Schizophrenia Patients Accepted Low-THC Cannabis but Preferred Their Regular High-Potency Product

Both substitute variants (low THC/no CBD and low THC/high CBD) were appreciated by patients. However, they preferred their usual high-potency cannabis. The low THC/high CBD variant was reported as too short-acting by 32% and not strong enough by 36%. The low THC variant was reported as not strong enough by 64%.

Crossover design with 12 male schizophrenia patients who daily smoked high-potency cannabis. Each patient smoked their usual cannabis on two occasions (unblinded) and each substitute variant on two occasions (blinded, randomized).

This study explores whether cannabis substitution (replacing high-potency with lower-risk products) is feasible in schizophrenia patients. While acceptance was positive, the preference for usual cannabis suggests substitution may work better as part of a gradual reduction strategy.

Cannabis substitution could be a harm reduction strategy for psychosis patients who cannot or will not stop using cannabis entirely. This pilot suggests such substitution is feasible, even if patients prefer their usual product.

Very small sample (n=12). All male. Short-term preference assessment does not indicate long-term compliance. Unblinded comparison to usual cannabis biases preference. No clinical outcome measures.