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Abstract
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Delta-8-THC is a largely unregulated psychoactive isomer of traditional delta-9-THC. Until more information is available, clinicians should especially advise adolescents and patients with psychotic disorders or a clinical high-risk state for psychosis to abstain from delta-8-THC in addition to delta-9-THC.
An increasing number of legislatures around the world are debating decriminalization as well as legalization of the cultivation, production, sale, and consumption of cannabis for both medical and recreational use [1]. This rapidly shifting global regulatory landscape has been paralleled by the popularization of a variety of novel cannabis derivatives containing chemically altered tetrahydrocannabinol (THC). Chief among these is a delta-9-THC isomer termed delta-8-THC, which is colloquially known as "delta-8." Delta-8-THC grew in popularity in the late 2010s in regions of the United States (US) where traditional delta-9-THC products were illegal [2-5]. This growth was facilitated by a regulatory loophole in US federal cannabis regulation created when the Agriculture Improvement Act of 2018 removed hemp and its derivatives from the definition of cannabis [6, 7]. Manufactures subsequently discovered that non-intoxicating cannabidiol (CBD) from hemp plants can be chemically converted into high concentrations of the naturally rare psychoactive delta-8-THC molecule. Recent international regulatory changes are now laying the groundwork for the drug's global spread [1]. Although there are well documented short- and long-term psychiatric risks associated with delta-9-THC, as well as some limited data on the acute intoxicating effects of delta-8-THC, the safety profile of regular, long-term delta-8-THC use is unknown. Until more information is available, clinicians should especially advise adolescents and patients with psychotic disorders or a clinical high-risk state for psychosis to abstain from delta-8-THC in addition to delta-9-THC.
To inform clinical recommendations on this topic, providers must consider both the available data specific to delta-8-THC, as well as the more robust evidence-base on delta-9-THC, which may be applicable given the similarities between the molecules. In contrast to the many thousands of patients that have participated in well-designed observational and experimental studies on delta-9-THC and its pharmaceutical analogs, the clinical research on delta-8-THC is limited to human and animal data focused on the acute toxicity of the drug and a small number of consumer surveys
Language: en |