Exploring cannabis concentrates on the legal market: User profiles, product strength, and health-related outcomes

Abstract

Background: Concentrated cannabis products are increasingly available and used, particularly in states with legal cannabis, but little is known about the profiles and characteristics of concentrate users. We aimed to characterize user profiles of cannabis users living in states with legal medical or recreational cannabis who reported using concentrates to those who do not use concentrates.

Methods: An anonymous online survey was advertised in California, Colorado, Nevada, Oregon, and Washington. We compared respondents who endorsed frequent concentrate use (FC; N = 67) (i.e. 4 days/week) with cannabis users who never use concentrates (NC; N = 64), and with those who smoke/vaporize cannabis flower frequently but never or very rarely use concentrates (FF; N = 60), on measures related to cannabis use patterns and cannabinoid product strength, other substance use, and occupational functioning and health.

Results: FC endorsed more symptoms of cannabis use disorder as compared to non-concentrate users (p < 0.05), but were similar to FF and NC on other health and occupational outcomes. FC also differed from FF and NC in that they tended to use cannabis that was higher in THC (p < 0.0005), even when using non-concentrated forms of cannabis (p < 0.005). Over half of FC users reported typically using concentrates of at least 80% THC, and 21% endorsed use of (non-concentrated) dry cannabis flower containing at least 30% THC.

Conclusions: Concentrate users endorsed higher symptoms of cannabis use disorder and use higher strength cannabis even when using non-concentrated forms. Frequent use of concentrates may be associated with additional risks over and above frequent use of flower forms.

Keywords: Abuse liability; CBD; Concentrated cannabis; Dabbing; Marijuana; THC.

Fig. 1

THC and CBD concentrate strength among frequent concentrate users. The breakdown of THC and CBD concentration in typical concentrated products used among the Frequent Concentrate User (FC) group. 59.1% endorsed using concentrates containing at least 80% THC, and CBD levels were generally less the 50%.

Fig. 2

THC and CBD cannabis flower strength endorsed across groups. Comparison of self-reported strength of THC and CBD of respondents' most commonly used strains of cannabis flower across groups. Fig. 2a. THC strength of typical flower used across groups. Over 20% of frequent concentrate (FC) users reported typically using flower strengths of greater than 30% THC, compared to just 1.8% of non-concentrate (NC) using respondents. Only 20.6% of FC reported strengths of 10–20% THC, compared to 42.1% of NC users. Further, FC group's dry flower THC strength was higher than those who use frequently use flower forms of cannabis, but rarely or never use concentrates (FF). Fig. 2b. CBD strength of typical flower used across groups. Conversely, the estimated CBD strength of typical dry flower product for the FC group was generally lower than for the NC and FF groups. Given that CBD potentially carries less abuse liability than THC, we highlight the lower reported CBD levels in the flower products used by our frequent user groups (FC and FF) as compared to our more general cannabis use group (NC).