Synthetic cannabinoids

How are synthetic cannabinoids used?

Synthetic cannabinoids are most commonly smoked.2 The effects are usually felt within minutes.5

Effects of synthetic cannabinoids

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

Synthetic 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)
• environment (where the drug is taken).

The effects of synthetic cannabinoids can include:

• relaxation
• euphoria
• loss of coordination
• fast and irregular heartbeat
• racing thoughts
• agitation, anxiety and paranoia
• psychosis
• aggressive and violent behaviour
• chest pain
• vomiting
• raised blood pressure (hypertension)
• breathing difficulties
• hyperthermia (overheating)
• breakdown of muscle tissue (rhabdomyolysis)
• acute kidney injury
• seizures
• stroke
• death.^{1, 6, 7}

Set and Setting

Synthetic cannabinoids 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 psychoactive drugs, and expectations of what’s going to happen.⁹ For example, feelings of stress or anxiety before using synthetic cannabinoids can be magnified and result in an unpleasant experience.
• Setting: the environment in which someone consumes synthetic cannabinoids – whether it’s known and familiar, who they’re with, if they’re indoors or outdoors, the type of music and light.⁹ For example, using synthetic cannabinoids in a calm, quiet and relaxed environment can lead to a pleasant experience but being in a noisy, crowded place may result in a negative experience.

Overdose

If you take a large amount, or have a strong batch, you could overdose. Call an ambulance straight away by dialling triple zero (000) if you have any of the following symptoms (Emergency services are there to help and can provide instructions over the phone):

• fast/irregular heart rate
• chest pain
• breathing difficulties
• severe hyperthermia (high body temperature)
• delusional behaviour. ^{1, 6, 7}

Long-term effects

Regular use of synthetic cannabinoids can eventually cause mental health conditions, heart problems, and behavioural and cognitive impairments.^{8, 9}Synthetic cannabinoids and mental health

People with mental health conditions or a family history of these conditions should avoid using synthetic cannabinoids.

People who use synthetic cannabinoids have a higher risk of experiencing symptoms of anxiety and depression, and long-term use is strongly linked to serious mental health conditions.^{7, 10, 11}

Both healthy and vulnerable individuals can experience psychosis after using synthetic cannabinoids.^{7, 12-14} And, compared to cannabis, the psychotic symptoms associated with synthetic cannabinoids are more severe and can last for weeks following last use.^{7, 14, 15}

Tolerance and dependence

People who regularly use synthetic cannabinoids can quickly become dependent on the drug. They may feel they need synthetic cannabinoids to go about their normal activities like working, studying and socialising, or just to get through the day. They may also develop a tolerance to it, which means they need to take larger amounts of synthetic cannabinoids to get the same effect.

Mixing synthetic cannabinoids with other drugs

The effects of taking synthetic cannabinoids with other drugs − including over-the-counter or prescribed medications − can be unpredictable and dangerous.

• Synthetic cannabinoids + antidepressants: mixing with antidepressant drugs such as SSRIs (selective serotonin reuptake inhibitors) is dangerous and can lead to fever, fast heartbeat, convulsions, organ failure, coma and death.¹⁶
• Synthetic cannabinoids + stimulants such as crystal methamphetamine (ice) or cocaine: effects can be particularly dangerous and increase likelihood of experiencing anxiety.

Use of more than one drug or type of drug consumed at the same time is called polydrug use.¹⁷

Giving up synthetic cannabinoids after using them for a long time is challenging because the body has to get used to functioning without them.

It has been reported that some people who use synthetic cannabinoids heavily, on a regular basis, may experience withdrawal symptoms when they try to stop, including:

• insomnia
• nausea and vomiting
• loss of appetite
• paranoia
• panic attacks
• agitation and irritability
• anxiety
• mood swings
• rapid heartbeat.^{19, 20}

The risk of tolerance and dependence on synthetic cannabinoids and their associated effects may be reduced by taking regular breaks from smoking the drug and avoiding using a large amount at once.

Health and safety

There is no safe way to use synthetic cannabinoids. If you do decide to use the drug, it’s important to consider the following:

Regulating intake

• It is difficult to predict the strength and effects of synthetic cannabinoids (even if it has been taken before) as its strength varies from batch to batch.
• Trying a very small dose first can help gauge the strength and possible effects. Dose size should only be increased slowly – time should be given for the previous dose to wear off.
• Taking synthetic cannabinoids on their own without a ‘mixer’ such as tobacco or dried parsley should always be avoided. Similarly, inhaling the drug via bongs or pipes can increase the risk of an overdose or bad reaction.

Misleading packaging

• The packaging of synthetic cannabinoids can be misleading. Although contents may be described as ‘herbal’, the actual psychoactive material is synthetic.
• Not all ingredients or their correct amounts might be listed, which can increase the risk of overdose.
• Chemicals usually vary from batch to batch, so different packets can produce different effects, even if the packaging looks the same.

When it absolutely shouldn’t be used

Use of synthetic cannabinoids is likely to be more dangerous when:

• taken in combination with alcohol or other drugs, particularly stimulants such as crystal methamphetamine (‘ice’) or MDMA
• driving or operating heavy machinery
• judgment or motor coordination is required
• alone (in case medical assistance is required)
• the person has a mental health problem
• the person has an existing heart problem.

Getting help

If your use of synthetic cannabinoids is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about a loved one, you can find 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

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If you're looking for other information or support options, send us an email at druginfo@adf.org.au