Elsevier

Drug and Alcohol Dependence

Volume 178, 1 September 2017, Pages 399-407
Drug and Alcohol Dependence

Full length article
Characterizing marijuana concentrate users: A web-based survey

https://doi.org/10.1016/j.drugalcdep.2017.05.034Get rights and content

Highlights

  • 66% of the sample reported lifetime use of marijuana concentrate.

  • 13% of marijuana concentrate users reported daily use of concentrates.

  • Concentrate users were more likely to be from liberal marijuana policy states.

  • Daily concentrate use was associated with therapeutic use and use of vape-pens.

  • Marijuana concentrates were viewed as more risky than herbal/flower cannabis.

Abstract

Aims

The study seeks to characterize marijuana concentrate users, describe reasons and patterns of use, perceived risk, and identify predictors of daily/near daily use.

Methods

An anonymous web-based survey was conducted (April-June 2016) with 673 US-based cannabis users recruited via the Bluelight.org web-forum and included questions about marijuana concentrate use, other drugs, and socio-demographics. Multivariable logistic regression analyses were conducted to identify characteristics associated with greater odds of lifetime and daily use of marijuana concentrates.

Results

About 66% of respondents reported marijuana concentrate use. The sample was 76% male, and 87% white. Marijuana concentrate use was viewed as riskier than flower cannabis. Greater odds of marijuana concentrate use was associated with living in states with “recreational” (AOR = 4.91; p = 0.001) or “medical, less restrictive” marijuana policies (AOR = 1.87; p = 0.014), being male (AOR = 2.21, p = 0.002), younger (AOR = 0.95, p < 0.001), number of other drugs used (AOR = 1.23, p < 0.001), daily herbal cannabis use (AOR = 4.28, p < 0.001), and lower perceived risk of cannabis use (AOR = 0.96, p = 0.043). About 13% of marijuana concentrate users reported daily/near daily use. Greater odds of daily concentrate use was associated with being male (AOR = 9.29, p = 0.033), using concentrates for therapeutic purposes (AOR = 7.61, p = 0.001), using vape pens for marijuana concentrate administration (AOR = 4.58, p = 0.007), and lower perceived risk of marijuana concentrate use (AOR = 0.92, p = 0.017).

Conclusions

Marijuana concentrate use was more common among male, younger and more experienced users, and those living in states with more liberal marijuana policies. Characteristics of daily users, in particular patterns of therapeutic use and utilization of different vaporization devices, warrant further research with community-recruited samples.

Introduction

Marijuana concentrates, also known as “dabs,” “hash oil,” “shatter,” or “wax,” are highly potent tetrahydrocannabinol (THC) preparations derived from cannabis plant material, frequently using solvent-based methods (Drug Enforcement Administration, 2014, Drug Policy Alliance, 2015). Such products contain very high THC levels that can range from 40% to 80% (Drug Enforcement Administration, 2014). In comparison, according to 2014 data, THC content in illicit cannabis plant material was found to be around 12% (ElSohly et al., 2016). Marijuana concentrates are typically vaporized using various types of vaporization devices ranging from discreet e-cigarette-like devices (dabs or wax pens) adapted for concentrate use to large dabs “rigs” (water pipes) that require use of a torch to heat a titanium or glass “nail” to vaporize the concentrate (Budney et al., 2015, Drug Policy Alliance, 2015). They can also be placed on top of dried marijuana plant material and smoked (Drug Enforcement Administration, 2014).

There are numerous slang names that are being used to refer to marijuana concentrates, such as “dabs,” “shatter,” “wax,” and “oil,” including names that suggest how the concentrates were produced (e.g., “butane hash oil” or BHO) (Bailey, 2017). The terminology is still evolving as new types of production (e.g., rosin) or use methods (e.g., gravity bong dabs) emerge. “Dabs” is one of the more commonly appearing slang terms that is used to refer to concentrates regardless of how they have been produced (e.g., “BHO dabs” or “rosin dabs”) or how they are consumed (e.g., “dabs rig” or “vape pen for dabs” or “vaping dabs”) (Chambers, 2017).

Marijuana concentrate use is a growing trend across the United States (Bell et al., 2015, Carson, 2013, Drug Enforcement Administration, 2014, Relyea, 2016, Woods, 2016, Zhang et al., 2016). In states that allow retail of marijuana products for recreational use, they can be obtained legally from licensed retailers and producers. Qualified patients can also have legal access to such products at some medical marijuana dispensaries (Drug Enforcement Administration, 2014).

Because of the increased THC concentration and novel means of administration, use of marijuana concentrates may contribute to more severe problems in terms of the risks associated with cannabis use, such as addiction, psychotic disorders, and potential cognitive impairment (Degenhardt et al., 2013, Hall and Degenhardt, 2009, Keller et al., 2016, Miller et al., 2016, Moore et al., 2007, Stogner and Miller, 2015). Furthermore, with increasing use of more potent marijuana products, findings from older studies on the effects of marijuana use should be re-assessed for relevance to current patterns and trends of use (Volkow et al., 2014).

Although media reports about marijuana concentrate use in the U.S. have been increasing (Associated-Press, 2014, Associated-Press, 2015, Denson, 2014, Healy, 2015, Wyatt and Johnson, 2015), research remains limited. One prior web-based survey used Craigslist to recruit 357 individuals in the U.S. who reported “dabs” use. The study found that users viewed marijuana concentrates to be more dangerous than herbal/flower cannabis and reported an increase in tolerance and withdrawal symptoms (Loflin and Earleywine, 2014). A study that focused on e-cigarette use to vaporize cannabis among high school students in Connecticut, found that 4.5% of the total sample (N = 3847) had used e-cigarettes to vaporize hash oil (Morean et al., 2015). Several case reports have been presented on adverse medical consequences associated with marijuana concentrate production in patients presenting for treatment in states with more liberal cannabis legalization policies (Bell et al., 2015, Keller et al., 2016).

Analysis of Twitter data demonstrated a greater level of marijuana concentrate-related tweeting activity in states that allow recreational and/or medical use of cannabis (Daniulaityte et al., 2015). Similarly, analysis of Google search data found that dabbing searches were significantly more frequent in states with recreational marijuana legalization, and indicated an increasing trend in the U.S. (Zhang et al., 2016). Another Twitter-based study analyzed a sample of 3540 tweets related to dabbing marijuana concentrates and found relatively few tweets mentioning extreme effects related to dabbing; “passing out” and respiratory issues were among the more commonly mentioned physiologic effects (Cavazos-Rehg et al., 2016a, Cavazos-Rehg et al., 2016b). Prior research has also concluded that dabbing-related information is readily available on YouTube (Krauss et al., 2015) and Instagram (Cavazos-Rehg et al., 2016a, Cavazos-Rehg et al., 2016b).

There is a lack of data on the characteristics of marijuana concentrate users as well as user knowledge, attitudes, and behaviors related to marijuana concentrate use. This study is based on an anonymous web-based survey conducted via the Bluelight.org web forum. Data obtained from the U.S.-based subsample were analyzed to: 1) identify regional (state-level cannabis policy-related), socio-demographic, cannabis, and other drug use characteristics associated with marijuana concentrate use; 2) characterize marijuana concentrate users’ perceptions of risk and sources, patterns and reasons of use, and 3) identify regional, socio-demographic, and marijuana concentrate use characteristics associated with daily/near daily concentrate use.

Section snippets

Bluelight web forum

Bluelight.org is a publicly available web forum that is focused on sharing information and experiences related to drug use practices, including cannabis-related discussions. Bluelight is the largest and one of the most popular drug discussion websites (Anderson et al., 2017). Furthermore, the Bluelight community supports research and has been used as data source for web-based research on illicit drug use by numerous prior studies (Anderson et al., 2017, Soussan and Kjellgren, 2014, Soussan and

Demographic and drug use characteristics

The majority of the U.S.-based respondents (N = 673) were male (76%), with at least some college education or more (74%), and employed (60%). The majority self-identified race as white (87%), and about 6% indicated that they were of Hispanic ethnicity (Table 1). The sample characteristics are similar to other studies that used Bluelight and other web forums to recruit participants (Chiauzzi et al., 2013, Vandrey et al., 2012).

The sample included respondents from all states except Nebraska. As

Discussion

This study is one of the first to describe the characteristics of marijuana concentrate users based on web-based survey data collected through a drug web-forum.

Over 66% of the U.S.-based respondents (N = 673) reported use of marijuana concentrates, and about 13% of concentrate users reported using concentrates almost every day or every day. This relatively high prevalence is likely linked to the fact that the study recruited from the population of users who are engaged in web-based sharing of

Contributors

R. Daniulaityte, A. Sheth, R. Carlson, R. Nahhas, S. Martins and E. Boyer designed the study. F. Lamy contributed to design, testing and implementation of the web survey. M. Barratt helped with survey implementation and recruitment of study participants. R. Daniulaityte reviewed the literature, conducted statistical analyses and wrote the first draft of the paper. All authors reviewed, commented, and edited the manuscript. All authors contributed to and have approved the final manuscript.

Role of funding source

This study was supported by the National Institute on Drug Abuse (NIDA), Grant No. R01 DA039454 (Daniulaityte, PI; Sheth, PI).

Dr. Barratt was supported by a fellowship from Australia’s National Health and Medical Research Council (APP1070140). The National Drug and Alcohol Research Centre and the National Drug Research Institute are supported by funding from the Australian Government under the Substance Misuse Prevention and Service Improvement Grants Fund. She also acknowledges the

Conflict of interest

Monica Barratt is a volunteer research administrator at Bluelight.org. All other authors declare that there are no conflicts of interest.

Acknowledgements

This research was supported by and advertised through Bluelight.org. Bluelight.org is a non-profit online community dedicated to reducing drug-related harm. The content is solely the responsibility of the authors and does not necessarily represent the official views of Bluelight.org. The authors express gratitude to Bluelight community members for their help with this web-based survey.

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