Sex differences in the subjective and reinforcing effects of smoked cannabis

Preclinical studies have shown sex‐based differences in the reinforcing effects of cannabinoid 1 receptor agonists such as delta‐9‐tetrahydrocannabinol (THC). This study sought to test whether these sex differences translate to humans by assessing the subjective and reinforcing effects of smoked cannabis in male and female volunteers. We pooled data (n = 68; 55M, 13F) from two within‐subject randomized controlled trials of healthy, ≥weekly cannabis users comparing the subjective and reinforcing effects of smoked active (~25 mg THC) versus placebo cannabis (0‐mg THC). Subjective ratings of drug effects and mood were measured using visual analogue scales, and reinforcing effects were measured with a cannabis self‐administration task. Sex‐dependent outcomes were explored using generalized linear mixed models. Under active cannabis conditions, female participants reported greater reductions from baseline in cannabis craving and significantly higher cannabis‐specific ratings of strength, liking, willingness to take again and good effect, compared with males (interaction p