The International Cannabis Toolkit (iCannToolkit): a multidisciplinary expert consensus on minimum standards for measuring cannabis use

Abstract Background The lack of an agreed international minimum approach to measuring cannabis use hinders the integration of multidisciplinary evidence on the psychosocial, neurocognitive, clinical and public health consequences of cannabis use. Methods A group of 25 international expert cannabis researchers convened to discuss a multidisciplinary framework for minimum standards to measure cannabis use globally in diverse settings. Results The expert‐based consensus agreed upon a three‐layered hierarchical framework. Each layer—universal measures, detailed self‐report and biological measures—reflected different research priorities and minimum standards, costs and ease of implementation. Additional work is needed to develop valid and precise assessments. Conclusions Consistent use of the proposed framework across research, public health, clinical practice and medical settings would facilitate harmonisation of international evidence on cannabis consumption, related harms and approaches to their mitigation.

[1]  U. Bonnet,et al.  Is the Urine Cannabinoid Level Measured via a Commercial Point-of-Care Semiquantitative Immunoassay a Cannabis Withdrawal Syndrome Severity Predictor? , 2020, Frontiers in Psychiatry.

[2]  M. di Forti,et al.  Changes in delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) concentrations in cannabis over time: systematic review and meta-analysis. , 2020, Addiction.

[3]  D. Hammond,et al.  Knowledge of Tetrahydrocannabinol and Cannabidiol Levels Among Cannabis Consumers in the United States and Canada. , 2020, Cannabis and cannabinoid research.

[4]  V. Lorenzetti,et al.  'Standard THC Units': a proposal to standardise dose across all cannabis products and methods of administration. , 2020, Addiction.

[5]  V. Lorenzetti,et al.  Mapping and mitigating the health risks of legalizing recreational cannabis use: a call for synergy between research and policy , 2020, World psychiatry : official journal of the World Psychiatric Association.

[6]  M. Munafo,et al.  Association of High-Potency Cannabis Use With Mental Health and Substance Use in Adolescence , 2020, JAMA psychiatry.

[7]  Dustin C. Lee,et al.  The state of clinical outcome assessments for cannabis use disorder clinical trials: A review and research agenda. , 2020, Drug and alcohol dependence.

[8]  W. Hall,et al.  Estimation of the proportion of population cannabis consumption in Australia that is accounted for by daily users using Monte Carlo Simulation. , 2020, Addiction.

[9]  S. Martins,et al.  Cannabis use disorder among people using cannabis daily/almost daily in the United States, 2002-2016. , 2019, Drug and alcohol dependence.

[10]  Peter B. Jones,et al.  The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): a multicentre case-control study , 2019, The lancet. Psychiatry.

[11]  C. Morgan,et al.  Which biological and self-report measures of cannabis use predict cannabis dependency and acute psychotic-like effects? , 2018, Psychological Medicine.

[12]  J. Caulkins,et al.  Variation in cannabis potency and prices in a newly legal market: evidence from 30 million cannabis sales in Washington state , 2017, Addiction.

[13]  M. Delgado-Rodríguez,et al.  Systematic review and meta-analysis. , 2017, Medicina intensiva.

[14]  J. Rehm,et al.  The Standard Joint Unit. , 2017, Drug and alcohol dependence.

[15]  L. Miquel,et al.  Working on a Standard Joint Unit: A pilot test. , 2016, Adicciones.

[16]  M. Yücel,et al.  Effects of Cannabis Use on Human Behavior: A Call for Standardization of Cannabis Use Metrics. , 2016, JAMA psychiatry.

[17]  J. Ferris,et al.  No Smoke without Tobacco: A Global Overview of Cannabis and Tobacco Routes of Administration and Their Association with Intention to Quit , 2016, Front. Psychiatry.

[18]  M. Yücel,et al.  The Role of Cannabinoids in Neuroanatomic Alterations in Cannabis Users , 2016, Biological Psychiatry.

[19]  A. Evins,et al.  Early onset marijuana use is associated with learning inefficiencies. , 2016, Neuropsychology.

[20]  A. Winstock,et al.  Examining the profile of high-potency cannabis and its association with severity of cannabis dependence , 2015, Psychological Medicine.

[21]  A. David,et al.  Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study. , 2015, The lancet. Psychiatry.

[22]  Matt Anderson.  European Monitoring Centre for Drugs and Drug Addiction , 2014 .

[23]  C. Morgan,et al.  Just say 'know': how do cannabinoid concentrations influence users' estimates of cannabis potency and the amount they roll in joints? , 2014, Addiction.

[24]  R. de Graaf,et al.  Cross-sectional and prospective relation of cannabis potency, dosing and smoking behaviour with cannabis dependence: an ecological study. , 2014, Addiction.

[25]  A. Fornito,et al.  The association between regular cannabis exposure and alterations of human brain morphology: an updated review of the literature. , 2014, Current pharmaceutical design.

[26]  L. Sobell,et al.  Reliability of the Timeline Followback for cocaine, cannabis, and cigarette use. , 2014, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[27]  Natania A. Crane,et al.  An Evidence-Based Review of Acute and Long-Term Effects of Cannabis Use on Executive Cognitive Functions , 2011, Journal of addiction medicine.

[28]  D. Hine,et al.  The 'grass ceiling': limitations in the literature hinder our understanding of cannabis use and its consequences. , 2011, Addiction.

[29]  M. Huestis,et al.  Urinary elimination of 11-nor-9-carboxy-delta9-tetrahydrocannnabinol in cannabis users during continuously monitored abstinence. , 2008, Journal of analytical toxicology.

[30]  M R Moeller,et al.  Cognition and motor control as a function of Delta9-THC concentration in serum and oral fluid: limits of impairment. , 2006, Drug and alcohol dependence.

[31]  J. Hughes,et al.  The time course and significance of cannabis withdrawal. , 2003, Journal of abnormal psychology.

[32]  Yiyun Huang,et al.  Rapid Changes in CB1 Receptor Availability in Cannabis Dependent Males after Abstinence from Cannabis. , 2016, Biological psychiatry. Cognitive neuroscience and neuroimaging.

[33]  J. Stirling,et al.  Cannabis-Induced Psychotic-Like Experiences Are Associated with High Schizotypy , 2005 .

[34]  H. Kranzler,et al.  The Alcohol Use Disorders Identification Test (AUDIT): validation of a screening instrument for use in medical settings. , 1995, Journal of studies on alcohol.

[35]  Linda C. Sobell,et al.  Timeline Follow-Back A Technique for Assessing Self-Reported Alcohol Consumption , 1992 .