Welcome to the 20th (!) edition of our newsletter. This time, we turn our attention to the health impact, social impact, and the use of synthetic cannabinoids (newsletter 19).

Synthetic cannabinoids, or ‘Spice’, have been a subject of concern due to their growing prevalence and the associated risks. Reports have emerged of users engaging with ‘Spice’ in hazardous situations and struggling to cease consumption despite significant interference with their daily lives1.

Health Impact

One of the most concerning aspects of synthetic cannabinoid use is the difficulty many users experience when trying to stop consumption. In 2015, Macfarlane and Christie2 found that out of 47 patients who were using synthetic cannabinoids daily and sought help at a detoxification center, 41 found it challenging to stop. It wasn’t just a mental battle – their bodies were putting up a fight too, with withdrawal symptoms making the journey to recovery even more difficult.

The most common withdrawal symptoms were agitation and irritability, experienced by a significant 83-89% of the patients. Anxiety was another common symptom, reported by 55%. Mood swings were also prevalent, affecting 55% of patients. Physical symptoms such as nausea and vomiting were reported by 44% of patients, and loss of appetite was reported by 17%.

In another study, 2 years earlier, Nacca and other researchers3 examined two patients who had been smoking 3g of a herbal smoking mixture daily for over a year. The results were concerning – severe anxiety and sinus tachycardia were identified as withdrawal symptoms. Other symptoms reported by synthetic cannabinoid users included nervousness, irritability, insomnia, and impatience1.

Social Impact

Much like cannabis, synthetic cannabinoids can have negative impacts on social functioning. This can manifest in various ways, from strained relationships to decreased productivity at work or school. However, the effects of synthetic cannabinoids can be more severe due to their unpredictable nature and the potential for more intense psychological effects.

One of the more concerning trends is the increasing use of synthetic cannabinoids among vulnerable groups, such as people in prison and those experiencing homelessness. For these individuals, synthetic cannabinoids can exacerbate existing problems and create new ones. For example, in prisons, the use of synthetic cannabinoids has been linked to an increase in bullying, debt, aggression, and violence. This not only poses a threat to the individuals involved but can also disrupt the overall safety and security of the prison environment4,5,6,7.

Prevalence of Use

When it comes to synthetic cannabinoids, the numbers tell a compelling story. While the overall prevalence of synthetic cannabinoid use is generally less than 1% in population-based studies, the picture changes when we zoom in on specific subpopulations8,9. 

For instance, among high school students, people experiencing homelessness, and prisoners, the use of synthetic cannabinoids is noticeably higher. One of the reasons synthetic cannabinoids have gained a foothold in these communities is their reputation as a ‘legal’ alternative to cannabis. This, together with their ability to induce a profound state of intoxication and their relative cheapness compared to other substances, makes them an attractive option for some10.

However, the use of synthetic cannabinoids is rarely an isolated behavior. Polydrug use, or the use of multiple substances, is common among synthetic cannabinoid users. This can compound the risks associated with synthetic cannabinoid use, as the interaction between different substances can lead to unpredictable effects and increased health risks9.

The increasing use of synthetic cannabinoids among vulnerable groups underscores the need for awareness, education, and support. These studies shed light on the health impact of synthetic cannabinoids. They’re not just a substitute for cannabis, they’re a whole different ball game with their own set of rules and risks.

This was our last newsletter before we go on summer break! We’ll be back September with more in-depth, as well as, new topics regarding cannabis.