Over one-fifth of adults in America reported using hemp-derived cannabinoids such as cannabidiol (CBD) and delta-8 tetrahydrocannabinol (THC) in a survey of responses collected last summer.
Researchers not only identified the extent of how popular hemp-derived products are, but emphasized that states that prohibit cannabis lead to a higher rate of delta-8 THC use—probably because that’s all people can get legally in those states.
The study, “Past-Year Use Prevalence of Cannabidiol, Cannabigerol, Cannabinol, and Δ8-Tetrahydrocannabinol Among US Adults,” was published Dec. 13 in the Journal of the American Medical Association (JAMA) and referenced data gathered in a 2019 Gallup poll.
According to the new findings, 25.2% of adults reported past-year use of any emerging hemp-derived cannabinoid, including delta-8 THC, CBD, cannabigerol (CBG), cannabinol (CBN), etc. Of those, 21% of adults said they had used CBD specifically. Other products derived from hemp had lower rates of use: 11.9% of the survey respondents reported using delta-8 THC, 5.2% reported using CBG, and 4.4% reported using CBN—one of the least significant cannabinoids.
The study was written by doctors Adrianne R. Wilson-Poe, Tristin Smith, Michael R. Elliott, Daniel J. Kruger, and Kevin F. Boehnke. “We provide the first estimates, to our knowledge, of past-year use prevalence of CBN, Δ8-THC, and CBG in the US. A Gallup poll reported that 14% of US adults personally used CBD in 2019; our reported 21% use prevalence of CBD represents a 50% increase over the past 4 years,” researchers wrote.
“Prevalence of past-year cannabis use was somewhat higher than in other studies but was similarly associated with younger age, and past-year cannabis use was also associated with using emerging cannabinoid products,” the report continues. “Higher Δ8-THC use in states without medical or adult-use cannabis laws suggests that cannabis prohibition may unintentionally promote Δ8-THC use. There are few controlled human studies with emerging cannabinoids, but surveys suggest these products are used for treating sleep or pain1 and in place of other drugs, including pain medications.”
The researchers noted that hemp products are frequently psychoactive, and these are the main compounds they’re concerned with.
“Based on these results, we support ongoing public health surveillance efforts targeting emerging cannabinoids because of lack of industry standards to protect consumers and similar pharmacology or effects of Δ9-THC and its hemp-derived impairing analogues (eg, Δ8-THC), which may be of particular concern for adolescents and young adults,” the study reports. “Study limitations included not assessing emerging cannabinoid use patterns (eg, dose and use frequency) and possible sampling biases, although NORC implements probability-based recruitment best practices for their AmeriSpeak panel. Our results highlight the importance of future research to better understand perceptions of safety, motivations for use, and outcomes of use of these products.”
Researchers cautioned that the products are not regulated and could put patients at the risk of adverse effects from unknown contaminants.
The 2018 Farm Bill legalized the cultivation and sale of hemp, and it created a legal loophole, allowing hemp-derived products that are now sold online and at smoke shops, gas stations, and other retailers.
Medscape reports that the U.S. Food & Drug Administration (FDA) does not regulate hemp-derived products; therefore, no federal standards exist for testing ingredients for safety or verification of ingredients as listed on labels.
“If someone is picking up one of these products to use medically, and it ends up having heavy metals and pesticides and it doesn’t even have the active ingredient in it, that is not good,” said Kevin F. Boehnke, PhD, a research assistant professor in the Department of Anesthesiology and the Chronic Pain and Fatigue Research Center at the University of Michigan in Ann Arbor.
Prohibition Leads to Delta-8 Use
In states where medical cannabis is legal, residents had 56% lower odds of using delta-8 THC, whereas those in states where adult-use cannabis is legal had 55% lower odds of using delta-8 THC than those surveyed in states without legalization.
The findings suggest “cannabis prohibition may unintentionally promote delta-8-THC use,” Boehnke and his colleagues wrote.
Alice Kuo, MD, PhD, a pediatrician and professor of internal medicine and pediatrics at the David Geffen School of Medicine at the University of California in Los Angeles, told Medscape that she has seen a large increase in patients who say they use cannabinoid products, and believe them to be “natural.”
“My official response to patients who ask me for my opinion is that I don’t have enough scientific background to give an opinion: If you think it helps you and you have no side effects, then I’m not going to tell you to stop,” Kuo said.
The FDA warns about delta-8 THC and similar products, which it says are products that have not been proven to be safe.