Clinical withdrawal symptom profile of synthetic cannabinoid receptor agonists and comparison of effects with high potency cannabis.
Sam Craft, Jason Ferris, Monica J Barratt, Larissa J. Maier, Michael T. Lynskey, Adam Winstock, Tom P. Freeman
Psychopharmacology May 1, 2022 DOI: 10.1007/s00213-021-05945-1 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional survey Peer reviewed |
|---|---|
| Sample size | 284 |
| Population | People reporting use of SCRAs >10 times in the past 12 months, a previous SCRA quit attempt, and lifetime use of high-potency herbal cannabis |
| Topics | Cannabis |
| Keywords | Abuse liability Effect profile Scra Spice Synthetic cannabinoids Withdrawal |
| Citations | 19 |
| Key findings | SCRA withdrawal symptoms are more likely after greater SCRA exposure, and SCRAs produce a more severe withdrawal syndrome and greater risk of problematic use than high-potency herbal cannabis. |
Abstract
Synthetic cannabinoid receptor agonists (SCRAs) may be used as an alternative to natural cannabis; however, they may carry a greater risk of problematic use and withdrawal. This study aimed to characterise the withdrawal symptom profile of SCRAs and compare their profile of effect with high-potency herbal cannabis. Global Drug Survey data (2015 and 2016) were used to access a clinically relevant sample of people reporting use of SCRAs >10 times in the past 12-months, a previous SCRA quit attempt, and lifetime use of high-potency herbal cannabis. Participants completed an 11-item SCRA withdrawal symptom checklist and compared SCRAs and high-potency herbal cannabis on their onset and duration of effects, speed of the development of tolerance, severity of withdrawal, and difficulty with dose titration. Participants (n = 284) reported experiencing a mean of 4.4 (95% CI: 4.1, 4.8) withdrawal symptoms after not using SCRAs for >1 day; most frequently reported were sleep issues (59.2%), irritability (55.6%), and low mood (54.2%). Withdrawal symptoms were significantly associated with frequency (>51 vs. 11-50 times per year: IRR = 1.43, 95% CI: 1.16, 1.77, p = 0.005) and quantity (grams per session: IRR = 1.13, 95% CI: 1.05, 1.22, p = 0.001) of SCRA use. Compared to high-potency herbal cannabis, SCRAs were rated as having a faster onset and shorter duration of effects, faster development of tolerance, and more severe withdrawal (p's < 0.001). In conclusion, SCRA withdrawal symptoms are more likely to occur after greater SCRA exposure. The effects of SCRA indicate a more severe withdrawal syndrome and a greater risk of problematic use than natural cannabis.