Abstract
Vaporization is an increasingly popular method for cannabis administration, and policy changes have increased adult access to cannabis drastically. Controlled examinations of cannabis vaporization among adults with infrequent current cannabis use patterns (>30 days since last use) are needed. To evaluate the acute dose effects of smoked and vaporized cannabis using controlled administration methods. This within-participant, double-blind, crossover study was conducted from June 2016 to January 2017 at the Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, and included 17 healthy adults. Six smoked and vaporized outpatient experimental sessions (1-week washout between sessions) were completed in clusters (order counterbalanced across participants); dose order was randomized within each cluster. Cannabis containing Δ9-tetrahydrocannabinol (THC) doses of 0 mg, 10 mg, and 25 mg was vaporized and smoked by each participant. Change from baseline scores for subjective drug effects, cognitive and psychomotor performance, vital signs, and blood THC concentration. The sample included 17 healthy adults (mean [SD] age, 27.3 [5.7] years; 9 men and 8 women) with no cannabis use in the prior month (mean [SD] days since last cannabis use, 398 [437] days). Inhalation of cannabis containing 10 mg of THC produced discriminative drug effects (mean [SD] ratings on a 100-point visual analog scale, smoked: 46 [26]; vaporized: 69 [26]) and modest impairment of cognitive functioning. The 25-mg dose produced significant drug effects (mean [SD] ratings, smoked: 66 [29]; vaporized: 78 [24]), increased incidence of adverse effects, and pronounced impairment of cognitive and psychomotor ability (eg, significant decreased task performance compared with placebo in vaporized conditions). Vaporized cannabis resulted in qualitatively stronger drug effects for most pharmacodynamic outcomes and higher peak concentrations of THC in blood, compared with equal doses of smoked cannabis (25-mg dose: smoked, 10.2 ng/mL; vaporized, 14.4 ng/mL). Blood THC concentrations and heart rate peaked within 30 minutes after cannabis administration and returned to baseline within 3 to 4 hours. Several subjective drug effects and observed cognitive and psychomotor impairments persisted for up to 6 hours on average. Vaporized and smoked cannabis produced dose-orderly drug effects, which were stronger when vaporized. These data can inform regulatory and clinical decisions surrounding the use of cannabis among adults with little or no prior cannabis exposure. ClinicalTrials.gov Identifier: NCT03676166.
Highlights
Cannabis policy and regulation are under dramatic reform throughout the developed world
Blood THC concentrations and heart rate peaked within 30 minutes after cannabis administration and returned to baseline within 3 to 4 hours
Vaporized and smoked cannabis produced dose-orderly drug effects, which were stronger when vaporized. These data can inform regulatory and clinical decisions surrounding the use of cannabis among adults with little or no prior cannabis exposure
Summary
Cannabis (marijuana) policy and regulation are under dramatic reform throughout the developed world. Numerous countries in the European Union and elsewhere have approved cannabis for medicinal (eg, Australia) and nonmedicinal (eg, Uruguay and Canada1) use. Corresponding with these policy changes, perceived harm associated with cannabis use has decreased.[2,3] These changes have spawned a new retail cannabis marketplace, which has increased access to cannabis and driven the development of numerous novel cannabis products and formulations. Cannabis has predominantly been smoked using various implements such as joints, pipes, bongs, and blunts.[4] Assorted vaporizers, analogous to electronic cigarettes, have emerged[5] and become an increasingly popular method for cannabis administration,[6,7] in states permitting nonmedicinal use of cannabis (eg, California[8]). Vaporization is associated with less toxicant exposure (eg, polycyclic aromatic hydrocarbons) relative to traditional smoking methods,[10,11] which increases product appeal.[6,7]
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