High-Risk Cannabis Use: A Proposal of an Operational Definition through Delphi Methodology for Scientific Consensus

Area of Science:

• Public Health
• Addiction Medicine
• Cannabis Research

Background:

• Cannabis is a widely used psychoactive substance globally.
• Cannabis use is linked to physical, mental, social, and economic health issues.
• Hazardous substance use increases the risk of harmful consequences.

Purpose of the Study:

• To establish an operational definition of high-risk cannabis use for Spain.
• To achieve expert consensus on defining high-risk cannabis consumption patterns.
• To identify specific vulnerability factors associated with cannabis use.

Main Methods:

• A three-round Delphi study involving 45 experts in Spain.
• Online surveys utilizing Likert scale and open-ended questions.
• Consensus defined as ≥75% agreement, using Standard Joint Units (SJUs) for dosage.

Main Results:

• High-risk use: >4 SJUs (>28 mg THC) weekly or cannabis >10% THC potency.
• Concurrent use with other drugs and smoked administration routes identified as high-risk.
• Vulnerable groups include individuals under 21, pregnant/breastfeeding women, those with psychiatric or medical issues, and certain professionals.

Conclusions:

• The operational definition clarifies high-risk cannabis use patterns and vulnerability factors in Spain.
• This definition can guide individuals, professionals, and policymakers in prevention and risk reduction.
• Evidence-based interventions can be facilitated by adopting this definition.