High potency cannabis flower use is associated with heavier consumption and risk for cannabis use disorder among young adults in California, United States.

AIMS: To measure associations between frequency and quantity consumed of cannabis flower for different levels of delta-9-tetrahydrocannabinol (THC) concentration.

DESIGN

Cross-sectional survey.

SETTING

California, USA (survey fielded June 2022-July 2023).

PARTICIPANTS

Young adults (n = 512) with mean age 25.86 (standard deviation = 0.87) years, 48.04% female, from a California-based cohort study, who endorsed past-month cannabis flower use.

MEASUREMENTS: Individuals completed survey items on cannabis use behavior (e.g. past-month use frequency, quantity consumed), symptoms of cannabis use disorder [using the Cannabis Use Disorder Identification Test - Revised (CUDIT-R)] and self-reported knowledge and perceived THC content (potency) of typical flower used. Multivariable linear and logistic regression models examined associations between perceived flower potency [rated on a scale from No THC (0) to Very High THC (5)], use behavior and CUDIT-R scores, adjusting for sociodemographic characteristics.

FINDINGS: Nearly one in five respondents (18.55%) indicated that they did not know the THC potency of flower typically used. Among those who endorsed knowing potency, nearly half (46.76%) endorsed typically using High or Very High THC flower. Results from separate adjusted linear regression models showed that a one-point increase in the perceived THC potency scale was associated with 3.33 more use days per month [B = 3.33, (standard error, SE = 0.46), P < 0.0001], 0.13 more grams of flower used per day [B = 0.13 (SE = 0.04), P < 0.01] and 1.21 greater CUDIT-R scores [B = 1.21 (SE = 0.29), P < 0.0001].

CONCLUSIONS

Self-reported use of higher potency cannabis flower appears to be associated with more frequent and higher-quantity cannabis consumption and greater Cannabis Use Disorder Identification Test - Revised (CUDIT-R) scores, which is inconsistent with the notion that individuals titrate use of higher-potency cannabis.