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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 evaluate marijuana withdrawal symptoms. Almost 16% of the most frequent marijuana 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. Müller 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 psychiatric 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
