How Are Americans Using Emerging Cannabinoids?

— Survey reports past-year use of cannabidiol, cannabigerol, cannabinol, and more

by Michael DePeau-Wilson, Enterprise & Investigative Writer, MedPage Today December 13, 2023

About a quarter of Americans have used emerging cannabinoids — such as cannabidiol (CBD), cannabigerol (CBG), and cannabinol (CBN) — in the past year, according to a cross-sectional survey.

Among 1,169 participants who completed the poll, 25.2% reported past-year use of these compounds, which have been cropping up after the passage of the 2018 Farm Bill, Kevin Boehnke, PhD, of the University of Michigan Medical School in Ann Arbor, and colleagues reported in a JAMA Network Open research letter.

While 21.1% reported past-year use of CBD, fewer had used delta-8-THC (11.9%), CBG (5.2%), or CBN (4.4%), they found.

“We were surprised that over a quarter of Americans used these emerging cannabinoid products in the past year,” Boehnke told MedPage Today in an email, noting that as their use becomes more common, more research will be needed to understand potential health ramifications.

He said these products aren’t required to undergo laboratory testing for safety, including for potential contaminants like pesticides, solvents, or heavy metals. This lack of testing means the content of these products is typically unknown, he added.

Boehnke also emphasized that the sellers of these products have few restrictions for minimum age, especially for online stores.

“Better regulations are needed to help protect consumers,” Boehnke said, noting this is “especially true for delta-8-THC products,” which reportedly causes similar effects to delta-9-THC — the compound generally referred to as THC, or tetrahydrocannabinol, the principal psychoactive component of cannabis.

To conduct the survey, Boehnke and co-authors turned to the National Opinion Research Center (NORC) AmeriSpeak panel from June 22 to 26, 2023. Participants ages 18 and up were recruited by NORC, and a total of 1,169 responded to the survey for a response rate of 17.5%. The majority were female (51.7%) and had a median age of 48.

The researchers found that more respondents had heard about CBD (71.7%) than delta-8-THC (41.2%), CBG (18.4%), and CBN (16.8%).

Overall, 26.3% reported past-year cannabis use, and this use was associated with higher odds of using any emerging cannabinoid, they found (OR 23.9, 95% CI 14.2-40.2, P<0.001).

Boehnke told MedPage Today these products were used differently by different groups based on age and location. Younger people (ages 18 to 39) had higher odds of using delta-8-THC products than those 40 and over (OR 2.38, 95% CI 1.18-4.84, P=0.02), while non-Hispanic Black Americans were less likely to use emerging cannabinoids than whites (OR 0.36, 95% CI 0.15-0.88, P=0.02).

They also found that living in states with medical or recreational cannabis laws was negatively associated with delta-8-THC use.

“This suggests that cannabis prohibition may be unintentionally promoting use of delta-8-THC products, which is problematic given that these products tend to be less regulated than those available in legal medical or recreational cannabis dispensaries,” Boehnke said.

The study didn’t assess use patterns such as dose and frequency, and possible sampling biases may have occurred, the researchers said.

Still, they concluded that they “support ongoing public health surveillance efforts targeting emerging cannabinoids,” and called for more research “to better understand perceptions of safety, motivations for use, and outcomes of use of these products.”

Michael DePeau-Wilson is a reporter on MedPage Today’s enterprise & investigative team. He covers psychiatry, long covid, and infectious diseases, among other relevant U.S. clinical news.