Psychopathological symptoms associated with synthetic cannabinoid use: a comparison with natural cannabis

Vincent T. Mensen,Annabel Vreeker,Rafael de la Torre,Tibor M. Brunt,Johannes G. Ramaekers,Johan Nordgren,Amanda Atkinson,Magi Farré

doi:10.1007/s00213-019-05238-8

Abstract

BackgroundSynthetic cannabinoids (SCs) are a class of new psychoactive substances that have been rapidly evolving around the world throughout recent years. Many different synthetic cannabinoid analogues are on the consumer market and sold under misleading names, like “spice” or “incense.” A limited number of studies have reported serious health effects associated with SC use. In this study, we compared clinical and subclinical psychopathological symptoms associated with SC use and natural cannabis (NC) use.MethodsA convenience sample of 367 NC and SC users was recruited online, including four validated psychometric questionnaires: The Drug Use Disorders Identification Test (DUDIT), Insomnia Severity Index (ISI), Altman Mania Scale (Altman), and Brief Symptom Inventory (BSI). The two groups were compared with analysis of variance (ANOVA) and covariance (ANCOVA), chi2 tests, and logistic regression when appropriate.ResultsThe SC user group did not differ in age from the NC user group (27.7 years), but contained less females (21% and 30%, respectively). SC users scored higher than NC users on all used psychometric measures, indicating a higher likelihood of drug abuse, sleep problems, (hypo)manic symptoms, and the nine dimensions comprising the BSI, somatization, obsessive-compulsive behavior, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. Odds ratios (95% CI) for the SC user group vs NC user group were, respectively, drug dependence 3.56 (1.77–7.16), (severe) insomnia 5.01 (2.10–11.92), (hypo-)mania 5.18 (2.04–13.14), and BSI psychopathology 5.21 (2.96–9.17).DiscussionThis study shows that SC use is associated with increased mental health symptomatology compared to NC use.

Highlights

There has been a dramatic increase in the diversity of new psychoactive substances (NPS) that are being sold as recreational drugs on the consumer market, mostly through the internet (European Monitoring Centre for Drugs and Drug Addiction 2015, 2017)
This study aims to quantify a wide range of psychopathological symptoms in a group of recreational synthetic cannabinoids (SCs) users in a non-clinical setting and compare them to natural cannabis (NC) users
Using logistic regression to examine the clinical outcome measures of the psychometric instruments, we found that participants in the SC user group were between 3.56 and 5.21 times more likely than participants in the NC user group to score in the clinical range of the psychometric instruments (Table 6)

Summary

Introduction

There has been a dramatic increase in the diversity of new psychoactive substances (NPS) that are being sold as recreational drugs on the consumer market, mostly through the internet (European Monitoring Centre for Drugs and Drug Addiction 2015, 2017). Whereas the diffusion of NPS on the consumer market initially started out with stimulants, such as synthetic cathinones (Bossong et al 2005; Brunt et al 2011), these were followed by a wide array of other chemicals belonging to a range of drug classes These include hallucinogens such as nbenzyl-oxy-methyl derivatives (NBOMes) and the 2C-class drugs (Burns et al 2014; Caudevilla-Gálligo et al 2012; Hondebrink et al 2015), entactogens such as benzofurans (Hondebrink et al 2015; Soh and Elliott 2014) and synthetic opioids and the cannabis analogues, synthetic cannabinoids (SCs) (Martinotti et al 2017). The two groups were compared with analysis of variance (ANOVA) and covariance (ANCOVA), chi tests, and logistic regression when appropriate

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