What is a "Cannabis User"?

The increasing legalization and use of cannabis necessitate robust, standardized methods for identifying and characterizing cannabis users in research and clinical settings. Variability in user demographics, consumption patterns, and product types complicates comparisons across studies, hindering the development of evidence-based policies and interventions. This commentary aims to highlight the need for urgent development and adoption of uniform methodologies to enhance the reliability and generalizability of cannabis-related research.

A review was conducted of correlational studies on outcomes associated with cannabis use to assess methods for identifying and characterizing cannabis users in study populations. Gaps in standardization were identified through comparisons of survey tools, self-report measures, health records, and biochemical assays. A review of existing frameworks for characterizing cannabis use was conducted.

Current methods lack consistency in defining key variables such as "occasional use" or "heavy use" (ranging from monthly to weekly to daily); they fail to capture sufficient nuance in cannabis use patterns, such as lifetime patterns of use, form (eg, flower, concentrate, edibles), dose, and content (eg, THC, CBD) of use; and they fail to identify cannabis users, due to self-report biases, lack of health codes for general cannabis use, and inaccuracies in biological tests. A standardized framework, including the development of validated, easy-to-administer surveys, together with the assurance that study participants are safe from repercussions associated with honestly reporting cannabis use, could address these issues.

Standardized methods would improve the comparability of cannabis research, enabling meta-analyses and longitudinal studies to inform public health strategies. Consistent user characterization could guide clinical practices, such as tailored interventions for dependence or therapeutic use. Policymakers would benefit from reliable data to shape regulations. There is an urgency for collaborative efforts to develop and adopt global standards for identifying and characterizing cannabis users.