Synthetic Cannabinoid Withdrawal Became a Major Demand on New Zealand Detox Services | Research

The takeaway

In one year, 47 people sought detoxification help for synthetic cannabinoid withdrawal in Auckland, with many requiring inpatient admission and medication, making it the third largest group admitted to detox services.

Read this if you use synthetic cannabinoids and are concerned about dependence or withdrawal.

Third largest group admitted to detox services in Auckland

What the researchers found

Researchers reviewed records from Auckland detoxification services over 12 months and found 47 people presenting for help with synthetic cannabinoid withdrawal. Twenty required inpatient admission for medical management.

The most common withdrawal symptoms were agitation, irritability, anxiety, and mood swings. Symptoms were managed with diazepam and quetiapine. Notably, most patients did not have significant co-occurring substance dependence beyond nicotine.

Synthetic cannabinoid withdrawal patients became the third largest group admitted to inpatient detox, behind only alcohol and methamphetamine, representing a new and substantial demand on treatment services.

Why it matters

This study documented an emerging clinical reality: synthetic cannabinoids can produce significant physical dependence and withdrawal that requires medical intervention, challenging assumptions that cannabinoid products do not cause serious withdrawal syndromes.

The numbers in context

47 presentations in 12 months; 20 admitted as inpatients; third largest group in detox services; most common symptoms: agitation, irritability, anxiety, mood swings; treated with diazepam and quetiapine

How the study worked

Retrospective audit of electronic and paper records from Auckland detoxification services between May 2013 and May 2014. Collected demographics, substance use patterns, withdrawal symptoms, and treatment data.

What this study cannot tell us

Single-center retrospective audit. No standardized withdrawal assessment tools used. Cannot determine the true prevalence of synthetic cannabinoid dependence in the community. New Zealand's synthetic cannabinoid market may differ from other countries.

How to read the evidence

Retrospective audit from a single center, documenting a clinical trend rather than testing a hypothesis. Provides important descriptive data but limited generalizability.

When this study was published

Published in 2015. Synthetic cannabinoid markets have continued to evolve with new compounds and varying legal status.

The bigger picture

Synthetic cannabinoids are pharmacologically distinct from natural cannabis, often acting as full agonists at CB1 receptors rather than partial agonists. This explains why their withdrawal can be more severe than natural cannabis withdrawal and why they created unexpected demand on treatment services.

Questions still open

How does synthetic cannabinoid withdrawal compare to natural cannabis withdrawal in severity? What is the optimal pharmacological treatment protocol? Are some synthetic cannabinoid products more likely to produce dependence than others?

Common questions

Are synthetic cannabinoids more addictive than natural cannabis?

This study suggests they may produce more severe physical dependence. Synthetic cannabinoids often act as full agonists at CB1 receptors (compared to THC, which is a partial agonist), potentially leading to greater tolerance and more intense withdrawal.

What does synthetic cannabinoid withdrawal feel like?

The most common symptoms reported were agitation, irritability, anxiety, and mood swings. Some patients required inpatient admission and medication (benzodiazepines and antipsychotics) to manage symptoms.

Read the original research

Synthetic cannabinoid withdrawal: a new demand on detoxification services.

Drug and alcohol review, 34(2), 147-53

View on PubMed ↗Publisher’s paper ↗

Citation

Macfarlane, Vicki; Christie, Grant. (2015). Synthetic cannabinoid withdrawal: a new demand on detoxification services.. Drug and alcohol review, 34(2), 147-53. https://doi.org/10.1111/dar.12225