Thank you so much. I apologize for the technical problems. I am on vacation in Hawaii, so I am not in with my normal support system.
I want to talk to you today about Washington State's experience and what we went through transitioning from an unregulated medical system to a regulated both recreational and medical system. Our medical system was first approved by voter initiative in 1998. It was a very simple initiative. It provided an affirmative defence to criminal prosecution for patients and their caregivers who possessed no more than a 60-day supply of marijuana. It didn't authorize commercial production or processing, sales or other transactions for consideration, regulation by any type of government entity whatsoever, the right to use marijuana, or legalization or arrest protection for patients and their caregivers.
Being from the Department of Health, I'm very interested in the role of the health care provider. We have medical doctors, osteopathic physicians, physician assistants, ARNPs, and naturopaths who can authorize the medical use of marijuana. They can discuss the risks and benefits, sign the patient's authorization form, testify in court, and they should educate about marijuana, but they cannot legally dispense or administer marijuana.
It stayed pretty quiet for many years after that, until our recreational initiative in 2012, and that of course allows adults aged 21 and older to purchase up to an ounce of marijuana and corresponding amounts of liquids and edible products that are obtained from a state-licensed system of private producers, processors, and retail stores. The hallmarks of the recreational market that were missing from the medical market were regulation and enforcement of any kind, seed-to-sale tracking, testing and labelling requirements, serving-size limits, product restrictions in terms of products that may be attractive to children, and any form of taxation.
When the recreational initiative passed in 2012, it did allot a certain amount of tax revenue to the Department of Health to create and maintain an education and public health program, to have a marijuana use hotline, to have grants and programs for local health departments, and to have media-based education campaigns that separately targeted both youth and adults. One of the issues we had with that is that it was funded out of tax revenue, but we were legalized in January of 2013 and sales didn't actually start until July 7, 2014. We had an 18-month lag during which we had legalization in Washington but we had no tax revenue coming in to fund the system.
One tip I would give to you or to any other government entity starting up a marijuana system is to make sure you have that educational funding up front and that you don't rely just on taxation dollars, because doing that is going to put you behind the eight ball. We had our citizens crying out for this kind of educational material, which we did not yet have the funding to put together. Since the sales revenue began, we now get about $7.5 million per year for our educational campaign, and we are in our third campaign. We first targeted parents about how to talk to their children. Then we targeted youth aged 16, 17, and 18. We're currently working on a campaign for our younger kids, aged 13, 14, and 15.
When sales started for the recreational system, we ended up with two systems living side by side—a highly regulated, highly taxed recreational market, and a completely unregulated, untaxed, kind of out-of-control medical market. Our legislature really started looking for a way to align these two systems.
That happened in 2015. They passed a bill that provided regulation of the medical use of marijuana through a single system of licensed producers, processors, and retail stores, with consistent labelling, testing, and product standards, and specific requirements for patients who are under the age of 18. We had never had that before in our initial medical system. There was no consideration for minors who might be patients; therefore, we had children who were literally going out and getting an authorization for medical use of marijuana without their parents even being aware of that, which raised a lot of concerns.
The goals of the alignment from the health department's point of view included clarifying what is meant by “the medical use of marijuana”. We have very strict standards in our law about what conditions you must have to qualify for the medical use of marijuana, but a lot of people use it to self-medicate. Is that medical or recreational? We also wanted tax breaks for patients who are signed up in our database or our registry. As well, we wanted to give them arrest protection for the first time, because, as I said, until that point they'd had only an affirmative defence at trial. We also wanted to better protect our medical patients by making sure that the products they were using were tested and accurately labelled, so that patients were actually getting what they were thinking they were getting when they went into our unlicensed medical dispensary.
On my slides, which I believe have been printed out, you can see some of the products—we have two pages of products—and the kinds of things that were in our unregulated medical market prior to 2015. They include products that mimic popular candy and treats, products that have 1,000 milligrams of THC in a single package. As you may have heard, a serving size is 10 milligrams, so that is a very high serving of marijuana. Also, it looks like a Twinkie. A small child may not understand that this is a marijuana-infused product.
I also have here a photograph that I took in a medical dispensary of completely unmarked and unlabelled edible products. I was in that dispensary. I held up a bag of Goldfish crackers that had been sprayed with marijuana concentrate and asked three different workers in that dispensary what was in the baggie, and they told me three different things. From a public health standpoint, that's very concerning. If you're a patient and you're relying on these products for your health, to go in and not be able to know what you're buying.... You're not going to have consistency and you're not going to have safety. You're not going to be able to rely on these products.
After the bill for alignment passed in 2015, the health department was given three notable tasks. There were several tasks in there, but there are three that I want to talk about. One is to create rules for products that would be beneficial for patient use. Another one is to create within the health department a new licensed profession called “medical marijuana consultant”, and one is to create a database, but most people refer to it as a registry. We were, up to that point, the only state that had legalized medical marijuana and did not have a registry. It was a pretty frustrating situation. I would get calls on a regular basis asking me how many patients we had in the state of Washington, and I would have absolutely no answer because we didn't have a way of tracking them.
For compliant products, when we were deciding what products are beneficial to patients, we really listened to our patient community and what they wanted from their system. They wanted better testing for pesticides, heavy metals, and mycotoxins, because those were not being tested for in the recreational market. As I spoke about earlier, we also wanted additional requirements for labelling, safe handling, and employee training. In my slides, which you have in front of you, I have a photograph of what a compliant product looks like. Something that has met all those requirements and rules can use a label developed by the health department to show the buyer that it does in fact meet those enhanced quality standards.
For the medical marijuana consultants, this was a compromise between our recreational initiative that said that people in the retail stores were not allowed to talk about the medical benefits of marijuana in any way. Compare that with what had been going on in our unlicensed dispensaries where workers in the dispensaries were basically practising medicine without a licence on a daily basis along the lines of, if you use this product, it will cure your cancer and you don't need to go back to your oncologist.
The legislature tried to create a balance between those two those things by creating a new profession that does have some training but is not a health care profession. At this time we have three training programs for consultants. Two of those are online so we can reach our rural populations. We received a little over 1,100 applications and issued 720 consultant certificates. These are people who can only work within a retail store and give advice about product selection but not medical care.
Our third major task was the database. It went live on July 1, 2016, which was the day of the alignment when all the unlicensed, basically illegal, medical dispensaries had to close. Initial and renewal cards for the database cost one dollar. It is not mandatory; however, it is voluntary, and if you're in the database, you get extra benefits as a patient in terms of not having to pay sales tax. You can grow more plants. You can purchase more products. It is entirely voluntary.