Introduction
PD, Δ9-THC, cognitive and psychomotor performance
SECONDARY
Globally, the reform of laws regulating cannabis products and their constituent chemical components has increased access to these products and decreased the stigma associated with their use. As of this writing, 37 US states and Washington, DC, have legalized the use of cannabis for recreational and/or medicinal purposes. Collectively, more than 5 million individuals in the US have registered as medicinal cannabis users, and approximately 50 million people in the US reported using cannabis in 2020.Δ9-Tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) are the 2 primary cannabinoids contained in cannabis products and are the most commonly purported constituents to have therapeutic benefits.Prior controlled Δ9-THC and CBD studies have predominantly used inhaled routes of administration, meaning much of the extant data regarding acute interactions between Δ9-THC and CBD may not translate to oral cannabis products (ie, edibles), which undergo first-pass metabolism in the intestine and liver before reaching the systemic circulation.The primary goal of this study was to evaluate potential cannabinoid-drug interactions with 5 established CYP probe drugs (ie, caffeine, losartan, omeprazole, dextromethorphan, and midazolam) administered as an oral CYP cocktail, and the secondary goal (and focus of the present manuscript) was to compare the PK and PD (ie, subjective drug effects, cognitive and psychomotor performance, and vital signs) of a cannabis extract high in Δ9-THC (20 mg) and containing no CBD with an extract high in CBD containing the same dose of Δ9-THC and a therapeutically-relevant dose of CBD (640 mg).