Synthetic cannabis, known commercially as Kronic, K2, Kaos or Spice, was designed to circumvent drug laws and give users a “legal high”. But Western Australia banned the product earlier this month and South Australia, Victoria and Tasmania are poised to take similar steps.
What is synthetic cannabis?
While pharmaceutical cannabis has been used to treat conditions including nausea and pain with varying effectiveness, synthetic cannabis has been marketed under its commercial names predominantly for its euphoric effects.
Researchers looking at the composition of synthetic cannabis have found laboratory-synthesised chemical copies of the active ingredients of marijuana: delta-9-tetrahydrocannibinol or THC.
These lab-made chemicals, which have fairly lacklustre names like JWH-018 or CP-47,497-C8, act on the same brain receptors as those found in “conventional” plant cannabis.
Synthetic cannabis is smoked so it produces a quick and intense psychoactive drug effect.
What are the effects?
The precise composition and doses in synthetic cannabis aren’t known, so its effects aren’t completely clear.
Most studies have focussed on the ill effects of synthetic cannabis and have reported exacerbation of psychosis, anxiety and agitation. These reports are consistent with the adverse effects of plant cannabis.
But very few cases of synthetic cannabis use have been studied – we definitely need to understand it more.
Is it addictive?
Addiction is characterised by some loss of control over behaviour, with associated dysfunction. Often, neurobiological changes increase the need for larger doses of the drug (tolerance) and a withdrawal phenomenon when the drug is discontinued.
We’ve recognised these tolerance and withdrawal symptoms with plant cannabis, but in many ways they differ from opioid or alcohol dependence. In cannabis withdrawal we don’t see the pronounced physiological effects of alcohol, benzodiazepine or opioid withdrawal.
For a drug to be addictive it usually needs to produce a neurochemical reward, which certainly appears to be the case with synthetic cannabis.
How severe is the problem?
Most indicators suggest the use of synthetic cannabis is dwarfed by the use of plant cannabis, which is the most popular illicit drug in Australia (but is of course far less widely used than alcohol and tobacco).
Anecdotally, my colleagues and I who work in specialist addiction medicine clinics rarely, if ever, see patients presenting for treatment for synthetic cannabis abuse.
In fact, I’ve only seen two patients in the last year report using synthetic cannabis and that was to try to manage their dependence on plant cannabis.
Recent concern about the use of synthetic cannabis is based on the fact that metabolites (agents of the drug) may not be detected by conventional drug screening, used on mine sites, among other workplaces. This is a limitation of drug testing that applies to other synthetic agents, as well as to many prescribed drugs that can cause workplace impairment.
Where to now?
The chemicals used in synthetic cannabis are designed to stay a step ahead of drug laws.
So we need to develop comprehensive policies that take into account the ingenuity of drug users and producers, and the prevalence of substance abuse problems other than those caused by standard illicit drugs.
The effectiveness of the internet as a growing synthetic drug marketplace is reason for concern but these changes are also a chance to examine the traditional societal responses to drug use.
We’re still learning about the effects of plain old pot, despite many decades of popularity of this drug. So synthetic agents pose new challenges for clinicians, public health experts, policy makers and law enforcement agencies.
But before we can tackle the problem, we need some solid research. This needs to be very carefully structured to investigate the effects of unregulated, clandestinely used, quasi-legal substances in the open market.