Even a moderate dose of synthetic cannabinoid JWH-018 caused psychotic-like symptoms in healthy people | Research

The takeaway

In a controlled trial of 24 healthy volunteers, a moderate dose of synthetic cannabinoid JWH-018 induced psychedelic effects, dissociation, depersonalization, derealization, amnesia, and confusion.

People who use or are considering synthetic cannabinoids, clinicians treating synthetic cannabinoid reactions, and policymakers.

Pronounced psychotic-like symptoms in people with no mental illness

What the researchers found

JWH-018 (average dose 5.52 mg) caused psychedelic effects (altered internal and external perception), dissociative effects (amnesia, derealization, depersonalization), and confusion in healthy participants with no history of mental illness.

Why it matters

This is one of the few controlled studies of a synthetic cannabinoid in humans, providing direct evidence that even moderate doses produce pronounced psychotomimetic symptoms in otherwise healthy individuals.

The numbers in context

24 participants. Average dose 5.52 mg JWH-018. Pronounced effects on altered perception, dissociation, amnesia, derealization, depersonalization, and confusion within 4.5 hours.

How the study worked

Placebo-controlled, double-blind, within-subjects trial of 24 healthy participants (10 males, 14 females). Inhaled vapor of placebo or 75 mcg/kg JWH-018 with optional booster dose. Assessed subjective high, dissociative states (CADSS), psychedelic symptoms (Bowdle), mood (POMS), and cannabis reinforcement over 4.5 hours.

What this study cannot tell us

Only 24 participants. Single moderate dose tested, which may not reflect the higher doses commonly used recreationally. Healthy volunteers may respond differently than typical synthetic cannabinoid users.

How to read the evidence

Moderate: placebo-controlled, double-blind design, but small sample and single dose level.

When this study was published

Published in 2022.

The bigger picture

Synthetic cannabinoids remain widely available and are often consumed by vulnerable populations. This controlled evidence of psychotomimetic effects at moderate doses underscores the serious mental health risks these substances pose.

Questions still open

How do these effects compare at higher recreational doses? Are individuals with psychiatric vulnerability at greater risk? Do the psychotomimetic effects persist or cause lasting changes with repeated use?

Common questions

What is JWH-018?

JWH-018 is one of the earliest and most widely available synthetic cannabinoids. It activates the same brain receptors as THC but is typically much more potent.

How is this different from marijuana?

Unlike marijuana, which contains dozens of compounds that may moderate effects, JWH-018 is a single potent compound. The psychotomimetic effects (psychosis-like symptoms) were more pronounced than typically seen with natural cannabis.

Could these effects lead to lasting psychosis?

This study examined single-dose effects, which resolved within 4.5 hours. However, the pronounced psychotomimetic response in healthy individuals raises concerns about the risk of triggering lasting psychosis in vulnerable people or with repeated use.

Read the original research

Psychotomimetic symptoms after a moderate dose of a synthetic cannabinoid (JWH-018): implications for psychosis.

Psychopharmacology, 239(5), 1251-1261

View on PubMed ↗Publisher’s paper ↗

Citation

Theunissen, Eef L; Reckweg, Johannes T; Hutten, Nadia R P W; Kuypers, Kim P C; Toennes, Stefan W; Neukamm, Merja A; Halter, Sebastian; Ramaekers, Johannes G. (2022). Psychotomimetic symptoms after a moderate dose of a synthetic cannabinoid (JWH-018): implications for psychosis.. Psychopharmacology, 239(5), 1251-1261. https://doi.org/10.1007/s00213-021-05768-0