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Making sense of Washingtonâ&#x20AC;&#x2122;s new medical laws Local budtenders are ready to help What to expect at retail shops

Spokannabist is a product of The Spokesman−Review’s marketing division. • Friday, June 24, 2016

W H AT TO E X P E CT

F I R S T M A R I J UA NA SHOPPING TRIP By NICOLE SKINNER Marketing Correspondent

If you’ve never been to a Washington recreational marijuana store, you may find the shopping experience unfamiliar, maybe even overwhelming. After showing ID proving you’re age 21 or over, you’ll see plenty to catch your eye and perhaps tickle your nose. “Don’t be afraid to ask for help,” said Becca Johnson, general manager at Cinder in Spokane Valley. She said employees, known as budtenders, enjoy interacting with customers and helping everyone find the perfect product, which could be edibles, flower products or concentrates. Johnson said the most common question she hears is what strains are available. When recreational marijuana was illegal, black market shoppers often were stuck with whatever quality or quantity their seller claimed to have on hand. Now, legal retailers have access to a wider variety of common and less common strains, which can offer new experiences for even seasoned users. “It’s one of the huge benefits of legalized marijuana,” she said. “If you know what kind of effects you are looking for, we can help you choose.” For instance, some strains have properties that give you more energy, some are more calming and some provide pain relief.

Johnson says the most misunderstood rule her team has observed is at what point customers have to show ID and when shops have to ask for it. The short answer to both is all the time. “It doesn’t matter how old you are or if you are in every day, we need to see it,” she said. “We are trying to protect the ability to continue to purchase legal marijuana, and part of that means always having valid identification available.” Shops must follow other state restrictions about location, the size and distance of business signage, and types of advertising. Retailers can’t offer free samples, product giveaways or discount coupons. Advertisements can’t appeal especially to minors, such as using cartoon figures. The rules and regulations can pose challenges in how marijuana shops can communicate with customers. Many shops use a website or social media to share current inventory or specials. The owners and staff can also utilize online advertising that follows state regulations. But there are also restrictions on keeping the images and content away from minors. “It can be difficult to share information about current product,” she said. “There are a few sites that allow us to update our current menu and inventory, such as Weedmaps, AllBud, and Leafly.”

Spokannabist is a product of The Spokesman−Review’s marketing division. • Friday, June 24, 2016

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Spokannabist is a product of The Spokesman−Review’s marketing division. • Friday, June 24, 2016

GUEST

PHYSICIAN PERSPECTIVE ON LEGALIZED MARIJUANA

If you consider yourself an expert in Washington’s legal marijuana industry and would like to be considered for a future guest column, please email SPOKANNABIST@spokesman.com.

Editor’s Note: This column was provided by the Spokane County Medical Society

Physicians, Physician Assistants and Nurse Practitioners are charged with improving and protecting the health of their patients. As part of that mission, it is our duty to inform patients of the risks of recreational substance use and abuse, whether it is legal or illegal. This applies to alcohol, tobacco, caffeine, marijuana and illicit drugs. With the legalization of marijuana in the state of Washington, there has been controversy regarding the risks of its use. We do know that increasing segments of the public do not appreciate the risks associated with marijuana use. [1] It is the goal of this article to not only outline the typical risks, but to also indicate where its use might provide medicinal beneﬁt. One of the big concerns about marijuana use is the long-term cognitive effects. A study in 2012 showed that people who started using marijuana in their teens with ongoing use lost signiﬁcant IQ points and this did not return if they quit in adulthood. Alternatively, adult-onset use has not been shown to result in the same cognitive decline. [2] The effects during childhood, pregnancy and breastfeeding are concerning. As physicians, we clearly recommend avoidance during these critical periods of brain development. It is expected that those who smoke marijuana are at risk for respiratory problems as well as lung disease, such as cancer similar to those seen in tobacco users. Other effects of marijuana have been observed, such as hallucinations/paranoia, fertility

concerns, job performance and decreased life satisfaction. We suspect risk is related to the amount of exposure. However, further studies need to occur to substantiate these risks. Of particular concern is the theory that marijuana serves as a gateway drug to other illicit substances. This theory has been a topic of controversy since the 1970s. There have been studies supporting this theory [4], while other studies did not reach the same conclusion [5]. However, there is a high degree of association between marijuana use and the use of other illicit drugs [6]. Given the rising drug abuse crisis in America this concern warrants particular consideration.

The medicinal uses of marijuana have been studied in many ﬁelds including

chronic pain, oncology, anxiety disorders and neurologic disorders, such as multiple sclerosis and Parkinson’s disease. The literature is summarized in a recent issue of the Journal of the American Medical Association. [3]

Additional studies will further elucidate which conditions and by which route of administration these substances are most helpful. However, marijuana’s use for medicinal purposes does not make it safe for all users under all conditions and certainly not for recreational use. As with all medications, the risks are always weighed against the expected beneﬁts before prescribing and is expected to be safe when used by the patient as prescribed. Many medications can be harmful and even deadly when used by a person other than for whom it was prescribed. In summary, the effects of using marijuana require further study. It certainly appears that there are very appropriate medical uses. As with any recreational substance, we, as the medical community, recommend caution in its use and responsible choices of activities while under its inﬂuence. Photo by Shallan Knowles Recreational cannabis can be found in several forms, including edible chocolates (above).

REFERENCES 1 Johnston L, O’Malley P, Miech R, Bachman J, Schulenburg J. Monitoring the Future: National Survey Results on Drug Use: 1975-2015: Overview: Key Findings on Adolescent Drug Use. Ann Arbor, MI: Institute for Social Research, the University of Michigan, 2015. 2 Meier MH, Caspi A, Ambler A, et al., 2012. Persistent cannabis users show neuropsychological decline from childhood to midlife. Proc Natl Acad Science USA 109: E2657-E2664. 3 Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez AV, Keurentjes JC, et al., 2015. Cannabinoids for Medical Use: A Systemic Review and Meta-analysis. JAMA 313: 2456-2473. 4 Int J Drug Policy. www.ncbi.nlm.nih.gov/pubmed/25168081# 2015 Feb;26(2):135-42. doi: 10.1016/j.drugpo.2014.07.011. Epub 2014 Aug 2. 5 Arch Gen Psychiatry. http://www.ncbi.nlm.nih.gov/pubmed/10839332# 2000 Jun;57(6):547-52. 6 Addiction. 2000;95(4):505–520

Spokannabist is a product of The Spokesman−Review’s marketing division. • Friday, June 24, 2016

MEDICAL MARIJUANA Know the Law By ALLISON HALL Marketing Correspondent

Medical marijuana is currently legal in right around half the U.S. states and the District of Columbia, including the addition of Ohio earlier this month. Since 1998, with the passage of Initiative 692, Washington has been part of this list. Washingtonians have seen several changes to state marijuana policies over the years, such as the legalization of recreational marijuana in 2014 for users age 21 and older. But this July 1 will bring signiﬁcant modiﬁcations to current laws for medical customers.

QUALIFYING MEDICAL CONDITIONS Talk to your healthcare provider to see if your medical condition meets qualifying staterecognized medical conditions such as chronic pain, cancer treatment, cramping, loss of appetite, vomiting/nausea, spasticity, muscle spasm, seizures, and others. He or she can issue you a medical authorization form. As of July 1, patients can bring their authorization form to any licensed and medically endorsed retail marijuana store in Washington and enroll in the state’s Medical Marijuana Authorization Database. Their photo will be taken and they will be given a Medical Marijuana Recognition Card.

This card provides additional rights and protections including arrest protection for state criminal penalties, the ability to purchase three times the legal limit of recreational marijuana, to purchase products sales taxfree at medically-endorsed retail stores, and to grow up to six plants producing eight ounces of usable marijuana. If the health care provider believes that more than the standard quantities are needed, he or she can authorize an increased amount, up to 15 plants and 16 ounces of usable marijuana for personal use. Those without a card, but with an authorization form, can purchase no more than four plants and six ounces of usable marijuana for personal use, even if more is indicated on their authorization form.

Spokannabist is a product of The Spokesman Review’s marketing division. • Friday, June 24, 2016

MEDICAL R ULE CHANGES COM Allowable quantities, costs will be affected Even as the recreational marijuana market continues to boom in Washington, changes to medical marijuana laws effective July 1 are creating confusion. On this date, existing medical cannabis shops must merge with recreational cannabis shops, but how this will happen is still being worked out.

The uncertainty has its roots in a law aimed at reconciling the generally unregulated medical marijuana industry and making it follow similar rules to the existing recreational market. The primary concern some patients have is the reduction of the personal possession limit from 24 ounces to 3 ounces, as well as limiting the number of medical plants that can be grown from 15 to 6. Doctors can recommend a larger amount of cannabis based on individual patient needs. Spokane-area resident Grace Freeman has been growing marijuana to treat Ehlers-Danlos Syndrome, a connective tissue disorder which has become increasingly painful. Pain and weakness keep her in a motorized wheelchair most days, but lack of mobility and independence makes it easiest for her to grow marijuana at home instead of visiting a dispensary. “Over time, I’ve gotten better at growing it, but there are many days when I just don’t feel well enough to harvest all that I need,” she said. Freeman also picks up several ounces of ﬂower a week at a dispensary. She’s concerned about the reduced possession limits. “I don’t understand how anyone can buy legal recreational pot, but the lawmakers seem to have come down harder on those who survive with medical weed,” she said.

Her boyfriend, Nick Charles, tak multiple sclerosis symptoms. Charl concerned about the new medical he is about the increase in taxes. With a medical recommendation exempt from sales tax but still mus set around 30-37 percent for both m recreational customers. “I don’t get why medical patient high as recreational users,” Charle don’t desire the ‘high’ part. I want t very different than recreational use Although Washington’s Liquor a Control Board has not announced licenses will be available under the board expects upwards of 800 disp statewide, and about half to be app Those interested in using medic relief must meet certain state qualiﬁcations, which were ﬁrst set in 1998. A citizen initiative removed state criminal penalties for patients who possess

Photos by Courtney Dunham Grace Freeman (left) uses medical marijuana to help with pain from Ehlers-Danlos Syndrome. Beth Schilling uses cannabis oil, pictured right, to ﬁght breast cancer.

Spokannabist is a product of The Spokesman Review’s marketing division. • Friday, June 24, 2016

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“valid documentation” from their physician afﬁrming that he or she suffers from a debilitating condition and that the “potential beneﬁts of the medical use of marijuana would likely outweigh the health risks.” The rules were updated in 2008 to add Crohn’s disease and hepatitis C, plus qualifying medical conditions like debilitating nausea, vomiting, appetite loss and other conditions unrelieved by standard treatments or medications. Chronic renal failure was added in 2010. When the Cannabis Protection Act goes into effect this July, it will also create the Medical Marijuana Authorization Database. Registered patients and designated providers who voluntarily register receive a card that ensures protection from state criminal penalties for use, possession or cultivation, plus a tax break on medication.

By COURTNEY DUNHAM Marketing Correspondent

CANNABIS OIL OFFERS ALTERNATIVE CANCER FIGHTER Spokane woman fights cancer with CBD oil Beth Schilling always ate right, worked out at least four times a week and kept her weight in check. But the day before her first half marathon, she found a lump in her breast. She knew right away it was cancer. “It was one of those moments where your heart sinks instantly because you just have a feeling that something bad is about to happen,” she said. “My mother had (cancer) and eventually died from it. Of course my thoughts went to my kids.” Less than two weeks later, a mammogram and biopsy results confirmed her fears. But this diagnosis inspired her to fight. “I knew deep inside that I was going to beat it,” she said. Schilling upped her health game

even more and cut out sugar completely. She declined radiation treatment and underwent a little chemotherapy, which she later regretted. Instead, she visited a naturopath and began her own intensive health research. She found dozens of stories about people who treated breast and lung cancers with cannabis oil. Cannabis oil is made up of cannabinoids such as CBD and the THC, the active chemicals found in the cannabis plant that causes the “high.” Schilling’s research indicated that cannabis oil may also possess anti-cancer properties that help stem the growth of malignant tumors. “In theory, cancer cells can’t survive in this environment,” she said. “Eventually along with several health supplements, the CBD oil was the only ‘drug’ I was taking to

ﬁght my cancer.” Schilling also had a complete mastectomy four years ago, and so far remains cancer free. She still takes the CBD oil daily. “I am truly convinced that the cannabis killed the cancer in me instead of the other way around,” she said. “Now I don’t want it to ever come back, so I’m going to take it forever.” Cannabis oil and other cannabinoid compounds can be used for inﬂammation, multiple sclerosis, epilepsy, glaucoma, schizophrenia, cardiovascular disorders, obesity, and many other systematic diseases. Medical cannabis is also used by some to treat muscle spasms, cramping, loss of appetite, vomiting or nausea.

Spokannabist is a product of The Spokesman−Review’s marketing division. • Friday, June 24, 2016

THE B USINESS OF BUDTENDERS Getting high often doesn’t mean getting hired easily By MARIESA STOKES Marketing Correspondent

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If you’re interested in being a ‘budtender’ at a recreational store, it takes more than recreational knowledge. Area employers will tell you that the best attribute they seek is the ability to provide superior service. “Awareness of what it means to serve is the ﬁrst thing I look for,” said Sam Calvert, owner of Green Star Cannabis. “It’s a behavioral identiﬁer I can’t see until I sit down and talk with someone.” Team members must have good personalities, be outgoing, excited and energetic --“authentic, genuine adults,” he said.

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Green Star has a rigorous training process, starting with a two-week trial period.

Calvert says 40 percent of new hires leave within 90 days. “They think it’s a headshop, but they have to be professional -they can’t forget that this is my money, my livelihood, my wife and my family at risk. I don’t have time to spend partying.” Matt Gill, purchasing and marketing manager at Cannabis & Glass, says the shop looks for abilities beyond a candidate’s resume. “We want to ensure that our hiring manager thinks an applicant is good, the GM thinks they’ll be good and the owners think they’ll be good. They have to mesh with

Spokannabist is a product of The Spokesman−Review’s marketing division. • Friday, June 24, 2016

everyone,” he said. The team looks for candidates who are patient, honest, engaging and lively, and who show integrity and a positive demeanor. Gill says budtenders should have advanced knowledge of marijuana, but also an interest in the business. “We have a well-educated staff,” he said. “We have college students, four people with business degrees, and I have a master’s degree. We want motivated people who are capable, intelligent and willing to grow and make this industry what it needs to be.”

People looking to get paid to party need not apply. “We are incredibly busy,” said Gill. “We expect people to come here to work, not play. Every minute of every day there are tasks to be done. Our staff cannot be high on the job. That’s a big thing.”

The industry generally pays well: Cannabis & Glass starts budtenders at $15 per hour. Calvert hosts Christmas parties, gives holiday bonuses and has an employee purchasing program. Employees can also evaluate product, off-duty, and samples are also available of edibles and concentrates. “Our employees get full-page review sheets along with new products,” says Calvert. “Everyone checks everything from smell to taste, potency proﬁle, duration and more.” Gill says employees sample and contribute to a review system sharing information about ﬂavor, smell, density, what kind of high it gives, how it burns, etc. “Our staff is 100 percent expected to sample. They don’t have to smoke to work here, but how will you know or recommend products if you haven’t tried it?”

Randy Claﬂin, Cannabis & Glass budtender and purchasing assistant, says the job is serious, and comes with an expectation to work hard. He has learned about the endless varieties of pot, as well as the extraction process, oils, packaging, aesthetics and general marketing, and loves sharing this info. “I consider myself very knowledgeable but there’s still so much to learn. Just because you’ve been smoking for 10 years doesn’t Photo by Joe Butler mean you have the depth of knowledge,” Randy Claﬂin, Cannabis & Glass he said. “There are people coming in you wouldn’t expect to come in, and we help educate them about their options and what they’re getting.” The retail recreational industry provides opportunities for advancement, management and to learn from those already running successful businesses.

Spokannabist is a product of The Spokesman−Review’s marketing division. • Friday, June 24, 2016

2016 CHANGES TO WASHINGTON MEDICAL MARIJUANA LAWS POSSESSION LIMITS Currently: Patients can possess up to 24 ounces of usable COLLECTIVE GARDENS Currently: Up to 10 people could participate in a cannabis, or a 60-day supply community garden with a cap of 45 plants As of July 1: Patients can possess 3 ounces of usable cannabis, 48 ounces of infused product in solid form, 216 As of July 1: Only 4 patients may participate, but the ounces of infused product in liquid form and 21 grams of cannabis concentrates

maximum number of plants increases to 60

LICENSING GUIDELINES GROW LIMITS Currently: Patients can grow up to 15 plants As of July 1: Patients may grow 4 or 6 plants

Medical dispensaries must apply for a license to operate legally, and certain dispensaries will get priority if the business has been operating since January 2013; if it previously applied to the Washington State Liquor and Cannabis Board for a recreational license; and if the business has been paying local and federal taxes

depending on their physician’s authorization and whether they’re part of the state database

SALES TAX REQUIREMENTS

Currently: Patients paid sales tax on their medical cannabis As of July 1: Patients are exempt from sales tax, but still must pay the state’s 37 percent excise tax

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Spokannabist is a product of The Spokesman−Review’s marketing division. • Friday, June 24, 2016