Patients do not always know what they are getting
Jessica Tonani, a Seattle biotech executive, has what she calls a “broken stomach.” Put politely, she doesn’t digest food properly, which can cause vomiting, nausea and severe weight loss.
She’s had multiple surgeries, tried all the recommended treatments for her disorder and sits twice weekly for intravenous infusions.
Tonani, 38, decided several years ago to try pot. And it has worked for her, she said, especially strains low in the psychedelic chemical THC and high in the non-psychoactive ingredient cannabidiol, known as CBD.
As a medical-marijuana patient, Tonani knows it can be hard to find the rare strains that don’t make you high — and it can be even harder to get the same kind of pot consistently.
Testing shows that some marijuana strains are not what they purport to be in name, chemical content and genetics. This is particularly concerning for patients seeking pot low in intoxicants and high in pain-relief or other therapeutic qualities.
One strain widely known for its high-CBD and popular among medical-marijuana patients is called Harlequin. But when Tonani and a leading Seattle pot-testing lab analyzed 22 samples of Harlequin from various growers and dispensaries, five of them were high in THC and had virtually no CBD, which means people trying to take medicine were just getting high instead.
Misnaming and inconsistent chemical profiles are extremely common, said Dr. Michelle Sexton, a naturopath, founder of PhytaLAB and an adviser to the state Liquor Control Board.
This problem can be significant for patients who don’t want to be stoned while working or behind the wheel. It’s even more so for pediatric patients. “You don’t want a 6-year-old with epilepsy being put on a bus under the influence of a psychedelic chemical,” Tonani said.
And there’s this irony: Recreational-pot users will soon have greater assurances about the safety and chemical content of the pot they buy at retail stores in the state’s new legal pot system than the best-educated patients have in the largely unregulated medical system, where testing and accurate labeling are not mandated for dispensaries.
“It’s completely backwards from what it should be,” said Randy Oliver, chief scientist at Analytical 360, the lab that collaborated with Tonani’s firm on the research.
Alison Holcomb, chief author of Initiative 502, which legalized adult possession of marijuana, noted that I-502 is not — as many call it — a recreational-pot law. Its requirement that all products display THC and CBD content is likely to make medical patients more informed.
“It creates a legal marijuana market. The requirements apply equally to all marijuana that is being used, whatever the purpose of consumption,” said Holcomb, criminal-justice director for the ACLU of Washington state.
There’s still some mystery, due to a lack of scientific research, about how certain chemicals in pot impact different people.
But there’s enough evidence about the anticonvulsant qualities of CBD that the federal government’s only pot-growing facility plans to produce up to 600 kilos of high-CBD marijuana for study.
“The whole thing is just so loose and unregulated,” said Dr. Mahmoud ElSohly, director of the Marijuana Research Project at the University of Mississippi, about medical marijuana in states such as Washington. ElSohly’s goal is to grow high-CBD pot, with a very consistent chemical profile so it can be used in standardized research.
Since she’s been using pot, Tonani said, friends, family and other patients have queried her about what to use and where to get it. About a year ago, she said, she really came to understand dramatic differences in the quality of dispensaries and in marijuana called the same name.
That led her to form Verda Bio, a company devoted to researching the genetics and therapeutic uses of marijuana.
Tonani began collaborating with Analytical 360, which encourages transparency in the industry by posting on its website the results of all testing the lab has done on samples in the past 60 days.
She went out and bought five samples of Harlequin at Seattle-area dispensaries. Four of the samples varied considerably in their potency of THC and CBD. Even though they all had roughly a 2-to-1 ratio of CBD to THC, their variations in potency would make consistent dosing difficult. A fifth sample was radically different, with almost no CBD and high THC.
Tonani’s findings essentially matched an analysis by Analytical 360 of 17 samples called Harlequin it tested recently. Four of the samples were nothing like Harlequin.
Further DNA tests by Tonani on two of the samples she acquired showed that they were not even genetically similar.
Experts cite a number of reasons for such inconsistencies.
One may be the lack of testing standards for labs analyzing medical marijuana, Sexton said. It’s a problem addressed by I-502 rules, which set requirements for accredited labs.
Another likely culprit is genetics. When growing from seeds — and not carefully cultivated clippings — there’s a possibility of variation in the plant’s chemical profile because of dominant and recessive genes, said breeder Chris Kelly, CEO of Seattle’s Green Lion Farms, and Seattle grower Jerry Whiting, co-owner of LeBlanc CNE, growers and brokers of medical marijuana.
Age also could be a factor, even when growing from clippings. The mother plants can lose their vigor over time, just as elderly people would.
Human error, such as the mislabeling of clippings, also could be to blame. Labels fall off and often get misplaced, Sexton said.
Lastly, growers and sellers could be engaging in fraud, calling something Harlequin because they think it will sell better or command a higher price.
Whiting believes the medical-marijuana community is too caring to engage in fraud. “No one is lying,” he said about the errantly named Harlequin samples.
Ross Skocilich is director of the Trees Collective in Seattle, where Tonani said she bought the outlier sample of Harlequin with virtually no CBD.
Skocilich said he got the Harlequin from a local grower who had not tested the pot. Skocilich had it tested and results were shared with anyone who asked for them. He still believes the marijuana was Harlequin, but grown from a seed with the kind of genetic variability that Kelly and Whiting described.
He said the collective’s budtenders likely would have advised patients looking for Harlequin that this particular batch did not fit the usual high-CBD profile.
Tonani described the collective as professional and said test results were provided when she asked for them. But she did not recall staff telling her the Harlequin did not contain CBD.
“We didn’t claim it did,” Skocilich said. “There was no hiding that it didn’t have high CBD.”
John Davis, CEO of two Seattle dispensaries and executive director of the Coalition for Cannabis Standards and Ethics, uses his own spot tests as a safeguard. “My policy is the grower tests it,” he said. “But I’ve done spot checks to see if someone is in the same ballpark.”
If Davis uncovers a problem, he said, he won’t work with that grower again. “It doesn’t pay to deal with those people at all,” Davis said. “I would encourage [dispensary owners] to at least be vigilant about things making claim to be high CBD.”
Connecticut developed standards
For consumers, one solution is to look at the chemistry, not just the names of marijuana, Tonani said.
As more become educated about CBDs, dispensaries will respond by displaying timely, accurate information, said Dr. Lara Taubner, chief scientist along with Oliver at Analytical 360.
The state also could develop standards for how much chemical variety should be allowed in a given strain, Sexton said, like Connecticut has done.
Growers in Connecticut can’t label pot products with the same name unless lab results show they vary less than 3 percent in their key chemicals.
Nor can growers use names that may encourage use for anything but a debilitating medical condition. Patients in Connecticut will not see pot with some names found in Washington dispensaries, such as “Durban Poison” and “AK-47.”
Connecticut’s rules are modeled on those for the pharmaceutical industry, said Bill Rubenstein, the state’s commissioner of consumer protection.
“The idea for patients is they’re getting a certain benefit not from pot in general but from the active ingredient profile,” Rubenstein said. “They should have a degree of assurance that the product that works for them is the same product they are going to purchase each time.”
All of this moves medical marijuana closer to Big Pharma, which is anathema for many growers, patients and merchants.
But such standards are common among agricultural crops such as Red Delicious apples, Oliver said, so why not have the similar requirements for Harlequin and other strains?
“I’d argue patients are overwhelmed with the condition they have and it’s difficult knowing what to look for and how to get what you need. We need to simplify things for patients,” Tonani said.