Cannabinoids

What do cannabinoids look like?

Cannabinoids come in many different forms, including:

• cannabis leaves and flowers (buds)
• ground plant material sprayed with chemicals in brightly coloured packaging (synthetic cannabinoids)
• capsules and pills
• foods, also known as edibles (gummies, brownies, etc.)
• skin patches, creams and lotions
• oils
• mouth sprays
• tinctures.⁴

Other names for cannabinoids

There are many other names for cannabis, these include marijuana, yarndi, pot, weed, hash, dope, gunja, joint, stick, chronic, cone, chuff, mull, 420, 710, dabs, dabbing, BHO.

‘Novel’ synthetic cannabinoids are marketed under different names. Spice was one of the earliest and more common terms. Other names have emerged including Kronic, Northern Lights, K2 and Kaos.

Types of cannabinoids

Natural (phytocannabinoids)

Cannabis plants produce hundreds of phytocannabinoids, with at least 120 being identified to date.⁵

The most well-known are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).⁵

THC is the main cannabinoid responsible for the psychoactive (‘high’) effects of cannabis.

CBD has many potential medicinal benefits and may lessen the intensity of the psychoactive effects from THC.⁵

Other cannabinoids found in cannabis include:

• Cannabigerol (CBG), works with THC and CBD to balance effects on the nervous system and lessens the effects of THC
• Cannabinol (CBN), slightly psychoactive; lessens effects of THC
• Cannabichromene (CBC), similar in chemical structure to THC, but is not known to be psychoactive
• Tetrahydrocannabivarin (THCV).⁵

Novel synthetic and semi-synthetic cannabinoids

There are also synthetic and semi-synthetic cannabinoids, also known as ‘novel cannabinoids’ found in the illegal market.

Novel synthetic cannabinoids are designed to mimic the effects of THC but often produce more potent and unpredictable effects. They often come in brightly coloured packaging or are incorrectly sold as cannabis.⁶ Examples include: AB-CHMINACA, JWH-018, UR-144.

Novel semi-synthetic cannabinoids are made from plant-based cannabinoids being altered in a lab. Examples include: Hexahydrocannabinol (HHC), Delta-8-THC, and Delta-10-THC.⁷

Both can produce more potent and unpredictable effects.

Medical cannabinoid products

Therapeutic Goods Administration (TGA) approved medical cannabinoid products are available in Australia with a prescription. They include brand name products Sativex® and Eipdyolex®.⁴

Other plant-based cannabinoid products, not tested for quality and safety by the TGA, are available through the Special Access Scheme (SAS) under different brand names.⁸

There are also prescribed synthetic and semi-synthetic medical cannabinoid products, which have been tested for quality and safety, unlike novel synthetic cannabinoids.⁴ They are usually designed with the aim to have similar effects to THC or CBD. None of these products are approved for use in Australia, but they are prescribed in some countries internationally. Examples include Marinol®, Syndros® and Cesamet®.

How are they used?

Cannabinoids are most often smoked, eaten/swallowed or vaporised.⁹

Medicinal cannabis is prescribed to relieve the symptoms of chronic or cancer-related pain, multiple sclerosis (MS), epilepsy, Tourette syndrome, and a range of other health conditions.⁴ THC for medical use is taken in many ways, including:

• vaporised
• eaten
• dissolved under the tongue (sub-lingual)
• mouth sprays
• suppositories
• applied onto the skin.¹⁰

Smoking cannabinoids for medicinal reasons is not recommended, as it’s harder to accurately dose and the harms to your body from smoking can be worse than the benefits experienced from the cannabinoids.¹¹

Effects of cannabinoids

The use of any drug can have risks. It’s important to be careful when taking any type of drug.

Cannabinoids affect everyone differently, based on:

• size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken
• the strength of the drug (varies from batch to batch)
• the environment (where the drug is taken).

Onset and duration of effects

How fast a drug takes effect and how long it lasts can vary depending on how it's taken - for example, whether it's smoked or swallowed.¹²

Effects

Learn more about the effects of a specific cannabinoid:

• THC
• CBD
• Synthetic Cannabinoids.

Effects can include:

• feeling happy or excited
• feeling relaxed or calm
• anxiety, paranoia or panic
• dry mouth
• loss of motivation
• impaired memory/concentration
• bloodshot eyes
• dizziness
• increased heart rate
• increased body temperature
• nausea
• seizures.¹³

Impact of mood and environment

Drugs that affect a person’s mental state (psychoactive drugs) can also have varied effects depending on a person’s mood (often called the ‘set’) or the environment they are in (the ‘setting’):

• Set: a person’s state of mind, previous encounters with the drug, and expectations of what’s going to happen. For example, feelings of stress or anxiety before using certain cannabinoids, like THC, may result in an unpleasant experience and make those feelings worse.
• Setting: the physical and social environment where you take cannabinoids– whether it’s known and familiar, who you're with, if you're indoors or outdoors, the type of music or sounds, and lighting. The ideal setting to take cannabinoids will vary based on the individual and what they’re using. For example, one person might enjoy cannabinoids in a loud social setting like a party, while another may prefer a quieter place with close friends.¹⁴

Being in a good state of mind, with trusted friends and a safe environment before taking cannabinoids reduces the risk of having a bad experience.¹⁴

Overdose

There have been no recorded deaths from THC or CBD overdose in Australia.^{15, 16}

But synthetic cannabinoid overdose can cause death.¹⁷ And, sometimes people take synthetic cannabinoids without knowing, thinking they’re using cannabis (THC).

Call triple zero (000) and request an ambulance if you, or someone else, has any of the following symptoms (emergency services are there to help and can provide instructions over the phone):

• chest pain or discomfort that may feel like pressure, squeezing, heaviness, or burning. It may also be felt in the arm, shoulder, back, neck, or jaw
• irregular heartbeat
• breathing difficulties
• hallucinations, paranoia.¹⁸

Mixing cannabinoids and other drugs

Mixing cannabinoids with other drugs can have unpredictable effects and increase the risk of harm. Mixing means using more than one drug (including alcohol or medications) at the same time, or one after another. You should also consider what drugs you’ve taken in the last 24 hours.

Using more than one drug or type of drug at the same time is also called polydrug use.¹⁹

Reducing harm

There are ways you can reduce the risk of harm when using cannabinoids:

• Start low, go slow - try a little bit first, to see how you feel:
• if you have eaten/swallowed cannabis, wait at least 4 hours before deciding whether to take more
• if you have used cannabis any other way, wait at least 30 minutes.
• Avoid novel synthetic cannabinoids - due to their unpredictable effects. These drugs often come in brightly coloured packages with the flower or plant material pre-chopped or powdered.
• Choose ‘full spectrum’ products with a balance of other cannabinoids like CBD, rather than THC only products - this may help reduce the risk of negative side effects and prevent worsening symptoms of mental health conditions, like schizophrenia and psychosis.^{20, 21}
• If affected by cannabinoids, don’t drive, operate heavy machinery or do any other potentially risky activities, such as swimming - as cannabis slows response times and affects coordination and balance.⁴
• Take less or avoid using THC or synthetic cannabinoids entirely if you:
• are a young person (25 and under), as young people can experience additional negative effects
• have experienced, or have a family history of, schizophrenia or bipolar disorder
• have an existing heart condition, as they can put extra strain on your heart. It’s especially important to avoid taking stimulants if you have a heart condition and choose to take cannabis.⁴

If smoking or vaping:

• avoid using tobacco as a mixer
• clean smoking equipment regularly, including mouthpiece and any water containing parts to avoid mould or bacterial growth
• avoid smoking out of plastic bottles or aluminium cans due to toxic fumes
• use edibles, oils, or a vape instead of smoking to avoid harmful smoke and chemicals.²²

Pregnancy, breastfeeding and cannabinoids

We know that the endocannabinoid system plays an important role in reproduction and pregnancy.²³ And that most cannabinoids likely pass through breastmilk into the newborn baby.²⁴

Because of this, it’s recommended not to use cannabinoids if pregnant or breastfeeding.

Getting help

If your use of cannabinoids is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about someone you care about, there is help and support.

• Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs
• Search our Help and Support database directly to find your preferred support, by adding your location or postcode and filtering by service type.