Synthetic cannabinoids

How are synthetic cannabinoids used?

Synthetic cannabinoids are usually smoked in joints, pipes, or bongs, or used in vapes.³

They’re also sometimes ingested through food, drinks, or edible products such as gummies and lollipops.³

Medical synthetic cannabinoids

There are also prescribed synthetic and semi-synthetic medical cannabinoid products, which unlike novel synthetic cannabinoids have been tested for quality and safety.⁹

They come as a pill that you swallow and are usually designed to have similar effects to THC or CBD. None of these products are approved for use in Australia, but they are prescribed in some countries internationally. Examples include Marinol®, Syndros® and Cesamet®.⁹

Effects of synthetic cannabinoids

The use of any drug can have risks. It’s important to be careful when taking any type of drug.

Synthetic cannabinoids affect everyone differently, based on:

• size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken
• the strength of the drug (varies from batch to batch)
• environment (where the drug is taken).

Onset and duration of effects

How fast a drug takes effect and how long it lasts can vary depending on how it's taken - for example, whether it's smoked or swallowed.¹³

When smoked or vaped, the effects of synthetic cannabinoids are usually felt within minutes and can last anywhere from 1-2 hours to 5-6 hours, depending on the type of synthetic cannabinoid used.⁹

When swallowed, it can take longer to feel the effects than smoking or vaping. The effects may also last longer.⁹ This method of use is much less common than smoking or vaping.⁹

Effects of synthetic cannabinoids

Synthetic cannabinoids can produce many negative and dangerous side effects not caused by cannabis. The effects are also often felt sooner and are more intense than the effects of cannabis.¹⁴

Because there are so many different synthetic cannabinoids, the effects vary significantly. 

The effects of synthetic cannabinoids can include:

• relaxation
• euphoria (feeling happy)
• altered perceptions and sense of time
• loss of coordination
• dizziness
• agitation
• anxiety
• confusion
• paranoia
• hallucinations
• seizures
• feeling tired
• unconsciousness
• irregular blood pressure
• irregular heartbeat
• chest pain
• overheating (hyperthermia)
• internal bleeding
• breakdown of muscle tissue (rhabdomyolysis)
• kidney injury.^14-16

Impact of mood and environment

Drugs that affect a person’s mental state (psychoactive drugs) can also have varied effects depending on a person’s mood (often called the ‘set’) or the environment they are in (the ‘setting’): 

• Set: a person’s state of mind, previous encounters with the drug, and expectations of what’s going to happen. For example, feelings of stress or anxiety before using synthetic cannabinoids may result in an unpleasant experience and make those feelings worse.¹⁷
• Setting: the physical and social environment where you take synthetic cannabinoids – whether it’s known and familiar, who you’re with, if you’re indoors or outdoors, the type of music or sounds, and lighting. The ideal setting to take synthetic cannabinoids will vary based on the individual and drug they’re using. For example, one person might enjoy using synthetic cannabinoids in a calm, quiet and relaxed environment while another may prefer to take synthetic cannabinoids in a loud social setting, like a party.¹⁷

Being in a good state of mind, with trusted friends and a safe environment before taking synthetic cannabinoids reduces the risk of having a bad experience.¹⁷

Overdose

If you take a large amount, or have a strong batch, you could overdose. Some synthetic cannabinoids are extremely strong, meaning you can overdose on a very small amount.¹⁸

Synthetic cannabinoids can cause death. 

Call triple zero (000) and request an ambulance if you or someone else has any of the following symptoms (emergency services are there to help and can provide more instructions).

Signs of synthetic cannabinoid overdose can include:

• fast/irregular heart rate
• seizures
• vomiting
• irregular (high or low) body temperature
• slow breathing, confusion, loss of consciousness
• psychosis, delusions or unpredictable behaviour
• chest pain or discomfort that may feel like pressure, squeezing, heaviness, or burning. It can also be felt in the arm, shoulder, back, neck, or jaw.^{7, 18}

Mixing synthetic cannabinoids with other drugs

Mixing synthetic cannabinoids with other drugs can have unpredictable effects and increase the risk of harm.

An Australian report found that other drugs contributed to around three-quarters of synthetic cannabinoid–related deaths.¹⁸

Mixing means using more than one drug (including alcohol or medications) at the same time, or one after another. You should also consider what drugs you’ve taken in the last 24 hours.

• Synthetic cannabinoids and depressants (alcohol, benzodiazepines, GHB): mixing with depressants can increase risk of fatal overdose and strain on the heart. Alcohol is one of most common drugs present in synthetic cannabinoid overdose deaths.¹⁸
• Synthetic cannabinoids and stimulants (cocaine, methamphetamine): increases the likelihood of experiencing anxiety and psychosis and puts added strain on the heart.¹⁹
• Synthetic cannabinoids and psychedelics (LSD, magic mushrooms, 2CB): increases the likelihood of experiencing anxiety and psychosis.¹⁹
• Synthetic cannabinoids and lithium: increases risk of psychosis and seizures.¹⁹

Use of more than one drug or type of drug consumed at the same time is called polydrug use.²⁰

Reducing harm

There are ways you can reduce the risk of harm when using synthetic cannabinoids:

• Start low, go slow - try a very small dose first before taking more, it can help you to understand the strength and potential effects. The dose should only be increased slowly – time should be given for the previous dose to wear off.
• Let a friend know what you’ve taken – so they can help if you’re unwell.
• If affected by synthetic cannabinoids, don’t drive, operate heavy machinery or do any other potentially risky activities, such as swimming – it can slow response times and affects coordination and balance.
• Take less or avoid using synthetic cannabinoids if you:
• are a young person (25 and under), as young people can experience additional negative effects
• have experienced, or have a family history of, schizophrenia or bipolar disorder
• have an existing heart condition, as it can put extra strain on your heart. It’s especially important to avoid taking stimulants if you have a heart condition and choose to use synthetic cannabinoids.

If smoking or vaping:

• avoid using tobacco as a mixer
• clean smoking equipment regularly, including mouthpiece and any water containing parts to avoid mould or bacterial growth
• avoid smoking out of plastic bottles or aluminium cans due to toxic fumes.

Coming down

After using synthetic cannabinoids, you may experience comedown or hangover effects, however these effects haven’t been fully described in research yet. Synthetic cannabinoids may cause more hangover effects than cannabis (THC).²¹

Long-term effects

Long-term effects can vary depending on how much, how often and how synthetic cannabinoids are consumed. Regular use may eventually contribute to:

• mental health conditions such as depression, anxiety, and psychosis
• heart disease
• kidney disease
• insomnia
• problems with thinking and memory.¹⁵

There are long-term health risks that are specifically related to smoking synthetic cannabinoids. The risk is even higher if mixed with tobacco. These include:

• respiratory health issues like asthma, bronchitis, pneumonia
• reduced lung capacity
• cavities, tooth decay, and gum disease.^22-24

Synthetic cannabinoids and mental health

People who use synthetic cannabinoids have a higher risk of experiencing symptoms of anxiety and depression.¹⁵

And long-term or heavy use is strongly linked to serious mental health conditions such as psychosis and schizophrenia, including in people who’ve never had previous experiences of psychosis. There are also reports of psychosis occurring after a person has stopped taking synthetic cannabinoids.^{15, 25}

Compared to cannabis, the psychotic symptoms associated with synthetic cannabinoids are more common and can be more severe.¹⁵

Because of these risks, people with mental health conditions or a family history of these conditions should avoid using synthetic cannabinoids.

Tolerance

Regularly taking synthetic cannabinoids can lead to developing a tolerance, which means you need to take larger amounts to get the same effects.¹⁹ Tolerance to synthetic cannabinoids can develop much faster than tolerance to cannabis (THC).²⁶

Dependence

People who regularly use synthetic cannabinoids may become dependent. They may feel they need to use synthetic cannabinoids to go about usual activities, like working, studying and socialising, or just to get through the day.¹⁹

The risk of becoming dependent on synthetic cannabinoids is higher than cannabis (THC).²⁶

Withdrawal

Withdrawal refers to the symptoms that can occur when someone who is dependent on a drug, or has used it regularly over time, stops or reduces use.²⁷

Withdrawal can include physical symptoms (such as headaches, or nausea) and psychological symptoms (such as anxiety, or depressed mood).²⁷

Symptoms - including how strong they are and how long they last - will vary depending on the type of drug and a person’s history of use.²⁷

Withdrawal from synthetic cannabinoids can be potentially life-threatening. 

If you, or someone you care about, is planning to stop taking synthetic cannabinoids after using them for a long time, it’s important to speak with a medical professional for guidance and supervision. 

Generally, synthetic cannabinoid withdrawal symptoms are more severe than the symptoms of cannabis (THC).²⁶

Reducing, or stopping using, synthetic cannabinoids after a period of regular use can lead to withdrawal symptoms, including:

• trouble sleeping
• irritability, agitation
• depression, suicidality
• restlessness, mood swings
• anxiety, nervousness, panic attacks
• sweating
• paranoia
• loss of appetite
• cravings
• rapid or irregular heartbeat, chest pain
• weird dreams
• hallucinations, psychosis
• seizures.^{26, 28}

Withdrawal symptoms usually start within 1-2 days after last using. For some synthetic cannabinoids, the withdrawal symptoms can start as early as a few hours after last using. For other synthetic cannabinoids, withdrawal symptoms don’t start for up to 5 days.²⁸

They should peak within a few days after the symptoms start and mostly settle down after a week or two.²⁸

Pregnancy, breastfeeding and synthetic cannabinoids

There’s limited research on how synthetic cannabinoids affect pregnancy and breastfeeding. 

But we know that the endocannabinoid system plays an important role in reproduction and pregnancy.²⁹ And that cannabinoids are likely to pass through breastmilk into the newborn baby.³⁰

Because of this, it’s recommended not to use synthetic cannabinoids if trying to get pregnant, pregnant or breastfeeding.

Getting help

If your use of synthetic cannabinoids is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about someone, there is help and support. 

• Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs.
• Use the confidential Path2Help portal to get matched with information and services specific to your needs.
• Search our Help and Support database directly to find your preferred supports, by adding your location or postcode and filtering by service type.  

If you’re looking for other information or support options, send us an email at [email protected]