High potency cannabis flower use is associated with heavier consumption and risk for cannabis use disorder among young adults in California, United States

Aims To measure associations between frequency and quantity consumed of cannabis flower for different levels of delta‐9‐tetrahydrocannabinol (THC) concentration. Design Cross‐sectional survey. Setting California, USA (survey fielded June 2022–July 2023). Participants Young adults ( n = 512) with mean age 25.86 (standard deviation = 0.87) years, 48.04% female, from a California‐based cohort study, who endorsed past‐month cannabis flower use. Measurements Individuals completed survey items on cannabis use behavior (e.g. past‐month use frequency, quantity consumed), symptoms of cannabis use disorder [using the Cannabis Use Disorder Identification Test ‐ Revised (CUDIT‐R)] and self‐reported knowledge and perceived THC content (potency) of typical flower used. Multivariable linear and logistic regression models examined associations between perceived flower potency [rated on a scale from No THC (0) to Very High THC (5)], use behavior and CUDIT‐R scores, adjusting for sociodemographic characteristics. Findings Nearly one in five respondents (18.55%) indicated that they did not know the THC potency of flower typically used. Among those who endorsed knowing potency, nearly half (46.76%) endorsed typically using High or Very High THC flower. Results from separate adjusted linear regression models showed that a one‐point increase in the perceived THC potency scale was associated with 3.33 more use days per month [B = 3.33, (standard error, SE = 0.46), P < 0.0001], 0.13 more grams of flower used per day [B = 0.13 (SE = 0.04), P < 0.01] and 1.21 greater CUDIT‐R scores [B = 1.21 (SE = 0.29), P < 0.0001]. Conclusions Self‐reported use of higher potency cannabis flower appears to be associated with more frequent and higher‐quantity cannabis consumption and greater Cannabis Use Disorder Identification Test ‐ Revised (CUDIT‐R) scores, which is inconsistent with the notion that individuals titrate use of higher‐potency cannabis.