Synthetic Cannabinoid Use Made Opioid Withdrawal Last Significantly Longer

Opioid-dependent patients who also used synthetic cannabinoids had significantly longer withdrawal and craving symptoms during detoxification, with higher doses and longer use histories predicting worse outcomes.

Prilutskaya, Mariya et al.·Human psychopharmacology·2017·Moderate EvidenceProspective Cohort
RTHC-01491Prospective CohortModerate Evidence2017RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Prospective Cohort
Evidence
Moderate Evidence
Sample
N=193

What This Study Found

Among 193 patients with opioid use disorder undergoing detoxification in Kazakhstan, the 47 who also regularly used synthetic cannabinoids (SCs) experienced significantly longer withdrawal and craving symptoms compared to those who did not use SCs (p < 0.001).

The study identified a dose-response relationship: higher SC intake in the past 30 days (p = 0.045), more recent SC use (p = 0.033), longer total duration of SC use (p < 0.001), and higher SC doses (p < 0.001) were all independently associated with longer symptom duration.

This was the first prospective study to examine how synthetic cannabinoid use affects the course of opioid withdrawal, revealing that polysubstance use involving SCs creates a more difficult detoxification process.

Key Numbers

193 total patients. 47 (24.4%) used synthetic cannabinoids. SC users had significantly longer withdrawal (p < 0.001) and craving (p < 0.001). Dose-response relationships confirmed for SC intake (p = 0.045), recency (p = 0.033), duration (p < 0.001), and dosage (p < 0.001).

How They Did This

Prospective case-control study at addiction clinics in Kazakhstan. 193 patients with opioid use disorder underwent integrated detoxification. 47 were regular SC users. Opioid withdrawal was measured using the Clinical Opiate Withdrawal Scale and craving was assessed with a visual analogue scale at multiple time points.

Why This Research Matters

Synthetic cannabinoids are increasingly used alongside opioids in many parts of the world. Understanding that SC use complicates opioid detoxification has practical implications for treatment planning: patients with concurrent SC use may need longer treatment stays and different management protocols.

The Bigger Picture

This study provides clinical evidence for the molecular cross-talk between cannabinoid and opioid systems that has been demonstrated in basic science research. The endocannabinoid and endogenous opioid systems share neuroanatomical overlap and functional interactions, and disrupting both simultaneously through polysubstance use appears to make recovery from either substance more difficult.

What This Study Doesn't Tell Us

Conducted at addiction clinics in Kazakhstan, which may limit generalizability to other populations and treatment settings. The synthetic cannabinoids used were not chemically identified, and SC products vary widely in composition and potency. The study did not account for other substances of use beyond SCs and opioids.

Questions This Raises

  • ?Do natural cannabis and synthetic cannabinoids have different effects on opioid withdrawal?
  • ?Should detoxification protocols be modified for patients with concurrent SC use?
  • ?Would cannabinoid receptor modulation during opioid detox improve or worsen outcomes?

Trust & Context

Key Stat:
Synthetic cannabinoid users had significantly longer opioid withdrawal symptoms (p < 0.001)
Evidence Grade:
Moderate evidence from a prospective study with appropriate controls and dose-response analysis.
Study Age:
Published in 2017. First prospective study on SC-opioid withdrawal interaction.
Original Title:
Impact of synthetic cannabinoids on the duration of opioid-related withdrawal and craving among patients of addiction clinics in Kazakhstan: A prospective case-control study.
Published In:
Human psychopharmacology, 32(3) (2017)
Database ID:
RTHC-01491

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Enrolls participants and follows them forward in time.

What do these levels mean? →

Frequently Asked Questions

Do synthetic cannabinoids make opioid withdrawal worse?

This study found that regular synthetic cannabinoid use was associated with significantly longer opioid withdrawal and craving symptoms during detoxification. Higher doses and longer histories of SC use predicted worse outcomes.

Would natural marijuana have the same effect on opioid withdrawal?

This study only examined synthetic cannabinoids, which are typically much more potent at cannabinoid receptors than natural cannabis. Whether natural marijuana would have the same effect on opioid withdrawal duration is unknown and was not studied here.

Read More on RethinkTHC

Cite This Study

RTHC-01491·https://rethinkthc.com/research/RTHC-01491

APA

Prilutskaya, Mariya; Bersani, Francesco Saverio; Corazza, Ornella; Molchanov, Sergey. (2017). Impact of synthetic cannabinoids on the duration of opioid-related withdrawal and craving among patients of addiction clinics in Kazakhstan: A prospective case-control study.. Human psychopharmacology, 32(3). https://doi.org/10.1002/hup.2618

MLA

Prilutskaya, Mariya, et al. "Impact of synthetic cannabinoids on the duration of opioid-related withdrawal and craving among patients of addiction clinics in Kazakhstan: A prospective case-control study.." Human psychopharmacology, 2017. https://doi.org/10.1002/hup.2618

RethinkTHC

RethinkTHC Research Database. "Impact of synthetic cannabinoids on the duration of opioid-r..." RTHC-01491. Retrieved from https://rethinkthc.com/research/prilutskaya-2017-impact-of-synthetic-cannabinoids

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.