Regulating Marijuana Concentrates

The act requires the Colorado school of public health to do a systematic review of the scientific research related to the possible physical and mental health effects of high-potency THC marijuana and concentrates using only funding provided by the general assembly. The act creates a scientific review council (council) to review the report and make recommendations to the general assembly. Based on the research and findings, the Colorado school of public health shall produce a public education campaign for the general public, to be approved by the council, regarding the effect of high-potency THC marijuana on the developing brain and mental health.

Current law requires a doctor to conduct a full assessment of the patient's medical history when making a medical marijuana recommendation. The act requires that assessment to include the patient's mental health history. If the recommending physician is not the patient's primary care physician, the act directs the recommending physician to review the records of a diagnosing physician or licensed mental health provider. When a practitioner makes a medical marijuana authorization, the practitioner must certify that authorization to the department of public health and environment (department). The act requires the certification to include:

• The date of issue and the effective date of the recommendation;
• The patient's name and address;
• The recommending physician's name, address, and federal drug enforcement agency number;
• The maximum THC potency level of medical marijuana being recommended;
• The recommended product, if any;
• The daily authorized quantity, if the quantity exceeds the maximum statutorily allowed amount for the patient's age;
• Directions for use; and
• The recommending physician's signature.

The act prohibits a physician for charging an additional fee for recommending an extended plant count or making a recommendation related to an exception to a medical marijuana requirement. The act directs the department to annually report on the number of physicians who made medical marijuana recommendations in the past year, how many recommendations each physician made, and the number of homebound patients ages 18 to 20 years old in the registry.

The act imposes the following requirements on medical marijuana patients ages 18 to 20 years old:

• Two physicians from different medical practices have to diagnose the patient as having a debilitating or disabling medical condition after an in-person consultation;
• One of the physicians must explain the possible risks and benefits of the medical use of marijuana to the patient;
• One physician must provide the patient with the written documentation specifying that the patient has been diagnosed with a debilitating or disabling medical condition and the physician has concluded that the patient might benefit from the medical use of marijuana; and
• The patient attends follow-up appointments every 6 months after the initial visit with one of the physicians unless the patient is homebound.

The act requires the department to create a report from emergency room and hospital discharge data of patients who presented with conditions or a diagnosis that reflects marijuana use and provide that report at the department's annual "State Measurement for Accountable, Responsive, and Transparent (SMART) Government Act" hearing.

The act directs the association representing coroners to establish a working group to study methods to test for all scheduled drugs and the presence and quantity of THC in each case of a non-natural death and make recommendations by July 1, 2022. The recommendation must be reported to the house of representatives health and insurance committee and the senate health and human services committee, or their successor committees. Beginning January 1, 2022, the act requires the coroner in each case of a non-natural death to complete a toxicology screen. The coroner shall report the results of the toxicology screen to the Colorado violent death reporting system. The department then produces an annual report of the data beginning January 2, 2023, and annually each year thereafter.

The act prohibits medical marijuana advertising that is specifically directed to persons ages 18 to 20 years old and requires medical and retail marijuana concentrate advertising to include a warning regarding the risks of medical marijuana concentrate overconsumption.

A medical marijuana store and retail marijuana store shall provide a patient with a tangible education resource regarding the use of medical or retail marijuana concentrate when selling concentrate.

The act requires medical marijuana stores to immediately record transactions in the seed-to-sale inventory tracking system to allow the system to:

• Continuously monitor entry of patient data to identify discrepancies with daily purchase limits and potency authorizations;
• Access and retrieve real-time sales data based on patient identification number; and
• Respond with a user error message if a sale to a patient or caregiver will exceed the patient's allowed purchase limit for that business day or potency authorization.

The data collected is confidential and shall not be shared with anyone except when necessary to complete a sale.

The act limits the amount of medical marijuana concentrate that a patient can purchase in one day to 8 grams, unless the patient is 18 to 20 years old then the limit is 2 grams, except in the case of a homebound patient, if the patient's certification states that the patient needs more than 8 grams or 2 grams respectively. The limit does not apply to medical marijuana patients if it would be a significant physical or geographic hardship for the patient to make a daily purchase or if the patient had a registry identification card prior to being 18 years old.

The act limits the amount of retail marijuana concentrate that a patient can purchase in one day to 8 grams.

The marijuana enforcement division shall convene a stakeholder work group to develop and complete by January 1, 2022:

• A uniform certification form to be used by recommending physicians when authorizing the patient to purchase more than the statutorily allowed quantities, as required by section 25-1.5-106 (5), Colorado Revised Statutes, which may be relied upon by medical marijuana stores. The form must contain a uniform weight and uniform potency description to enable a medical marijuana store to fulfill its obligations without the need to make a further calculation or examine other documents. The form shall not contain any information concerning the patient's medical condition or diagnosis.
• A tangible educational resource regarding the use of regulated marijuana concentrate.

For the 2021-22 state fiscal year, the act appropriates:

• $4,000,000 from the marijuana tax cash fund to the department of higher education for use by the Colorado school of public health and any unexpended money from the appropriation is further appropriated to the department for the same purpose;
• $541,826 to the department of public health and environment for use by the center for health and environmental information: $265,656 of the appropriation is from the general fund and is $276,170 from the medical marijuana program cash fund;
• $50,000 from the general fund to the department of public health and environment for use by disease control and public health response;
• $255,167 from the marijuana cash fund to the department of revenue to implement the act;
• $95,706 and allocates 0.5 FTE to the department of law from reappropriated funds from the department of revenue; and
• $2,000,000 from the first time drunk driving offender account to the department of transportation.
  (Note: This summary applies to this bill as enacted.)