Cannabis use was the strongest predictor of synthetic cannabinoid use among high-risk drug patients in treatment

Among 342 drug-dependent patients in Israel, 16.1% reported recent synthetic cannabinoid use, with cannabis use being the strongest predictor (adjusted OR 9.86), while 24.9% used prescription opioids or fentanyl patches.

Shapira, Barak et al.·Journal of psychoactive drugs·2020·Moderate EvidenceCross-Sectional
RTHC-02839Cross SectionalModerate Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=342

What This Study Found

Of 342 patients in drug dependence treatment, 16.1% reported past-12-month synthetic cannabinoid receptor agonist (SCRA) use and 24.9% reported recent prescription opioid or fentanyl patch use. SCRA use was strongly associated with cannabis use (AOR 9.86) and synthetic cathinone use (AOR 5.47). Prescription opioid/fentanyl use was associated with gabapentinoids (AOR 14.33), stimulants (AOR 7.12), heroin (AOR 5.81), and benzodiazepines (AOR 4.63).

Key Numbers

342 patients; 16.1% recent SCRA use; 24.9% prescription opioid/fentanyl use; SCRA→cannabis AOR 9.86; SCRA→cathinones AOR 5.47; opioid→gabapentinoids AOR 14.33.

How They Did This

Cross-sectional study of 342 patients in drug dependence treatment in Israel, using questionnaires on recent drug use with adjusted odds ratios from logistic regression.

Why This Research Matters

The near 10-fold association between cannabis and SCRA use confirms that cannabis users are the primary population at risk for synthetic cannabinoid exposure. Clinicians treating cannabis users should screen for SCRA use, which carries far greater toxicity risks.

The Bigger Picture

The polysubstance patterns are clinically important: SCRA users cluster with cannabis and stimulant users, while prescription opioid users cluster with benzodiazepine and gabapentinoid users. These distinct drug use clusters may need different treatment approaches.

What This Study Doesn't Tell Us

Treatment-seeking population in Israel; self-report of drug use; cross-sectional (cannot determine directionality); 342 patients is moderate sample; Israeli drug market may differ from other countries.

Questions This Raises

  • ?Would cannabis legalization reduce SCRA use by eliminating the "legal alternative" motivation?
  • ?Should gabapentinoid prescribing be more closely monitored in opioid-using populations?

Trust & Context

Key Stat:
Cannabis use: AOR 9.86 for synthetic cannabinoid use; gabapentinoids: AOR 14.33 for opioid use
Evidence Grade:
Moderate: clinical treatment population with adjusted regression, but cross-sectional and self-report.
Study Age:
Published 2020.
Original Title:
Recent Use of Synthetic Cannabinoids, Synthetic Opioids, and Other Psychoactive Drug Groups among High-risk Drug Users.
Published In:
Journal of psychoactive drugs, 52(4), 334-343 (2020)
Database ID:
RTHC-02839

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

Who uses synthetic cannabinoids?

Cannabis users are the primary risk group. In this study, cannabis use was associated with nearly 10-fold higher odds of synthetic cannabinoid use. Synthetic cathinone use was also a strong predictor.

What prescription drugs are associated with opioid misuse?

Gabapentinoids showed the strongest association (AOR 14.33 for prescription opioid/fentanyl use), followed by stimulants, heroin, benzodiazepines, and synthetic cathinones.

Read More on RethinkTHC

Cite This Study

RTHC-02839·https://rethinkthc.com/research/RTHC-02839

APA

Shapira, Barak; Berkovitz, Ronny; Rosca, Paola; Neumark, Yehuda. (2020). Recent Use of Synthetic Cannabinoids, Synthetic Opioids, and Other Psychoactive Drug Groups among High-risk Drug Users.. Journal of psychoactive drugs, 52(4), 334-343. https://doi.org/10.1080/02791072.2020.1754534

MLA

Shapira, Barak, et al. "Recent Use of Synthetic Cannabinoids, Synthetic Opioids, and Other Psychoactive Drug Groups among High-risk Drug Users.." Journal of psychoactive drugs, 2020. https://doi.org/10.1080/02791072.2020.1754534

RethinkTHC

RethinkTHC Research Database. "Recent Use of Synthetic Cannabinoids, Synthetic Opioids, and..." RTHC-02839. Retrieved from https://rethinkthc.com/research/shapira-2020-recent-use-of-synthetic

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.