With legal cannabis dispensaries set to open in Minnesota in early 2025, many state residents — especially those involved in the addiction treatment world — want to know more about the impact that the substance’s wide availability could have on their communities.
Last month, with that question in mind, Hazelden Betty Ford Graduate School hosted its first-ever Cannabis Summit, a gathering designed to help academics, mental health professionals and others build a greater understanding of the risks and effects of cannabis use, and to learn more about research and public policy as well as the potential impact that cannabis can have on the developing brains of adolescents and young adults.
Kevin Doyle, Hazelden Betty Ford Graduate School president and CEO, said he and his colleagues invited a slate of top researchers and legal scholars to take a deeper dive into the topic. “There is more that needs to be thought about around this issue,” Doyle said, adding that the event attracted more than 100 attendees. “Hopefully the summit contributed to that conversation. We’re seriously talking about doing another one next year.”
One Cannabis Summit presenter was Ken Winters, Ph.D, a retired professor at the University of Minnesota Medical School’s Department of Psychiatry and Behavioral Sciences, senior research scientist at the Oregon Research Institute and one of the founders of Smart Approaches to Marijuana-Minnesota (SAMMn), an organization that educates Minnesotans about the research and science around cannabis use as well as cannabis’ harms and potential as medicine. Winters, whose academic work has largely focused on the impact of excessive cannabis use on adolescent health, gave a talk titled “The Interplay of Youth, Cannabis and Health.”
Recently, I spoke with Winters about his Cannabis Summit presentation, diving deeper into his research and his motivation for forming SAMMn. This conversation has been edited for length and clarity.
MinnPost: Much of your research and activism has been focused on the impact of cannabis use on teens and young adults. Why is that?
Ken Winters: I’ve always been an adolescent researcher. I’ve heard some real heartbreaking stories of the impact of cannabis addiction on the brains of adolescents and young adults. The data is compelling. The U.S. hasn’t seen a lot of big data research but the European countries have, and they have seen some warning signs.
MP: Can you tell me about some of the European research you’re citing?
KW: The country of Denmark, for instance, saw a three- to four-times greater percentage of new cases of psychosis emerging in their health system in recent years compared to prior years. They further nailed down the relationship by looking at whether they were seeing a connection between the percentage of people with psychosis and a comorbid cannabis use disorder. That showed a huge increase. They concluded that there is a pattern of psychosis that looks to be linked to heavy cannabis use.
But the mental health story for heavy cannabis use is more than simply psychosis. There is also a potential link to depression and suicidality. If you overuse cannabis it makes anxiety worse for some — even though many who use it say it helps them relax. Sometimes you take a drug and it feels like one step forward, but it is really two steps backward — because you aren’t actually helping the problem you took the drug for in the first place. You are making it worse.
MP: How did your Cannabis Summit presentation go?
KW: I told two terrible jokes that didn’t work and then I got into the talk. I talked about the impact of cannabis on youth brain development. Then I drilled a little deeper into four health topics. One is the impact of the use of cannabis in school achievement. The others were cannabis’ impact on mental health, addiction and long-term psychosocial functioning.
MP: What was the audience’s reaction to your presentation?
KW: It was a friendly audience, unlike some I encountered early on in my work with SAMMn. There was not any commentary or questions that challenged my basic conclusions. There was a group of students from Hamline University who came with their professors. At one point, we got a nice discussion going with them about how some people say they see psychological benefits from cannabis use. If that is the case, I asked, doesn’t that mean that all substances should be considered medicinal because some people say they use them for psychological relief? That would make all drugs and alcohol medicine.
MP: Were there any issues around cannabis use and young people that got members of your audience especially riled up?
KW: Someone in the audience reminded the group that it is remarkable how much more potent cannabis products have become. We talked about how I’m hoping the state will put a potency cap on cannabis products; we might be seeing products available at as much as 70% potency. This is a big issue. It alters the risks of potential harm significantly if a person is using the high-potency products when they are relatively young. Long-term studies show psychosocial functioning downstream isn’t so rosy when those types of products are used.
During one of the breaks, a professor who’d come with some of his students from Hamline came up to me and said, “Aren’t you surprised that the ‘cannabis is harmless’ mentality still exists? People are too often reflecting on the potency of cannabis that was available in the ‘60s and ‘70s. It was so much different then.’”
MP: Medical cannabis has been legal in Minnesota since 2014. Recreational cannabis will be widely available in retail settings in 2025. Are there any legislative changes that you and your colleagues at SAMMn hope to see change before then?
KW: There are a lot of features in the retail market that are under the advisement and rulemaking of the state Office of Cannabis Management. There is still room to help shape how retail advertising, accessibility and education about health impacts and warnings will be regulated in the retail environment. The health and safety warnings on labels and in stores is still an issue in play. There’s a lot of time for working on what kind of warnings might be on packaging and what might be allowed in retail environments.
MP: What has SAMMn been able to achieve since its founding?
KW: We helped delay the legalization of cannabis by one term. We lost that last time, of course, but we gained a lot of relationships and support in the process. We’re further encouraged by interest in influencing politicians in the next legislative session to see if the bill as it was approved could get some fixes.
MP: One thing you and your SAMMn colleagues hoped for was that, because of your concern about the negative impact of heavy cannabis use on the brains of young adults, the legal age for recreational cannabis in the state would be set at 25. That didn’t happen. Do you have any hopes that that could still change?
KW: We were hoping state lawmakers would bite on that wonderful idea. But they didn’t. Just because the legal age is 21 and cannabis is now considered medicine doesn’t mean that young people should be using it. It doesn’t mean it is safe for their brains. But we aren’t going to be able to turn back the clock, so we need to work with what we’ve got.
Lawmakers could have provided a lot more public health guardrails. Instead, they gave that responsibility to the Office of Cannabis Management. That office is going to have a lot of push from public health folks, from the retail world, from marketing folks. One has to realize that they might not always put public health ahead of retail or marketing interests. The law could’ve done so much more to protect the public.
MP: What do you think state lawmakers could’ve done to guarantee more public protection around recreational cannabis?
KW: It’s too bad lawmakers didn’t put a very rigorous potency cap in writing. They just left it up to the Office of Cannabis Management. So far, we don’t know of any potency cap that they are considering.
When Europeans have studied this topic they have come to the conclusion that any cannabis product with a potency of over 10% presents a greater risk of contributing to psychosis in users. The Europeans did a really good job of figuring out to what extent people were using high-potency products. Then they looked at the difference or risk of developing psychosis between high- or low-potency users.
MP: In the early days of your involvement with SAMMn, you and your colleagues encountered some strong resistance from legalization activists. Now that recreational cannabis has been legalized in Minnesota, have those interactions mellowed?
KW: Way back when we first got started as an organization, the year that recreational legalization didn’t get passed, we planned a news conference at the state Capitol. We thought it would be a good idea to get the word out to the media that we exist. Pro-cannabis activists showed up and shouted us down and called us names. Depending on how you look at it, it was pretty nasty or hilarious or memorable. We laugh about it now but at the time it was no fun at all.
These days, it is easier for us in a lot of ways. We can’t say we don’t want cannabis to be legal because it is legal. We’re not on the prohibition side anymore. Instead, we have to be focused on harm and risk reduction. We’re trying to take our inspiration from what the obesity-prevention folks do. They are not prohibiting eating foods; they are simply giving guidelines for healthy eating. That’s what we need to be doing now.
Andy Steiner
Andy Steiner is a Twin Cities-based writer and editor. Before becoming a full-time freelancer, she worked as senior editor at Utne Reader and editor of the Minnesota Women’s Press. Email her at asteiner@minnpost.com.
