Characterising heterogeneity in the use of different cannabis products: latent class analysis of 55,000 cannabis users and associations with severity of cannabis dependence

Background

As new cannabis products and administration methods proliferate, global patterns of use are becoming increasingly heterogenous. However, few studies have explored different profiles of cannabis use and their association with health-related outcomes.

Methods

Latent class analysis (LCA) was used to identify subgroups of past-year cannabis users endorsing distinct patterns of use from a large international sample (n= 55,240). Past-12-months use of 6 different cannabis types (high potency herbal, low potency herbal, resin, cannabis concentrates, kief, edibles) were used as latent class indicators. Participants also reported the frequency/amount of cannabis use, lifetime mental health diagnoses and their severity of dependence on cannabis.

Results

LCA identified 7 distinct classes of cannabis users, characterised by high probabilities of using: All Types (5.7% of the sample); Main three types (high and low potency herbal & resin; 20.4%); Resin & low potency herbal (18.8%); Herbal (high and low potency; 30.3%); Concentrates & high potency herbal (1.7%); Edibles & low potency herbal (4.6%) and Low potency herbal only (18.4%). Relative to the class using low potency herbal cannabis only, classes characterised by high potency herbal cannabis and/or resin use had increased dependence severity. By contrast, classes characterised by use of concentrates or edibles did not show elevated rates of cannabis dependence. The class characterised by concentrate use had the highest rates of lifetime mental health diagnoses.

Conclusions

The identification of these distinct classes underscores heterogeneity among cannabis users and provides novel insight into their different associations with addiction and mental health diagnoses.