Synthetic cannabinoids got their name because they act on the same brain cell receptors as tetrahydrocannabinol, which is the main active ingredient in cannabis. A number of these chemicals were first developed by scientists for their medical properties to investigate whether synthetic cannabinoids could be used in treating certain diseases, such as pain disorders and cancer. However, they first appeared as recreational drugs in Europe in 2006.
Synthetic cannabinoids are classified as new psychoactive substances. In 2018, Malta added the term ‘new psychoactive substances’ with the definition of illicit drugs.
Manufacturers of synthetic cannabinoids are very adaptable as they alter the substances they use when one chemical is about to be legally controlled. The flexibility of this market makes detecting, monitoring and responding to synthetic cannabinoids particularly challenging.
Synthetic cannabinoid products are marked ‘not for human consumption’ and are presented in attractive and colourful packaging. They are particularly dangerous since brand names are not reliable indicators of the contents. From tests carried out in laboratories, scientists concluded that cannabinoid constituents and dosage can vary greatly between products and between batches of the same brand.
The 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD), which targets 15- to 16-year-old students, included questions on these substances in the 2015 and 2019 studies.
At this point in time, no treatments have been developed specifically for synthetic cannabinoids
The Foundation for Social Welfare Services researchers Sharon Arpa and Petra Borg (2020) found that, among students, four per cent reported using synthetic cannabinoids.
One of the dangers of consuming these substances is that, often, users assume that the doses are similar to that of natural cannabis. Studies have shown that while natural cannabis has harmful effects, synthetic cannabinoids produce a quicker onset of effects, having significantly shorter duration of action, worse hangover effects and more intense visual hallucinations, paranoid feelings and behavioural disturbances.
Synthetic cannabinoids have longer half-lives and high potency, meaning that smaller doses may produce the same effects as larger quantities of natural cannabis. Studies with individuals using synthetic cannabinoids have reported its unpredictable effects and big differences could be observed at each drug consumption episode.
Several studies focused on the adverse effects reported following the use of synthetic cannabinoids. Some of the most common effects include seizures, fast heart rate and breathing problems. Some other effects include drowsiness, memory loss or changes, neuromuscular effects, loss of consciousness, dizziness and headaches. Other synthetic cannabinoid users exhibited cognitive deficits, kidney failure, hyperthermia, lethargy and paralysis.
A number of studies found that repeated or even single use of synthetic cannabinoids has been associated with acute psychosis, aggravations of previously stable psychotic disorders and new onset psychosis in individuals who have not had any psychiatric issues in the past. It is concerning to note that psychotic episodes associated with synthetic cannabinoids occur more frequently, are more severe and are linked to greater agitation than episodes associated with natural cannabis.
Fatalities related to the use of synthetic cannabinoids have also been reported. As with any other substance, long-term and frequent use of synthetic cannabinoids may lead to dependence. A qualitative study with six participants indicated that dependence on synthetic cannabinoids developed after only a few consumption episodes. Several withdrawal symptoms were reported such as chest pains and chest pressure, fast heart rates, palpitations, anxiety, agitation, paranoia and suicidal ideation. Participants reported that they continued using synthetic cannabinoids to avoid the intensity of these symptoms. They also felt that they needed a residential facility to help them in their detoxification process.
At this point in time, no treatments have been developed specifically for synthetic cannabinoids. The Novel Psychoactive Treatment UK Network advises clinicians to adopt evidence-based approaches used for other drugs, particularly natural cannabis. A combination of interventions based on the needs of the individuals must be considered in order to provide the best care possible. If you or someone you know are using any substances, you may contact Aġenzija Sedqa on 2388 5110 or helpline 179 after office hours for support.
Stephanie Dimech, Research executive within the research team at the Foundation for Social Welfare Services