Delta-8 Tetrahydrocannabinol Exposures Reported to US Poison Centers: Variations Among US States and Regions and Associations with Public Policy

Introduction This study investigated exposures involving triangle 8-tetrahydrocannabinol (triangle 8-THC) reported to US poison centers (PCs), including variation among states and regions. It evaluated whether the triangle 8-THC exposure rate was lower among states with triangle 8-THC regulations and states where cannabis (triangle 9-THC) use was legal. Methods National Poison Data System data for triangle 8-THC exposures in 2021-2022 were analyzed, including comparisons of state and regional population-based exposure rates. Results There were 4,925 exposures involving triangle 8-THC as the primary substance reported to US PCs from January 1, 2021, to December 31, 2022, with 69.8% of these reported in the US South. The rate of exposure per 100,000 US population increased by 79.2% from 0.53 in 2021 to 0.95 in 2022. In 2022, the mean rate of triangle 8-THC exposures in states where cannabis use was illegal was 1.64 per 100,000 population (95% CI: 1.08-2.20) compared with 0.52 (95% CI: 0.29-0.76) in states where cannabis use was legal (P = 0.0010). In 2022, the mean rate of triangle 8-THC exposures in states where triangle 8-THC was unregulated was 1.36 per 100,000 population (95% CI: 0.95-1.77) compared with 0.17 (95% CI: 0.06-0.27) in states where triangle 8-THC was banned (P < 0.0001). Conclusions The rate of triangle 8-THC exposures reported to US PCs increased by 79% from 2021 to 2022, with the US South accounting for more than two-thirds of exposures. The rate of triangle 8-THC exposures reported to PCs was significantly lower among states where triangle 8-THC was banned and among states where cannabis use was legal. Consistent regulation of triangle 8-THC across all states should be adopted.