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A survey study to characterize use of Spice products (synthetic cannabinoids)

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Abstract

Background

Synthetic cannabinoids are a rapidly emerging class of abused drugs. Synthetic cannabinoids are typically sold as “herbal blends” or “incense,” commonly referred to as Spice products. No controlled human experiments have been conducted on the effects of Spice products or the synthetic cannabinoids they often contain.

Methods

An internet-based survey study was conducted with adults reporting at least one lifetime use of a Spice product.

Results

Respondents were primarily male, Caucasian and ≥12 years of education. Use of other psychoactive drugs was common, though 21% identified Spice products as their preferred drug. Spice products were most frequently obtained from retail vendors and smoked, though other forms of ingestion were endorsed. Mean age of first use was 26 and mean frequency of use in the past year was 67 days (range 0–365). Primary reasons for use were curiosity, positive drug effect, relaxation, and to get high without having a positive drug test. Acute subjective effects were similar to known effects of cannabis, and a subset of users met DSM criteria for abuse and dependence on Spice products.

Conclusions

Participants exhibited a diverse profile of use patterns as is typical for other drugs of abuse. There was evidence that users continued to seek and use these drugs after being banned by local authorities. This study should be interpreted with caution due to methodological limitations. Controlled laboratory research is needed to further examine the behavioral pharmacology of individual synthetic cannabinoids found in Spice products.

Introduction

Synthetic cannabinoids represent a rapidly emerging class of drugs. Sold as “herbal blends” or “incense,” Spice products (named for one of the more popular brands) are readily available in retail stores and over the internet. In order to circumvent drug laws and regulation, Spice products contain package labels indicating they are to be used as “incense” and are “not for human consumption.” However, they are frequently marketed as legal/natural alternatives to cannabis (marijuana) and are generally purchased for the purpose of getting intoxicated (Vardakou et al., 2010).

Forensic toxicology analyses have identified over a dozen synthetic cannabinoids in these products, none of which are included on package labeling (Dresen et al., 2010, Lindigkeit et al., 2009, Hudson and Ramsey, 2011). Many of the cannabinoids found in samples of Spice products have an affinity for the CB1 receptor that is 4–5 times greater than THC and have demonstrated greater potency compared with THC on classical cannabinoid tetrad tests (Aung et al., 2000, Wiley et al., 1998). Variability also exists in the combinations and concentrations of the synthetic cannabinoids within Spice products such that using different brands, or even different batches of the same brand, can produce markedly different effects (Auwärter et al., 2009, Dresen et al., 2010).

Evidence is emerging to suggest synthetic cannabinoid use can be problematic. Case reports suggest that tolerance develops quickly and withdrawal has been observed following chronic use (Zimmermann et al., 2009). Case reports of adverse events following use of Spice products confirmed to contain JWH-018 and JWH-073 indicate these drugs can produce anxiety, disorientation, panic, tachycardia, and acutely exacerbate psychotic episodes (Schneir et al., 2011, Müller et al., 2010a, Müller et al., 2010b). German physicians have reported cardiovascular and nervous system problems following chronic synthetic cannabinoid exposure, and poison control centers in Sweden have reported an increase in the number of people suffering from “Spice toxicity” (EMCDDA, 2009). The American Association of Poison Control Centers reported that calls related to synthetic cannabinoids and Spice products increased from 13 calls in 2009 to about 3000 calls in 2010 (AAPCC, 2010).

There are limited epidemiological data regarding the use of synthetic cannabinoids and there is a lack of published data regarding the subjective and behavioral effects of Spice products among individuals not seeking emergency care. The aim of this study was to collect data on the characteristics and beliefs of individuals who have used Spice products, independent of whether they had previously experienced unwanted or serious side effects.

Section snippets

Methods

An anonymous internet-based survey study was conducted using a paid account on the Internet survey host SurveyMonkey.com. Participants were recruited via posts on e-mail listserves and internet message boards/forums containing references to Spice products (e.g., drugs-forum.com; shroomery.org). Participants were excluded if they had never used Spice products, were not fluent in English, were under the age of 18, and/or if they had already completed the survey. No remuneration was provided for

Participants

Study completers represented 13 different countries and 42 of the 50 U.S. states. They were primarily male (83%), Caucasian (90%), and had never been married (67%). The majority (96%) had a high school level of education, and 48% had a college degree. At the time of survey completion, 47% were employed full time, 28% were students, 9% were unemployed, and 38% were subject to drug testing procedures.

Respondents endorsed lifetime use of a variety of licit and illicit drugs including: alcohol

Discussion

Synthetic cannabinoids are a rapidly emerging class of psychoactive drugs for which little scientific data is available. To date, most published reports have been limited to toxicology reports focused on identifying the chemical constituents of commercial Spice products or case reports of individuals who present to hospitals following an adverse drug effect. Participants in this survey were generally experienced drug users, having reported use of a number of other psychoactive substances, in

Role of funding source

This research was supported by grants R01 DA025044 and T32 DA07209 from the National Institute on Drug Abuse. The study design; collection, analysis and interpretation of data; writing of the report; and decision to submit the paper for publication were all completed at the sole discretion of the authors with no role of any funding agencies. This study was not a clinical trial and was not registered in a clinical trials database.

Contributors

All authors contributed to the design and execution of the study, analysis of data, and preparation of the written manuscript. All authors have approved the final manuscript.

Conflict of interest

The authors have no conflicts of interest to declare.

Acknowledgement

The authors wish to thank our colleagues at the Behavioral Pharmacology Research Unit (BPRU) for their valuable feedback on the design and execution of this research.

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