User characteristics and effect profile of Butane Hash Oil: An extremely high-potency cannabis concentrate

Background: Recent reports suggest an increase in use of extremely potent cannabis concentrates such as Butane Hash Oil (BHO) in some developed countries. The aims of this study were to examine the characteristics of BHO users and the effect profiles of BHO. Design: Anonymous online survey in over 20 countries in 2014 and 2015. Participants aged 18 years or older were recruited through onward promotion and online social networks. The overall sample size was 181,870. In this sample, 46% (N = 83,867) reported using some form of cannabis in the past year, and 3% reported BHO use (n = 5922). Measurements: Participants reported their use of 7 types of cannabis in the past 12 months, the source of their cannabis, reasons for use, use of other illegal substances, and lifetime diagnosis for depression, anxiety and psychosis. Participants were asked to rate subjective effects of BHO and high potency herbal cannabis. Findings: Participants who reported a lifetime diagnosis of depression (OR = 1.15, p = 0.003), anxiety (OR = 1.72,p < 0.001), and a larger number of substance use (OR = 1.29, p < 0.001) were more likely to use BHO than only using high potency herbal cannabis. BHO users also reported stronger negative effects and less positive effects when using BHO than high potency herbal cannabis (p < 0.001) Conclusion: Mental health problems and other illicit drug use were associated with use of BHO. BHO was reported to have stronger negative and weaker positive effects than high potency herbal cannabis.