Self-titration of cannabis consumption: An epidemiological perspective

Cannabis legalization has expanded access to high-potency products (e.g., dab concentrates) that deliver large amounts of delta-9-tetrahydrocannabinol (THC). It is unclear whether cannabis consumers mitigate the effects of higher-potency products by consuming smaller amounts (i.e., self-titration). We investigated whether users adjust consumption amounts in response to potency when using cannabis flower and concentrates. Data come from four online surveys of U.S. cannabis consumers (N = 8158) reporting past-month flower and/or dab concentrate use. Participants reported their typical amounts (number of hits or grams) and potencies (%THC). We analyzed relationships between consumption amounts and %THC in three ways: (1) within-subject/between-product, (2) between-subject/between-product, (3) between-subject/within-product. To assess selection biases, we examined correlations among potency, use frequency, and age of initiation. Participants were approximately 52 % female, 84 % White, and 73 % reported daily cannabis use; average age was 42 years (SD = 16). In within-subject/between-product analyses, 59 %-92 % of participants used larger amounts of flower than concentrates. In between-subject/between-product analyses, flower-only consumers reported greater amounts than concentrate-only consumers (Median Hits: 8-14 vs. 5-8; Median Grams: 1-1.5 vs. 0.18-0.5). In between-subject/within-product analyses, using higher-THC versions of a product predicted larger amounts (Flower/Hits: r_s = 0.12-0.19; Flower/Grams: r_s = 0.07-0.29; Concentrate/Hits: r_s = 0.09-0.14; Concentrate/Grams: r_s = 0.19-0.25), more frequent use (r_s = -0.01-0.39), and earlier initiation (r_s = -0.06 to -0.33). Results suggest that cannabis consumers self-titrate when switching between flower and concentrate product types, but more frequent consumers prefer higher-potency versions of a given product type and consume them in larger amounts.