Synthetic Cannabinoid Use Linked to 48% Higher Concussion Risk in Teen Athletes

Adolescents who used synthetic cannabinoids like Spice or K2 had 48% higher odds of sports-related concussion compared to non-users, independent of alcohol and marijuana use — suggesting these products impair athletic safety.

Kalra, Saurabh et al.·The Journal of school health·2026·Moderate EvidenceCross-Sectional
RTHC-08372Cross SectionalModerate Evidence2026RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=27,482

What This Study Found

Synthetic cannabinoid use was associated with 48% higher odds of sports-related TBI (AOR=1.48, 95% CI=1.30-1.70), with TBI prevalence of 22.9% among SC users vs. 12.4% among non-users. Natural marijuana use was also a significant but weaker predictor (AOR=1.16).

Key Numbers

N=27,482; 6.0% SC use; 13% sports TBI; SC users: 22.9% TBI vs 12.4% non-users; SC AOR=1.48; marijuana AOR=1.16; alcohol AOR=1.75; boys AOR=1.38

How They Did This

Analysis of 2017-2021 Youth Risk Behavior Survey data (n=27,482 nationally representative adolescents), using weighted multivariable logistic regression examining lifetime synthetic cannabinoid use and self-reported past-year sports-related concussion.

Why This Research Matters

Synthetic cannabinoids are cheap, evade standard drug tests, and may impair coordination and reaction time more severely than natural cannabis — creating a hidden safety risk in youth sports.

The Bigger Picture

As synthetic cannabinoids evade standard sports physicals and drug tests, incorporating specific SC screening questions could help identify athletes at higher concussion risk.

What This Study Doesn't Tell Us

Cross-sectional design; self-reported outcomes; cannot determine temporal relationship; lifetime SC use may not reflect use during sports; concussion self-report may be inaccurate; potential confounding from risk-taking behavior generally.

Questions This Raises

  • ?Do synthetic cannabinoids impair athletic performance more than natural cannabis?
  • ?Would SC-specific drug testing at sports physicals reduce injuries?
  • ?Are there cumulative effects of SC use and repeated concussions?

Trust & Context

Key Stat:
Evidence Grade:
Large nationally representative sample with appropriate adjustment, but cross-sectional design and self-reported measures limit causal inference.
Study Age:
Published 2026; uses 2017-2021 YRBS data.
Original Title:
Synthetic Cannabinoid Use and Sports-Related Concussion Risk Among US Adolescents: Implications for School Health Screening and Prevention.
Published In:
The Journal of school health, 96(2), e70112 (2026)
Database ID:
RTHC-08372

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Do synthetic cannabinoids increase concussion risk?

This national study found that teens who used synthetic cannabinoids (Spice, K2) had 48% higher odds of sports-related concussion, even after accounting for alcohol and marijuana use — suggesting these products pose unique athletic safety risks.

Should sports physicals screen for synthetic cannabinoid use?

This study supports it — since 6% of teens reported SC use and these users had nearly double the concussion rate, asking about SC use during pre-sport evaluations could help identify at-risk athletes.

Read More on RethinkTHC

Cite This Study

RTHC-08372·https://rethinkthc.com/research/RTHC-08372

APA

Kalra, Saurabh; Nagaraja, Nandakumar; Kalra, Deepak. (2026). Synthetic Cannabinoid Use and Sports-Related Concussion Risk Among US Adolescents: Implications for School Health Screening and Prevention.. The Journal of school health, 96(2), e70112. https://doi.org/10.1111/josh.70112

MLA

Kalra, Saurabh, et al. "Synthetic Cannabinoid Use and Sports-Related Concussion Risk Among US Adolescents: Implications for School Health Screening and Prevention.." The Journal of school health, 2026. https://doi.org/10.1111/josh.70112

RethinkTHC

RethinkTHC Research Database. "Synthetic Cannabinoid Use and Sports-Related Concussion Risk..." RTHC-08372. Retrieved from https://rethinkthc.com/research/kalra-2026-synthetic-cannabinoid-use-and

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.