California May Require Mental Health Hazard Warning on Potted Products: Shots

Liz Kirkaldie says her grandson’s marijuana use led to her being diagnosed with schizophrenia. She says she’s skeptical whether the labels will work: “But if it helps even one person? Great.”

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Liz Kirkaldie says her grandson’s marijuana use led to her being diagnosed with schizophrenia. She says she’s skeptical whether the labels will work: “But if it helps even one person? Great.”

Beth LaBerge/KQED

Liz Kirkaldie’s grandson was top of his class in high school and a talented jazz bassist when he started smoking weed. The more serious he got about music, the more serious he got about weed.

And the more serious he got about weed, the more paranoid he became, even psychotic. He began to hear voices.

“They were going to kill him and people would come and eat his brain. Weird, weird stuff,” Kirkaldie says. “I woke up one morning, and Kory nowhere. Well, as it turned out, he’d run down Villa Lane completely naked here.’

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Kory came to live with his grandmother in Napa, California for a few years. She thought she might be able to help. Now she says that was naive.

Kory was diagnosed with schizophrenia. Kirkaldie blames the pot.

“The drug use really triggered the psychosis, I think,” she says.

Indeed, many scientific studies have linked marijuana use with an increased risk of developing psychiatric disorders, including schizophrenia. According to a study published in The Lancet Psychiatry in 2019. A study found that eliminating marijuana use among adolescents would reduce the global rate of schizophrenia by 10%.

Doctors and lawmakers in California want cannabis makers to warn consumers about these and other health risks on their packaging labels and advertisements, similar to the requirements for cigarettes. They also want vendors to distribute health brochures to first-time customers detailing the risks cannabis poses to young people, motorists and those who are pregnant, especially cannabis with high concentrations of THC, the chemical primarily responsible. for the mental effects of marijuana.

“Today’s turbocharged products amplify the harm associated with cannabis,” says Dr. Lynn Silver of the Public Health Institute, a nonprofit that sponsors proposed labeling legislation, SB 1097, the Cannabis Right to Know Act.

Californians voted in 2016 to legalize recreational marijuana. Three years later, emergency room visits for cannabis-induced psychosis rose 54% in the state, from 682 to 1,053, according to state hospital data. For people who already have a psychotic disorder, cannabis makes things worse — leading to more emergency room visits, more hospitalizations and more legal problems, says Dr. Deepak Cyril D’Souza, a professor of psychiatry at Yale University School of Medicine who also serves on the advisory board of physicians for Connecticut’s medical marijuana program.

But D’Souza struggles to convince his patients of the dangers, especially since 19 states and the District of Columbia have legalized recreational marijuana.

“Both my patients with schizophrenia, as well as adolescents, are hearing very conflicting reports that it is legal; in fact, there may be medical uses for it,” he says. “If there are medical applications, how can we say there’s something wrong with them?”

Legalization isn’t the problem, he says, but rather the commercialization of cannabis — the heavy marketing, which may aim to attract young people to become customers for life, and the rise in THC from an average of 4% to between 20% and 35% in current varieties.

Limiting the amount of THC in potted products and including health warnings on labels can help reduce the health damage associated with cannabis use, D’Souza says, much the same way those methods worked for cigarettes. He attributes warning labels, education campaigns and marketing restrictions to the sharp decline in smoking rates among children and teens over the past decade.

“We know how to message them,” D’Souza says. “But I don’t think we have the will and the resources yet.”

Some states, including Colorado, Oregon and New York, have dabbled with cannabis warning label requirements. California’s proposed rules are modeled on elaborate protocols laid out in Canada: Rotating health warnings would be set against a bright yellow background, use a black 12-point font, and take up one-third of the front of the package. The bill suggests language for 10 different warnings, including:

California's proposed rules are modeled on elaborate protocols laid out in Canada: Rotating health warnings would be set against a bright yellow background, use a black 12-point font, and take up one-third of the front of the package.
California's proposed rules are modeled on elaborate protocols laid out in Canada: Rotating health warnings would be set against a bright yellow background, use a black 12-point font, and take up one-third of the front of the package.

Opponents of the proposed warning labels say the requirements are excessive and expensive, especially since marketing to children is already banned in California and people must be 21 to buy.

“This bill is really duplication and puts an unnecessary burden on the legal cannabis industry as we already have incredibly restrictive packaging and advertising requirements,” said Lindsay Robinson, executive director of the California Cannabis Industry Association, which represents legal weed companies.

The state should focus more on fighting the illegal marijuana market rather than further regulating the legal market, she says. Legal pharmacies are already struggling to keep up with existing rules and taxes — the state’s 1,500 licensed pot retailers generated $1.3 billion in state tax revenue last year. Adding more requirements will only make it harder for them to compete with the illegal market, she says, and make them more likely to go bankrupt.

“The only real option if they don’t get out of the legal system is to shut down their businesses altogether or go underground. And I don’t think the state of California, with the tax revenues, wants either to happen,” she says. † “The crux of the problem is that there is a huge, unregulated market in the state.”

Liz Kirkaldie holds a photo of her grandson Kory as a child. He started smoking weed in high school and developed schizophrenia.

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Liz Kirkaldie holds a photo of her grandson Kory as a child. He started smoking weed in high school and developed schizophrenia.

Beth LaBerge/KQED

Some people are skeptical that the labels will work. Liz Kirkaldie’s grandson, Kory, is now stable and living with his father. But she’s not sure if a yellow warning would have stopped him when he was a teenager.

“They just don’t pay attention,” she says. “But if it helps even one person? Great.”

Scientists still don’t know what causes schizophrenia, but they believe multiple factors play a role, including genetics, family history, trauma, and other influences in a person’s environment, such as smoking weed. Some scientists believe that having schizophrenia itself predisposes people to smoking weed. While it’s difficult to prove a direct causal link between cannabis use and schizophrenia, the associations are strong enough to warrant action, D’Souza says, and most importantly, cannabis use is one of the few risk factors people can control.

“Not everyone who smoked cigarettes developed lung cancer, and not everyone who has lung cancer smoked cigarettes,” he says. “But I think we can all agree that one of the most preventable causes of lung cancer is cigarette smoking.”

It is far too late to apply the same health education strategies to cannabis that were used for tobacco, he says.

This story comes from NPR’s reporting partnership with: KQED and Kaiser Health News (KHN).