Abstract
Background: The 2018 U.S. Farm Bill led to a rapid expansion of derived cannabinoid products. Prior studies examining their use rely on self-reported data, which can be unreliable. Nightclubs offer a unique environment for biological surveillance due to their high prevalence of substance use.Objectives: We used biological measures to better understand the prevalence of specific cannabinoids.Methods: Throughout 2024, adults entering New York City nightclubs (n = 1,024; 45.9% female) were surveyed and had their saliva tested for cannabinoids including tetrahydrocannabinolic acid A (THCA-A) and cannabinol (CBN). We calculated the prevalence and correlates of detection for these two compounds.Results: Tetrahydrocannabinol (THC) was detected in 30.8% of the sample, THCA-A in 11.7% and CBN in 8.9%. Compared to males, females had lower odds of testing positive for THCA-A (aOR = 0.28, 95% CI: 0.16-0.48) and CBN (aOR = 0.47, 95% CI: 0.27-0.83), and compared to white participants, black participants had higher odds of testing positive for THCA-A (aOR = 2.04, 95% CI: 1.12-3.72) and CBN (aOR = 3.74, 95% CI: 1.94-7.23). Compared to those with a college degree or higher, those with a high school diploma or less had higher odds of testing positive for THCA-A (aOR = 4.02, 95% CI: 2.40-6.74) and CBN (aOR = 2.49, 95% CI: 1.34-4.63) and those with some college had higher odds of testing positive for CBN (aOR = 2.02, 95% CI: 1.10-3.72).Conclusions: A sizable proportion of nightclub attendees had detectable levels of THCA-A and CBN, highlighting the need to screen for derived cannabinoids alongside THC. Biological drug testing with self-report may improve public health surveillance.