•  Half of respondents (50.9%) reported using MJ more than once a day and indicated joints, blunts, or

spliffs as their most commonly preferred mode of use (Table 2).

•  A majority of current MJ users (58.33%) reported trying concentrates with about a third (36.54%)

reporting current, regular concentrate use.

•  Most concentrate users (42.43%) did not know the potency of their concentrate products (Table 3).

•  The majority (37.17%) of current concentrate users reported dabbing multiple times per day (Table 4).

•  While the majority of respondents reported no negative side effects of MJ use regardless of mode,

11.31% of participants reported negative side effects with dabs use (Table 5).

•  Very few respondents (6.52%) reported experiencing negative side effects of dabs after the high had

passed, but just over a third (33.26%) noticed an increase in tolerance after using dabs (Table 5).

•  Most respondents did not report high severity of dependence on the SDS (Table 8).

•  Participants perceived dabbing as being the most unsafe method of MJ use (Table 6).

•  Most common reasons for using MJ were enjoyment, lower perception of risk, and relief of medical

symptoms (Table 7).

•  A more varied response pattern emerged regarding MJ use for medical purposes, particularly among

conventional flower product users (Table 7).

•  Findings underscore the importance of assessing concentrate use and potential impact on a range of

clinical and cognitive domains, especially given the growing number of concentrate users across the

nation.

Snap, Crackle, and Pot: Exploring the Use of Marijuana Concentrates and Dabbing

Results

Summary of Results & Future Directions

References

Introduction

Methods

Ashley M. Lambros1, Kelly A. Sagar1,2, M. Kathryn Dahlgren1,3, Rosemary T. Smith1, Korine B. Cabrera1, & Staci A. Gruber1,2

1Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, 2Department of Psychiatry, Harvard Medical School, Boston, MA, 3Department of Psychology, Tufts University, Medford, MA

•  As medical and recreational marijuana (MJ) use expands across the country, MJ-based concentrates

(also referred to as dabs or dabbing) are becoming increasingly more popular.

•  Compared to conventional MJ products, concentrates contain higher levels of Δ9-tetrahydrocannabinol

(THC), the main psychoactive constituent of MJ.

•  Concentrates have an average THC level of 60.3% with some approaching 75% (Raber et al.,

2015), which stands in stark contrast to the average potency of flower products, which is

approximately 12% (ElSohly et al. 2016).

•  These potent forms of MJ are created by extracting cannabinoids from plant matter and are categorized

as either solvent or non-solvent based (Rosenthal & Downs, 2014).

•  Non-solvent based concentrates include kief, resin, and different types of hash

•  Solvent based products consist mainly of dabs, oils, and tinctures

•  Butane Hash Oil (BHO) is a popular concentrate and is also the basis of numerous other

concentrates including wax, budder, shatter, oil and more (Stogner & Miller, 2015)

•  A recent analysis of 48 concentrates detected residual solvents in 83.3% of samples (Raber et al.,

2015), which is a considerable safety concern

•  Individuals who report a preference for concentrates to other MJ products have indicated that it takes

fewer hits to achieve the same high with stronger and longer lasting effects (Loflin & Earleywine, 2014).

•  While some users report that concentrates have positive effects such as promoting relaxation and sleep,

others report negative effects, including passing out, feeling a loss of control over one’s body, or vomiting

(Loflin & Earleywine, 2014).

•  While these products have become increasingly popular, research is limited regarding the composition

and overall impact of concentrate use. As little is known about MJ concentrate use, including

motivation for use and overall effect, we developed a comprehensive, internet-based survey

study to assess use of concentrates across the nation.

§ Survey content includes questions addressing demographics, substance use history,

concentrate use, and questionnaires about motives for use and severity of dependence

§  Inclusion criteria: (see Table 1 for demographics & Figure 1 for a regional breakdown)

•  Individuals over age 18 who sign an online consent form to participate in the survey

•  Those who use MJ and concentrates are targeted for survey participation

§ Substance Use: For the purpose of this study, regular use of any substance was considered once a

month or more. Conventional MJ users were participants who didn’t report a history of concentrate use.

§ Questionnaires:

• Marijuana Motives Measure (MMM): 25-item questionnaire focused on reasons for using MJ. Each

questions falls into one of five categories: social, coping, enhancement, conformity, and expansion

motives (Lee et al., 2009); only 15 of the original items were chosen for the survey based on their

factor loading scores.

• Severity of Dependence Scale (SDS): a 5-item questionnaire evaluating problematic MJ use within the

last 3 months (Piontek et al., 2008)

ElSohly, M. A., Mehmedic, Z., Foster, S., Gon, C., Chandra, S., & Church, J. C. (2016). Changes in cannabis potency over the last 2 decades (1995–2014): analysis of current data in the United States. Biological psychiatry, 79(7), 613-619.

Loflin, M., & Earleywine, M. (2014). A new method of cannabis ingestion: the dangers of dabs?. Addictive behaviors, 39(10), 1430-1433.

Raber, J. C., Elzinga, S., & Kaplan, C. (2015). Understanding dabs: contamination concerns of cannabis concentrates and cannabinoid transfer during the act of dabbing. The Journal of toxicological sciences, 40(6), 797-803.

Rosenthal, E., & Downs, D. (2014). Beyond Buds. ISBN: 978-1-936807-23, 9. Stogner, J. M., & Miller, B. L. (2015). Assessing the dangers of “dabbing”: mere marijuana or harmful new trend? Pediatrics, 136(1), 1-3.

~210,440 individuals saw the link or advertisement

9,736 (4.63%) individuals clicked the link

5,412 (55.59%) individuals agreed to participate

4,077 (75.33%) participants completed MJ questions

3,674 (67.89%) participants completed the entire survey

2,378 (43.94%) reported a history of concentrate use

Survey constructed and hosted on Survey Monkey

Survey launched – data is checked daily and exported to

a back up drive

Ad created to target specific individuals with Facebook

marketing algorithms based on users’ page likes

Assessment of responses to ad and functionality of survey

design

3 day testing period

Data collected over 36 days (from 12/20/16 – 1/28/17) and

exported

Dataset cleaned, coded, and analyzed by the research

team

Table 3. MJ Users Who Have Tried Concentrates (n = 2378) Last Use n (%) Today 450 (18.92%) This week 280 (11.77%) This month 281 (11.82%) Within the last 6 months 590 (24.81%) Within the last year 306 (12.87%) More than a year ago 444 (18.76%) Non-Response 27 (1.12%) Estimated amount used each time n (%) Grain of rice or smaller 910 (38.27%) Eraser on a pencil 1000 (42.05%) Penny or larger 355 (14.93%) Other 16 (0.67%) Non-Response 72 (3.03%) Most frequently used concentrates n (%) Wax 454 (19.09%) Shatter 341 (14.34%) Kief 315 (13.25%) Estimated potency n (%) Greater than 75% THC 571 (24.01%) Between 50% - 75% THC 415 (17.45%) Between 35% - 50% THC 201 (8.45%) Less than 35% THC 88 (3.7%) Other 14 (0.59%) Unknown 1009 (42.43%) Non-Response 80 (3.36%)

Table 4. Current Regular Concentrate Users (n = 869) Frequency n (%) More than once a day 323 (37.17%) Once a day 83 (9.55%) 6 - 7 times a week 24 (2.76%) 4 - 5 times a week 35 (4.03%) 2 - 3 times a week 113 (13%) Once a week 69 (7.94%) 2 - 3 times a month 130 (14.96%) Once a month 87 (10.01%) Amount $ spent per month n (%) $150 or more 160 (18.41%) $100 - $150 76 (8.75%) $75 - $100 123 (14.15%) $50 - $75 101 (11.62%) $25 - $50 125 (14.38%) $25 or less 97 (11.16%) Get it from someone else 182 (20.94%) Quantity purchased or made per month n (%)

<1 gram 46 (5.29%) 1 – 3 grams 392 (45.11%) 4 – 5 grams 159 (18.3%) 5 – 10 grams 17 (1.96%) 10+ grams 60 (16.57%) Someone else buys/gives it to me 144 (16.57)

Table 7. Marijuana Motives Measure (MMM) Results

(n = 4077) (n = 2378)

Almost never/ never

Some of the time

Half of the time

Most of the time

Almost always/always

No response

Enjoyment To enjoy the effects of it Flower Products 3.07% 11.14% 8.17% 19.72% 50.53% 7.38%

Concentrates 12.74% 14.47% 7.65% 17.24% 43.65% 4.25% Conformity To be cool 85.68% 4.49% 0.66% 0.54% 1.25% 7.38%

88.44% 4.21% 1.22% 0.42% 1.47% 4.25% Coping To forget your problems 52.78% 24.65% 6.67% 4.02% 4.49% 7.38%

64.63% 18.5% 6.06% 2.69% 3.87% 4.25% You were depressed 34.9% 31.67% 10.45% 7.63% 7.97% 7.38%

55.55% 23.17% 6.35% 4.42% 6.27% 4.25% To relieve medical symptoms* 5.79% 11.16% 9.96% 17.86% 47.85% 7.38%

16.69% 13.58% 10.09% 13.29% 42.05% 4.29% Experimentation You were curious about MJ 70.03% 14.18% 1.99% 2.06% 4.37% 7.38%

63.75% 14.76% 4.79% 4.29% 8.16% 4.25% Boredom You had nothing better to do 64.04% 19.23% 4.29% 2.67% 2.38% 7.38%

68.33% 16.15% 5.09% 2.31% 3.87% 4.25% Alcohol You were drunk 74.71% 13.81% 1.77% 0.91% 1.42% 7.38%

83.64% 8.03% 2.06% 0.67% 1.35% 4.25% Celebration It was a special occasion 36.6% 37.23% 6.45% 4.02% 8.31% 7.38%

40.29% 33.22% 7.15% 5.03% 9.8% 4.25% Altered Perception To alter your perspective 44.67% 25.58% 7.63% 7.92% 6.82% 7.38%

47.81% 23.3% 7.61% 6.77% 10.26% 4.25% Social Anxiety Relaxes you in an insecure situation 18.35% 27.81% 10.94% 15.7% 19.82% 7.38%

32.46% 27.08% 8.79% 10.43% 16.99% 4.25% Relative Low Risk It is safer than drinking alcohol 12.12% 7.24% 4.37% 12.88% 56.02% 7.38%

21.49% 6.69% 3.78% 9.17% 54.63% 4.25% It is not a dangerous drug 13.47% 3.61% 2.16% 9.03% 64.36% 7.38%

19.93% 5.09% 4.21% 9.42% 57.11% 4.25% Sleep You are having problems sleeping 10.13% 25.29% 14.57% 15.01% 27.62% 7.38%

25.61% 23.63% 11.94% 11.65% 22.92% 4.25% Availability It is readily available 48.2% 22.08% 6.62% 5.94% 9.79% 7.38%

49.45% 22.16% 6.77% 6.31% 11.06% 4.25%

Table 1. Demographics (n = 4077)

M (SD) or n (%) M (SD) or n (%) Age 44.09 (13.84) Level of Education Gender Partial high school/GED 338 (8.29%) Male 2459 (60.31%) High school diploma 1304 (31.98%) Female 1599 (39.22%) Partial college (at least 1 year) 991 (24.31%) Other 13 (0.32%) Specialized training/Associate degree 832 (20.41%) Ethnicity Bachelor's degree or higher 454 (11.14%) Hispanic 273 (6.7%) Other 14 (0.34%) Non-Hispanic 3175 (77.88%) Household Income Prefer Not To Answer 300 (7.36%) $0 - $49,999 2858 (70.1%) Unknown 329 (8.07%) $50,000 - $99,999 939 (23.03%)

$100,000 & Up 280 (6.87%)

Figure 2. Regional Demographics (n = 4077)

Figure 1. Flow Chart of Survey Development, Implementation, and Data Collection

THC 85.22% 82.35% 61.5% 16.27%

CBD 1.07% 0.89% 0.7% 1.26%

Figure 3. Average MJ Potency Across Product Types

Table 5. Safety of MJ Use (n = 2378)

Experienced negative side effects n (%) Yes, while smoking 220 (9.25%) Yes, while vaporizing 99 (4.16%) Yes, while dabbing 269 (11.31%) Yes, while consuming edibles 248 (10.43%)

Accidents while making dabs n (%) Yes 18 (0.76%) No 964 (40.54%) Haven't made my own 1314 (55.26%)

Accidents while dabbing n (%) Yes 99 (4.16%) No 2197 (92.39%)

Change in tolerance after dabbing n (%) Yes 791 (33.26%) No 1505 (63.29%)

Negative side effects after high has passed n (%) Yes 155 (6.52%) No 2141 (90.03%)

Table 2. All MJ Users (n = 4077) Preferred Mode of Use n (%) 1st Joint/Blunt/Spliff 1276 (31.3%) 2nd Bong/Water Pipe/Bubbler 876 (21.49%) 3rd Bowl/Pipe/One-Hitter 763 (18.71%) Current MJ Use n (%)

More than once a day 2075 (50.9%) Once a day 574 (14.08%) 6 -7 times a week 221 (5.42%) 4 - 5 times a week 185 (4.54%) 2 - 3 times a week 280 (6.87%) Once a week 106 (2.6%) 2 - 3 times a month 144 (3.53%) Once a month 159 (3.95) Not a current user 257 (6.3%) Non-Response 76 (1.86%)

Table 6. Perceived Safety of Each Method (n = 2378) n (%)

Very safe Safe Neutral Unsafe Very unsafe No Response Smoking 1719 (72.29%) 370 (15.56%) 133 (5.59%) 11 (0.46%) 61 (2.57%) 84 (3.53%)

Vaporizing 1467 (61.69%) 384 (16.15%) 289 (12.15%) 19 (0.79%) 65 (2.73%) 154 (6.48%)

Dabbing 1198 (50.38%) 531 (22.33%) 395 (16.61%) 68 (2.86%) 67 (2.82%) 119 (5.0%)

Edibles 1446 (60.81%) 434 (18.25%) 276 (11.61%) 25 (1.05%) 62 (2.61%) 135 (5.68%)

Table 8. Severity of Dependence Scale (SDS) Results (n = 4077) n (%)

Q1: MJ Use Out of Control

Q2: Missed Opportunity

Q3: Worry About Use

Q4: Wish to Stop Using

Q5: Difficult to Stop

Never/almost never 3455 (84.74%) 2769 (67.92%) 3299 (80.92%) 3598 (88.25%) Not difficult 2570 (63.04%)

Sometimes 358 (8.78%) 906 (22.22%) 516 (12.66%) 234 (5.74%) Quite difficult 739 (18.13%)

Often 26 (0.64%) 107 (2.62%) 27 (0.66%) 14 (0.34%) Very difficult 327 (8.02%)

Always/nearly always 14 (0.34%) 71 (1.74%) 11 (0.27%) 7 (0.17%) Impossible 217 (5.32%)

No Response 224 (5.49%) 224 (5.49%) 224 (5.49%) 224 (5.49%) No Response 224 (5.49%)

Shatter Wax Kief Flower

*Average potencies are from New England Treatment Access’s Brookline Menu 3/28/17