Synthetic Cannabinoid Users Had More Severe and Persistent Psychotic Symptoms Than THC Users or Non-Users

What the researchers found

SPICE users had more severe and persistent positive symptoms than THC users and non-users. Non-users showed better recovery in global functioning compared to SPICE users. All groups showed decreasing aberrant salience scores over time, but SPICE users maintained higher global scores and improved less. Negative symptoms were most prominent in non-users.

Why it matters

Synthetic cannabinoids are far more potent at CB1 receptors than THC, and this study provides clinical evidence that psychosis associated with synthetic cannabinoid use is more severe and harder to recover from than THC-associated or non-substance psychosis.

The numbers in context

N=62 first-episode psychosis patients (20 non-users, 21 THC users, 20 SPICE users). Assessed at 3 timepoints using 5 validated scales. SPICE users showed persistently higher positive symptoms and aberrant salience.

How the study worked

Comparative study of 62 patients with first-episode psychosis divided into non-users (N=20), THC users (N=21), and SPICE users (N=20). Assessed at onset, 3 months, and 6 months using PANSS, GAF, DES-II, SSI, and ASI scales.

What this study cannot tell us

Small sample size (62 total, ~20 per group). Non-randomized group assignment. Cannot control for all confounders between groups. Self-reported substance use. 6-month follow-up may not capture long-term trajectory.

How to read the evidence

Small comparative study with repeated measures at 3 timepoints using validated scales, but limited by sample size and non-randomized design.

When this study was published

Published in 2023.

The bigger picture

The aberrant salience findings are particularly interesting. Aberrant salience, the tendency to assign excessive meaning to neutral stimuli, may be a mechanism through which synthetic cannabinoids drive and maintain psychosis more powerfully than THC.

Questions still open

• Does the higher aberrant salience in SPICE users persist beyond 6 months?
• Would targeted interventions for aberrant salience improve outcomes in synthetic cannabinoid psychosis?

Common questions

Read the original research

Aberrant salience in cannabis-induced psychosis: a comparative study.

Frontiers in psychiatry, 14, 1343884

Citation

Ricci, Valerio; Di Muzio, Ilenia; Ceci, Franca; Di Carlo, Francesco; Mancusi, Gianluca; Piro, Tommaso; Paggi, Andrea; Pettorruso, Mauro; Vellante, Federica; De Berardis, Domenico; Martinotti, Giovanni; Maina, Giuseppe. (2023). Aberrant salience in cannabis-induced psychosis: a comparative study.. Frontiers in psychiatry, 14, 1343884. https://doi.org/10.3389/fpsyt.2023.1343884

Explore the wider topic

• How THC Affects Your Amygdala: The Brain's Threat Detector and Cannabis
• The Anandamide Connection: Your Body's Natural Bliss Molecule
• How Long for Cannabinoid Receptors to Return to Normal
• Cannabis and the Developing Brain: What Every Teenager (and Parent) Should Know
• Why Can't I Enjoy Anything Without Weed? The Science Behind It
• Dopamine Recovery After Quitting Weed: What the Science Says
• The Endocannabinoid System Explained Simply: What It Does and Why It Matters
• Your Endocannabinoid System Explained: Why Withdrawal Happens
• Your Nervous System After Quitting Weed: Fight or Flight
• Using Weed Under 18: What It Does to Your Developing Brain
• What THC Does to Your Brain: Why Withdrawal Happens
• THC and Your Prefrontal Cortex: What Cannabis Does to Your Decision-Making Brain
• Weed, Cortisol, and Stress: What Cannabis Does to Your Stress Hormones
• Weed and Memory: What the Science Says About THC and Your Hippocampus
• Weed and Motivation: Is Amotivational Syndrome Real?
• Weed and Your Nervous System: What THC Actually Does to Your Brain and Body
• How Weed Rewires Your Reward System (And How to Reset It)