Sex differences in acute cannabis effects revisited: Results from two randomized, controlled trials

Summary

Males and females show few differences in their acute responses to a moderate dose of vaporized cannabis containing 13.75 mg THC, with or without 13.75 mg CBD. After controlling for body mass index and plasma THC concentrations, males performed better on a divided attention task and had higher peak plasma levels of a THC metabolite (11-COOH-THC), but no sex differences appeared in subjective drug effects, cardiovascular measures, or plasma concentrations of THC, CBD, or other metabolites. The findings suggest an absence of systematic sex differences at this dose, though differences might emerge with higher THC doses or other routes of administration.

Study at a glance

Abstract

Some evidence suggests that males and females may differ in their responses to acute cannabis effects, including subjective drug effects and behavioural effects, and cannabinoid pharmacokinetics. This is significant given current changes to cannabis-related policies and, in consequence, increased cannabis accessibility. The present study combines data from two randomized controlled trials to investigate possible differences among males (n = 21) and females (n = 19) in the acute effects of vaporized cannabis containing 13.75 mg Δ9-tetrahydrocannabinol (THC), with and without cannabidiol (CBD; 13.75 mg). To control for differences in the timing of assessments, peak (or peak change from baseline) scores were calculated for a range of measures including subjective drug effects, cognitive performance, cardiovascular effects, and plasma concentrations of THC, CBD, and their respective primary metabolites. While THC elicited robust and significant changes in all but one outcome measure relative to placebo, relatively few sex differences were observed after controlling for BMI and plasma THC concentrations. Relative to females, males performed better overall on a divided attention task (DAT) and had higher peak plasma concentrations of 11-nor-9-carboxy-THC (11-COOH-THC). Males and females did not differ with respect to plasma concentrations of any other analyte, subjective drug effects, or cardiovascular measures. These data indicate an absence of systematic sex differences in acute cannabis effects given a moderate dose of vaporized cannabis. They do not preclude the possibility that sex differences may emerge with higher THC doses or with other commonly used routes of administration (e.g., orally administered oils or edibles).