ISMP Urges National Regulation of Medical Marijuana Labeling

The Institute for Safe Medication Practices (ISMP) has released a statement urging national regulation of medical marijuana labeling, saying that the lack of regulation has led to confusing labeling and errors.¹

The statement pointed out that the spread of legalized marijuana products has increased the need for unified labeling requirements.¹ Currently, 33 states and the District of Columbia have legal medical marijuana, and 11 of those states have legalized recreational marijuana use.²

Although all medical marijuana growers must confirm the contents of their products so that information can be accurately disseminated to dispensaries and patients, the ISMP statement noted that requirements vary by state.¹

“The amounts of THC and CBD are important to know in order to dose properly, and manage a patient’s symptoms, but the way they are listed on product labels can be difficult to understand,” the statement said.¹

Some of those issues include inconsistent labeling, look-alike containers and labels, unlabeled bottles and cartridges, missing information, and inaccurate labeling.¹

Inconsistent labeling is a key issue. Amounts of THC and CBD can be listed as a ratio or as a percentage, but there is no regulation of which should be used or in what order they should be listed.¹ Similarly, in products that list the ingredients as percentages, they are not required to give the total volume in the container, which can lead to further confusion.¹

For some liquid products and most vapor cartridges, the statement continued, only the outer box is labeled. Without the box, therefore, the product could easily be confused for something else.¹

Inaccurate labeling is also a significant concern, according to the statement.¹

“There have been many reports of CBD-only products containing either no detectible CBD or significantly more CBD than is on the label,” the statement said. “Studies have found that some CBD-only products contain detectable amounts of THC, which could cause a positive urine drug screening test.”¹

Clarifying these concerns would allow health care providers to more safely recommend the best dose and frequency of marijuana use for their patients, according to the statement.¹

Finally, the statement advised patients to ask for a demonstration of how to measure each dose of the product they select. However, some states prohibit dispensers from opening the container to show the patient; such regulations prohibit patient education and should be addressed, the statement said.

REFERENCES

• ISMP Warns that Medical Marijuana Product Labeling Problems Have Led to Errors [news release]. Horsham, PA; Jan 13, 2020. Institute for Safe Medication Practices. https://www.ismp.org/news/ismp-warns-medical-marijuana-product-labeling-problems-have-led-errors. Accessed Jan 14, 2020.
• Legal Medical Marijuana States and DC. ProCon.org, https://medicalmarijuana.procon.org/legal-medical-marijuana-states-and-dc/. Accessed Jan 14, 2020.