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

Abstract

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.

Communicating THC levels and ‘dose’ to consumers: Implications for product labelling and packaging of cannabis products in regulated markets

“…We appreciate the commentaries [1][2][3][4] which support our proposal for a standard THC unit [5] and raise insightful points for progressing with this initiative.…”

“…Chester et al [1] outline the importance of experimental cannabinoid studies for informing the standard tetrahydrocannabinol (THC) unit. Our proposal for a 5-mg THC unit was informed by experimental studies showing that this low dose produces intoxication in infrequent users with minimal risk of adverse acute effects [5]. Moving forward, experimental cannabinoid studies can quantify doseresponse effects of THC unit consumption on acute harms and benefits, such as driving performance [6].…”

Factors Moderating the Association between Cannabis Use and Psychosis Risk: A Systematic Review

“…Likewise, the definition of high-potency cannabis varied between studies, and actual THC/CBD concentrations of cannabis samples were not assessed. Standardized measures for assessing cannabis use and determining THC/CBD concentrations in cannabis are highly needed for improving the comparison and interpretation of results [114,115]. Third, although the present systematic review provides an up-to-date and detailed overview of the most recent literature, possible differences in the quality of the included studies were not assessed in a systematic way.…”

Commentary on Chan & Hall (2020): Advances in specifying cannabis consumption

“…This issue is becoming increasingly complex with the proliferation in many jurisdictions of cannabis‐based products such as edibles and highly concentrated oils and waxes used in vaping or dabbing devices. Freeman proposes to standardize cannabis use by adopting a 5‐mg Δ‐9‐tetrahydrocannabinol (THC) approach . In this approach, oral, combustible, vaporized (and other) formulations would all be based on how much THC is ingested overall.…”

“…Similarly, national surveys in the United States have relied upon measures of frequency and self‐reported ‘joints’ as an approximation for the quantity consumed . It is clear that more research is needed to inform cannabis standardization measures .…”