The Rise of Synthetic Cannabinoids, Bath Salts, and Other "Legal Highs" | Research

The takeaway

A clinical review documented the rapid growth of synthetic drugs including synthetic cannabinoids (K2/Spice), describing significant toxicities and psychosis risk that often go undetected by routine drug screens.

Parents, clinicians, and anyone wanting to understand the risks of synthetic cannabinoids like K2 and Spice.

Synthetic cannabinoids evade routine drug screening and have unpredictable potency

What the researchers found

This review for family practitioners cataloged the expanding landscape of synthetic recreational drugs. Synthetic cannabinoids, sold as "K2" or "Spice," are sprayed onto herbal preparations and marketed as not for human consumption to avoid regulation.

Because the chemical compounds change frequently and are not included in routine drug screening, their use often goes undetected. The unpredictable concentrations of active ingredients make toxicity common. Adverse effects of synthetic cannabinoids include psychosis, among other serious reactions.

The review also covered synthetic cathinones ("bath salts"), MDMA variants, and new hallucinogens, noting that adolescents and young adults are the primary users of these substances.

Why it matters

Synthetic cannabinoids present unique clinical challenges because they are more potent and unpredictable than natural cannabis, they evade standard drug tests, and their chemical composition constantly shifts. Clinicians who are unaware of these substances may miss the diagnosis.

The numbers in context

No specific prevalence data were presented. The review noted a "large increase" in synthetic drug use and identified adolescents and young adults as the primary user population.

How the study worked

This was a clinical review published in a family practice education journal, summarizing the pharmacology, toxicology, and clinical presentation of emerging synthetic drugs for practicing clinicians.

What this study cannot tell us

This was a clinical overview rather than a systematic review. It did not provide detailed epidemiological data or head-to-head comparisons of harm profiles. The rapidly changing nature of synthetic drugs means specific compounds discussed may no longer be prevalent.

How to read the evidence

This is a clinical review for family practitioners, summarizing known information about emerging drugs rather than presenting new research data.

When this study was published

Published in 2016. The synthetic drug market has continued to change rapidly, with new compounds emerging regularly.

The bigger picture

The synthetic cannabinoid market has continued to evolve since this review, with new compounds regularly appearing. The pattern of creating legal ambiguity by constantly changing chemical structures while maintaining psychoactive effects remains an ongoing challenge for regulators and clinicians.

Questions still open

How can drug screening keep pace with constantly changing synthetic compounds? What are the long-term health effects of synthetic cannabinoid use compared to natural cannabis?

Common questions

Are synthetic cannabinoids the same as marijuana?

No. Despite being marketed as cannabis alternatives, synthetic cannabinoids are chemically different, often much more potent, and carry greater risks of serious adverse effects including psychosis. They bind more strongly to cannabinoid receptors than THC does.

Why are these substances hard to detect?

Standard drug screening panels are designed to detect THC and other well-known substances. Synthetic cannabinoids have different chemical structures that change frequently, so they do not trigger positive results on routine tests.

Read the original research

The Changing Drug Culture: Emerging Drugs of Abuse and Legal Highs.

FP essentials, 441, 18-24

View on PubMed ↗

Citation

Albertson, Timothy E; Chenoweth, James A; Colby, Daniel K; Sutter, Mark E. (2016). The Changing Drug Culture: Emerging Drugs of Abuse and Legal Highs.. FP essentials, 441, 18-24.