THC-O-acetate: understanding consumer experiences with a novel semi-synthetic cannabinoid

Background and Objective: Researchers conducted the first known survey to systematically examine consumer experiences with THC-O, a cannabinoid widely available after the 2018 “Farm Bill.” Methods: Researchers recruited participants for an anonymous Qualtrics survey though online forums discussing THC-O or cannabinoids in general. Results: Participants (N = 267) primarily consumed THC-O by vaping concentrates or extracts (71%) and edibles (49%); most (66%) used THC-O at least once a week. Experiential properties generally resembled those of THC, though with a greater latency of effects. About a third (36%) of participants used THC-O to treat a health or medical condition, most commonly mental health issues such as anxiety or panic attacks (26%), depression or bipolar disorder (20%), and stress (15%). About a quarter (24%) reported drug substitution. Internet discussion forums (85%) and websites (82%) were the predominant sources of information on THC-O, only 4% of participants received THC-O information from their primary care provider. Conclusions: The increasing diversity of cannabinoid products presents challenges for policymakers to develop appropriate regulations, and for healthcare professionals to promote harm reduction. THC-O use raises unique concerns, including greater latency of effects, longer duration of effects, and the potential for exposure to toxic ketene gas when inhaling heated THC-O.