How High are You? An EMA Comparison of Subjective Effects After Edible and Smoked Cannabis

Introduction: Edibles, THC-infused food products, are a popular type of cannabis. However, there is limited research on how acute effects of edibles differ from more traditional cannabis types, such as smoked flower (e.g., dried bud). The current study examined the subjective response of cannabis between smoked flower and edibles using a two-week long ecological momentary assessment (EMA). Sex differences were also examined.Method: Individuals (n=101) using both edibles and flower at least once weekly completed a cannabis report within 30 minutes (T1) of first cannabis use each day as well as two follow-up reports sent 1.5 (T2) and 3 hours (T3) after initial use. Participants additionally completed assessments throughout the day for fourteen consecutive days to examine daily affect. Multi-level models examined whether overall high, low-arousal negative effects, high-arousal negative effects, and general positive effects differed by edibles and flower. Given time differences in effects between cannabis types, subjective effects were examined at T1, T2, and T3, as well as for the peak effects across the three-hour time window. Covariates included demographics, variant- and invariant- cannabis use characteristics, and daily affect. Results: At T1, edibles produced lesser positive effects (b=-0.60, S.E.=0.16, p=0.001) and overall high (b=-2.00, S.E.=0.27, p<0.001) relative to flower. At T2, edibles produced greater positive effects (b=0.52, S.E.=0.21, p=0.01) relative to flower. At T3, edibles produced greater low-arousal negative effects (b=0.63, S.E.=0.23, p=0.01) relative to flower. Edibles produced greater peak low-arousal effects relative to flower (b=0.59, S.E.=0.21, p=0.01), With respect to sex differences, there was an interaction between sex and cannabis type at T1 for positive effects (b=-0.99, S.E.=0.31, p=0.001), such that males reported greater positive effects for flower. Males additionally reported lesser low-arousal effects at T1 (b=-0.60, S.E.=0.30, p=0.05) and greater overall high at T3 relative to females (b=1.24, S.E.=0.56, p=0.03). Discussion: Smoked flower produced greater effects immediately and edibles produced greater delayed effects. Edibles appear to have greater peak levels of low-arousal effects (e.g., sluggish, drowsy, slow) relative to smoked flower. Males may be more sensitive to the rewarding effects of cannabis, particularly when smoking flower.