Dr. Willie McKinney answers questions at the Keller and Heckman E-Vapor and Tobacco Law Symposium.

Q: If you would go back to one of the slides showing only 22% are falling within plus or minus 10% and the majority are at higher levels, do we know what behavioral effects will occur with the 87.6% or 76% that are falling way above the level indicated on the package? What happens when you go from what it’s saying to the extreme outlier?

A: It’s a great question. Here we were looking at CBD, which is not necessarily psychoactive. However, some of the FDA’s concerns include male reproductive effects and liver effects at certain concentrations. Consumers may be making choices based on incorrect labels, which could have impacts, but we don’t know for sure. Policy considerations should address this.

Q: Since you looked at the global level, specifically on CBD and the products being tested, label accuracy is an issue. Did you notice any trends in particular countries or regions, or even stateside, regarding safety concerns around CBD?

A: Yes, there’s one trend I’ve been paying attention to: an increase in psychosis, especially with Delta-8. This could be driven by Delta-8 or contamination with other substances. There are quite a few papers and reports of increases in psychosis.

Q: Regarding the variations in test results, for the products you picked in the US market, did these products already have third-party lab reports from recognized labs?

A: Great question. This was a quick review where we pulled data from scientific literature. In the US, we used one publication that evaluated illicit products, including those involved in the EVALI incident, and others that measured cannabinoids in non-EVALI products. We reviewed the methods of those papers and concluded they were valid, which is why we included them in this summary. We are also trying to publish this.

Q: There may be a link between Delta-8 and psychosis. Considering how variables can be related, is it possible some people use Delta-8 instead of pharmaceutical drugs for anxiety or depression, contributing to comorbidity issues?

A: Absolutely, this is a complex issue. The articles suggest that people on the borderline may tip the scale when using these products. I’ll share a personal experience: I bought some products to try, and that night, I was extremely paranoid. It could have been the specific product or contamination, but I won’t take the risk again until there are regulations and manufacturing practices in place.