High potency cannabis use, mental health symptoms and cannabis dependence: Triangulating the evidence

Kat Petrilli, Lindsey Hines, Sally Adams, Celia J. Morgan, H. Valerie Curran, Tom P. Freeman

Research output: Contribution to journalArticlepeer-review

1 Citation (SciVal)


Background: Cannabis potency (concentration of Δ-9-Tetrahydrocannabinol) has been associated with risks of adverse mental health outcomes and addiction but no studies have triangulated evidence from self-report and objective measures of cannabis potency. We hypothesised that users of high potency cannabis would have higher levels of (a) anxiety, (b) depression and (c) psychosis-like symptoms (d) cannabis dependence than users of lower potency cannabis. Methods: A cross-sectional study of 410 participants donated a sample of cannabis for analysis of THC concentration and reported their cannabis potency preference. These two exposure measures were investigated for their association with cannabis dependence, depression, anxiety, and psychosis-like symptoms in separate linear/logistic regression models. Results: High potency cannabis preference was associated with a slight increased risk of cannabis dependence after adjusting for confounding, with the exception of cannabis use frequency (OR = 1.16, 95% CI 1.04–1.28). No association was found between THC concentration in cannabis and cannabis dependence. There was weak evidence of a small association between cannabis potency and depression and anxiety. There was no association between high potency cannabis preference or THC concentration in cannabis and psychosis-like symptoms. Conclusions: Users of cannabis who preferred high potency types might be at increased risk of problematic cannabis use. This should be considered with caution as we were not able to triangulate these results with an objective measure of cannabis potency. More research is needed to understand the association between high potency cannabis use and depression and anxiety.

Original languageEnglish
Article number107740
JournalAddictive Behaviors
Early online date24 Apr 2023
Publication statusPublished - 30 Sept 2023

Bibliographical note

Funding Information:
Roles of Funding Sources. KP was funded by the Economic and Social Sciences Research Council (ESRC) as part of the South West Doctoral Training Partnership (SWDTP). The study was funded by a UK Medical Research Council grant (G0800268) to HVC and CJAM. The funders had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

Data Availability
The authors do not have permission to share data.


  • Cannabis dependence
  • Cannabis potency
  • Mental health

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Toxicology
  • Psychiatry and Mental health


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