Thread by @trikomes

Getting questions about recent @Forbes article. Article makes good points + gives good advice, but also makes erroneous claims based on misreading recent #cannabis research. Basic claims of article + breakdown of the new study in this thread. 1/

forbes.com/sites/chrisrob…

Many #cannabis consumers buy weed based on THC level, trying to get the most THC for their $. High THC weed sells faster. Article says that buying weed based just on THC is a bad idea. There's more to quality than just THC %. I agree with this, but the article goes further... 2/

The article is making the further claim that THC content is a poor indicator of #cannabis potency, and that weed with higher THC levels will *not* get you more high.

Wait? So if you consume flower with 18% THC, it will get you just as high as a concentrate with 80%?

Well.. 3/

That is *not* an accurate reading of the referenced study, which I'll break down below. People are now asking me if it's true that they can consume #cannabis concentrates with >70% THC w/o worrying about getting "too high." This is NOT accurate. Let's look at the new study:

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Full study available at link below. Basic idea: two groups of people. One gets #cannabis flower w/ 16-24% THC, other gets concentrates w/ 70-90% THC. Each group consumes product, and they look at how high people get. Let's look at study design + results 5/ jamanetwork.com/journals/jamap…

First, study used experienced #cannabis consumers. Did not use novice consumers. To participate, must have consumed at least 4 times in past month, and have used highest potency flower or concentrate used in the study at least once before.

Full inclusion criteria below:

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Study had four groups: low-THC flower (16%), high-THC flower (24%), low-THC concentrate (70% THC), high-THC concentrate (90% THC).

THC levels based on prior lab testing, and *not* independently measured for this study (the importance of that is a story for another day...)

7/

Last thing before results. Consumers had 5 days to freely consume their #cannabis before the experimental session. This is important. So, this is naturalistic consumption prior to testing, which allow for tolerance/adaptation to the product they have been given. Now results... 8/

On test day, they consume in their home, however they want ("naturalistic consumption"), then walk outside into mobile lab for testing. They measure blood levels of THC and record subjective + objective measures of intoxication. These are compared across the four groups. 9/

Fig 1: Blood levels of THC (left), 11-OH-THC (right). This result is unsurprising. Concentrate groups have higher blood levels of THC. 70% and 90% THC groups have similar levels on avg. Error bars are standard errors (lots of variance within groups). 10/

People consuming concentrates have higher blood THC levels, so you's think they are also "more high," right? Nope. On avg, people in each group report similar levels of high-ness. "Subjective drug effects" basically means you ask someone to rate how high they feel on a scale. 11/

What about objective measures, i.e. cognitive and motor function as assessed by researchers. Same thing. No glaring differences between groups, on average. 12/

Holy cow, so this means that you won't get more high if you consume #cannabis with higher THC levels, and that THC has nothing to do with potency?! No, these results to *not* indicate that. This is why #science journalism can be frustrating... 13/

First, let's look at some explanations offered by the study's authors: 14/

Again, this study used experienced consumers, and they had five days to freely consume this product prior to testing. So, this allows tolerance to build, etc. We know experience + consumption levels matter. Let's think about these results in a couple ways... 15/

First, apply common sense. These are experienced consumers and they each consumed in a "naturalistic setting." This just means they consumed as much/little as they wanted, and presumably stopped consuming whenever they reached their own personal desired level of high-ness... 16/

If each group was given a controlled amount of vapor or smoke, with different levels of THC in each group, these results would likely have been different, at least at relatively low doses before any ceiling effects kick in. 17/

We also know from past research that experience level w/ #cannabis greatly influences intoxication levels. Inexperienced consumers are much more sensitive to THC and CBD levels. This randomized control trial from 2019 is a good reference: 18/

pubmed.ncbi.nlm.nih.gov/30661105/

It shows that frequent #cannabis consumers have similar levels of intoxication across different THC/CBD levels, but infrequent consumers' level of intoxication varies quite a bit with different THC/CBD levels. 19/

So, back to the @Forbes article, which states that, "High-THC weed doesn't even get you 'more high!'"

A novice #cannabis consumer could read this and think, "Oh wow, I can consume a product with any THC % and it won't be a problem. THC doesn't impact potency at all!" 20/

That is not good messaging. If a novice consumer takes one puff of a joint with 18% THC, vs a same-sized puff off of their friend's dab rig to inhale a 85% THC concentrate, they are *not* going to have comparable experiences. /21

The @Forbes article is right to point out that there's much more to #cannabis than THC, and that the fixation on THC % is problematic on a number of levels. I'm a big believer in this. This focus on THC leads to all sorts of problems, including inflated lab results... /22

But the recent JAMA study does not show that THC levels have nothing to do with potency, so if you're new to #cannabis and curious about dipping your toes in the water, do *not* ignore the THC levels of the product you're trying. /end