Buffalo HealthCast

Recreational Cannabis Legalization in New York State, with R. Lorraine Collins

April 20, 2022 University at Buffalo Public Health and Health Professions Season 1 Episode 15
Buffalo HealthCast
Recreational Cannabis Legalization in New York State, with R. Lorraine Collins
Show Notes Transcript

Recreational cannabis legalization in New York State comes with many questions.  This conversation between our cohost Schuyler Lawson and renowned researcher Dr. R. Lorraine Collins answers all of them.  Listen to learn more about the legalization process, regulatory issues, and social justice around cannabis legalization on this 4/20. 
R. Lorraine Collins is a psychologist who has conducted NIH-funded addictions research for decades. The focus of her research has included: 1) emerging and young adults substance (alcohol, marijuana) use; 2) cognitive and behavioral approaches to the conceptualization, prevention, and treatment of addictive behaviors; 3) psycho-social issues (e.g., gender, ethnicity, socio-economic status) related to substance use and misuse; 4) research methods that use technology (e.g., ecological momentary assessment, smart phone apps) for assessment and intervention; 5) high-risk behaviors (e.g., intimate partner aggression, condom use) related to substance use.

Teaching Notes

Resources:
https://cannabis.ny.gov/adult-use

https://cannabis.ny.gov/medical-cannabis

https://publichealth.buffalo.edu/community-health-and-health-behavior/faculty-and-staff/faculty-directory/lcollins.html

Credits: 
Host/Writer/Researcher - Schuyler Lawson, MA 
Guest - Dr. R. Lorraine Collins, PhD
Audio Editor - Omar Brown
Production Assistant - Sarah Robinson

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Intro  0:00 
Hello and welcome to Buffalo HealthCast, a podcast by students, faculty and staff of the University at Buffalo's School of Public Health and Health Professions. We are your cohosts Tia Palermo, Jessica Kruger, and Schuyler Lawson, and in this podcast, we cover topics related to health equity here in Buffalo, around the US and globally. In this first semester of the podcast, we're taking a deeper look at racism and health. We'll be talking to experts around the US, as well as individuals here on campus and in the Buffalo community who are working to remove inequities to improve population health and wellbeing. You'll hear from practitioners, researchers, students and faculty from other universities who have made positive changes to improve health equity and inclusion.

Schuyler Lawson  0:47 
Hello everyone, and welcome to another episode of Buffalo HealthCast, the University at Buffalo's premier public health podcast. I'm your host, Schuyler Lawson, a second-year PhD student in the Department of Community Health and Health Behavior. With us today is Dr. R. Lorraine Collins, the Associate Dean for Research and tenured professor in the Department of Community Health and Health Behavior in the University at Buffalo's School of Public Health and Health Professions. Thank you very much for taking the time to speak with us today.

Dr. R. Lorraine Collins  1:12
 
Thank you for inviting me.

Schuyler Lawson  1:13 
You're welcome. So first off, tell us a little about yourself.

Dr. R. Lorraine Collins  1:19 
It's a complicated story. So from birth to now, I was born in Jamaica, I emigrated to Canada when I was nine years old, and grew up there and went to undergraduate university there. Graduated from McGill University with a Bachelor's in Psychology. I moved to the US in order to pursue behavioral training in psychology and went to Rutgers. After Rutgers, or at least as part of my PhD, I went to University of Washington in Seattle, where I did a one-year internship. And following that I wanted to stay in Seattle, and I landed a two-year postdoctoral training position in the Department of Psychology at U-Dub, as we call it. Subsequently, I came back east and started my academic career in the SUNY system at Stony Brook in their Department of Psychology. I am grateful for the fact that somebody from Buffalo at the Research Institute on Addictions, the new director, Howard Blane, called me literally out of the blue to ask if I might be interested in a full time research position. And I'm like, full time research? I'm there! Anyway, I came, gave a talk, saw a little bit of the city. Wasn't sure, so I accepted the position. But then I maintained a one-year position continuing at Stony Brook because they didn't want me to go, especially because I landed my first grant, just there and decided after a year at RIA that I really liked Buffalo, so I've been in Buffalo ever since. That's a long story.

Schuyler Lawson  3:12 
It is, but you summarized it pretty well, so I'm pretty sure there are more rich details there. But I think that's a pretty good summary of it.

Dr. R. Lorraine Collins  3:21 
You can follow up on whatever you'd like.

Schuyler Lawson  3:23 
So how long have you been in Buffalo?

Dr. R. Lorraine Collins  3:25  
I came to Buffalo in the late 80s, and didn't think I would be in Buffalo for my entire career. But among other things, I met and married here, and have a daughter who was born in Buffalo. And that among other things, the satisfaction I had in my career while at Buffalo kept me here, and at this point, I'm just happy to continue living in Buffalo. It's a wonderful city and has a lot of amenities that I don't know that everyone appreciates. Great parks, good restaurant culture, proximity to the outdoors. There's just a lot going on in Buffalo.

Schuyler Lawson  4:13 
As a transplant, I can also agree to that sentiment.

Dr. R. Lorraine Collins  4:17 
Yep.

Schuyler Lawson  4:17  
So getting back to your trajectory that landed you here, tell us a bit about your research background.

Dr. R. Lorraine Collins  4:25 
So at Rutgers, I actually did my dissertation, behavioral intervention related to obesity. But when I got to my postdoc, I switched from obesity to alcohol research. And part of this switch had to do with the fact that the overall issue in which I was interested was self control. And the interesting thing about eating is you really have to exhibit some kind of self control because you have to eat, some people, three meals a day. With alcohol, it was different because alcohol is not essential the way food is essential. But still, there were similar issues with regard to self control. And so making that transition actually went, I think, pretty smoothly. I mean, I ended up doing a lot of reading at the start of my postdoc, but I was able to catch up relatively quickly, because the underlying issues and many of the theories overlapped. And so it worked out well.

Schuyler Lawson  5:41 
Okay, and I guess what led to the transition to cannabis?

Dr. R. Lorraine Collins  5:47 

So that happened in a study that I ran in Buffalo. We had gotten a grant to look at malt liquor use. And the reason I was interested in it is because the stereotype of who uses malt liquor is that it's an African American male. And I'm not fond of stereotypes, and so I wanted to look into what's going on there. And there was a special RFA from the NIH, because they were also interested. What had happened is, each year the heads of Addictions Institute, well, all the institute's in NIH, go in front of Congress, and a congress person asked the then head of NIAAA, "You know, there's a lot of malt liquor in my community, what are you doing about that?" And he literally did not have an answer, and so they scrambled to provide an answer. So anyway, got this grant, applied, and went through all the peer review and what have you. And in it, we conducted a survey, in which we tried to recruit people who were regular malt liquor drinkers, and I give my staff an incredible amount of credit. I mean, they were at Thursday in the Square, they were all over Buffalo, recruiting folks who drank malt liquor. And we ended up with a sample of over 600 people, which was just, I think blew my mind and all of our minds. And the stereotype is not true. Among the folks who responded to our survey, were kind of the range of ethnicities, but definitely a sizable number of people who were from European backgrounds, as well as African, as well as you know, you name it. So given all of that, we were able to publish a couple of papers making that point. But one of the intriguing findings, unexpected for me, anyway, was that half of our sample also reported regular cannabis use. And we always ask about use of a wide range of substances, and usually, you have a sprinkling here and there, but for half of our 600 participants, who were predominantly male, to report regular cannabis use was very intriguing. And so I said to my staff, we got to follow up on this, because this is new. I'm trying to think of when that work was published, it was probably early 90s. And so that's when we started to pursue cannabis research. And at that time, there was hardly any.

Schuyler Lawson  8:45 
This is pre-medical cannabis?

Dr. R. Lorraine Collins  8:48  
Oh yes, it was pre-medical cannabis. And there were kind of reports of cannabis use, kind of often linked to other illicit drugs, but an out and out study of just what's going on with cannabis was not that common.

Schuyler Lawson  9:11 

Okay, and since conducting that study, was there any follow-up studies you did involving cannabis specifically?

Dr. R. Lorraine Collins  9:20 
I've done some studies, again, funded by NIH. I did one where we looked at behavioral economic demand for cannabis, and that's kind of an experimental procedure where we vary the price of the product and ask people to respond to those differences in price by telling us how much they would purchase.

Schuyler Lawson  9:46 
This is hypothetical?

Dr. R. Lorraine Collins  9:48 
It is all hypothetical, done in a lab, and what we found is that cannabis is like every other product, which is as prices go up, purchases go down. We also found, and I don't have the numbers in my mind, but we also found that there was a price at which people would essentially lessen their purchases. Well, I won't say a number because I know I'll be wrong. But anyway, that, I'm proud to say, was the first experimental behavioral economics study of cannabis purchasing and demand curves and characteristics related to cannabis. Others have continued in that work. There had been work done on alcohol for a number of years. But we were the first with cannabis. I probably, most recently, I did a pilot study that we're hoping will turn into a bigger grant, but did a pilot study for cannabis users where we developed a smartphone app. So folks came into Kimball, they met with a therapist for about an hour. There were four sessions where they learned all sorts of behavioral techniques. And then they interacted with the app, learning tips, kind of being able to reinforce what had happened in the session, and providing us with self reports that are related to another innovation with which I've contributed, and that is ecological momentary assessment of substance use. So that research started with tobacco smoking. Saul Shiffman, at University of Pittsburgh, was the innovator. I saw Saul give a talk and I said to him, we have to apply that to alcohol. And so after some efforts, we got funding to do that. Just so you know, the reviewers at NIH, were not convinced that people could self report on their alcohol use if they had been drinking. So we have to do studies to make that case. And what ecological momentary assessment involves is, we randomly prompt them, usually three to four times a day just to find out, Hey, what's going on? How are you feeling? Who are you with? What are your plans? What activities? Where are you located - home, driving? And then what we do is, before they drink, and this is after some training, we ask them to report on what's going on - similar questions, but then we might also ask about, are they craving? Do they have specific amounts that they plan to consume during that party or that dinner? And then after the episode has ended, we asked them, how are they feeling? How intoxicated are they? What's their mood, plans to continue drinking, that sort of thing. So we did that for a few years. And again, an innovation of mine was to move ecological momentary assessment to cell phones. Prior to that, we had used what are called personal digital assistants, and they were fraught with problems. People were carrying their phones and this other device, the data that they provided was loaded on the device, which sometimes would lead to glitches with data, storage, and so forth. So we did, again, proud to say, the first cell phone study involving ecological momentary assessment for anything. That was published in 2003. So you can tell we've come a long way when it comes to smartphones now. So anyway, we did a study where we had people coming in for sessions using our smartphone app during the rest of the week, and providing us with ecological momentary assessment data. One of the groups, so we had two groups. One was what I just described, and the second group, just because of some other work I had done looking at physical activity and substance use, we included a physical activity component where we recommended three free fitness apps. We kind of used multiple apps and found three that we thought were reasonable. And long story short, at six months, although both groups had reduced their cannabis consumption, the group that included the physical activity had reduced it more so, significantly more so. Which kind of reinforced the idea that was in the literature that physical activity was actually a useful component in behavioral programs to lessen substance use. It's been done in smoking and alcohol, and again, we showed it in cannabis, and we were one of the first. Boy, talking about this, I'm like, Whoa! I have fun doing research. I have fun thinking about things and applying ideas from one area to another. So I suppose that's how it's come.

Schuyler Lawson  15:27 
Another interesting part of your trajectory is that you actually had a stint in the public policy realm. In 2018, you were part of a working group created by then Governor Andrew Cuomo, that was tasked with drafting legislation on how to regulate cannabis in New York State. What did your work entail?

Dr. R. Lorraine Collins  15:45 
So, it was about a six-month very intense experience, intense in the sense that we were trying to get a lot done in a relatively short time. It was a wide ranging group of professionals. One of the people I was kind of surprised to see in the room, although now I understand why was the Department of Agriculture. Like, Oh, why would they be there, but guess what, you have to cultivate cannabis, so they were there. Obviously, physicians, public health, the Sheriff's office and State Police. So kind of judicial folks, a couple of community-oriented prevention people, and then the New York State office that focuses on substance abuse treatment, OASAS, they had representation. And we met mostly in New York City. I can remember at least one meeting in Albany, and we would discuss all the issues that we thought were relevant to New York's moving to adult recreational cannabis access. And I say adult because the age of 21 was kind of our marker. One good thing for us is that other states had moved into recreational cannabis well ahead of us. I think another useful thing was that New York State had a medicinal cannabis program, and so we could learn from that, in terms of what parameters might be useful, who might be involved, that sort of thing. In the end, we made - Oh, I should mention, we also as a group, there were 17 community sessions where, not all of the group, but members of the group attended. We did not participate, but we attended and listened to testimonials and other statements from folks who are on both sides of the recreational cannabis issue, and I attended two held in this area and it was very interesting. A lot of the people who made statements were medicinal cannabis users. And they supported recreational cannabis in certain ways. But I think everyone expressed, well, no, I shouldn't say everyone, many expressed concerns about what recreational cannabis might mean. Would it mean lower prices for medicinal? They were all for that. Many parents and prevention types were concerned about kids getting access in upstate. There were folks who were farmers, or in areas where they thought they might want to grow cannabis. And so folks in those rural areas, who often are concerned about jobs, and just being able to survive and make a living, they were keen, so it was quite a diverse group. Each session lasted a couple of hours. And in that time, I think each person had about two minutes. There were transcripts and so forth, but it really gave us a feel for how the residents and citizens of New York felt about this issue. And those community listening sessions were everywhere from New York City to obviously Western New York, all of Central New York and as far north as the Canadian border, so we covered a lot of territory.

Schuyler Lawson  19:47 
A pretty broad range of New Yorkers.

Dr. R. Lorraine Collins  19:49  
Yeah.

Schuyler Lawson  19:50 
So in light of your contributions to the working group, what are your thoughts about how New York State rolled out its recreational cannabis? Like legalization?

Dr. R. Lorraine Collins  20:01 
So what everyone has to understand is it's not rolled out yet, we're still in the implementation phase. The law was passed in March of 2021, actually just about a year ago, because it was March 31. It's a very complicated bill, and that's probably going to mean hiccups along the way. I think New York had the right idea in terms of having this working group listening to its citizens, and really trying to put a lot of limitations in place so that it wasn't just a wild and crazy rollout the way we've seen in other states, some other states. So all of that is to the good. One of the things that I advocated for, and I was not alone in this, is that day the working group started to meet, given that we were looking at this issue, we should start public health education. We should have, just like we have with COVID, we should have public health ads that talk about 'New York is considering this, and here's what you need to know.' And we should be doing pretty wide ranging assessments of current use patterns, especially in high risk groups like young adults. To my knowledge, that has not happened. And we are in kind of this rush now to implement and I still haven't seen a single public health message anywhere that talks about the fact that recreational cannabis is coming, what it might mean, how to approach it, what the products are, how it will help New Yorkers to know that they're using safe and well regulated products, the goal of it. I mean, the goal is to kind of move people away from the illegal market to the legal market where there are, I think, a lot of safety procedures and licensing requirements in place. The illegal market is wild, and I don't think people understand that. I mean, you can cut cannabis with so many other scary drugs like fentanyl, and people don't know it, and they smoke it, and the next thing you know, we have an opiate overdose. So I'm all for the regulation, which is why I participated in the New York working group. I personally would like to see federal regulation so that we don't have the patchwork that we currently have. And I also, as a researcher, would like to see the removal of constraints on access to cannabis. So the big one, as everyone probably knows, is that the Drug Enforcement Agency, the DEA designated cannabis as schedule I, which means it's in the same class as heroin, it's designated as not having any medicinal properties, which we know is not true. I participated, the year before New York State, I participated in a national academies review of the health effects of cannabis. And although the evidence wasn't great in a number of areas, there were areas such as chronic pain, where there was strong evidence and so we need to find out more. And I'm particularly concerned because the advocates for medicinal cannabis and our local state legislatures and various other groups are presenting medicinal cannabis as if it's a panacea. I mean, there's almost no disorder that's not on a list somewhere of disorders that can be helped by cannabis. And it's just that we don't have research evidence to support that.

Schuyler Lawson  24:15 
Do you know if any of the recreational cannabis legislation will protect against that type of marketing that sort of touts cannabis as being a cure all?

Dr. R. Lorraine Collins  24:26 
So the law does include regulations about marketing. Here's my concern. The current guidelines literally say for New York State, that a practitioner, and there's a relatively small list of practitioners right now, but let's say physicians, physician's assistants, I think it's gone to nurses, dentists, their health professionals, that they can prescribe cannabis for any disorder, "they believe" it can help. Belief is not science. And to me, to have that language is reinforcing the notion that it can treat everything when we know it cannot. And it also leaves the field wide wide open to, for want of a better word, charlatans and snake oil salesmen who can say, Well, I believe this is going to help you, and sell whatever the product. It's just not good.

Schuyler Lawson  25:40  
In that review for the National Academy of Science, was there any evidence that looked at the effect of cannabis on serious mental illnesses such as schizophrenia?

Dr. R. Lorraine Collins  25:52  
Well, that is one of the findings that we reviewed, and I teach a cannabis course. And I mentioned that in the course, and students are always intrigued by it. But yes, people who have a family history or personal history of mental health problems, especially if it involves hallucinations and other kinds of psychotic symptoms, should not use cannabis. It's as simple as that. It seems to exacerbate their symptoms. And although there are, to my knowledge, no deaths that are directly linked to using highly potent cannabis, there definitely are folks who had to be hospitalized because of psychotic episodes, linked to using highly potent cannabis or just not realizing how much they were using, and then not being able to manage the cognitive and physiological changes that they experienced.

Schuyler Lawson  26:56  
I thought about that, because you described the arbitrariness of how practitioners can just prescribe medicinal cannabis to mix with whichever condition they deem requires it, and depending on who it is, and they don't have to have a knowledge of the patient's mental health history, it could be, potentially, a public health issue.

Dr. R. Lorraine Collins  27:18 
It's a huge public health issue, and even more disturbing, the way the medicinal cannabis works in New York, it's not a direct prescription. So the health professional can essentially write a script that says, this person could benefit from using cannabis. That's it, they don't really specify anything. Potency, mode, they just make a general statement. That patient then goes to an outlet that provides medicinal cannabis. And I will say New York State has done a really good job of regulating that. But anyway, they go and then it's the people at that - it's not exactly a retailer, but at that distributor dispensary, I think, is probably the right word. It's up to the staff at that dispensary to choose what the person should try or should use. And I worry about what kind of training those people get. In New York State, a pharmacist needs to be involved. But it's still kind of scary, unknown, what they might get for their so called disorder. One of the things we learned...So that National Academies Report was published in 2017. It's still being downloaded at a fair clip, because it's over 400 pages long and has a ton of information. And we've heard through the grapevine that there are dispensaries that use that to help their staff to train. So I'm pleased to hear that it's being put to that kind of use. But there's nothing in that report that's prescriptive. It's just, you know, we review the literature and here's what we found, and this has strong and this has weak. So I don't know that, although it's a great starting point, I don't know that some of the people who work in these dispensaries, other than the, "Oh, if you use the sativa bud, it will help you with...", or "If you use the indica tincture, it will..." I just don't know the basis for some of the recommendations. And then, although we probably don't have time to get into it, there's a huge, huge, huge proliferation of CBD products. Those don't have to occur in a dispensary. You can buy CBD at Wegmans. But that's another completely unregulated space, where because it's not officially a supplement, lots of claims are being made, and the Food and Drug Administration has not really gotten in there to regulate.

Schuyler Lawson  30:25  
Okay, so it's the wild, wild west when it comes to weed.

Dr. R. Lorraine Collins  30:28  
It's wild, wild everywhere.

Schuyler Lawson  30:32 

Okay, so getting back to recreational, how do you think the New York State's recreational cannabis approach compares to other states that have done similar legislation?

Dr. R. Lorraine Collins  30:42 
So New York did a wise thing in trying to learn from best practices and failures in other states, and I think because of that, our regulations are pretty decent. Again, I still don't know what's going to happen with implementation, because that's a work in progress. If we can implement in a way that addresses some of the issues that were raised in that working group and some of the issues that continue to exist, then I think New York will be doing a pretty good job. What I worry about is the legislature, the fact that even people who've been appointed to some of these committees and boards to regulate cannabis, don't know much about cannabis. You know, in teaching that cannabis course, one of the things we do is to break down how complicated a plant we're dealing with. And everybody doesn't understand that marijuana is not marijuana, is not marijuana. It's hundreds of different products. It's hundreds of different interactions in the body. It's very complicated in ways that, for example, alcohol is pretty straightforward. How do most people use alcohol? They drink, end of story. How do people use cannabis? They smoke it, they vape it, they drink it, they put it on their skin, they eat it in gummies and brownies. There's so many complicating factors. And I'm not sure that that's as well understood as it should be.

Schuyler Lawson  32:34  
I guess, what would you say are some of the pitfalls that other states before New York experienced in their recreational cannabis legalization?

Dr. R. Lorraine Collins  32:43 

Oh, wow. Where do we begin? A big one is marketing. There are states - Nevada comes to mind - where cannabis products are labeled and marketed to look like food products, to look like candy. They're plays on names of legitimate products that are given to cannabis products. The wrappings are colorful and flashy. And it really is just completely unregulated marketing. There are billboards, there are two for one sales. So that's a huge, huge problem that I don't think we'll have in New York. Potency's another one. I'm not sure what the upper level of potency will be in New York, but I know that there are states, again Nevada comes to mind, where you can buy concentrate that's 90% THC. Well, that's not a good thing. 90% THC is setting you up for psychotic episodes and some of the other problems that we know can occur. So those are two, I think, really good ones. There's a lot of regulation of the cultivation of cannabis, the processing of it, the retail outlets that not many, well, some states failed to do or now are backtracking to try to do. We recommended no vertical integration of the cannabis industry. So if you grow it, and process it, then you can't own the retail outlets. Because when you own all of that, that's called vertical integration. And what it means is that companies, as we call them, Big Marijuana, they can come in and do what Big Tobacco did. And so New York is trying to lessen the occurrence of that kind of integration. New York does have a social justice component that I hope will work. We just heard a few weeks ago that the governor okayed cultivation licenses, and they had to do that because the planting season is about to begin, and if they had waited, that would have been missed. And you want to have product for the likely opening of retail outlets in 2023. So anyway, in applying for cultivation license, one of the things that companies have to do is to include kind of an internship training component, where folks who have not been in the industry, but are interested in coming into the industry, and I think there's a provision for folks from disadvantaged backgrounds or backgrounds that have suffered as a result of New York drug laws, as well as women and other groups that have not fully participated in the industry, can start to learn. And so if all of that comes into play, it will help.

Schuyler Lawson  36:09 
Yeah, that actually got into my next question. So the War on Drugs has disproportionately impacted communities of color, particularly African Americans, with respect to experiencing serious legal consequences for possession and sale of small quantities of cannabis. So what has New York State done to address the social justice issue of dispensaries selling a product that not too long ago contributed to the disproportionate arrests of New Yorkers of color? I know you mentioned having priority for underrepresented groups for licenses, but are there other policies that have been proposed as well?

Dr. R. Lorraine Collins  36:41 
So one of the things that happened is that New York reiterated in 2019, a decriminalization law that had first been passed, I think in the late 70s. But anyway, there had been decriminalization of cannabis in New York, and it went nowhere. No one paid attention, I'm not sure of the details of the law. In 2019, a new version of that law was passed. And as a function of that law, having smaller amounts of cannabis is no longer a felony, it's more something that you get a ticket for. And the limit is less than two ounces of flower, which is the law, which is a lot because it doesn't weigh that much. So that has helped. And related to that, there has begun and continues to be process of expunging laws, or at least people who suffered from laws where they were arrested for having on their person or having in their possession, small amounts of cannabis. The last I looked at the data, New York has expunged about 200,000 records. There's another 200,000 to go. And what expungement means is that their arrest for cannabis gets removed from the public. It's no longer accessible to landlords or employers or really most entities, in some cases, it just is gone. There's a difference between just possession and for example, selling larger amounts or committing a crime where gun is involved, those will continue. So expungement is important because now that the records have been expunged, there are people, many of them, most of them African American men, who can apply for student loan, who can live in public housing, who can apply for jobs and so forth. And so that provides an opportunity for them to get on with their lives and not be hampered by the burden of being caught once with, you know, three ounces of cannabis. So that's really, I think, very, very good. There are also provisions where licenses, I'm thinking it's 40% of licenses, will go to folks from communities, often African American communities where there was a disproportionate negative effect from things like stop and frisk policies, where a lot of African American men were kind of caught up in police raids and hauled off to jail. So if we do that, that all sounds good. I worry about how that will work. I mean, we know that in construction and in other areas, there are firms that are minority headed, but when you kind of look deeper, minorities are not fully engaged in reaping the benefits. So that's something that I think we have to keep an eye on. The other thing I worry about is retail licensing that predominates in lower SES, or minority communities. The situation with liquor licenses in New York is an abomination, it's criminal. You can go to the east side of Buffalo and find a corner where you've got three alcohol outlets, there's a liquor store, there's a bar, and there's a corner store that sells alcohol, and you just kind of walk 20 feet and you go from one to the other. That's not a good thing. And if we do retail licensing of cannabis, the way we've done retail licensing of alcohol, we're gonna end up in a similar situation. Now there was an opportunity for communities to opt in or out of retail outlets, as well as kind of social use clubs. And that's been interesting. And I don't understand it all. But you know, you can have villages within towns saying no, but then the town's saying yes. And so, I did a piece on this in one of my lectures, and Hamburg comes to mine, in this area. So the village of Hamburg said no, but the town of Hamburg said yes, something like that.

Schuyler Lawson  41:36 
Does that supersede what the village declared?

Dr. R. Lorraine Collins  41:42  
I don't know, I've never understood how New York is organized. Many people don't. It's one of the most convoluted that I'm aware of, in the entire country. And so anyway, we have this opt in/opt out feature and surprise, surprise, higher SES communities, or communities that want to maintain "their traditional lifestyles" and kind of sense of selves are opting out. The opt ins are motivated in a lot of ways by tax benefits that they hope will come, and some by jobs. Although when you come down to it, it's probably more the taxes than the jobs. But anyway, it's going to be interesting to see what happens with all of this licensing, because it could go really well. Or it could be a disaster.

Schuyler Lawson  42:46 
So speaking of taxes, have there been any talk about where the recreational cannabis tax revenues are going to be put towards?

Dr. R. Lorraine Collins  42:54 
Oh, of course, a sizeable proportion. And again, I don't want to quote percentages, but I'm thinking 40 to 50(%) of the tax revenues and benefits are to go to disadvantaged communities, or communities that have disproportionately suffered as a result of the past drug laws. I'm not sure how that gets handled. Does it go to City Hall? Does it go to businesses? I'm not sure how that will be apportioned. One of the drivers of the social justice components of this law is Crystal Peoples-Stokes, who is from Buffalo, and who really, over many years worked hard to get cannabis regulation in New York State. And she is very purposefully driven to make sure that communities will receive benefits rather than harms. And so I'm thinking with her keeping an eye on things, that it could help, but so many details have to be worked out. And some of them we really won't know the consequences until after they're in play. And then the challenge will be, how do we fix that? How do we fix the problems? What kind of tweaks or out note changes do we need to make?

Schuyler Lawson  44:31 
Yeah, so it's gonna be an ongoing project, it seems.

Dr. R. Lorraine Collins  44:34 
For a few years, yes.

Schuyler Lawson  44:35 
So from a scientific perspective, what would you say are the advantages and disadvantages of recreational cannabis legalization?

Dr. R. Lorraine Collins  44:45 
So what I've mentioned before is safety. Kind of knowing the product that you're using. I mean, if a product says 10% THC, and we take it to a lab, the lab should tell us Oh, it's 10% THC. Right now, in some states, the label could say 10%, and the lab could say zero, or the lab could say 30. I mean, people don't really know what they're using, and I think it's important that people know. Moving people away from the illegal market is, I think, really important, not just from the perspective of generating taxes, but just the elements that benefit from that market are not elements that we want to support. So I think that that's really good and useful. The other thing to understand, the harms of alcohol, in many areas are probably worse than the harms from cannabis. It's kind of strange, that other than that blip of prohibition, alcohol has been readily available for centuries, and cannabis has not. So that kind of makes some sense.

Schuyler Lawson  46:03 
Yeah. I suppose I would also put tobacco in a similar sort of situation to this illegal product that's caused quite a bit of harm.

Dr. R. Lorraine Collins  46:11 

Well, the interesting thing about tobacco is, I'm not aware of any benefits. It's fully harmful. With cannabis, we've talked about medicinal benefits, and it really does seem less prone to egregious negative consequences than alcohol for sure.

Schuyler Lawson  46:37  
So before we conclude our interview, is there anything else you'd like to share with our listeners?

Dr. R. Lorraine Collins  46:43
 
I think it's really important to advocate for public health education. I continue to be disappointed that that is not happening. And I think it's important to advocate for the removal of cannabis from Schedule I DEA designation because, until that happens, research is going to be stymied. And I think that it's important to learn from best practices elsewhere. So in the marketing realm, for example, Canada, all plain packaging, no billboards or marketing. You go into a store retail outlet, and it's very, very austere, as compared to walking into an outlet that looks like you're in a Vegas casino. So they're best practices, not only among other states in the US, but other countries. And we might want to learn from them as well.

Schuyler Lawson  47:43  
All right, well, thank you again for taking the time to be on our podcast. We hope to have you on again to discuss future issues, as the cannabis situation in New York is, like I said, it's going to be constantly evolving. So is there a way that our listeners can learn more about your cannabis research?

Dr. R. Lorraine Collins  47:58  
I have a web page. It's under CHHB (Community Health and Health Behavior). I do have a web page. I suppose you could do a search for my name.

Schuyler Lawson  48:10  
Yep, for Dr. R. Lorraine Collins, and also probably Google Scholar, to type in your name.

Dr. R. Lorraine Collins  48:17  
Yeah, my name gets weird on some search engines because I use a first initial, I will just caution that, but yes. If you do, Collins probably stuff will pop up. So thank you very much, Schuyler, this was interesting. I tried to pack a lot in - I hope it isn't overwhelming. But this is such an important and timely topic. I'm glad that you chose to focus on it with me or with others, because there are a lot of folks at UB doing cannabis research.

Schuyler Lawson  48:51 
Thank you. Thank you. Thank you again for being a part of the podcast and providing this valuable information on a very complicated topic.

Dr. R. Lorraine Collins  49:02 

My pleasure.

Schuyler Lawson  49:03 
You're welcome, and I'm Schuyler Lawson, and thanks for listening to another episode of Buffalo HealthCast. Take care and be well.

Outro  49:10 
This has been another episode of Buffalo HealthCast. Tune in next time to hear more about health equity in Buffalo, the US and around the globe.