JMIR Publications

ABSTRACT

Background:

Cannabis is one of the most commonly used psychoactive substances globally. The potency of cannabis, indexed by the concentration of its primary psychoactive constituent, delta-9-tetrahydrocannabinol (THC), may influence health outcomes of users in positive and negative ways. Emerging evidence indicates use of cannabis with higher THC potency increases the risk for certain adverse health outcomes. However, THC is also responsible for some of cannabis’s therapeutic effects. The cannabis policy landscape in the US and other countries has changed markedly over the past 25 years, accompanied by increases in the average THC potency and rise in the availability and use of high potency cannabis and intoxicating hemp products. Additional evidence is needed to understand the relative impact of THC potency on health outcomes to inform public health and policymaking, and provide direction for future action.

Objective:

We present a scoping review protocol that aims to identify and map existing literature comparing the effects of high-THC cannabis and hemp-derived product use either to low-THC product use or no use on multiple health and functioning outcomes, covering potential risks and health benefits.

Methods:

The review will apply the Joanna Briggs Institute methodological framework for scoping reviews and follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) reporting guidelines. Study inclusion criteria: Original research articles published from 2000 onward that present findings from controlled observational studies, experimental studies, or randomized trials examining health or functional outcomes related to high-THC cannabis or hemp product use compared to active or passive control conditions or that compare acute or long-term effects following administration of THC at different doses. A literature search will be conducted in five databases: PubMed, APA PsycINFO, Embase, CINAHL Plus, and Web of Science. Search results will be uploaded to Covidence for screening and data extraction. Two reviewers will independently review each record as a part of title and abstract screening and subsequent full-text screening, applying predefined eligibility criteria. Discrepancies will be resolved through group consensus. Data will be extracted using a standardized tool; key variables will include population characteristics, THC exposure, and health outcomes.

Results:

Findings of the scoping review will be conveyed through narrative synthesis and evidence mapping. Included studies will be charted and categorized according to the PICOTSS and PECOTSS (population, intervention or exposure, comparator, outcomes, timing, setting, and study design) frameworks. Results will be reported in a forthcoming peer-reviewed publication.

Conclusions:

This review will contribute to the growing evidence base on the health effects, positive and negative, related to use of high-THC cannabis and hemp products. Findings may inform future research, clinical considerations, and public health policy. Clinical Trial: OSF Registration DOI: https://doi.org/10.17605/OSF.IO/WGVRE