Majority of Medical cannabis preparations tested either did not contain the labeled contents or had a small % compared to the labeled amount.All medical cannabis preparations are not made equal and may have different cannabinoid content and composition.Therefore, the cannabinoid composition specific to the needs of the underlying pathobiology and symptoms needs to be selected for treatment.Outbreaks of coagulopathy from products marketed as cannabinoids but containing long-acting rodenticide raises life-threatening concerns.Commercially available, mislabeled and adulterated cannabis products pose major health risks.Therefore, awareness and education of individuals regarding potential harms of the adulterated and unreliable cannabis products needs to be raised and users and healthcare providers need to validate the reliability of the contents.While many of the aforementioned clinical studies suggest that cannabinoids may be effective therapeutic agents for treating pain, cannabinoid use in the U.S.remains controversial.The illicit use of cannabis remains a major concern due in part to racial biases in cannabis sanctions in the U.S., especially for SCD patients that mostly comprise individuals of African descent.As a Schedule I substance, federal law designates cannabis as a drug “with no currently accepted medical use and a high potential for abuse,” but medical cannabis is currently approved in 36 states, Guam, Puerto Rico, US Virgin Islands and District of Columbia.Given the growing legality of medical cannabis use,ebb and flow this substance warrants rigorous study to accurately determine its risks and benefits in SCD.There is a strong need for randomized, placebo-controlled studies to accurately determine the effects of specific cannabinoids on SCD.

Such studies require special attention to not only cannabis dosing and route of administration , but also to the chemical composition of cannabis plants due to existence of variable cannabinoid contents in cannabis plants.Access to cannabis for research purposes remains a major roadblock in the U.S.and many parts of the world despite increasing preclinical evidence suggesting that it may be a valuable strategy for treating otherwise difficult to manage pain, which may be the case in SCD.Research funding allocation for cannabis’s safe use in disease-specific manner is needed to prevent the cannabinoid epidemic before it is too late.Given the growing body of evidence supporting the potential benefits of cannabinoids for the treatment of pain in adults, but the lack of randomized, placebo-controlled studies evaluating their use in treating SCD pain, this area of research deems high significance in order to develop more effective therapeutic options requiring more effective management of sickle pain.Observing patterns in retail prices is fundamental for understanding the economics of any agricultural consumer product.The study of cannabis retail prices, like the study of other economic aspects of the cannabis industry, is fraught with difficulty, in part because cannabis remains a Schedule I narcotic under U.S.federal law.Consumer price indexes, tax records, commercial retail scanner data, industry association reports and other sources of data typically available for agricultural products such as wine, almonds and cut flowers are unavailable for cannabis.Cannabis retailers have limited access to banking services; most cannabis retail transactions are conducted in cash; and cannabis businesses are understandably reluctant to share their financial data.There is a need for better information about all aspects of the cannabis industry, including prices and price patterns.In this article, we aim to contribute to the scant literature on cannabis retail prices by describing the basic patterns of price ranges at retailers in California over a 21-month time span during which the industry underwent a series of significant regulatory changes.

Several times between October 2016 and July 2018, researchers at the UC Agricultural Issues Center gathered cannabis retail prices published on Weed maps, a leading online cannabis retail platform.We report average maximum and minimum prices for three common types of cannabis packages: one-eighth ounce of dried cannabis flower, 1 ounce of dried cannabis flower and 500-milligram cannabis-oil cartridges.In our first 11 months of data collection , we collected prices from retailers in seven representative counties around California.Next, in November 2017, we collected prices from all retailers in California that listed prices on Weed maps, while continuing to track prices in the representative counties.After mandatory licensing began in January 2018, we collected three more rounds of prices from all retailers that listed prices on Weed maps and that had received temporary licenses to operate legally from the Bureau of Cannabis Control, a state regulatory agency.Despite differences in coverage among our rounds of data collection, the data seem to represent a wide swath of cannabis retail prices for retailers that posted prices openly and were part of the legal medicinal or adult-use cannabis segments during a period of unusual change for the cannabis industry.Under California law, medicinal cannabis patients have been able to legally purchase a variety of cannabis products since the Compassionate Use Act of 1996.However, state regulation of the industry was minimal for the two decades following the passage of the Act.The legislative process that finally introduced regulation and taxation to the California cannabis market is summarized in Gold stein and Sumner and covered in greater depth in Sumner et al.and UC Agricultural Issues Center.Here we will review only the major regulatory changes that occurred between 2016 and 2018, when we were collecting price data.Proposition 64, a voter initiative, decriminalized adultuse cannabis in November 2016, the month following our first round of price data collection.The proposition — the Adult Use of Marijuana Act — eliminated criminal penalties for possession, by adults 21 and over, of up to 1 ounce of cannabis flower and/or six cannabis plants.

Changes to criminal penalties took effect almost immediately, but state regulatory agencies were given until January 1, 2018 to write regulations for licensing, safety and taxation for all legal cannabis.This left a period of about 13 months, from November 2016 to December 2017, during which California’s 20-year-old medicinal cannabis industry was able to continue operating largely as it had before AUMA: permitted but unregulated on the state level, partially and inconsistently regulated at the county and/or municipal levels and mostly untaxed on any level.During this 13-month period, medicinal retailers continued selling cannabis to state residents with up-to-date recommendations from physicians.However, some medicinal cannabis businesses faced unusual local challenges in 2017 as some cities and counties that were opposed to the establishment of an adult-use cannabis industry restricted or banned all cannabis operations from their jurisdictions.On January 1, 2018, all cannabis businesses that had not applied for temporary licenses from state agencies became illegal from the point of view of the state.The Bureau of Cannabis Control, the California Department of Food and Agriculture,dry racks the California Department of Public Health and other state agencies propagated regulations that implemented most parts of a regulatory structure that merged AUMA with previous medicinal cannabis legislation.As of January 1, 2018, licensed distributors were required to pay a 15% state excise tax on all medicinal and adult-use cannabis sold at retail, and licensed growers were expected to pay a cultivation tax of $9.25 per ounce for any cannabis that entered legal market channels in 2018.In some counties and cities, additional local taxes were imposed.All licensees were also required to follow costly new regulations governing security, age verification, handling, labeling, child-proof packaging, inventory storage and “seed-to-sale” tracking — but not yet mandatory testing, one of the costliest elements of the new regulations.A final regulatory point worth noting is that since the launch of adult-use sales in January 2018, the California cannabis retail environment has drawn little distinction between medicinal and adult-use cannabis, and we do not distinguish between the two in our reporting of retail prices.There are some differences between the medicinal and adult-use systems: Retailers need separate medicinal cannabis permits to sell medicinal cannabis; the minimum age for purchasing medicinal cannabis is 18 instead of 21; the maximum quantity that may be purchased is 8 ounces instead of 1 ounce; and purchases are exempt from sales tax if the customer has a medicinal recommendation and a county-issued medicinal ID card.However, the cannabis supply for adult-use and medicinal sales is interchangeable.Medicinal and adult-use cannabis are subject to the same testing, labeling and packaging standards.Cultivators and manufacturers have no reason to distinguish between the two product types.In general, the only substantial cost faced by a medicinal cannabis retailer who enters the adult-use market is an additional license fee.

Meanwhile, the potential market for medicinal retailers is severely limited because consumers of medicinal cannabis, if they wish their purchases to be exempt from sales tax, must obtain county identification cards for medicinal cannabis in addition to medical recommendations — at a combined cost of up to $100 per year.With adult-use cannabis now widely available, many consumers who participated in the medicinal market in 2017 chose not to renew their medicinal recommendations in 2018.From an economic perspective, the 2018 California cannabis market is thus more usefully viewed as a single market than as separate adult-use and medicinal markets.The leading source of publicly available data on U.S.cannabis retail prices is Weed maps, an internet platform that enables retailers in California and other states to publish and update their price lists, locations and other practical information on a standardized consumer-facing website and app.Weed maps has operated since 2008.Researchers have used it to study the California cannabis industry since well before the autumn of 2016, when AIC researchers first gathered information from the site.For instance, Freisthler and Gruenewald used Weed maps listings to study the industrial organization of cannabis retailers in California.We found no reliable estimates of the percentage of California retailers listed on Weed maps.But because retailers may add or remove listings from Weed maps for business or marketing reasons other than opening or closing, Weed maps provides incomplete and constantly changing coverage of California’s retail cannabis market.Bierut et al., another study that uses Weed maps data, finds that Weed maps includes about 60% of retailers in Colorado and 40% of retailers in Washington, but does not analyze California retailers on Weed maps.This uncertainty should be kept in mind when interpreting our data.We began gathering price data from Weed maps in October 2016.We recorded prices by product type and also collected information on retail sales locations and whether retailers were storefront or delivery-only operations.We collected only the minimum and maximum listed price for three of the most common cannabis products.Many retailers listed a price schedule with just two levels for each product type: entry-level and “top-shelf” prices.Some retailers maintained three to four price levels, but during the first year of data collection, we rarely encountered more than five levels.With or without intermediate prices, we had no access to information about quantities sold and could not construct quantity-weighted average prices.Moreover, cannabis strains and forms of packaging were often specific to individual retailers, and measures of specific brand or product characteristics were not consistently available on Weed maps.Considering that not all retailers list prices on Weed maps, and that some retailers who at some point listed prices on Weed maps might have removed their listings while continuing to conduct business, we supplemented our data set with prices from Leafly, a competing cannabis portal whose functionality and business model are similar to those of Weed maps.In particular, we turned to Leafly when Weed maps price information was not available for retailers whose prices we were already tracking — or, in later rounds of data collection, from retailers that had obtained licenses from the Bureau of Cannabis Control to operate in the regulated 2018 environment.Coverage provided by Weed maps and Leafly is partly overlapping: Some retailers list prices on both portals whereas others list prices only with one service or the other.To test for bias that might result from the inclusion of Leafly prices as part of our data set, we compared Weed maps and Leafly average minimum and average maximum prices in a sub-sample of non-overlapping retailers, controlling for package size, and we found no statistically significant differences between Weed maps and Leafly average minimum and average maximum prices.All retailers listed prices for one-eighth ounce of packaged flower.Not all retailers listed prices for 1 ounce of packaged flower or 500-milligram oil cartridges.In later rounds of data collection, the share of retailers listing prices for 1 ounce of flower was smaller and the share of retailers listing prices for 500 milligrams of oil was larger.For instance, in October 2016, 90% of the 542 retailers listed prices for 1 ounce of flower and 57% listed prices for 500 milligrams of oil.In August 2017, 91% of retailers still listed prices for 1 ounce of flower and 82% listed prices for 500 milligrams of oil.