Potential Risks from Cannabis-Infused Beverages: A Critical Review

Abstract

Although Canada legalized cannabis beverages in 2019, most available research on acute cannabis intoxication derives from dried flower and edible products. The distinct bioavailability and pharmacokinetic properties of phytocannabinoids ingested from beverages, however, contribute to significantly different acute and long-term effects that need to be better understood to ensure consumer safety. Objective: This review investigates existing cannabis beverage literature, with a particular focus on acute intoxication effects. Method: PubMed, PsycINFO and Web of Science databases were systematically searched. A structured search generated 29 eligible studies, comprising studies of consumption patterns and beliefs, advertisements and marketing, acute effects in human models, and drink composition. Results: Human studies report aversive acute subjective and physiological effects induced by cannabis beverages in healthy, infrequent users. Beverages also showed inaccurate cannabinoid labeling, posing potential risks to consumers. This review highlights the paucity and inconsistency of available research, further exacerbated by the sheer diversity of formulations investigated, while beginning to address some questions surrounding the safety and risks associated with cannabis beverages. Conclusions: Given the extensive differences in effects across cannabis-infused beverages, and the growing ‘drinkables’ market, it is essential that more studies directly examine both acute and long-term impacts of cannabis beverage consumption.