Use of CBD and low-THC products in North Macedonia

Background: Cannabis products labeled as CBD or low-THC have gained global availability. In North Macedonia, the cultivation of medical cannabis was legalized in February 2016 under the Law for Control of Narcotic Drugs and Psychotropic Substances. The law allows access to products with less than 0.2% THC without a prescription, while those exceeding this limit require a doctor's prescription. The content of non-psychotropic cannabinoids like CBD is not legally restricted. This legal framework has made cannabis products accessible to the citizens of the Republic of North Macedonia (RNM) for both preventive and curative purposes.
The objective is to present the current landscape of CBD and low-THC product utilization in North Macedonia, offering insights from the perspective of users several years after the legalization for medical purposes.
Methods: It was used online survey as a cross-sectional study from the European Monitoring Centre for Drugs and Drug Addiction, between March and May 2021. The survey covered drug users aged 18 years or older. The primary instrument used was the European Web Survey on Drugs – questionnaire (EWSD). Descriptive and analytical statistical methods were used for data analysis.
Results: According to the EWSD results in RNM, 90% (303 respondents) acknowledged cannabis use in the last 12 months, with 28% (86 respondents) reporting the use of CBD and/or low-THC products. Among the various choices provided, the majority (84%) indicated the use of these products, predominantly in the form of herbal cannabis. Consumption methods varied, with 51% using them as cigarettes or joints, 24% in cannabis resin form, 15% in cosmetic products, 13% in edible products, 8% as e-liquids, and 3% as crystals.
In response to the question regarding motives for usage in the last 12 months, participants provided multiple choices: 69% used CBD and/or low-THC products to reduce stress or relax, 56% to improve sleep, 43% for recreational purposes, 40% for socialization, 38% to address depression or anxiety, 27% for pain or inflammation reduction, 16% for enhanced performance, 15% to avoid/reduce illegal cannabis use, 10% out of curiosity/experimentation, and 7% for treating cannabis withdrawal symptoms.
Conclusions: This study looked at how people in RNM used CBD and low-THC products a few years after medical cannabis was allowed. The results are based on 86 people's responses and show that 84% of people, used these products in the past year, mostly in the form of herbal cannabis. People use these products for different reasons, like reducing stress, relaxing, and improving sleep. The study also found that people use these products in various ways, like smoking, cosmetics, etc. These findings can help policymakers, doctors, and the public understand how people use these products. The study suggests that ongoing efforts are needed to monitor and educate people for responsible use of CBD and low-THC products.