Synthetic cannabinoids (SCs) are structurally similar to δ-9-tetrahydrocannabinol, the psychoactive constituent in crude cannabis. Many of the street grade synthetics are full CB1 and/or CB2 cannabinoid agonists. As a result, the potency, level of impairment and adverse reactions are unpredictable and associated with a variety of negative health effects including cardiovascular events and death. Yet, little is known about the risk and protective factors associated with the use of SCs among adolescents including psychiatric history, psychological issues and known substance-use and abuse risk factors. Ninnemann, Choi, et al., hypothesized that anxiety, depression, impulsivity and marijuana use could predict SC use during adolescence. Using cross-sectional methodology, over a 12 month span, with subjects (n=964) from multiple schools in Texas.

The results showed that depressive symptoms, cannabis, alcohol and SC use at baseline were predictive of SC use at one-year follow-up. Anxiety and impulsiveness at baseline were not predictive of SC use at follow-up. In addition, African Americans and females were less likely to use SCs than males or other ethnic groups. Findings from other studies have demonstrated that lifetime cigarette, marijuana, alcohol, or other illicit drug use dramatically increased the likelihood of past-year SC use. Yet, the frequency of past marijuana use is the strongest correlate of future SC use.

Why Does This Matter?

The use of SCs among high school students has declined over the past few years (Monitoring the Future Survey, 2016) largely because we have identified and outlawed many of the chemicals used to manufacture SCs. However, the deleterious effects and mortality has increased as young amateur chemists have also identified the ingredients to create and sell dangerous, homemade SCs to unwitting teens.

This is the first prospective research of SC use among a high risk cohort. Learning that depressive symptoms, marijuana and alcohol use are predictive of subsequent SC use is the first step in developing much needed, evidence-based prevention strategies.