58% of Frequent Synthetic Cannabinoid Users Were Classified as Dependent | Research

The takeaway

Among 105 frequent legal high users recruited outside licensed stores in Auckland, 80% used synthetic cannabinoids, 47% used daily or more, and 58% met criteria for dependence, with high rates of insomnia, nausea, agitation, and anxiety.

Read this if you use synthetic cannabinoids or want to understand the health risks of these products.

58% of frequent synthetic cannabinoid users met criteria for dependence.

What the researchers found

Researchers recruited 105 frequent legal high users from outside randomly selected licensed legal high stores in central Auckland during a period when synthetic cannabinoids were sold legally in New Zealand.

Eighty percent used synthetic cannabinoids (SC), and use was intensive: 47% of SC users consumed daily or more. A striking 58% of SC users were classified as dependent. Twenty-seven percent reported a lifetime history of mental illness.

The most commonly reported problems from SC use were insomnia (29%), nausea/vomiting (25%), short temper/agitation (21%), anxiety (21%), strange thoughts (16%), and heart palpitations (14%).

Despite these problems, health service utilization was low: only 9% had seen a doctor about SC use, 3% called an ambulance, and 3% visited an emergency department. Most SC users also used other substances, including alcohol (80%), cannabis (59%), ecstasy (18%), and methamphetamine (15%).

Why it matters

This study captures a population using synthetic cannabinoids during a brief period of legal regulated sale. The 58% dependence rate is alarming and higher than typical cannabis dependence rates, supporting the argument that synthetic cannabinoids have greater addiction potential than natural cannabis.

The numbers in context

105 participants. 80% used SC. 47% used SC daily+. 58% of SC users met dependence criteria. 27% had lifetime mental illness. 59% also used cannabis. Health service use: 9% GP, 3% ambulance, 3% ED, 3% hospitalization.

How the study worked

Cross-sectional survey of frequent legal high users (monthly or more) recruited from outside 8 randomly selected licensed legal high stores in central Auckland, April-May 2014. 105 completed an online survey assessing use patterns, health problems, and healthcare utilization.

What this study cannot tell us

Recruited outside legal high stores, which selects for frequent users and may overestimate dependence rates in the broader user population. Self-selected sample with potential bias. Small sample size. Cross-sectional design. The specific SC products available during this period may differ from products in other markets or time periods.

How to read the evidence

Preliminary evidence from a small convenience sample recruited at point of purchase, limiting generalizability but providing insight into frequent user health outcomes.

When this study was published

Published in 2016. New Zealand has since ended legal sale of untested synthetic cannabinoids.

The bigger picture

New Zealand's experiment with regulated sale of synthetic cannabinoids provided a unique window into what happens when these products are legally available. The high dependence rate, significant health problems, and low health service engagement suggest that legal availability did not make these products safer or lead to better health outcomes for users.

Questions still open

Would the dependence rate be lower with regulated potency limits? Did the legal status of SC products delay help-seeking because users perceived them as safe? How do SC dependence rates compare to natural cannabis in population-based studies?

Common questions

Are synthetic cannabinoids addictive?

This study found that 58% of frequent synthetic cannabinoid users met criteria for dependence. This is substantially higher than the approximately 9% dependence rate seen with natural cannabis, suggesting synthetic cannabinoids have greater addiction potential.

What health problems do synthetic cannabinoids cause?

Common problems reported in this study included insomnia (29%), nausea/vomiting (25%), agitation (21%), anxiety (21%), strange thoughts (16%), and heart palpitations (14%). Despite these problems, very few users sought medical help.

Read the original research

An exploratory study of the health harms and utilisation of health services of frequent legal high users under the interim regulated legal high market in central Auckland.

The New Zealand medical journal, 129(1431), 51-8

View on PubMed ↗

Citation

Wilkins, Chris; Prasad, Jitesh; Wong, K C; Rychert, Marta; Graydon-Guy, Thomas. (2016). An exploratory study of the health harms and utilisation of health services of frequent legal high users under the interim regulated legal high market in central Auckland.. The New Zealand medical journal, 129(1431), 51-8.