Health officers, attorneys see need to better protect consumers in MD recreational weed market

Public health professionals and attorneys say Maryland must do more to protect at-risk consumers as the state’s recreational cannabis market enters its second year.

Those monitoring and studying the billion-dollar market have said they’re also concerned about keeping the drug away from children.

Data showing specifically how — or whether — legalizing recreational cannabis in Maryland has affected use rates isn’t yet available.

But with recreational use cannabis legal in nearly half of U.S. states and the federal government’s recent move to reclassify it as a less dangerous drug, some say they’ve seen a shift in public perception among Marylanders since legalization in July 2023. They worry about both sellers and consumers downplaying the effects that use can have on some at-risk groups.

Dr. Maura Rossman, Howard County‘s health officer, said that changes to sale interactions and regulations governing direct marketing would especially help those with a cannabis-use disorder or addiction.

“Right now, you’re at the, I don’t want to call it the mercy — it’s whoever is behind the counter telling you about this type of gummy or leaf,” Rossman, a pediatrician who also serves on a statewide public health commission, said in a recent phone interview. “It’s a drug, we should treat it as a drug, and the persons who are selling it should provide informed consent about what they’re selling.”

Rossman said it’s imperative that customers receive accurate and consistent information about the cannabis products they’re considering purchasing.

She said cannabis sales should feature informed consent — the process through which a doctor provides information about risks and benefits of a procedure, treatment, test or trial to a patient to help them decide how to proceed.

The state currently requires employees of licensed dispensaries, cultivators and processes to complete annual standardized training, online or in-person, focused on responsible handling, sale, service and consumption of cannabis products, a Maryland Cannabis Administration spokesperson wrote in an email.

All budtenders and employees of growing and processing businesses are required to complete the training by Jan. 1, 2025, and each year after.

Businesses, cannabis education professionals and other “qualified professionals” who meet minimum qualifications, like course length, can provide the state-required training.

Requiring informed consent and further regulating sale interactions would appear to go against the more relaxed attitude toward cannabis consumption that has accompanied the wave of states legalizing recreational use.

The change in public perception, though, is also tied to many of the concerns that health officials like Rossman have raised, said Mathew Swinburne, a University of Maryland law school associate director and cannabis law and policy expert.

“It ties into youth access, it ties into the concerns around pregnant individuals. It just permeates a lot of the challenges and it makes it harder for health departments to execute their initiative,” Swinburne said of the public’s changing views of cannabis in a recent phone interview.

A new legal resource team that Swinburne leads recently compiled survey responses from 22 of Maryland’s 24 local health departments about officials’ experience in medical clinics, youth programs and other settings since the recreational market opened.

Health officials most commonly cited youth use and access, including the potential for increased use rates and use in schools, as the most pressing public health concern related to cannabis that their departments have faced in recent months, Swinburne said.

“These were issues prior to legalization,” he said. “But, there is a big concern that this policy change is affecting the decisions people make without appropriately taking into account the risks of the behavior.”

Ruth Maiorana, executive director of the Maryland Association of Public Health Officers, said her members are also especially hurt by the lack of research outlining the specific health impacts of cannabis use.

“This information would be invaluable to our members, who are the chief health strategists for their communities, to help them inform guidance to our state and local officials and to their communities across the state,” Maiorana wrote in an email.

The cannabis administration has rolled out an awareness campaign called BeCannabisSmart that provides people information about the risks of drugged driving, use while pregnant or breastfeeding, use among young people, safe storage and more.

Swinburne said the concerns have persisted despite Maryland’s “strong” policies for minimizing cannabis use among young people, including advertising restrictions and requirements that companies not package products in ways that may attract children.

Rossman, the Howard County health officer, said that she received two to three text messages per day about products on sale after visiting dispensaries for research. For a drug that’s potentially addictive and to which people can develop tolerances, such direct marketing tactics should be prohibited, she said.

“The more you use, the more you need to use,” she said. “It benefits the seller if someone needs to use more and more and more.”

Working as a member of a Howard County cannabis workgroup that provided a 100-page report and recommendations to the County Council earlier this year, Rossman and her team have pushed for the state to require that warning labels have text that’s larger than 9-point font.

The cannabis administration currently allow fonts to be as small as 6-point, or 1/12 of an inch.

The workgroup also recommended pushing state lawmakers to require better guidance for parents and guardians to store their cannabis products away from children, and Rossman specifically said that dispensaries should refrain from product names, like ‘gummies,’ and packaging that may prompt children to want to try them.

“This is a drug,” she said. “We shouldn’t be thinking of it as a candy.”