Higher average potency across the United States is associated with progression to first cannabis use disorder symptom

Arterberry, Brooke J.; Padovano, Hayley Treloar; Foster, Katie; Zucker, Robert A.; Hicks, Brian M.

doi:10.1016/j.drugalcdep.2018.11.012

Cited by 73 publications

(45 citation statements)

References 27 publications

(27 reference statements)

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“…Such undesirable adverse effects may lead to a perception of treatment failure in patients who have already failed traditional pain management therapies, while dependence may potentiate the long-term use of high potency cannabis. The prolonged use of high potency cannabis increases the risk for psychotic disorders by 5-fold in daily users compared to never users [34], increases the risk of memory impairment and paranoia [35][36][37], and is associated with cannabis admissions to drug treatment [38]. People who use cannabis for medicinal purposes have more frequently reported daily or almost daily cannabis use, Fig 6. Percent of THC (A) and percent CBD (B) in CO and WA medicinal and recreational programs.…”

Section: Discussionmentioning

confidence: 99%

Mapping cannabis potency in medical and recreational programs in the United States

et al. 2020

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Cannabis related online searches are associated with positive attitudes toward medical cannabis, particularly when information is obtained from dispensaries. Since pain is the main reason for medicinal cannabis use, information from dispensary websites has the potential to shape the attitude of pain patients towards cannabis. This is relevant because cannabis has demonstrated efficacy in neuropathic pain with low tetrahydrocannabinol (THC) concentrations (< 5-10%), in contrast to potent cannabis (>15% THC), which is highly rewarded in the recreational realm. The role of CBD in pain is not clear, however it has gained popularity. Thus, we hypothesize that the potency of medical cannabis that is advertised online is similar to the cannabis advertised for recreational purposes, which would potentially create a misconception towards medical cannabis. The current lack of knowledge surrounding advertised potencies in the legal cannabis market limits the ability to generate clear policies regarding online advertising to protect patients that are willing to use cannabis for their condition. Thus, we evaluated the advertised THC and CBD content of cannabis products offered online in dispensaries in the United States to determine products' suitability to medicinal use and compare the strength of products offered in legal medical and recreational programs. We recorded THC and CBD concentrations for all herb cannabis products provided by dispensary websites and compared them between or within states. Four Western states (CA, CO, NM, WA) and five Northeastern states (ME, MA, NH, RI, VT) were included. A total of 8,505 cannabis products across 653 dispensaries were sampled. Despite the clear differences between medicinal and recreational uses of cannabis, the average THC concentration advertised online in medicinal programs was similar (19.2% ±6.2) to recreational programs (21.5% ±6.0) when compared between states with different programs, or between medicinal and recreational programs within the same states (CO or WA). Lower CBD concentrations accompanied higher THC products. The majority of products, regardless of medicinal or recreational programs, were advertised to have >15% THC (70.3%-91.4% of products). These stated concentrations seem unsuitable for medicinal purposes, particularly for patients with chronic neuropathic pain. Therefore, this information could induce the misconception that high potency cannabis is safe to treat pain. This data is consistent with reports in which THC and CBD in products from legal dispensaries or in

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Section: Discussionmentioning

confidence: 99%

Mapping cannabis potency in medical and recreational programs in the United States

et al. 2020

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“…24,25,27 Previously, Hasin et al reported that the prevalence of cannabis use has doubled from 4.5% to 9.5% in the last decade in adults in the United States and overall 30% of these cannabis users advance further and develop cannabis use disorder. 27,28 Charilau et al studied the NIS database and found a threefold increase in the prevalence of cannabis use in the hospitalized US population in the last decade. 25 We observed that this increase in prevalence of cannabis use was more substantial in CVS patients.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of cannabis use has significantly increased in patients with cyclic vomiting syndrome

Siddiqui

Bilal

Singh

et al. 2020

Neurogastroenterology Motil

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Introduction Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder which leads to multiple hospitalizations and causes significant impairment of quality of life. Cannabis use is common in patients with CVS, and there are limited data on the national trends in the prevalence of its use in the United States. Methods We used the National Inpatient Sample (NIS) database from 2005 to 2014 and identified hospitalizations with a primary diagnosis of CVS by utilizing the International Classification of Diseases, 9th revision Clinical Modification (ICD‐9 CM) coding system. The primary objective of the study was to analyze the prevalence and trends in cannabis use in CVS patients. We also assessed healthcare resource utilization associated with cannabis use. Results A total of 129 090 hospitalizations with a primary diagnosis of CVS were identified and included in the study. In the United States, the overall rate of cannabis use among these patients was 104 per 1000 hospitalizations (N = 13 460). Over the last decade, the prevalence of cannabis use increased by 10‐fold, from 2.2% in 2005 to 21.2% in 2014. Conclusion Our analysis of the national database suggests that nearly 1 in 5 CVS hospitalizations have concurrent cannabis use. This prevalence is significantly rising over the last decade, perhaps due to changing legislation and increased utilization of cannabis. Age younger than 35, male gender, African American and Native American race, personal history of alcohol abuse and tobacco use were some of the strongest predictors of cannabis use.

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“…bong) or vaporisers (electronic devices which heat cannabis into a vapour for inhalation; Russell et al ., 2018) which may influence the pharmacokinetics and transient effects of THC (Spindle et al ., 2018). Evidence suggests that among these products, those with higher THC concentrations confer the greatest harms, including increased severity of dependence (Freeman and Winstock, 2015), cannabis use disorder symptom onset and treatment (Freeman et al ., 2018 b ; Arterberry et al ., 2019) and a greater risk of, and relapse to psychosis (Di Forti et al ., 2015; Schoeler et al ., 2016; Di Forti et al ., 2019). However, few studies have explored the risk of harms carried by the more novel products becoming increasingly prevalent.…”

Section: Introductionmentioning

confidence: 99%

Characterising heterogeneity in the use of different cannabis products: latent class analysis with 55 000 people who use cannabis and associations with severity of cannabis dependence

et al. 2019

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BackgroundAs new cannabis products and administration methods proliferate, patterns of use are becoming increasingly heterogeneous. However, few studies have explored different profiles of cannabis use and their association with problematic use.MethodsLatent class analysis (LCA) was used to identify subgroups of past-year cannabis users endorsing distinct patterns of use from a large international sample (n = 55 240). Past-12-months use of six different cannabis types (sinsemilla, herbal, hashish, concentrates, kief, edibles) were used as latent class indicators. Participants also reported the frequency and amount of cannabis used, whether they had ever received a mental health disorder diagnosis and their cannabis dependence severity via the Severity of Dependence Scale (SDS).ResultsLCA identified seven distinct classes of cannabis use, characterised by high probabilities of using: sinsemilla & herbal (30.3% of the sample); sinsemilla, herbal & hashish (20.4%); herbal (18.4%); hashish & herbal (18.8%); all types (5.7%); edibles & herbal (4.6%) and concentrates & sinsemilla (1.7%). Relative to the herbal class, classes characterised by sinsemilla and/or hashish use had increased dependence severity. By contrast, the classes characterised by concentrates use did not show strong associations with cannabis dependence but reported greater rates of ever receiving a mental health disorder diagnosis.ConclusionsThe identification of these distinct classes underscores heterogeneity among cannabis use behaviours and provides novel insight into their different associations with addiction and mental health.

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Higher average potency across the United States is associated with progression to first cannabis use disorder symptom

Cited by 73 publications

References 27 publications

Mapping cannabis potency in medical and recreational programs in the United States

Mapping cannabis potency in medical and recreational programs in the United States

Prevalence of cannabis use has significantly increased in patients with cyclic vomiting syndrome

Characterising heterogeneity in the use of different cannabis products: latent class analysis with 55 000 people who use cannabis and associations with severity of cannabis dependence

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