Associations between butane hash oil use and cannabis-related problems

Background High-potency cannabis concentrates are increasingly popular in the United States, and there is concern that use of high-potency cannabis might increase risk for cannabis-related problems. However, little is known about the potential negative consequences of concentrate use. This study reports on associations between past-year use of a high-potency cannabis concentrate, known as butane hash oil (BHO), and cannabis-related problems. Methods A sample of 821 college students were recruited to complete a survey about their health and behavior. Participants who had used cannabis in the past year (33%, n = 273) completed questions about their cannabis use, including their use of BHO and cannabis-related problems in eight domains: physical dependence, impaired control, academic-occupational problems, social-interpersonal problems, self-care problems, self-perception, risk behavior, and blackouts. Results Approximately 44% (n = 121) of past-year cannabis users had used BHO in the past year. More frequent BHO use was associated with higher levels of physical dependence (RR = 1.8, p < 0.001), impaired control (RR = 1.3, p < 0.001), cannabis-related academic/occupational problems (RR = 1.5, p = 0.004), poor self-care (RR = 1.3, p = 0.002), and cannabis-related risk behavior (RR = 1.2, p = 0.001). After accounting for sociodemographic factors, age of onset of cannabis use, sensation seeking, overall frequency of cannabis use, and frequency of other substance use, BHO use was still associated with higher levels of physical dependence (RR = 1.2, p = 0.014). Conclusions BHO use is associated with greater physiological dependence on cannabis, even after accounting for potential confounders. Longitudinal research is needed to determine if cannabis users with higher levels of physiological dependence seek out BHO and/or if BHO use increases risk for physiological dependence.