Synthetic cannabinoids are more potent and far more dangerous than natural cannabis
A public health review found that synthetic cannabinoids bind to brain receptors with much higher potency than natural cannabis and cause severe adverse effects including psychosis, kidney failure, and death.
Quick Facts
What This Study Found
Researchers reviewed the epidemiology and health effects of synthetic cannabinoids compared to natural cannabis from a public health perspective. The differences were stark.
Synthetic cannabinoid products contain mixtures of psychoactive compounds that bind to cannabinoid receptors with much higher potency than THC from natural cannabis. While they replicate the basic effects of cannabis, they induce substantially more severe adverse effects.
Acute effects include respiratory difficulties, hypertension, tachycardia, chest pain, muscle twitches, acute kidney failure, anxiety, agitation, psychosis, suicidal ideation, and cognitive impairment. Chronic use has been associated with serious psychiatric conditions, medical complications, and even death.
The unpredictability is a key danger: unlike natural cannabis with relatively predictable THC content, synthetic products contain unknown concentrations of multiple active compounds, any of which could produce toxic effects. As regulations ban specific compounds, manufacturers modify the chemical structure slightly, creating new untested substances.
Key Numbers
Synthetic cannabinoids bind cannabinoid receptors with higher potency than THC. Adverse effects include: respiratory difficulties, hypertension, tachycardia, chest pain, acute renal failure, psychosis, suicidal ideation. Chronic use associated with death. Continuous chemical modification circumvents regulation.
How They Did This
Narrative review of current literature on the epidemiology, acute effects, and chronic effects of synthetic and natural cannabinoid drugs, conducted from a public health perspective.
Why This Research Matters
Synthetic cannabinoids remain widely available despite regulatory efforts, and users often underestimate the risk because they view them as a form of cannabis. This review makes clear that synthetic cannabinoids are a fundamentally different and more dangerous class of drugs that happen to target the same receptors.
The Bigger Picture
The synthetic cannabinoid epidemic illustrates the limitations of substance-by-substance regulation. As fast as authorities ban specific compounds, manufacturers create new analogs. A public health approach focused on education about the fundamental differences between synthetic and natural cannabinoids may be more effective than regulatory whack-a-mole.
What This Study Doesn't Tell Us
This is a narrative review and does not systematically assess the quality of included studies. Adverse effect data come largely from case reports and poison control data rather than controlled studies. The rapidly evolving landscape of synthetic cannabinoids means any review quickly becomes outdated. Prevalence data are likely underestimates due to underreporting.
Questions This Raises
- ?Why do people choose synthetic cannabinoids over natural cannabis?
- ?Can regulation ever keep pace with the rate of new synthetic compound creation?
- ?Would expanded legal access to natural cannabis reduce synthetic cannabinoid use?
Trust & Context
- Key Stat:
- Synthetic cannabinoids cause psychosis, kidney failure, and death; natural cannabis does not
- Evidence Grade:
- This is a comprehensive public health review synthesizing evidence on a well-documented but under-studied drug class.
- Study Age:
- Published in 2018. The synthetic cannabinoid landscape continues to evolve with new compounds.
- Original Title:
- Synthetic and Non-synthetic Cannabinoid Drugs and Their Adverse Effects-A Review From Public Health Prospective.
- Published In:
- Frontiers in public health, 6, 162 (2018)
- Authors:
- Cohen, Koby(4), Weinstein, Aviv M(2)
- Database ID:
- RTHC-01623
Evidence Hierarchy
Summarizes existing research on a topic.
What do these levels mean? →Frequently Asked Questions
Are synthetic cannabinoids the same as marijuana?
No. While they target the same brain receptors, synthetic cannabinoids are far more potent and unpredictable. They cause severe adverse effects including psychosis, kidney failure, heart problems, and death that are not typically seen with natural cannabis.
Why are synthetic cannabinoids more dangerous?
They bind to cannabinoid receptors with much higher potency, they contain unknown mixtures of active chemicals, and their composition changes constantly as manufacturers modify structures to evade regulations. Users have no way of knowing what or how much they are consuming.
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Cite This Study
https://rethinkthc.com/research/RTHC-01623APA
Cohen, Koby; Weinstein, Aviv M. (2018). Synthetic and Non-synthetic Cannabinoid Drugs and Their Adverse Effects-A Review From Public Health Prospective.. Frontiers in public health, 6, 162. https://doi.org/10.3389/fpubh.2018.00162
MLA
Cohen, Koby, et al. "Synthetic and Non-synthetic Cannabinoid Drugs and Their Adverse Effects-A Review From Public Health Prospective.." Frontiers in public health, 2018. https://doi.org/10.3389/fpubh.2018.00162
RethinkTHC
RethinkTHC Research Database. "Synthetic and Non-synthetic Cannabinoid Drugs and Their Adve..." RTHC-01623. Retrieved from https://rethinkthc.com/research/cohen-2018-synthetic-and-nonsynthetic-cannabinoid
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.