"As health care professionals, we must educate patients about the risks associated with edible cannabis use and that current product labeling of these products does not accurately communicate their potential for harm," noted Donna M. Lisi, PharmD, in a letter in response to information on a JAMA Internal Medicine Patient Page.
Lisi noted the assertion from the Patient Page that edible cannabis products come in discrete serving sizes with easily measurable tetrahydrocannabinol (THC) and cannabidiol (CBD) content is not accurate.
"This statement is problematic as the serving sizes are often misunderstood and potency information on labeling is frequently inaccurate at current product labeling of these products," she said. The Centers for Disease Control and Prevention supports the claim that THC concentration in edible products is often unknown or inaccurately labeled.
Lisi also presented published evidence suggesting edible cannabis consumption may post significant risks. A research letter published in JAMA Internal Medicine found that the legalization of cannabis in Canada led to a rise in emergency department visits due to poisonings in both older adults and children. Furthermore, original research published in Annal of Internal Medicine from a major urban academic hospital in Colorado revealed that edible cannabis was more commonly associated with acute psychiatric and cardiovascular symptoms compared to inhalation exposure.
A Position/Policy Statement by the National Safety Council, evaluating 75 cannabis-derived edible products from 47 different brands, found that THC content was accurately labeled only 17% of the time. The Council reported that 23% of products were under-labeled and 60% were over-labeled.
Another concern raised by Lisi was that some states' labeling requirements do not mandate the display of total THC amount and activated tetrahydrocannabinolic acid (THC-A). THC-A, normally inactive, could convert to THC when heated, potentially resulting in toxic effects not reflected on product labels.
She emphasized the importance of educating patients about the risks associated with edible cannabis use and the inadequacy of current product labeling in communicating potential harm. More accurate labeling and stricter regulations in the edible cannabis market to ensure consumer safety are needed.
Lisi volunteers for the Expert Affiliate Council for the International Academy on the Science and Impact of Cannabis (IASIC). She authored an article for the U.S. Pharmacist on cannabis edibles and pediatric toxic effects in August 2022, for which she received an honorarium from the publication; the topic was self-identified based on a public health need, for which she maintained full control over research, writing, and authorship.