INTRODUCTION: There have been concerted research efforts internationally to examine the health effects of higher delta-9-tetrahydrocannabinol (THC) concentration cannabis products and to design policies to reduce potential negative health effects of their use. This study identifies international policy approaches for regulating higher THC products relevant to the Australian medicinal cannabis program.

METHODS: An environmental scan of international literature and policy as part of a broader study commissioned to inform Australian policy. Methods were prospectively registered with the Open Science Framework: 10.17605/OSF.IO/HNFUT. Peer-reviewed and grey literature on international policy approaches were identified through searches for 'high potency THC' and 'policy'. The literature was then narratively synthesised.

RESULTS: We identified 76 publications and other sources that described policy approaches recommended or implemented in five jurisdictions: Canada; Germany; the Netherlands; the United States; and Uruguay. Approaches included setting a threshold for cannabis flower THC concentration at or below the biological THC limit of 30%-35% found in the plant and a risk-tiered model for highly concentrated THC dosage forms. THC limits per dose and per package have been applied to edible products. Additional approaches included quantity limits, packaging and labelling requirements, pharmacovigilance, and education.

DISCUSSION AND CONCLUSIONS: Policy approaches for higher THC concentration cannabis products could be adapted to the Australian regulatory environment to reduce potentially harmful THC exposure.