Synthetic cannabinoids are not a substitute for cannabis

Although synthetic cannabinoids are not a stimulant drug, their toxicity profile and some of their effects are more similar to a stimulant (such as ice or cocaine) than cannabis.^{1, 4}

Many of the synthetic cannabinoid-related deaths in Australia have involved someone using synthetic cannabinoids as a cannabis substitute – not realising how different and potentially dangerous the effects are.⁴

In fact, it’s unclear whether the broader community understands the critical differences between the two drugs.⁴

People who use synthetic cannabinoids will often claim the effects are uniquely different from other drugs and often unpredictable.^{19, 20}

In fact, Australia’s low reported use of synthetic cannabinoids has been attributed to the fact that they don’t produce the kind of effects people are looking for.¹²

It has also been reported by users that a major motivation for taking synthetic cannabinoids is to experience ‘cannabis-like’ effects without the danger of it being detected in drug testing.²¹

However, many facilities and organisations now include synthetic cannabinoid testing in their drug testing procedures.²²

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

Synthetic cannabinoids pose a major risk to someone with a personal or family history of mental health issues.

People who use synthetic cannabinoids have a higher risk of experiencing symptoms of anxiety and depression, ²³ and chronic use is more strongly linked to serious mental health disorders.^{13, 24}

Synthetic cannabinoids also pose a particular risk for experiencing psychosis (disconnect from reality involving delusions/hallucinations).²⁵ This is in part because of the absence of CBD (cannabidiol).^{3, 13}

In plant-based cannabis, CBD makes the effects of THC less severe and it has antipsychotic (reduces likelihood of psychosis) and anticonvulsant (reduces likelihood of seizures) properties.^{3, 13} However, it is worth noting that the presence of CBD does not prevent the possibility of psychosis entirely, as the ratio of THC to CBD can vary across different types of cannabis.²⁶

Still, the absence of chemicals such as CBD from synthetic cannabinoids may be one of the reasons why they are more likely to produce psychotic symptoms.^{3, 13}

Many people have suffered repeated psychosis after using synthetic cannabinoids – this includes people both with and without an existing vulnerability to experiencing psychotic symptoms.^{13, 17, 27, 28}

And, compared to cannabis, the psychotic symptoms associated with synthetic cannabinoids are more severe and can last for weeks following last use.^{13, 28, 29}

People with pre-existing heart conditions should avoid using synthetic cannabinoids

Synthetic cannabinoid use can lead to serious heart problems for both adults and young people.^{13, 18, 30}

Older people (who have a higher risk of heart disease) or those with certain heart conditions, are particularly at risk.⁴

A number of the deaths in Australia have occurred because an existing heart condition was aggravated by synthetic cannabinoid use.¹ Many of the deaths also involved relatively older people – with around half of the cases aged 40 years or older.¹