Cannabis Concentrate Use in Adolescents

Abstract

BACKGROUND: Cannabis concentrates, which are cannabis plant extracts that contain high concentrations of D-9-tetrahydrocannbinol (THC), have become increasingly popular among adults in the United States. However, no studies have reported on the prevalence or correlates of cannabis concentrate use in adolescents, who, as a group, are thought to be particularly vulnerable to the harms of THC. METHODS: Participants are a racially and ethnically diverse group of 47 142 8th-, 10th-, and 12thgrade students recruited from 245 schools across Arizona in 2018. Participants reported on their lifetime and past-month marijuana and cannabis concentrate use, other substance use, and risk and protective factors for substance use problems spanning multiple life domains (ie, individual, peer, family, school, and community). RESULTS: Thirty-three percent of all 8th-, 10th-, and 12th-graders reported lifetime cannabis use, and 24% reported lifetime concentrate use. Seventy-two percent of all lifetime cannabis users had used concentrates. Relative to adolescent cannabis users who had not used concentrates, adolescent concentrate users were more likely to use other substances and to experience more risk factors, and fewer protective factors, for substance use problems across numerous life domains. CONCLUSIONS: Most adolescent cannabis users have used concentrates. Based on their risk and protective factor profile, adolescent concentrate users are at higher risk for substance use problems than adolescent cannabis users who do not use concentrates. Findings raise concerns about high-risk adolescents' exposure to high-THC cannabis. WHAT'S KNOWN ON THIS SUBJECT: Cannabis concentrates have high D-9-tetrahydrocannbinol (THC) content, and adolescents are thought to be especially vulnerable to the harms of THC. However, little is known about the prevalence or correlates of concentrate use in adolescents. WHAT THIS STUDY ADDS: Cannabis concentrate use was common in adolescents (prevalence = 24%). Concentrate users were worse off than nonconcentrate cannabis users on every risk and protective factor for substance use problems, raising concerns about high-risk adolescents' exposure to high-THC cannabis.

Update on the developmental consequences of cannabis use during pregnancy and lactation

“…With legalization, there are business reasons to increase THC concentration, and new cultivars are being grown that have potency as high as 30%. Cannabis concentrate, made by extracting THC from the marijuana plant, may have a THC content ranging from 39% to 69% (Meier et al, 2019). Cannabinoids are not regulated or approved by the U.S. Food and Drug Administration (FDA), with the exception of one prescription CBD medication and two prescription THC products.…”

“…There are many routes of exposure for cannabinoids including smoking the flowers and leaves, vaping concentrates, applying a vaporized spray to the buccal area, ingesting capsules, liquids, or foods and applying topical lotions. Potency and timing of effects on the user vary greatly according to method used (Meier, Docherty, Leischow, Grimm, & Pardini, 2019).…”

Setting the baseline: a description of cannabis poisonings at a Canadian pediatric hospital prior to the legalization of recreational cannabis

“…Children are especially vulnerable to cannabis poisoning due to their metabolism and lower body weight. 6,7 Other contributing factors…”

Use of Cannabis Concentrates by Adolescents

“…The study by Meier et al 6 in this month's issue of Pediatrics, entitled "Cannabis Concentrate Use in Adolescents," is the first report in which rates of use of these highly potent forms of marijuana by adolescents are described. 4 Using a state-wide, ethnically diverse sample of 46 850 middle and high school students (grades 8, 10, and 12) in Arizona, Meier et al 6 found that 33% of students reported lifetime use of any cannabis product, and of these lifetime users, almost three-quarters (72%) had also used concentrates. In addition, they found that those students who reported using concentrates were more likely than cannabis nonusers or cannabis concentrate nonusers to be women, to report using other substances, and to endorse risk behaviors such as rebelliousness and academic failure.…”

“…Increased efforts to regulate tetrahydrocannabinol concentrates and the delivery systems that teens are using to vape nicotine, flavorings, and marijuana, increase the minimum mandatory age to purchase all e-cigarette products to 21 years, and restrict marketing and advertising aimed at adolescents are clearly warranted. Additional research and reports such as that by Meier et al 6 may be the impetus needed to bring about much-needed oversight, education, and regulation. ABBREVIATION E-cigarette: electronic cigarette…”