Associations of alternative cannabis product use and poly-use with subsequent illicit drug use initiation during adolescence.
Specific cannabis products may differentially increase risk of initiating non-cannabis illicit drug use during adolescence. To determine whether ever- and poly-use of smoked, vaporized, edible, concentrate, or blunt cannabis products are associated with subsequent initiation of non-cannabis illicit drug use. High school students from Los Angeles completed in-classroom surveys. The analytic sample (N 2163 53.9% female 43.5% HispanicLatino baseline M age 17.1 years) included students who reported never using illicit drugs at baseline (spring, 11th grade) and provided data at follow-up (fall and spring, 12th grade). Logistic regression models assessed associations between use of smoked, vaporized, edible, concentrate, and blunt cannabis at baseline (yesno for each product) and any non-cannabis illicit drug use initiation-including cocaine, methamphetamine, psychedelics, ecstasy, heroin, prescription opioids, or benzodiazepines-at follow-up. Among those who never used non-cannabis illicit drugs at baseline, ever cannabis use varied by cannabis product (smoked 25.8%, edible 17.5%, vaporized 8.4%, concentrates 3.9%, and blunts 18.2%) and patterns of use (single product use 8.2% and poly-product use 21.8%). After adjustment for baseline covariates, odds of illicit drug use at follow-up were largest for baseline ever users of concentrates (aOR 95% CI 5.743.16-10.43), followed by vaporized (aOR 95% CI 3.11 2.41-4.01), edibles (aOR 95% CI 3.43 2.32-5.08), blunts (aOR 95% CI 2.661.60-4.41), and smoked (aOR 95% CI 2.57 1.64-4.02) cannabis. Ever use of a single product (aOR 95% CI 2.34 1.26-4.34) or 2 products (aOR 95% CI 3.82 2.73-5.35) were also associated with greater odds of illicit drug initiation. For each of five different cannabis products, cannabis use was associated with greater odds of subsequent illicit drug use initiation, especially for cannabis concentrate and poly-product use.