In the Journals

Synthetic cannabinoid use can affect psychological outcomes

Image of Hina Akram
Hina Akram

Although large-scale research is limited, findings from a systematic review showed that using synthetic cannabinoids can result in numerous psychological outcomes and users seem to differ from natural cannabis users and non-users on affective, behavioral and cognitive domains.

“Clinicians and drug users have seen serious adverse effects from smoking synthetic cannabis. Research, to better understand the effects of these drugs, is in its early stages with various methodological techniques employed,” Hina Akram, PsyD, DClinPsy, MSc, of the University College London clinical psychopharmacology unit, told Healio Psychiatry.

“Previous reviews focus on case-studies or retrospective research only,” she continued. “A review of what we know based on the existing literature from controlled administration, cross-sectional research, internet surveys and qualitative interviews was lacking.”

In this review, the researchers synthesized the available literature to better examine the psychological consequences of synthetic cannabinoid use. They searched clinical databases for relevant methodologically, controlled administration, cross-sectional, qualitative studies that evaluated the impact of synthetic cannabinoids on psychological outcomes across behavioral, affective and/or cognitive domains.

Overall, 17 studies were included in the review: one controlled administration study, seven cross-sectional studies, five internet surveys and four qualitative studies. Also, four studies examined psychosis and psychosis-related symptomatology, four examined depression, two examined anxiety and two examined cognition.

In all of the studies, paranoia, fear and anxiety were mentioned as effects of synthetic cannabinoid use, according to Mokrysz and colleagues.

One study found that synthetic cannabinoid users had significant impairment in working memory, inhibition and long-term memory compared with natural cannabis users and non-cannabis users. Findings from three studies showed that users experienced more anxiety, paranoia, psychoticism and depressive symptomatology compared with natural cannabis and non-cannabis users.

In another study, synthetic cannabinoid users experiencing psychosis had less severe negative symptoms and more anxiety than those with schizophrenia without co-morbid synthetic cannabinoid use, and another found significantly greater positive symptoms and fewer negative symptoms in psychiatric patients using synthetic cannabinoids than those using natural cannabis.

Results from internet surveys, which offered retrospective, self-report data on the acute effects of synthetic cannabinoid use, revealed that participants most frequently reported panic, anxiety, paranoia and breathlessness.

“The review highlighted the unpredictable profile of effects that can result when acutely intoxicated, as well as the potential long-term effects of use,” Akram said.

The researchers also observed methodological limitations across different study designs and there was limited evidence on how doses, frequency or type of synthetic cannabinoids affect psychological outcomes.

“The current available research techniques, such as accurate testing from blood/urine, restrict the utility of findings,” Akram told Healio Psychiatry. “Given the potency of these drugs in comparison to natural cannabis it is vital for users and clinicians to be better informed of the possible effects in order to reduce adverse outcomes.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.

Image of Hina Akram
Hina Akram

Although large-scale research is limited, findings from a systematic review showed that using synthetic cannabinoids can result in numerous psychological outcomes and users seem to differ from natural cannabis users and non-users on affective, behavioral and cognitive domains.

“Clinicians and drug users have seen serious adverse effects from smoking synthetic cannabis. Research, to better understand the effects of these drugs, is in its early stages with various methodological techniques employed,” Hina Akram, PsyD, DClinPsy, MSc, of the University College London clinical psychopharmacology unit, told Healio Psychiatry.

“Previous reviews focus on case-studies or retrospective research only,” she continued. “A review of what we know based on the existing literature from controlled administration, cross-sectional research, internet surveys and qualitative interviews was lacking.”

In this review, the researchers synthesized the available literature to better examine the psychological consequences of synthetic cannabinoid use. They searched clinical databases for relevant methodologically, controlled administration, cross-sectional, qualitative studies that evaluated the impact of synthetic cannabinoids on psychological outcomes across behavioral, affective and/or cognitive domains.

Overall, 17 studies were included in the review: one controlled administration study, seven cross-sectional studies, five internet surveys and four qualitative studies. Also, four studies examined psychosis and psychosis-related symptomatology, four examined depression, two examined anxiety and two examined cognition.

In all of the studies, paranoia, fear and anxiety were mentioned as effects of synthetic cannabinoid use, according to Mokrysz and colleagues.

One study found that synthetic cannabinoid users had significant impairment in working memory, inhibition and long-term memory compared with natural cannabis users and non-cannabis users. Findings from three studies showed that users experienced more anxiety, paranoia, psychoticism and depressive symptomatology compared with natural cannabis and non-cannabis users.

In another study, synthetic cannabinoid users experiencing psychosis had less severe negative symptoms and more anxiety than those with schizophrenia without co-morbid synthetic cannabinoid use, and another found significantly greater positive symptoms and fewer negative symptoms in psychiatric patients using synthetic cannabinoids than those using natural cannabis.

Results from internet surveys, which offered retrospective, self-report data on the acute effects of synthetic cannabinoid use, revealed that participants most frequently reported panic, anxiety, paranoia and breathlessness.

“The review highlighted the unpredictable profile of effects that can result when acutely intoxicated, as well as the potential long-term effects of use,” Akram said.

The researchers also observed methodological limitations across different study designs and there was limited evidence on how doses, frequency or type of synthetic cannabinoids affect psychological outcomes.

“The current available research techniques, such as accurate testing from blood/urine, restrict the utility of findings,” Akram told Healio Psychiatry. “Given the potency of these drugs in comparison to natural cannabis it is vital for users and clinicians to be better informed of the possible effects in order to reduce adverse outcomes.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.