Lastly, stark and modest increases in cannabis potency levels have been registered for resin and herbal cannabis, respectively, corroborating previous analyses in Europe and internationally [51], [52], [53]. In contrast to these trends, CUD prevalence is estimated to have declined in the past decade in most countries. These findings are consistent with survey data from the United States, showing that while the prevalence of cannabis use increased from 2001-2002 to 2012-2013, the prevalence of cannabis use disorders in cannabis users decreased [54]. However, potency level may be implicated with other health outcomes than CUD, such as psychotic outcomes [55] or genotoxic and epigenotoxic effects [17].
