versus marijuana in generations prior when things were more on the dark market, as you had said?

LB: One hundred percent. If we're going to talk natural, we're going to have to go back to a Chinese empire in 2900 BC. That's where we found that plant as it was given to us in this 1:1 ratio for THC and CBD. If we start to look at numbers, we've decided that 0.3% THC, the stuff that gets you high, is like hemp. [W]e as a society, have decided that that 0.3% kind of turns it into an agricultural product. We're going to make rope out of it, everything like that. If we had stopped there as a human race and just interacted with that product, most of us would probably not have much going on.

[Around the time of Woodstock in the late 1960s], we are changing the face of music, we are doing it as a cultural impact and a phenomenon. That had 4% THC. … Even in our diagnostic manuals, we didn't even have a category for withdrawal. Because when you consumed that product, that mind- and mood-altering substance, when it was coming out of your body, it didn't have much of an impact.

Now, we can see plant-based products up to 45% THC and concentrates up to 99.9% THC. The average dispensary when you're walking out for concentrates are around 60% to 70% THC, and we're not batting an eye. We’re consuming it now, and it's odorless, colorless. We're vaping. With our copious amounts of consumption, one might judge a little bit. If my latte had 2 shots of espresso, you'd be like, "Ooh, OK, Bader, you start the day." But if my latte had 8 shots of it, you'd be like, "Ohhh!” and make a face. That's the impact of cannabis today.

Our minds and our physical health cannot consume this substance without impact now. That’s what we're seeing. The withdrawal is significant. We have medical concerns now that get us to the emergency department and beyond. Because when this drug is in our bodies, we are high in a different way. When we’re simultaneously using alcohol and cannabis, that gets us in a really uncomfortable place—psychotic, dissociative types of things. That’s what we're seeing for mental health and physical health—a very significant impact directly on our agitation, our anxiety, our depression, bipolar, worsened symptoms of bipolar.

But the word that we haven't started to use until we industrialized cannabis is ‘psychosis.’ And we are talking correlational. If not, we're really starting to learn … that if I use high potency cannabis, this is about the trajectory that I am on. The same goes for our physical body. There is such a significant impact on what we're doing when the drug is in our body and then when it's coming out of our body. We now have cannabis withdrawal in our diagnostic manuals. Our emergency departments know it well. … Our brains and bodies were not made to handle this intensity of a drug.

AP: As legalization of cannabis becomes more widespread and higher-potency formulations are being developed, how are public health policies, public perception, and consumption trends being reshaped?

LB: This is where the politics meet public health. The industry wants to grow, and there's money behind it. With marketing, with state-by-state applications, with people in the industry, in our policy, in front of our policymakers, we are continuously decreasing the perception of risk. Literally, we're giving cannabis products to our dogs and we're trying to give it to our children. We have a marketing campaign across the nation right now to say, "It's OK. It's safe, it's natural.” … But we're not getting a lot of the science or we're not potentially listening to a lot of the science that's there.

That is actually what we had to do though for the science. We had to replicate and study these potency effects. I think about that when we talk potency. I can say all of the things that I just said for a potency of a 12% to 16% THC. That's our research. That's not where most of us stop. We don't stop at that level of THC. So, the legalization has reshaped the public policy, because that marketing message from the industry is getting to the same place as the moms whose kids have experienced psychosis and are no longer with us. And we're trying to share the same space and to say, "Hey, we have a pretty potent mind- and mood-altering substance in front of us. What are we going to do with that as a society?"

I heard a podcast, and I kind of thought about it. It stopped me long enough that the gentleman said, "If we knew everything that we knew about alcohol today, when we were legalizing it, when we were putting in everybody else's hands," he says, "there's no way we would legalize it."

And if you think about the impact, even the societal impact that we have, we've messed with the drinking age. We've tried, right? We've put caps on things, we've legalized how much spirits you can get versus beer. Even in that potency, we've put safety measures on alcohol because we've seen its impact. We won't let you have 7 shots the way that somebody else might have 4 beers—we know the safety of it.

That was one of the things that made me step back. … As a society, we want to have what we want to have. … Our focus on mental health is so significant right now too. We know we're all suffering a little bit. We're looking for a lot of solutions and they come through substances often.

AP:  the marketing message is not necessarily in line with the health impacts, what do we do with that? What steps can we take to create a better alignment there?

LB: We have conversations like this. We want to say it right. We try to put things out there and let people know. … Really, it’s finding a way that we can kind of govern ourselves. Often, it comes down to sharing the science and the stories. We learn that, especially as a health provider. I'm a psychologist myself, and I’ve learned that if you don't know the stories behind the numbers, they don't often make sense, even for regular chronic health issues. That’s what we must start to do: Listen to each other. We do give the consumer ability to choose. And we educate, educate, educate.

Again, because this is not federally regulated yet, we don't have the consumer protection laws that we have where, if you picked up a soda, it has to be a soda. Even Starbucks has to register their recipe so that you can go around the nation. It's a federally registered recipe so that a vanilla latte is a vanilla latte. That's consumer protection. That is what we're trying to do with pharmaceuticals. We're still in that state-by-state governance policy, so we're trying to get as much education as we can.

Reference

Bader L. Cannabis in the 21st century. Presented at Cape Cod Symposium on Addictive Disorders; September 7-10, 2023; Hyannis, Massachusetts.