‘CBD-Dominant’ Products May Actually Contain THC

The use of cannabis products and those containing cannabidiol (CBD) are becoming increasingly popular, with people turning to them as possible treatments for pain, including pain caused by chronic illness. However, whether products are advertised as containing Δ9-tetrahydrocannabinol (THC) or CBD may not always be accurate, a study suggests.

“People are buying products they think are THC-free but in fact contain a significant amount of THC,” said lead study author Jodi M. Gilman, PhD, an investigator in the Center for Addiction Medicine in the Massachusetts General Hospital Department of Psychiatry, in a press release. “One patient reported that she took a product she thought only contained CBD, and then when driving home that day she felt intoxicated, disoriented and very scared.”

Adults who wanted to use cannabis and related products for pain, insomnia, or depression underwent a series of interviews, at which time they also provided a urine sample. Interviewees were asked whether the products they were using were THC- or CBD-dominant, or a combination of the two. The researchers tested samples for THC and CBD metabolites.

There were 97 participants, with a mean age of 39.6 years, who provided 256 urine samples. At baseline, more than half of participants said they were using products infrequently, less than once a month. Overtime, participants reported increased use of products.

Of the 256 samples, 220 had at least one cannabis metabolite.

Surprisingly, among the samples of participants using CBD-dominant products, 30.3% contained no detectable CBD metabolite; the same was true in 37% of the equal CBD-THC products. Also among the CBD-dominant product group, 78.8% of samples had detectable THC. Meanwhile, in samples of patients using THC-dominant products, 10.3% had no detectable THC metabolites; the same was true of 35.2% of equal CBD-THC products.

Most patients preferred to vape their products, but 19.7% of samples from patients who said they vaped had no detectable cannabinoid. Both CBD metabolites and THC metabolites were less likely to be found in vaped products compared to those who took products orally.

“A lot of questions about the content of the products and their effects remain,” said Dr. Gilman. “Patients need more information about what’s in these products and what effects they can expect.”

The study was published in JAMA Network Open.