OCR
42 = USING INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS tellanos et al., 2011; Meshack et al., 2013). Other motivations to use include the wish to experience pleasant feelings, recreational effects, and relaxation (Barratt et al., 2013; Bonar et al., 2014). The lack of safety information may lead to the incorrect assumption that SCs are safe (Fattore & Fratta, 2011; Vandrey, Dunn, Fry, & Girling, 2012). Compared to cannabis use, the consumption of SCs may be associated with more adverse and unpredictable physical and psychological effects (Bonar et al., 2014; Castaneto et al., 2014; Fantegrossi, Moran, Radominska-Pandya, & Prather, 2014; Fattore, 2016), although people who use SCs reported subjective experiences that are similar to the use of cannabis, and they also described unique effects that are very different from other kind of drugs (Vandrey et al., 2012). In addition, in the study of A. R. Winstock and Barratt (2013) the effects of SCs last for a shorter time and they are more intense compared to cannabis, and many undesired effects have also been described by participants. In a study by Vandrey et al. (2012), 87% of people who use SCs reported having positive effects (e.g., they felt a pleasant high, stimulated, and energetic), but 40% reported negative or unwanted effects (e.g., dry mouth, heart racing, and paranoia). A subset of respondents felt unable to cut down or stop SC use (38%), experienced tolerance (36%), used for longer periods than originally intended (22%), and had interference with other activities (18%). Barratt et al. (2013) found that 68% of the people who used SC reported at least one side effect, such as decreased motor coordination, fast and irregular heart-beat, dissociation, dizziness, and psychosis. Winstock, Lynskey, Borschmann, and Waldron (2015) conducted a research study among people who used SC who sought emergency medical treatment following their SC use. They found the relative risk of severe side effects associated with use of SCs to be 30 times higher compared to that of cannabis (SC is a full agonist and THC is a partial agonist of the CB1 receptor (Huffman & Padgett, 2005; Loeffler, Hurst, Penn, & K, 2012)). Respondents reported more adverse symptoms after the consumption of SCs versus cannabis, including panic, paranoia, anxiety, and aggression, and they used emergency services more often as well. There is a growing body of literature on clinical case reports about severe consequences of SC use. The consumption of the drug leads to emergency room visits, though clinical treatment often remained short and symptomatic (Castaneto et al., 2014; Fattore, 2016). Castaneto et al. (2014) conducted a literature review on acute SC intoxication and found that patients reported that intoxication occurred within 2-5 h and lasted for about 24 h. Treatment to relieve symptoms included benzodiazepines and intravenous saline solution. In a systematic review, Tait, Caldicott, Mountain, Hill, and Lenton (2016) summarized the adverse events arising from SC use. They found that major complications included cardiovascular events, acute kidney injury, generalized