21st Century Cannabis

In the past, cannabis was mostly used by smoking the plant in a “joint” or eating it in a brownie. Not anymore. Legalization has brought a lot of changes to how cannabis is used, the product itself, and its accessibility. Times have changed!

THC Concentration (or potency)

THC is the intoxicating, mind-altering molecule in the plant that gives the “high” that some consumers seek. The percentage of THC inside cannabis products is used as a measure to determine cannabis concentration (also known as potency, meaning how strong the drug is). Over the years, due to improved cultivation processes, the plant has become increasingly concentrated. In 2016, the average THC concentration of the cannabis plant in Washington State was 20%, significantly higher than the average of 3% in 1995.1,2

In addition to the increase in THC concentration in the cannabis plant, the cannabis industry has been manufacturing cannabis products called concentrates or extracts. These products are created through processes that extract THC from the plant, resulting in products with THC concentrations that can reach 60-90%.3 This is significantly higher than what is found in the cannabis plant.

Although concentrates are popular among US consumers, many people do not realize that these products are so heavily manufactured they hardly resemble the plant. Manufactured cannabis extracts are as close to the cannabis plant as strawberry pop tarts are to strawberries. The high availability and popularity of these products has made the world of cannabis surrounding adolescents in the 21st century very different than the past, which creates new challenges for parents and guardians.

What types of cannabis products are available for non-medical use?

As of 2023, there are currently three main types of cannabis products used by non-medical consumers*: flower (the cannabis plant), concentrates, and edibles. New products are always emerging on the market, though, so more types of products might become available in the future.

*Other cannabis products such as lotions, suppositories, and tinctures also exist.

Cannabis flower

As of 2023, cannabis flower, part of the cannabis plant, is the most popular cannabis product among consumers in Washington.13 However, since cannabis legalization in WA, flower is becoming less popular while other cannabis products such as edibles and concentrates have increased rapidly in popularity.13

Although flower has less THC than other cannabis products, its average THC concentration has increased over 500% between 1995 and 2016.1,2 Cannabis flower is most often consumed through smoking; however, there are methods that allow people to vape cannabis flower as well. These methods are different from “vape pens”, which use cartridges with cannabis concentrates instead of the plant itself.

Vaping flower is considered the safest method of consumption for adult consumers because it doesn’t cause the same respiratory problems smoking does and delivers a small amount of THC per “puff”. It also doesn’t contain the same types of chemical residue found in concentrates.

Concentrates/extracts

Cannabis concentrates have been around for a long time (like hashish), but the concentrates found in the market today are typically more potent than hashish. Since cannabis legalization in WA, concentrates have been increasingly manufactured and marketed widely. A wide variety of cannabis concentrates are available on the market including vape cartridges, shatter, wax, budder, hash, kief, rosin and many more.

The most popular way of using concentrates in Washington is through vape pens.13 Vape pens are portable vaporizers that use cannabis oil cartridges. Cannabis vape cartridges typically contain concentrated THC and other parts of the plant, solvents used as thinning agents, and flavoring additives. Most pens use disposable cartridges that can be replaced when they run out.

“Dab rigs”, another popular device, are water pipes designed to work with cannabis concentrates. This is why many people refer to shatter, wax and other concentrates as “dabs”. “Dabbing” involves heating concentrates (called a dab) on a glass or metal bowl with a torch. The dab becomes vapor when it contacts the heated rig and can be filtered through water before being inhaled.

There are also similar devices called “dab pens” that act as a portable dab rig. Instead of using pre-filled cartridges like vape pens, these devices require the consumer to insert a dab into a chamber that has a heating mechanism. Then dab is then heated and turned into a vapor that is inhaled.

Infused joints are another way of using cannabis concentrate. An infused joint contains both cannabis flower and concentrate. In infused joints, concentrates are added to the inside of the joint or on the rolling paper.

Regardless of the type of concentrate product used or how it is consumed, these products are associated with greater health risks such as developing psychosis or cannabis addiction because of their very high THC concentration.3 There are also health risks from inhaling chemical residues left behind from the manufacturing process or from pesticides and additives that can be found in these products.

Edibles

Photo of canned drinks containing THC.

Edibles are food or drink items that are infused with cannabis. People have been creating their own edibles for a long time, but there are many new types of edible products available on the market that were not available before legalization. Unlike smoking or vaping cannabis products, where effects can be felt almost immediately, edibles take between 30 minutes to 2 hours to be felt, and their effects last longer.

In Washington State, a legal dose of edibles contains 10 milligrams of THC.5 Our state mandated this 10mg dose, a maximum of 10 doses per package, individual wrapping of every dose, and proper labeling of doses in all edible products. These requirements were defined after a significant increase in emergency department visits and calls to the Poison Center caused by unintentional over-intoxication by consumers who weren’t aware of the amount of THC they were consuming in edibles.6,14 For drinks, the only way to know the dose is through little lines marked on the bottle or cans, and each container typically contains 10 doses. For these products, emergency room visits and calls to the Poison Center have been increasing sharply in the last year.17 For safer consumption of THC infused drinks and edibles, consumers should read the instructions on product packaging carefully.

What should parents know about THC?

Tetrahydrocannabinol (THC) is the most prominent cannabinoid found in the cannabis plant. Parents should know that consuming high concentrations of THC and/or consuming THC often increases the likelihood of adverse health effects, especially for adolescents and young adults. Some of these health effects include:

  • Impaired memory and attention7,8
  • Impaired emotional development7,8
  • Onset of psychosis or psychotic disorders7,8
  • Development of Cannabis Use Disorder (addiction to cannabis)7,8

Using THC also increases the likelihood of poor school performance, driving under the influence, and  other negative behaviors.7 There may be other health and behavioral impacts that scientists are not currently aware of related to high-THC consumption or the chemical process used to manufacture high-THC products. Since the wide availability of these products is still relatively recent, people have not been using them long enough for scientists to understand all the long-term impacts.

Adults play a significant role in how teens think about cannabis. Having an open discussion with your kids about how cannabis products have changed over the years and the risks to teen brain development is important. Adults should also be aware of the legislation and regulations surrounding cannabis in the regions where their kids live and feel empowered to advocate for reduced availability and marketing of highly concentrated THC products. Learn more about reducing youth cannabis use.

What should parents know about CBD

CBD is the second most prominent cannabinoid in the cannabis plant. Unlike THC, CBD does not produce the psychoactive effects that make people get “high.” It has many therapeutic effects that are often sought out by medicinal cannabis users. The CBD market is a growing industry because people are interested in the therapeutic effects of cannabis, but don’t want to experience the mind-altering effects of THC.

CBD products have typically been available in retail stores and online. However, Washington State has recently changed legislation to restrict what types of CBD products can be purchased outside of the regulated cannabis market. While health and beauty CBD products (such as lotions, makeup, and haircare products) can be purchased in retail stores, consumable products are restricted to LCB licensed cannabis stores.9

Any CBD products purchased outside of licensed cannabis stores are unregulated and are not required to label the amount of CBD in their product. Analysis of these unregulated products has found varying levels of CBD and sometimes none at all. Unregulated products can also make health claims that are prohibited in the regulated cannabis market, so consumers may be deceived by false advertising.

While there is emerging evidence of some health benefits of CBD, like in the treatment of epilepsy10 or chronic pain,11 parents should know that CBD should not be used without first consulting with a healthcare provider. CBD can be obtained with a medical prescription as an FDA-approved extract with the commercial name Epidiolex, used to control severe forms of epilepsy in children.12 Outside cannabis stores, there are no regulatory agencies overseeing product safety and health claims made on product packaging so its purchase should involve a rigorous vetting of the companies that produce them.

What should parents know about THC extracted from hemp?

When people refer to the THC inside the cannabis plant, they are often referring to a certain type of THC called “delta-9.” Since delta-9 THC is so prevalent in the cannabis plant, it’s the type of THC that is extracted to make edibles and concentrates. However, there are many other forms of THC found in the plant in smaller amounts, like delta-8 and delta-10. These forms of THC are becoming more well-known because of the wide availability of hemp.

Hemp is a form of the cannabis plant that contains less than 0.3% delta-9 THC.9 Cannabinoids such as CBD and different forms of THC (like delta-8) can be synthetically derived from hemp to make a concentrated oil that can be ingested or inhaled to achieve a similar mind-altering effect as the delta-9 THC sold in the regulated market.

In 2023, Washington State made it illegal to manufacture and sell hemp-derived THC products.16 Parents should know that even with this law, adolescents can still purchase these products online from states where hemp-derived THC is not regulated. This means that youth have access to mind-altering products that do not have the same testing and safety regulations as cannabis found in Washington’s legal adult-use market. One thing adults can do to protect youth from these products is advocate for federal regulation of hemp and synthetic cannabinoids to minimize the accessibility of these products for youth online.

References

  1. ElSohly MA et al. Changes in cannabis potency over the last two decades (1995-2014) – Analysis of current data in the United States. Biol Psychiatry 2016;79(7):613-619.
  2. Smart R et al. Variation in cannabis potency and prices in a newly legal market: Evidence from 30 million cannabis sales in Washington State. Addiction 2017;112(12):2167-2177.
  3. PRSC Cannabis Concentration Workgroup. Cannabis Concentration and Health Risks: A Report for the Washington State Prevention Research Subcommittee (PRSC). Seattle, WA: University of Washington, 2020.
  4. Kilmer B et al. After the Grand Opening: Assessing Cannabis Supply and Demand in Washington State. RAND Corporation, RR-3138-WSLCB, 2019.
  5. Washington State Liquor and Cannabis Board. Packaging and Labeling Guide for Medically Compliant and Recreational Marijuana. December 2019.
  6. Washington Poison Center. Exposure Trends During the COVID-19 Pandemic. Special Focus: Cannabis (THC) (web page). December 2020.
  7. UW ADAI. Learn About Cannabis: Teens (web page).
  8. UW ADAI. Learn About Cannabis: People at Risk of Developing Problems with Cannabis (web page).
  9. Washington State Liquor and Cannabis Board. Hemp/CBD FAQ’s (web page).
  10. Silvestro S et al. Use of cannabidiol in the treatment of epilepsy: Efficacy and security in clinical trials. Molecules 2019;24(8):1459.
  11. Schilling JM et al. Cannabidiol as a treatment for chronic pain: A survey of patients’ perspectives and attitudes. J Pain Res 2021;14:1241-1250.
  12. Jazz Pharmaceuticals. Epidiolex (Cannabidiol): A treatment innovation. (website)
  13. Washington State Liquor and Cannabis Board. Recorded board caucus meeting, November 8, 2022 (TVW).
  14. Dilley JA et al. Trends and characteristics of manufactured cannabis product and cannabis plant product exposures report to US poison control centers, 2017-2019. JAMA Network Open 2021;4(5):e2110925.
  15. Firth CL et al. How high: Differences in the developments of cannabis markets in two legalized states. Int J Drug Policy 2020;75:102611.
  16. Washington State Legislature. SB 5367 – 2023-24: Concerning the regulation of products containing THC (website).
  17. Firth C. Learn About Cannabis: Calls to Washington Poison Center for Intentional Exposure to Cannabis, 2017-2021 (website).

Last updated August 2023.