Dabs and Dabbing: What Cannabis Concentrates Are, and What the Evidence Actually Shows

If you searched “dabs” and meant something other than cannabis, this is not your page. Here, dabs means cannabis concentrates and dabbing means inhaling them.

Concentrates are far stronger than herbal cannabis. Some risks attached to them are well evidenced and some are not, and this page keeps those categories apart. It describes nothing about how they are made or used.

What people mean by dabs

Concentrates are extracts of the cannabis plant rather than the plant itself. FRANK, the UK government drug information service, lists “‘Dab’/’shatter'” among cannabis forms and calls them “highly concentrated forms”. Wax, budder, rosin and live resin are consistencies, not different drugs.

The US National Institute on Drug Abuse puts it plainly: “Smoking or vaporizing highly concentrated oils or extracts, also called wax or shatter, from the cannabis plant is known as dabbing.” It adds: “Dabbing can rapidly deliver large amounts of THC to the body, which increases the risk of negative side effects.”

The potency question, and the study that complicates it

NIDA reports that “Between 1995 and 2022 the delta-9 THC potency (strength) in illegal cannabis products seized by law enforcement quadrupled from 3.96% to 16.14%”, and that “Cannabis flower and concentrates in dispensaries can have THC concentrations of more than 40%”. FRANK puts it differently: “Skunk and other forms of strong cannabis contain high levels of THC but very little, or no, CBD.”

A 2020 JAMA Psychiatry study compared people who used concentrates with people who used flower, at home, with their own products. Concentrate users “exhibited higher plasma THC levels and 11-hydroxy-delta-9-THC (THC’s active metabolite) across all points”.

Two caveats belong with that. The reported standard errors on the plasma measurements were larger than the means themselves, which is our observation, so the exposure difference is a direction rather than a precise multiple. And these were experienced regular users measured once, which says nothing about a first use.

Then the finding that usually gets dropped: “Differing outcomes for the type of product (flower vs concentrate) or potency within products were not observed.” Verbal memory and balance were impaired after use, across the board.

Our reading is that tolerance is the likeliest explanation for very high blood levels producing no extra measured impairment, and there is a mechanism for it. PET imaging in Molecular Psychiatry found “reversible and regionally selective downregulation of brain cannabinoid CB(1) receptors in human subjects who chronically smoke cannabis”, correlating with years of use. After roughly four weeks of monitored abstinence, “CB(1) receptor density returned to normal levels”.

Psychosis: what the research found, and what it did not

EU-GEI, the largest European study of this question, reported in Lancet Psychiatry in 2019 that “Daily cannabis use was associated with increased odds of psychotic disorder compared with never users (adjusted odds ratio [OR] 3.2, 95% CI 2.2-4.1), increasing to nearly five-times increased odds for daily use of high-potency types of cannabis (4.8, 2.5-6.3).” It estimated that “if high-potency cannabis were no longer available, 12.2% (95% CI 3.0-16.1) of cases of first-episode psychosis could be prevented across the 11 sites, rising to 30.3% (15.2-40.0) in London and 50.3% (27.4-66.0) in Amsterdam.”

Those figures are usually quoted without their scaffolding. The study was case-control, 901 people with first-episode psychosis against 1,237 controls, which establishes association rather than causation. A population attributable fraction is calculated as though the association were causal, so the London and Amsterdam figures rest on an assumption the design cannot test. That is our reading of what they carry, not a criticism the paper makes of itself.

We could find no study reporting a psychosis risk figure specific to concentrates. The potency evidence is applied to dabs by extension, and that extension is ours and everyone else’s, not the researchers’.

A 2022 Lancet Psychiatry systematic review screened 4,171 articles, included 20, and found “use of higher potency cannabis, relative to lower potency cannabis, was associated with an increased risk of psychosis and CUD”, while results for depression and anxiety were inconsistent. Its authors were plain: “Standardisation of exposure measures and longitudinal designs are needed to strengthen the evidence of this association.”

The vomiting nobody warns you about

Cannabinoid hyperemesis syndrome is the risk most people who dab have never heard of. StatPearls describes it as “a condition in which a patient experiences cyclical nausea, vomiting, and abdominal pain after using cannabis”, typically after “several years of preceding cannabis use”, recurring “every few weeks to months, at which time the patient is still using cannabis”. Distinctively, “their symptoms are relieved by hot baths or shower”. Complications listed include dehydration, aspiration and Boerhaave’s syndrome, a tear in the oesophagus. What resolves it is stopping cannabis.

A 2019 Colorado study in Annals of Internal Medicine found emergency department visits after inhaled cannabis more often involved “cannabinoid hyperemesis syndrome (18.0% vs. 8.4%)” than visits after edibles. A 2026 study in the International Journal of Drug Policy, based on 10,255 participants in the International Cannabis Policy Study, reported that approximately 6% reported past-year CHS, with more frequent use of cannabis edibles and concentrates among the risk factors.

The inconvenient half. A 2026 MMWR report found the proportion of US emergency department visits involving CHS rose “from 3.35 per 10,000 ED visits in September 2025 (preimplementation) to 11.26 per 10,000 ED visits in October 2025”, the month a specific diagnosis code came into use. Its authors concluded the rise may reflect improved recognition rather than rising incidence.

Cannabis use disorder and withdrawal are in the manuals

Many people still believe cannabis is not habit-forming and that there is no withdrawal from it. Both beliefs are wrong.

NIDA associates cannabis use disorder with chronic heavy use, meaning every day or almost every day, of cannabis products containing THC. It states that “Studies have estimated that 22% to 30% of people who use cannabis have the disorder”. Its withdrawal list runs “anger, irritability, aggression, feeling nervous or anxious, restlessness, decreased appetite or weight, depression, insomnia, experiencing strange or unsettling dreams, headaches, sweating, abdominal pain, and tremor”. FRANK’s UK list overlaps it.

A 2017 review in Substance Abuse: Research and Treatment describes stopping long-term use as producing “a specific withdrawal syndrome with mainly mood and behavioral symptoms of light to moderate intensity”, notes that women tend to report more intense symptoms including nausea and stomach discomfort, and notes that people with severe dependence or co-occurring conditions may need inpatient care.

We did not find a source describing cannabis withdrawal as medically dangerous in the way unmanaged alcohol or benzodiazepine withdrawal can be. That absence is not a guarantee of safety, and it is not a reason to do it alone if previous attempts have gone badly.

Clinically this is not fringe. England’s Office for Health Improvement and Disparities reported that “Over one-fifth of adults in treatment (21%) said they had problems with cannabis”, and that the number starting treatment for them rose again.

Burns, which are not a psychological risk at all

One category of concentrate is made using butane. We are not going to describe how. It is mentioned because the harm turns up in burn units.

A seven-year review in the Journal of Burn Care and Research examined 101 patients with butane hash oil related burns. Mean burn size was 26.8% of total body surface area, hospitalisation averaged several weeks, and three patients died. An earlier Colorado series in the Journal of Medical Toxicology reported a median burn size of 10% of total body surface area and a median admission of 10 days, with six patients needing intubation to protect the airway.

The legal position, which is moving

Any legal statement here is quoted, not interpreted, and none of it is legal advice.

Thailand has changed its cannabis law more than once in recent years. We could not verify the current position from a Thai government source, so we quote UK Foreign, Commonwealth and Development Office advice as it stood on 27 August 2026: “Cannabis use in Thailand is restricted to medical purposes only. You must not buy, possess or use it without a Thai-issued medical prescription, which is limited to a 30-day supply. Recreational use remains illegal.” It adds that “It is illegal to take cannabis out of Thailand without the appropriate export permission from the authorities.” Check that page yourself before travelling rather than relying on this one.

In the UK, GOV.UK lists cannabis as a Class B drug, with possession carrying “Up to 5 years in prison, an unlimited fine or both” and supply or production “Up to 14 years in prison, an unlimited fine or both”.

When it stops being a question about a drug

Three questions are worth taking to a clinician whichever way they come out. Whether the amount you use now would have seemed unthinkable a year ago. Whether stopping has been tried and did not hold. And whether the sections above described you rather than a stranger. If any answer is yes, that is a conversation to have with someone qualified. If it is no to all three and you are still reading at this depth, that is worth a conversation too.

If someone is acutely paranoid to the point of being unsafe, cannot keep fluids down, or cannot be roused, treat it as an emergency. In the UK call 999. Outside the UK, use your local emergency number.

Talking to Orchid

The Orchid Recovery is a residential addiction and mental health treatment centre in Hang Dong District, Chiang Mai, Thailand, for international English speaking adults.

If cannabis use has stopped being a choice, our pages on marijuana addiction treatment and medically supervised drug detox explain what residential treatment involves, and dual diagnosis treatment covers an anxiety, mood or psychotic condition sitting underneath the use. Our clinical team is listed here, and you can speak to us if it would help.

We have written separately about the signs of marijuana use disorder, how to quit weed and how marijuana addiction is treated. Most people reading this will not need a treatment centre, which is the right outcome.

Sources

• FRANK, Cannabis
• National Institute on Drug Abuse, Cannabis (Marijuana) DrugFacts
• National Institute on Drug Abuse, Marijuana Concentrates DrugFacts
• Di Forti et al, The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI), Lancet Psychiatry 2019
• Petrilli et al, Association of cannabis potency with mental ill health and addiction: a systematic review, Lancet Psychiatry 2022
• Bidwell et al, Association of Naturalistic Administration of Cannabis Flower and Concentrates With Intoxication and Impairment, JAMA Psychiatry 2020
• Hirvonen et al, Reversible and regionally selective downregulation of brain cannabinoid CB1 receptors in chronic daily cannabis smokers, Molecular Psychiatry 2012
• Bonnet and Preuss, The cannabis withdrawal syndrome: current insights, Substance Abuse: Research and Treatment 2017
• Cannabinoid Hyperemesis Syndrome, StatPearls, NCBI Bookshelf
• Monte et al, Acute Illness Associated With Cannabis Use, by Route of Exposure, Annals of Internal Medicine 2019
• Trends in Emergency Department Visits Involving Cannabis Hyperemesis Syndrome Identified Using a New Diagnosis Code, MMWR 2026
• Cannabinoid hyperemesis syndrome prevalence and risk factors in the U.S., International Journal of Drug Policy 2026
• Butane Hash Oil Burns: A 7-Year Perspective on a Growing Problem, Journal of Burn Care and Research
• Butane Hash Oil Burns Associated with Marijuana Liberalization in Colorado, Journal of Medical Toxicology 2015
• Office for Health Improvement and Disparities, Adult substance misuse treatment statistics 2024 to 2025
• UK Foreign, Commonwealth and Development Office, Thailand travel advice, safety and security
• GOV.UK, Drugs penalties