Validation of self‐reported cannabis dose and potency: an ecological study

Pol, Peggy van der; Liebregts, Nienke; Graaf, Ron de; Korf, D.J.; Brink, Wim van den; Laar, Margriet van

doi:10.1111/add.12226

Cited by 74 publications

(52 citation statements)

References 25 publications

(37 reference statements)

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“…First, this is because we assessed cannabis exposure in great detail, including cannabis use frequency, joints per using day, dose per joint, estimated cannabis potency and type of preferred cannabis. Although we recently showed that validity of self-reported cannabis dose and potency are indeed modest, the average dose per joint could be estimated accurately at the group level [40]. Second, self-reported exposure measures were sensitive enough to detect differences between dependence trajectories in cannabis exposure at follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…These included the separate lifetime CUD symptoms (total of 11 symptoms: 4 for cannabis abuse and 7 for cannabis dependence; table 3), the total sum of lifetime CUD symptoms and duration of lifetime dependence at baseline (measured as the number of years with three or more cannabis dependence symptoms). Second, variables related to cannabis exposure were assessed, including the age of first cannabis use and cannabis use in the last four weeks (number of cannabis using days, preferred type of cannabis (herbal yes; no), users' estimate of cannabis potency (high; middle; low [40]), number of joints per using day, cannabis dose per joint (1 g/number of joints from one gram [40])). In addition, total cannabis exposure (in grams) in the last four weeks was measured by multiplying the number of days that cannabis was used by the number of joints per day and the estimated dose per joint.…”

Section: Methodsmentioning

confidence: 99%

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Three-Year Course of Cannabis Dependence and Prediction of Persistence

et al. 2015

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Aims: To examine the course and the predictors of the persistence of cannabis dependence. Methods: Through cannabis outlets and chain referral, a prospective enriched community cohort of 207 young adults (aged 18-30) with DSM-IV cannabis dependence at baseline (T0) was formed and followed-up after 1.5 (T1) and 3 (T2) years. The presence of cannabis dependence, cannabis-related problems, functional impairment and treatment was assessed using the Composite International Diagnostic Interview (CIDI 3.0) and the Sheehan Disability Scale (SDS). Predictors of persistence were lifetime cannabis abuse and dependence symptoms, cannabis use characteristics, distant vulnerability factors (e.g. childhood adversity, family history of psychological/substance use problems, impulsivity, mental disorders), and proximal stress factors (recent life events, social support). Results: Four groups were distinguished: persistent dependent (DDD: 28.0%), stable non-persistent (DNN: 40.6%), late non-persistent (DDN: 17.9%) and recurrent dependent (DND: 13.5%). At T2, persisters (DDD) reported significantly more (heavy) cannabis use and cannabis problems than non-persisters (DNN/DDN/DND). Treatment seeking for cannabis-related problems was rare, even among persisters (15.5%). The number (OR = 1.23 (1.03-1.48)) and type (‘role impairment' OR = 2.85 (1.11-7.31), ‘use despite problems' OR = 2.34 (1.15-4.76)) of lifetime cannabis abuse/dependence symptoms were the only independent predictors of persistence with a total explained variance of 8.8%. Conclusions: Persistence of cannabis dependence in the community is low, difficult to predict, and associated with a negative outcome. The substantial proportion of stable non-persisters suggests that screening and monitoring or low-threshold brief interventions may suffice for many non-treatment-seeking cannabis-dependent people. However, those with many lifetime abuse/dependence symptoms may benefit from more intensive interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Three-Year Course of Cannabis Dependence and Prediction of Persistence

et al. 2015

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“…Missing from our work is a deeper consideration of the question of the dose and potency of cannabis consumed [84,85]. This includes indicators of cannabis exposure that capture dose and potency [86] as well as methods of ingestion (smoking, eating, and injecting), or more basic questions of how individuals ‘use' (e.g. duration of inhalation) cannabis.…”

Section: Discussionmentioning

confidence: 99%

Problems with the Identification of ‘Problematic' Cannabis Use: Examining the Issues of Frequency, Quantity, and Drug Use Environment

et al. 2014

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Considerable recent attention has focused on how harmful or problematic cannabis use is defined and understood in the literature and put to use in clinical practice. The aim of the current study is to review conceptual and measurement shortcomings in the identification of problematic cannabis use, drawing on the WHO ASSIST instrument for specific examples. Three issues with the current approach are debated and discussed: (1) the identification of problematic cannabis use disproportionately relies on measures of the frequency of cannabis consumption rather than the harms experienced; (2) the quantity consumed on a typical day is not considered when assessing problematic use, and (3) screening tools for problematic use employ a ‘one-size-fits-all approach' and fail to reflect on the drug use context (networks and environment). Our commentary tackles each issue, with a review of relevant literature coupled with analyses of two Canadian data sources - a representative sample of the Canadian adult population and a smaller sample of adult, regular, long-term cannabis users from four Canadian cities - to further articulate each point. This article concludes with a discussion of appropriate treatment interventions and approaches to reduce cannabis-related harms, and offers suggested changes to improve the measurement of problematic cannabis use.

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“…Only very recently have studies differentiated between different types of cannabis based on THC content 30,[37][38][39] , and most of these studies do not involve measures of THC and CBD content, but proxy measures of potency, such as analysis of police seizures or coffee shop cannabis, and a reliance on self-report measures. Although self-report measures are associated with THC and CBD content, these associations are modest and are weaker among infrequent users 84,85 . Future longitudinal studies may choose to collect cannabis cigarettes (joints) from their participants over the course of the study and collect information as to how often they would smoke such a cigarette.…”

Section: Making Cannabis Safermentioning

confidence: 93%