Synthetic cannabinoid JWH-018 impairs cognition and triggers dissociation in some users | Research

The takeaway

The synthetic cannabinoid JWH-018 impaired tracking ability and memory in all participants, but those who experienced a subjective high also showed slower reaction times, confusion, amnesia, and dissociative symptoms.

Anyone considering synthetic cannabinoids, emergency physicians, and drug policy researchers.

Dissociation and amnesia in responders

What the researchers found

JWH-018 increased heart rate and impaired critical tracking and memory performance overall. Participants who experienced a subjective high ("responders") had significantly higher serum JWH-018 concentrations and showed additional impairments in reaction time plus increased confusion, amnesia, dissociation, derealization, and depersonalization. Lack of control over drug delivery may have contributed to the large variability in response.

Why it matters

Synthetic cannabinoids are often marketed as legal alternatives to cannabis but may carry distinct risks. This controlled study documents specific cognitive and psychological effects under laboratory conditions.

The numbers in context

17 participants. Doses: 2-6.2 mg JWH-018. 12-hour monitoring. Responders had significantly higher serum concentrations. Impairments in critical tracking and memory across all participants.

How the study worked

Placebo-controlled, crossover study with 17 healthy cannabis-experienced participants. Participants inhaled vaporized JWH-018 (2-6.2 mg) and were monitored for 12 hours with vital signs, cognitive tests, and subjective experience measures.

What this study cannot tell us

Small sample size (17). Variability in drug delivery by vaporization. All participants had prior cannabis experience, so results may not generalize to naive users.

How to read the evidence

Controlled crossover design with objective measures, but small sample and variable drug delivery.

When this study was published

2019 study.

The bigger picture

The dissociative symptoms (derealization, depersonalization) reported by responders are not typical of natural cannabis and may help explain emergency department presentations from synthetic cannabinoid use.

Questions still open

How do JWH-018 effects compare to natural cannabis at equivalent receptor activation? What accounts for the large individual variability in response?

Common questions

Are synthetic cannabinoids more dangerous than natural cannabis?

This study found JWH-018 produced dissociation, derealization, and depersonalization in some users, effects not typically associated with natural cannabis, suggesting distinct risk profiles.

Does JWH-018 impair driving ability?

JWH-018 impaired critical tracking, memory, and reaction time, all of which are relevant to driving. The effects were most pronounced in those who achieved higher blood concentrations.

Read the original research

Neurocognition and Subjective Experience Following Acute Doses of the Synthetic Cannabinoid JWH-018: Responders Versus Nonresponders.

Cannabis and cannabinoid research, 4(1), 51-61

View on PubMed ↗Publisher’s paper ↗

Citation

Theunissen, Eef L; Hutten, Nadia R P W; Mason, Natasha L; Toennes, Stefan W; Kuypers, Kim P C; Ramaekers, Johannes G. (2019). Neurocognition and Subjective Experience Following Acute Doses of the Synthetic Cannabinoid JWH-018: Responders Versus Nonresponders.. Cannabis and cannabinoid research, 4(1), 51-61. https://doi.org/10.1089/can.2018.0047