PainRelief.com Interview with:
Kat Petrilli, PhD Student
Addiction and Mental Health Group (AIM)
Department of Psychology
University of Bath
PainRelief.com: What is the background for this study?
Response: Cannabis is the third most used drug globally, after alcohol and nicotine. Experimental studies show that THC, the main psychoactive component, causes intoxication, cognitive impairments, as well as symptoms of anxiety and psychosis-like experiences and these effects are dose-dependent, which means that higher potency cannabis products (products with high THC concentrations) could increase the risk of harm to cannabis users.
Previous studies have shown that concentrations of THC in cannabis have increased over the years. In the US and Europe concentrations of THC in cannabis have more than doubled over the past 10 years. In addition, new legal markets have facilitated the appearance of cannabis products with higher potencies than earlier products, such as cannabis concentrates. We also know from previous studies that cannabis use is associated with mental health disorders and 22% of people who use cannabis are estimated to meet the criteria for cannabis use disorder (CUD) or cannabis addiction.
International increases in cannabis potency and the availability of higher potency cannabis products makes it especially pressing to understand the association of cannabis potency with mental health outcomes.
PainRelief.com: What are the main findings?
Response: After systematically reviewing the literature looking at this association, we found that people who use high potency cannabis are more likely to experience addiction than those using low potency products. It also suggests that people using high potency cannabis are more likely to experience a psychotic disorder, such as schizophrenia. Links between cannabis potency and depression and anxiety are unclear.
PainRelief.com: What should readers take away from your report?
Response: Use of higher potency cannabis could increase the risk of developing cannabis addiction and other mental health problems. For people who use cannabis, choosing lower potency products rather than higher potency products could help to make cannabis use safer, and offers a sensible strategy for harm reduction.
PainRelief.com: What recommendations do you have for future research as a result of this work?
Response: In order to address limitations found across studies, future studies should incorporate better measures of exposure which do not rely on self-report measures and the use of cannabis products as a proxy of cannabis potency. Ideally, future research would include quantified measures of THC concentration in cannabis. Although we know this is more difficult in countries where cannabis is illegal as this information is not readily available. Use of standardised measures of cannabis consumption, such as the iCannToolkit and the standard THC unit, are also needed in order to better integrate the evidence. In addition, future research should include a more comprehensive list of confounders in their analysis and use of longitudinal designs in order to better understand the direction of the association.
Disclosures: GT reports previous funding from Pfizer (GRANT scheme) and owns a scientific consulting company doing work unrelated to this project.
KP, SO, LH, SA, and TPF declare no competing interests.
Association of cannabis potency with mental ill health and addiction: a systematic review
Kat Petrilli, MRes Shelan Ofori, MRes Lindsey Hines, PhD Gemma Taylor, PhD Sally Adams, PhDTom P Freeman, PhD
Published: July 25, 2022DOI:https://doi.org/10.1016/S2215-0366(22)00161-4
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