Cream of the Crop: Clinical Representativeness of Eligible and Ineligible Cannabis Users in Research.

Background: Experts have recommended criteria (Gonzalez etal., 2002) for recruiting pure chronic cannabis users (i.e., those without polysubstance use or psychiatric illness) when evaluating cannabis' non-acute effects on cognition. Objectives: We sought to demonstrate the implications of using such criteria by examining characteristics of respondents who completed an eligibility screening for a parent study evaluating the cognitive effects of chronic cannabis use. Methods: Over a 3-year, 8-month period, 612 respondents from the community completed an eligibility screening based on recommendations in the cannabis literature. Using independent samples t-tests and chi-square tests, we examined whether qualified/eligible respondents (n = 219) differed from non-qualified/ineligible respondents (n = 393). Results: Compared to ineligible cannabis users, eligible cannabis-using respondents were significantly younger, used cannabis more frequently, used alcohol less frequently, and were less likely to have a history of other drug use, a psychiatric diagnosis, or to have used psychiatric medication. Conclusions/Importance: Our findings indicate that eligible/pure cannabis users are not representative of typical cannabis users in the general community (i.e., ineligible users with polysubstance use and/or psychiatric diagnoses) who ultimately comprised the majority of our cannabis-using sample (65.2%). Thus, typical cannabis users may be more accurately characterized as polysubstance users, posing a number of challenges related to the generalizability of findings from studies utilizing pure samples of cannabis users. Recruiting samples of typical cannabis users will improve external validity in research. Furthermore, reporting comprehensive characteristics of such samples will enable consumers to gauge the applicability of study findings to populations of interest.