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3. ASSESSING THE EXPERIENCE OF USING SYNTHETIC CANNABINOIDS... m 43
tonic-clonic seizures, psychiatric presentations, and hyperemesis, and typically
involved young males with tachycardia, agitation, and nausea reguiring only
symptomatic care with a length of stay of less than 8 h. High intoxication level
was reported by cannabis users who reported floating feelings, being drowsy,
a sensation of time alteration, less sociability, more talkativeness, worsening
memory, inability to think clearly, paranoia, increased sexual pleasure, sleep
difficulties, hallucinations, and decreased sexual drive (Green, Kavanagh, &
Young, 2003).
According to clinical case reports, the withdrawal symptoms of SCs are
similar to cannabis but more severe (Nacca et al., 2013; Van Der Veer & Friday,
2011; Zimmermann et al., 2009). Withdrawal symptoms including agitation,
irritability, anxiety, and mood swings were reported by people who used SCs
(Macfarlane & Christie, 2015). In a study by Van Hout and Hearne (2016)
that examined the experience of SC withdrawal, participants described intense
cravings, compul-sive all-consuming seeking, use and redose behaviors, and
a fear of the psychiatric and self-harms caused during withdrawal. Cannabis
dependence syndrome could occur with heavy chronic use in individuals
who report problems in controlling their use and who continue to use the
drug despite experiencing adverse personal consequences (Hall & Solowij,
1998). Wiesbeck et al. (1996) conducted a study in a large population to eval¬
uate marijuana withdrawal symptoms. Almost 16% of the most frequent mar¬
ijuana users (who had used the drug daily for an average of almost 70 months)
experienced withdrawal syndrome. These symptoms included nervous tense,
restlessness, sleep disturbance, and appetite change.
Every-Palmer (2011) examined psychosis among people who used SC and
found that anxiety and psychosis symptoms were reported after SC use and
lasted between 2 days and several weeks. Miiller et al. (2010) reported a case
where a patient’s psychotic symptoms that had developed as a result of prior
cannabis consumption not only worsened after subsequent SC use but the
patient also started experiencing auditory and paranoid hallucinations that
he never had before. Bassir, Medrano, Perkel, Galynker, and Hurd (2016)
compared clinical presentations of SC users with cannabis users in a psychi¬
atric inpatient setting and found patients who had smoked SC where most
likely to experience psychosis, agitation, and aggression than those who only
smoked natural cannabis.
Bilgrei (2016) analyzed discussions on experiences of SC use in posts of
an online drug forum and in interviews with forum participants. The study
illustrates the process of alteration of experiences from positive to negative
during the consumption of SCs. While there is an increasing body of research
on the motivation and the effects associated with SC use (Arfken et al., 2014;
Barratt et al., 2013; Bonar et al., 2014; Castellanos et al., 2011; Meshack et al.,
2013) and Bilgrei (2016) examined experiences based on the forum partici¬