Dr. Matthew Rossheim of The University of North Texas Health Science Center at Fort Worth recently published a new study highlighting the prevalence and dangers of hemp-derived, intoxicating cannabis products sold widely at U.S. vape shops and other retailers.

Rossheim’s research, “Intoxicating Cannabis Products in Vape Shops: United States 2023,” published this month in the American Journal of Preventive Medicine, is one of the first studies to document that the U.S. is acting as a recreational cannabis country, with intoxicating products being sold in stores across all 50 states, Washington D.C. and Puerto Rico.

“Without a medical cannabis card, you can walk into a store in any state and buy a cannabis product that will get you high,” said Rossheim, an associate professor of health administration and health policy at the HSC School of Public Health.

Since 2020, many types of intoxicating cannabis products have entered the U.S. market, he said. Hemp-derived ICPs, including hexahydrocannabinol – which can affect mood, pain perception and central nervous system functions – and the psychoactive substance delta-8 tetrahydrocannabinol pose serious concerns about their youth-oriented marketing, potency and health effects. Some states have attempted to ban, restrict or regulate their sale, but these laws have been unsuccessful to date.

The U.S. Farm Bill, or Agriculture Improvement Act of 2018, authorized the production of hemp and removed hemp and hemp seeds from the Drug Enforcement Administration’s schedule of controlled substances.

Regulations on hemp-derived products

 Rossheim’s study shows that in states with limited or no delta-8 THC regulations, 92% of vape shops and other stores sold intoxicating cannabis products. In states with laws designed to limit potency or availability, 90% sold these products.

“It’s no surprise that regulations don’t work because these products are being designed to circumvent regulations,” Rossheim said. “Retailers are selling these intoxicating cannabis products as if they were hemp-produced T-shirts or shoes.

“This underscores the urgent need for comprehensive bans prohibiting any detectable levels of derived intoxicating cannabinoids that are well enforced, with product testing and large fines for noncompliance.”.

After adjusting for states where legal nonmedical cannabis is sold, Rossheim and colleagues from George Washington and Emory universities, HSC and the Pacific Institute for Research and Evaluation found a statistically significant reduction of sales in states where intoxicating synthetic products are banned. Vape shops and stores in states without bans had approximately 16 times the odds of selling intoxicating cannabis products, compared with those in states with bans.

Bans work, need strong enforcement

“Bans work, but they need to be comprehensive and enforced,” Rossheim said.

In May, a ban on intoxicating hemp products was proposed as a Farm Bill amendment by the U.S. House of Representatives. Previous legislation has made it easier for U.S. farmers to grow nonintoxicating varieties of cannabis, defined as hemp, for industrial and medical use.

“These derived products are a very different issue than naturally grown cannabis products. When pushing for the law, industry proponents said hemp is ‘rope, not dope,’ but now they are exploiting the language to sell intoxicating products,” Rossheim said.

Prior to 2020, he explained, most cannabis products on the market contained the naturally abundant delta 9 THC intoxicant.

“Since then, companies have created synthetic intoxicants, sprayed on hemp leaves, infused in candies and added to other foods and beverages. This is more dangerous than marijuana use,” Rossheim said.

The harms, laws being exploited

“Because there are limited studies at this point, we don’t know a lot about the harms of these chemically created products. Some have been found to contain pesticides, heavy metals and even chemical solvents.”

The U.S. has seen spikes in pediatric poisonings related to exposure of these products, and in 2023, one in nine high school seniors used delta 8 THC, one of the most popular types of derived intoxicating cannabis products, Rossheim said.

“Regulations so far haven’t worked because of bad actors who are constantly innovating these products to circumvent laws protecting public safety. These companies are exploiting current legislation to sell dangerous products that aren’t natural and were never intended by lawmakers to be legalized,” he said.

Rossheim and his research team are tracking the proposed federal Farm Bill amendment that would ban these products.

“Further legislative action also is needed to impose and enforce large fines and conduct product testing to ensure retailers are not selling these products,” Rossheim said.

A call for urgency

“Time is of the essence,” he said. “This study demonstrates that urgent action is needed to address the dangers in these products.”

Dr. Rossheim is traveling to conferences in major cities, including Denver and Chicago, to present these findings and urge action on this pressing public health danger.

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