A Clinical Framework for Evaluating Cannabis Product Quality and Safety

Abstract

Increase in medical cannabis use, along with available products, warrants the need for clinicians to be knowledgeable in evaluating the quality of any cannabis product presented in clinical practice. Determining whether a product is regulated within the region is key in assessing overall quality and safety. Regulated products are held to a higher standard including independent testing, contamination mitigation, and concentration limits. Here, we present a clinical framework in evaluating cannabis products to ascertain the quality and regulation level of the product. Evaluation includes assessing the source company, reviewing product details (e.g., type, cannabinoid content, and labeling), and assessing quality control variables such as manufacturing and decontamination processes. The quality of products patients use is an important part of mitigating cannabis-related harms, especially in medically vulnerable patients. Currently, there is a great need to implement widespread standardization and regulations to ensure product quality and safety.

Cannabis vaporisation: Understanding products, devices and risks

“…Regulated cannabis products are significantly safer than unregulated products [9,10]. Regulated products must uphold strict guidelines and pass standardised testing to ensure products remain free or within acceptable levels for human consumption of contaminants, pesticides, microorganisms, diluents or fillers, as well as being accurately labelled [9,11]. This can be more complicated in a country like the United States, where cannabis is not regulated federally, as it is in Canada.…”

The Dark Side of Cannabidiol: The Unanticipated Social and Clinical Implications of Synthetic Δ8-THC

“…Similar to other aspects of the cannabis industry, serious product quality control issues plague this new ACRCC-Δ 8 -THC marketplace. 35 The most important consideration of these products is the current absence of accepted product specifications or proper analytical standards and techniques for testing commercially produced ACRCC-Δ 8 -THC products. As this article was completed, a new certified analytical standard was made commercially available for the identification and quantification of Δ 8 -iso-tetrahydrocannabinol IX .…”

A Clinical Framework for Assessing Cannabis-Related Impairment Risk

“…We advise against the use of concentrated dosage cannabis forms for medical use (e.g., dabbing) as they are commonly associated with excessive impairment and health risks ( 40 , 41 ). To date, local application of topical cannabinoids to intact skin does not appear to be associated with central effects, and thus can be used without risk of impairment ( 42 ).…”

“…One study evaluating CBD products sold online, found that 21% of these products contained sufficient THC to produce impairment ( 43 ). Further, non-regulated products, especially purchased online, may contain synthetic cannabinoids or be more likely to be highly potent, increasing risk of impairment ( 40 ). Regulated products can provide some confidence that the label matches the product's cannabinoid content.…”

“…Regulated products can provide some confidence that the label matches the product's cannabinoid content. Regulated products normally have strict regional requirements (state, provincial, or federal) for labeling and testing ( 40 , 44 ).…”