Saliva detection of the cannabinoids tetrahydrocannabinolic acid A (THCA-A) and cannabinol (CBN) among nightclub attendees in New York City, 2024.

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. We used biological measures to better understand the prevalence of specific cannabinoids. Throughout 2024, adults entering New York City nightclubs ( = 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. 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). 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.