Characterizing Hemp-Derived Alternative Cannabinoid Product Use in the Natural Environment through Mixed Methods - Project Summary/Abstract The primary psychoactive cannabinoid in traditional cannabis (Δ9-tetrahydrocannabinol [Δ9-THC]) is federally illegal in the United States (US); however, in many jurisdictions, hemp-derived psychoactive cannabinoids are sold as ‘licit’ alternatives due to the 2018 Agriculture Improvement Act that legalized hemp (cannabis containing ≤ 0.3% Δ9-THC) and hemp-derived products. From 2020 to 2023, US sales of alternative cannabinoids increased by 1,283%, reaching nearly $2.8 billion. Among those using cannabis in 2023, 20% reported using both traditional and alternative cannabinoids. This cross-utilization suggests that environmental contexts may play a critical role in use; however, research is severely limited. As part of this K23 career development application, 2 national, de- centralized studies are proposed, the first being an online survey and the second a 6-month naturalistic, Ecological Momentary Assessment (EMA) study. The overarching goal is to assess alternative cannabinoid use and associations with use-contexts (e.g., social and physical environment, legal and practical accessibility), use- characteristics (e.g., craving, co-use with traditional cannabis), and post-use effects (e.g., objective impairment, subjective effects). Qualitative interviews will explore alternative cannabinoid use-motives. Participants will be US adults who primarily use either alternative cannabinoids or traditional cannabis for 4+ days per week. In Aim 1, Study 1 data will be used to characterize key components of alternative cannabinoid use, including use- characteristics and motives, use-contexts, dependence, craving, and subjective effects through a descriptive online survey consisting of standardized self-report assessments. Aim 2 will use data from 7-day EMA data collection bursts participants will complete every 2 months (Study 2) to determine whether contextual factors informed by, but not dependent on, Study 1 significantly differentiates alternative vs. traditional cannabis use. The DRIUD® app will collect objective indices of acute neurocognitive impairment following use in the natural environment in Study 2 and Aim 3 will compare DRIUD® results after alternative vs. traditional cannabis use. Finally, data from qualitative interviews for both studies (Aims 1 and 2) will be examined to identify hypothesis- driving themes that can be used to better study alternative cannabinoid use-experiences, perceptions of harm, use-motives, use-contexts, and quit intentions. Results from this K23 will generate essential knowledge on emerging alternative cannabinoid products that are showing sharp increases in use despite having unknown safety profiles and have important implications for creating education and intervention strategies for poly-product cannabinoid use, as well as informing clinical, legal, and public health initiatives. By providing foundational data and protected time for intensive career development and training, this award will be instrumental in Dr. Dowd’s transition to research independence, equipping her to establish a robust research program.
