Recreational use of cannabis has been stable in recent years.In recognition that this may remain the case for a time to come, many governing bodies across the globe have adopted a harm minimization approach towards recreational substance use. This approach operates in large part through health education campaigns, towards the goal of increasing public awareness on safe drug use (where abstinence is not a perceived option, at least). For example, reminders not to drive and drive are frequently located not only in public spaces but also within drinking premises themselves.
Despite its illegal status in most countries, cannabis is the most commonly used substance in the world after alcohol.1 From making household chores seem less mundane to facilitating social interactions, many cannabis users value it for its euphoric and relaxing properties. However, anecdotal evidence suggests that the effects of cannabis can vary between individuals, as well as within the same individual. A quick glance through open-access cannabis-related forums would yield a handful of worried and distressed individuals seeking explanations for a “bad trip”, or sub-threshold psychotic experience occurring during a cannabis high (e.g. suspicion, paranoia, anxiety, losing touch with reality).
Nonetheless, the effects of cannabis for the most part tend to be rewarding, time-limited, and relatively inconsequential for most of its users once intoxication has worn off. This creates somewhat of a conundrum when it comes to developing health education campaigns related to cannabis use: Most public health campaigns focus on presenting the long-term consequences associated with cannabis use, including various forms of brain damage leading to poor cognitive functioning. Yet, the recreational user may view these consequences as distant and irrelevant to them, incongruent with their short-lived hedonistic experience under the influence of marijuana. Furthermore, the consequences described in public health campaigns tend to apply to those who engage in chronic, heavy cannabis use. In contrast, most recreational users of the drug tend to use it only on occasion and do not go on to become addicted.1
In the current landscape of drug use where “street” cannabis is becoming increasingly accessible as well as potent (increasing in THC content)2, it is perhaps of particular relevance for harm minimization efforts to also address immediate risks proximal to the cannabis use event. To this end, a small but growing body of work has taken to translating anecdotal evidence for variations in cannabis experiences into empirical research. Rather than a novel paradigm, this work picks up from a classic theory of subjective drug experiences articulated by Norman Zinberg (1984): The intoxication experience of any given psychoactive substance is always shaped by three classes of factors. Namely, these are Drug (e.g. THC content, dose), Set (Psychological factors e.g. Mood, Personality), and Setting (e.g. Where and with whom one uses).
Hence, two people who use the same drug can report very different subjective experiences, depending on their psychological profile or circumstances of cannabis use. While research to date has developed our knowledge on pharmacological factors in shaping cannabis intoxication experiences, the role of Set and Setting are not yet well understood (learn more about the research underway here). Input from non-users, past users, and current users of cannabis could help contribute to a more comprehensive understanding of cannabis’ effects, and its immediate risks.
References
- Global Drug Survey (GDS; 2018). Retrieved from: https://www.globaldrugsurvey.com/gds-2018/
- ElSohly, M. A., Mehmedic, Z., Foster, S., Gon, C., Chandra, S., & Church, J. C. (2016). Changes in Cannabis Potency over the Last Two Decades (1995-2014) – Analysis of Current Data in the United States. Biological Psychiatry, 79(7), 613–619. http://doi.org/10.1016/j.biopsych.2016.01.004
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