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. 2019 Feb 1:195:186-192.
doi: 10.1016/j.drugalcdep.2018.11.012. Epub 2018 Dec 17.

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

Brooke J Arterberry  1 , Hayley Treloar Padovano  2 , Katherine T Foster  3 , Robert A Zucker  4 , Brian M Hicks  5
Affiliations

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

Brooke J Arterberry et al. Drug Alcohol Depend. .

Abstract

Objective: To determine if higher potency cannabis is associated with earlier progression to regular cannabis use, daily cannabis use, and cannabis use disorder symptom onset.

Methods: Data sources were the Michigan Longitudinal Study, an ongoing prospective, high-risk family study investigating the course and predictors for substance use disorders among youth beginning prior to school entry and time-parallel national average trends in delta-9-tetrahydrocannabinol (i.e., psychoactive compound in cannabis). The national average trends in delta-9-tetrahydrocannabinol were used to estimate potency level for the individual. Only cannabis users were included in analyses (n = 527).

Results: Cox regression showed an increased risk of progression from cannabis initiation to cannabis use disorder symptom onset by 1.41 times (p < .001) for each unit increase in national average delta-9-tetrahydrocannabinol as compared to those not endorsing CUD symptom onset, adjusting for sex, regular use, and cohort effects. Accounting for regular use, individuals initiating cannabis at national average 4.9% delta-9-tetrahydrocannabinol were at 1.88 times (p = .012) higher risk for cannabis use disorder symptom onset within one year compared to those who did not endorse CUD symptom onset, while those initiating cannabis at national average 12.3% delta-9-tetrahydrocannabinol were at 4.85 times (p = .012) higher risk within one year.

Conclusions: This study provides prospective evidence suggesting higher potency cannabis, on average in the U.S., increases risk for onset of first cannabis use disorder symptom. Development of guidelines regarding cannabis potency is critical for reducing the costs associated with negative health outcomes.

Keywords: Cannabis; Cannabis potency; Cannabis use disorder; Cannabis use patterns; Delta-9-tetrahydrocannabinol; High potency Cannabis.

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Conflict of interest statement

Conflict of Interest

Dr. Treloar Padovano has previously been a paid statistical consultant for Zynerba® Pharmaceuticals All other authors report no financial relationships with commercial interests.

Figures

Figure 1.
Figure 1.
Regular user status hazard ratios representing risk of reporting a CUD symptom in the first or second year after cannabis-use initiation by potency at year of initiation. Error bars reflect 95% confidence intervals for hazard ratios.
Figure 2.
Figure 2.
Daily user status hazard ratios representing risk of reporting a CUD symptom in the first or second year after cannabis-use initiation by potency at year of initiation. Error bars reflect 95% confidence intervals for hazard ratios.
See this image and copyright information in PMC

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