A California marijuana crackdown could hurt CBD patients

You may have heard the extraordinary story of Charlotte Figi, the little Colorado girl who was dying from unrelenting, violent seizures until her parents decided to try cannabidiol, or CBD, a non-psychoactive ingredient of cannabis and hemp that helped other ailing children.

CBD, it turned out, did for Charlotte what all the pharmaceuticals in the world could not: It saved her life.

For nine years, until she died at 13 in 2020, Charlotte was virtually seizure-free. Her story was chronicled by CNN’s Sanjay Gupta, who said Charlotte’s experience had completely changed his view of cannabis and its medical potential.

Gupta’s 2013 special on the subject, “Weed,” gave much-needed hope to Beth Sahyoun, a Reseda nursery school teacher whose son Armand, then 20, had suffered relentless seizures for six years.

“I was totally reluctant,” Sahyoun told me. “I am not familiar with cannabis. We had been part of the medical establishment, and this felt very, very uncomfortable, but when you are desperate, you go into uncharted territory. You have to.”

She soon found Dr. Bonni Goldstein, a Los Angeles pediatrician and leading cannabis doctor who has helped Armand use CBD to stay nearly seizure-free for nine years.

I met Goldstein years ago while writing about Proposition 64, the 2016 ballot measure that legalized recreational marijuana in California. She reached out to me recently, distressed that the California Legislature appears to be on the verge of making it impossible for her patients to obtain the CBD products they need to lead normal lives.

The legislation at issue, Assembly Bill 2223, is a well-intentioned attempt to close a loophole in the state’s cannabis laws that has allowed unregulated, intoxicating, hemp-derived products to flood the market. It has already passed the Assembly with bipartisan support and is now before the Senate.

The federal government legalized commercial production of hemp, a form of cannabis typically cultivated for non-intoxicating uses, in 2018. Under federal law, hemp can contain no more than 0.3% tetrahydrocannabinol, the psychoactive ingredient of marijuana known as THC, by weight. If that percentage is exceeded, the plant is considered cannabis, which, unlike hemp, is highly regulated, tested and taxed and can be legally sold only by dispensaries.

Here’s the loophole: A synthetic form of THC can be extracted from hemp-derived CBD. That substance, called delta-8 THC, is psychoactive. Because it is said to pack a softer punch than the THC in cannabis, delta-8 products are often called “weed lite” or “diet weed.” And because hemp is not regulated the way cannabis is, delta-8 products can be purchased by anyone online or in gas stations and convenience stores. A distressing number of teenagers report having used the product, which hasn’t undergone any systematic evaluation of its safety.

“During the conversion of CBD,” Goldstein said, “you get unintended byproducts. When you buy an unregulated, untested delta product, you are taking your health into your own hands.”

Dr. Bonni Goldstein, a pioneer in the use of CBD for pediatric patients, at Hesse Community Park in Los Angeles last week.

(Zoe Cranfill / Los Angeles Times)

Legal cannabis dispensaries, whose owners have jumped through almost unthinkable bureaucratic and financial hoops, are understandably unhappy about a product that seems to both undercut their business and endanger the public.

Assembly Majority Leader Cecilia Aguiar-Curry, a Yolo County Democrat, is the author of AB 2223, which would outlaw these “weed lite” products. The bill would ban any hemp products that contain more than 1 milligram of THC per container.

“The bottom line,” Aguiar-Curry said in a statement, “is that if it gets you high, it should not be sold outside a dispensary.”

In a statement emailed to me Friday morning, she added, “We are trying to strike the delicate balance between helping kids with health needs and keeping illegal drugs from being accessible to other kids.” Her bill, she said, “makes sure that CBD can be sold in the state as long as it has a non-intoxicating, trace amount of THC. Products containing higher levels of THC would be available in dispensaries, where they can’t fall into the hands of youth.”

The problem is that Goldstein’s patients would run afoul of the legislation. They are typically treated with a CBD-to-THC ratio of about 20 to 1 or more, but they take enough to exceed the proposed THC limit.

“If my patient takes 20 milligrams of CBD, they get 1 milligram of THC as well,” she said. “But if they are getting 200 milligrams of CBD, this same ratio then delivers 10 milligrams of THC. If they are taking 1,200 milligrams of CBD, they are getting 60 milligrams of THC. There is no intoxication because we first start with a low dose and titrate up, which minimizes any impairing effect. Second, the much higher amount of CBD dampens down the THC effects since CBD antagonizes the effects of THC.”

Armand Sahyoun, 29, is on a 25-to-1 formulation; he takes 1,600 milligrams of CBD per day, with 64 milligrams of THC.

“There is no impairment because it took months to work up to this dose,” Goldstein said. “He functions beautifully.”

In dispensaries, she added, “you are lucky if you can find a bottle that contains more than 600 milligrams of CBD. Meaning a child using these high doses would go through an $80 bottle per day.” Beth Sahyoun told me her son’s medicine costs $900 a month.

Paige Figi, Charlotte’s mother, founded the nonprofit Coalition for Access Now, which educates the public and lawmakers about the health benefits of CBD.

“We are collateral damage of these hastily written state bills that are trying to fix the delta-8 problem,” Figi told me. “Forty-five million Americans take a daily dose of CBD for their health — first responders, grandparents, kids with epilepsy, veterans, people with pain. These people are happily using this product.”

If there is no accommodation for families like the Sahyouns, the state Senate shouldn’t pass AB 2223. And if it does pass both houses in its current form, Gov. Gavin Newsom should not sign it.

“You have your child who is sick as a dog, you have no hope, you find CBD hemp, non-impairing, non-intoxicating,” Goldstein said. “Your child is thriving, and now the government says you can’t have it anymore? It’s almost too cruel and too stupid to comprehend.”

A sliver of hope emerged at the end of last week: After trying in vain to reach Aguiar-Curry for some time, Goldstein finally heard from her office. The physician expects to meet with the legislator to discuss her concerns this week.

@robinkabcarian

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