Higher average potency across the United States is associated with progression to first cannabis use disorder symptom
Open accessAbstract
Objective To determine if higher potency cannabis is associated with earlier progression to regular cannabis use, daily cannabis use, and cannabis use disorder symptom onset. Methods Data sources were the Michigan Longitudinal Study, an ongoing prospective, high-risk family study investigating the course and predictors for substance use disorders among youth beginning prior to school entry and time-parallel national average trends in delta-9-tetrahydrocannabinol (i.e., psychoactive compound in cannabis). The national average trends in delta-9-tetrahydrocannabinol were used to estimate potency level for the individual. Only cannabis users were included in analyses (n = 527). Results Cox regression showed an increased risk of progression from cannabis initiation to cannabis use disorder symptom onset by 1.41 times (p < .001) for each unit increase in national average delta-9-tetrahydrocannabinol as compared to those not endorsing CUD symptom onset, adjusting for sex, regular use, and cohort effects. Accounting for regular use, individuals initiating cannabis at national average 4.9% delta-9-tetrahydrocannabinol were at 1.88 times (p = .012) higher risk for cannabis use disorder symptom onset within one year compared to those who did not endorse CUD symptom onset, while those initiating cannabis at national average 12.3% delta-9-tetrahydrocannabinol were at 4.85 times (p = .012) higher risk within one year. Conclusions This study provides prospective evidence suggesting higher potency cannabis, on average in the U.S., increases risk for onset of first cannabis use disorder symptom. Development of guidelines regarding cannabis potency is critical for reducing the costs associated with negative health outcomes.
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Increases in cannabis potency have been associated with a faster progression to first onset of symptoms.
“Increases in cannabis potency have been associated with a faster progression to first onset of symptoms [59].”
From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [59]
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- Authors
- Arterberry, B. J., Treloar Padovano, H., Foster, K. T., Zucker, R. A., & Hicks, B. M.
- Affiliations
- Iowa State University (US)
- University of Michigan (US)
- Corresponding author
- Arterberry, Brooke J.
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2019-02
- Volume
- 195
- Pages
- 186-192
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC6376862
- OpenAlex
- W2904484597
- Cited by
- 103
- References
- 37
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 16 · 2023: 15 · 2022: 17 · 2021: 13 · 2020: 13 · 2019: 7
- FWCI
- 5.32
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and AlcoholismNational Institute on Alcohol Abuse and Alcoholism (NIAAA) (R01 AA007065)
- NIAAA (R01 AA007065, K23 AA024808, T32 AA007477)
- Topics
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Keywords
- cannabis potency, delta-9-tetrahydrocannabinol, cannabis use disorder, cannabis initiation, daily cannabis use, symptom onset, adolescent substance use
- MeSH terms
- Adolescent, Adult, Cannabis, Marijuana Abuse, Child, Female, Hallucinogens, Humans, Longitudinal Studies, Male, Marijuana Smoking, Michigan, Prospective Studies, Dronabinol, United States, Disease Progression, Young Adult
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