Prevalence and reasons for using cannabidiol, delta-8 tetrahydrocannabinol, cannabinol, cannabigerol, and hexahydrocannabinol among US adults.

BACKGROUND: Since the passage of the 2018 US Farm Bill there has been a market for cannabinoid products derived from Cannabis sativa L. that contain < 0.3% delta-9 tetrahydrocannabinol (THC). Understanding the characteristics and motivations of cannabinoid product users is crucial for appropriate regulation of these products. METHODS: We conducted a cross-sectional survey of 1,523 adults 18 years or older using the probability-based Ipsos KnowledgePanel, representative of 97% of US households. We assessed lifetime use of cannabidiol (CBD), delta-8 THC, cannabinol (CBN), cannabigerol (CBG), and hexahydrocannabinol (HHC), as well as self-reported reasons for using these products (i.e., medical vs. recreational). Using multivariable logistic regression models, we investigated associations of demographic and health behavior characteristics with product use. Lastly, we used the Medical Dictionary for Regulatory Activities to code medical reasons for cannabinoid product use into system organ class and preferred term categories. RESULTS: Lifetime use of CBD was 35.2% (95% CI 32.7-37.9), compared with 7.7% (95% CI 6.5-9.1) for delta-8 THC, 4.5% (95% CI 3.7-5.6) for CBN, 1.3% (95% CI 0.9-1.9) for CBG, and 1.5% (95% CI 1.0-2.1) for HHC. More adults used CBD for medical purposes (71.9%, 95% CI 68.9-74.7) than recreation (47.1%, 95% CI 43.9-50.3), which was also the case for CBN, CBG and HHC. Conversely, more adults used delta-8 THC for recreation (76.1% 95% CI 67.0-83.3) than for medical reasons (50.9; 95% CI 42.6-59.2). The most cited preferred terms for CBD use were anxiety (14.7%, 95% CI 13.0-16.6), pain (13.1%, 95% CI 11.5-15.0) and arthralgia (11.2%, 95% CI 9.5-13.2), for delta-8 THC use they were anxiety (18.6%, 95% CI 13.3-25.3), pain (15.2%, 95% CI 11.1-20.5) and insomnia (10.7%, 95% CI 7.4-15.3), and for CBN use they were insomnia (15.4%, 95% CI 9.6-23.9), pain (11.1%, 95% CI 6.4-18.7) and anxiety (10.9%, 95% CI 6.0-19.0). CONCLUSIONS: Use of cannabinoid products is appreciable, particularly CBD and delta-8 THC. Most adults use CBD, CBN, CBG, and HHC for medical reasons, but delta-8 THC for recreation. Pain, anxiety, insomnia and arthralgia were common medical reasons for use across the different cannabinoids assessed.