Quantitative Criteria to Screen for Cannabis Use Disorder

Casajuana, Cristina; López‐Pelayo, Hugo; Miquel, Laia; Balcells-Oliveró, María Mercedes; Colom, Joan; Gual, Antoni

doi:10.1159/000488346

Cited by 7 publications

(5 citation statements)

References 23 publications

(26 reference statements)

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“…CBD was found in joints containing cannabis resin but not herbal cannabis, and was not included in the standard joint unit. Advantages of this approach include its reference to a commonly used method of administration in Europe which may be easily applied in research and clinical settings and validation against problematic use . However, the standard joint unit does not capture other methods of use.…”

Section: Previous Arguments For Standard Cannabis Unitsmentioning

confidence: 99%

‘Standard THC units’: a proposal to standardize dose across all cannabis products and methods of administration

2019

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Background and Aims Cannabis products are becoming increasingly diverse, and vary considerably in concentrations of ∆9‐tetrahydrocannabinol (THC) and cannabidiol (CBD). Higher doses of THC can increase the risk of harm from cannabis, while CBD may partially offset some of these effects. Lower Risk Cannabis Use Guidelines currently lack recommendations based on quantity of use, and could be improved by implementing standard units. However, there is currently no consensus on how units should be measured or standardized among different cannabis products or methods of administration. Argument Existing proposals for standard cannabis units have been based on specific methods of administration (e.g. joints) and these may not capture other methods, including pipes, bongs, blunts, dabbing, vaporizers, vape pens, edibles and liquids. Other proposals (e.g. grams of cannabis) cannot account for heterogeneity in THC concentrations among different cannabis products. Similar to alcohol units, we argue that standard cannabis units should reflect the quantity of primary active pharmacological constituents (dose of THC). On the basis of experimental and ecological data, public health considerations and existing policy, we propose that a ‘standard THC unit’ should be fixed at 5 mg THC for all cannabis products and methods of administration. If supported by sufficient evidence in future, consumption of standard CBD units might offer an additional strategy for harm reduction. Conclusions Standard ∆9‐tetrahydrocannabinol (THC) units can potentially be applied among all cannabis products and methods of administration to guide consumers and promote safer patterns of use.

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Section: Previous Arguments For Standard Cannabis Unitsmentioning

confidence: 99%

‘Standard THC units’: a proposal to standardize dose across all cannabis products and methods of administration

2019

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“…For example, using two or more joints per day was associated with higher ASSIST mean scores than using one joint per day (Asbridge et al., 2014). The validity of joints per day was also confirmed using the CAST as measure for CUD risk (Casajuana et al., 2018): on additional joint per day increased the odds of CUD risk by 44%.…”

Section: Resultsmentioning

confidence: 90%

“…Questions without visual aids were employed in n = 16 studies collecting information from cannabis users in Canada (Asbridge et al, 2014;Callaghan et al, 2019;Rotermann, 2019;Sikorski et al, 2021;Zeisser et al, 2012), Spain (Casajuana et al, 2016(Casajuana et al, , 2018Madero et al, 2020), USA (Callaghan et al, 2020;Caulkins et al, 2020;Chen et al, 2022;Lennox et al, 2006;Prince et al, 2020;Ridgeway & Kilmer, 2016;Trull et al, 2022) or USA/Australia (Bonn-Miller et al, 2016) (see Table 1). In most studies, the cannabis quantities were collected for an average use day but some studies also referred to the peak amounts used (Lennox et al, 2006) or to light and heavy use days (Caulkins et al, 2020).…”

Section: Studies Without Visual Aidsmentioning

confidence: 99%

Measuring cannabis quantities in online surveys: A rapid review and proposals for ways forward

Manthey

Pons-Cabrera

Rosenkranz

et al. 2023

Int J Methods Psych Res

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ObjectivesCannabis use quantities are relevant for determining cannabis‐related harms. This research aims to provide an overview of the available methods to assess quantities through self‐report.MethodsA rapid review of various strategies to collect information on cannabis use quantities through self‐report. Two independent literature searches resulted in n = 38 studies included for review.ResultsA total of n = 14 studies employed methods for collecting cannabis use quantities that are not suitable for online surveys (e.g., rolling a fake joint). Of the remaining n = 24 studies with items that are suitable for online surveys, the quantity assessment was performed in three different ways. The data collection was either carried out by asking (a) for the total number of joints (i.e., crude joint method), (b) for the total weight (i.e., crude weight method), or (c) for specific products separately, for example, for the amount of flower and resin (i.e., product‐specific method). In only n = 8 studies, cannabis use quantities were ascertained by providing visual aids (e.g., illustration of various amounts of flower).ConclusionsThe crude joint method and the product‐specific method are the two most promising methods to collect information on cannabis use quantities. Using visual aids may potentially improve the accuracy of those methods.

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“…Also, a cohort study of Australian secondary students suggested a threshold of weekly cannabis use during adolescence for increased probability of cannabis use disorders (38). Nonetheless, other previous studies had already pointed to near-daily or daily frequency of cannabis use for increased risk of cannabis use disorders (39,40). According to previous studies, younger age at first cannabis use seems to be of crucial importance to the development of dependence.…”

Section: Discussionmentioning

confidence: 98%

Early, Chronic, and Acute Cannabis Exposure and Their Relationship With Cognitive and Behavioral Harms

et al. 2021

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Background: Cannabis is the third most consumed drug worldwide. Thus, healthcare providers should be able to identify users who are in need for an intervention. This study aims to explore the relationship of acute, chronic, and early exposure (AE, CE, and EE) to cannabis with cognitive and behavioral harms (CBH), as a first step toward defining risky cannabis use criteria.Methods: Adults living in Spain who used cannabis at least once during the last year answered an online survey about cannabis use and health-related harms. Cannabis use was assessed in five dimensions: quantity on use days during the last 30 days (AE), frequency of use in the last month (AE), years of regular use (YRCU) (CE), age of first use (AOf) (EE), and age of onset of regular use (AOr) (EE). CBH indicators included validated instruments and custom-made items. Pearson correlations were calculated for continuous variables, and Student's t-tests for independent samples were calculated for categorical variables. Effect sizes were calculated for each of the five dimensions of use (Cohen's d or r Pearson correlation) and harm outcome. Classification and Regression Trees (CART) analyses were performed for those dependent variables (harms) significantly associated with at least two dimensions of cannabis use patterns. Lastly, logistic binary analyses were conducted for each harm outcome.Results: The mean age of participants was 26.2 years old [standard deviation (SD) 8.5]. Out of 2,124 respondents, 1,606 (75.6%) reported at least one harm outcome (mean 1.8 and SD 1.5). In our sample, using cannabis on 3 out of 4 days was associated with an 8-fold probability of scoring 4+ on the Severity Dependence Scale (OR 8.33, 95% CI 4.91–14.16, p <0.001), which is indicative of a cannabis use disorder. Also, a start of regular cannabis use before the age of 25 combined with using cannabis at least once per month was associated with a higher probability of risky alcohol use (OR 1.33, 95% CI 1.12–1.57, p = 0.001). Besides, a start of regular cannabis use before the age of 18 combined with a period of regular use of at least 7.5 years was associated with a higher probability of reporting a motor vehicle accident (OR 1.81, 95% CI 1.41–2.32, p < 0.0001). Results were ambiguous regarding the role that age of first use and milligrams of THC per day of use might play regarding cannabis-related harms.Conclusions: The relationship among AE, CE, and EE with CBH indicators is a complex phenomenon that deserves further studies. The pattern of cannabis use should be carefully and widely evaluated—(not just including frequency but also other dimensions of pattern of use)—in research (preferably in longitudinal studies) to assess cannabis-related harms.

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Quantitative Criteria to Screen for Cannabis Use Disorder

Cited by 7 publications

References 23 publications

‘Standard THC units’: a proposal to standardize dose across all cannabis products and methods of administration

‘Standard THC units’: a proposal to standardize dose across all cannabis products and methods of administration

Measuring cannabis quantities in online surveys: A rapid review and proposals for ways forward

Early, Chronic, and Acute Cannabis Exposure and Their Relationship With Cognitive and Behavioral Harms

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