The landscape of psychoactive substance use has evolved drastically over the last few decades, giving rise to a category of products that challenge both scientific understanding and traditional legal frameworks. We are referring to synthetic cannabinoids. Although they share the name and act on receptors similar to natural cannabis, their artificial origin and radically different molecular structure give them a safety profile nonexistent in the Cannabis sativa plant. This article reviews the most relevant scientific developments, contrasting objective data with social perception to offer a clear view of one of the emerging public health issues.
In brief
- Higher toxicity: Studies indicate that the risk of requiring urgent medical attention is up to thirty times higher with synthetics than with natural cannabis.
- Elevated psychiatric risk: The probability of suffering from psychotic episodes or acute crises is four times higher in users of synthetic cannabinoids.
- Evading controls: Many consumers seek them out to avoid testing positive on urine screens, ignoring that their distinct chemical structure does not guarantee safety, but rather invisibility to standard tests.
- Availability and choice: In markets where natural cannabis is accessible and affordable, the preference for synthetics drops drastically (less than 2% of purchases).
- Harm reduction strategy: The solution does not lie in strict prohibition, which fuels the black market, but in facilitating access to natural products with a known profile.
The myth of “synthetic marijuana” and chemical reality
It is essential to dismantle a widespread misconception: that synthetic cannabinoids are simply improved or more potent versions of natural cannabis. The pharmacological reality is much more complex and dangerous.
While cannabis has been used by humanity for millennia, allowing for a wealth of knowledge regarding its effects, dosages, and risks, synthetic cannabinoids are molecules designed in laboratories, often without passing through rigorous phases of clinical trials in humans. They are frequently marketed as additives for herbal blends or under misleading trade names, taking advantage of a legal loophole that allows their sale until they are declared illicit.
The usual response from authorities has been immediate illegalization. However, this measure has a perverse consequence: by criminalizing these substances without studying them properly, scientific research into their long-term effects is hindered, and consumption is pushed toward unregulated markets where purity is uncertain.
Risk comparison: Hard data vs. perceptions
Recent medical literature offers an alarming comparison between both types of substances. A global analysis published in 2015, based on massive datasets, revealed that the need for urgent medical assistance after the use of synthetic cannabinoids is thirty times higher than that of natural cannabis. The associated clinical presentations are much more severe.
In another study conducted in New York on acute intoxications, it was corroborated that the toxicity of synthetics far exceeds that of traditional marijuana. Cases of severe neurotoxicity and fatal cardiac arrhythmias have been documented—effects that are not inherent to the responsible use of botanical cannabis.
The impact on mental health is equally concerning. Natural cannabis can induce anxiety or transient psychosis in situations of acute intoxication with high doses, especially in people without prior experience. However, the risk multiplies exponentially with synthetics. An Israeli study that analyzed cases of psychiatric intervention demonstrated that the probability of developing serious psychiatric problems is four times higher in users of synthetic cannabinoids.
The economic factor and market access
The influx of these products is not explained solely by their low cost. A bag of herbal blend containing these compounds can cost around ten euros (approx. $11), allowing for multiple uses. This accessible price is a significant barrier in countries where natural cannabis is illegal or extremely expensive.
In nations like Spain, where the availability and price of cannabis are relatively low, synthetic consumption rates are minimal (between 0.1% and 0.5%). Conversely, in the United States or the United Kingdom, where access to the natural product is more difficult and costly, adolescent usage figures range between 4% and 11%. This suggests a direct relationship: when the user has the option to choose a product with predictable effects and known risks, they tend to reject dangerous alternatives.
The illusion of evading controls
A frequent motivation for turning to these compounds is to avoid testing positive on urine screens. Standard analyses detect THC metabolites present in natural cannabis, which can remain in the body for weeks. Some consumers seek substances that act on the same receptors but are not detected by these tests.
Synthetic cannabinoids partially fulfill this goal by having a molecular structure different from that of THC or CBD. However, this strategy carries an unacceptable health cost. Furthermore, given that there are more than three hundred synthetic compounds belonging to ten different chemical families whose metabolism in humans is poorly studied, it is absurd to propose exhaustive systematic detection without first understanding the specific risks of each molecule.
The virtual market: Freedom or danger?
The acquisition of these products is carried out mainly through the internet. On the surface web, the number of pages dedicated to their sale has grown from a few in 2008 to hundreds in recent years. On the other hand, virtual markets on the Dark Web offer a degree of anonymity and allow transactions with cryptocurrencies.
A detailed analysis of one of these markets, Silk Road 2.0, provided revealing data on the preferences of the real consumer. Of the products offered, more than 20% belonged to the “New Psychoactive Substances” (NPS) category, which includes synthetic cannabinoids. However, when observing what users actually bought, the landscape changed drastically: 98.5% purchased natural products, and only 1.4% opted for synthetics.
This data underscores a crucial conclusion: in free-market conditions where there is a choice, consumers prioritize their health over convenience or price. The volume of business with natural cannabis exceeded sales of its synthetic alternatives by thousands.
Harm reduction strategies and critical perspective
Given the accumulated evidence, what is the most coherent stance from a public health perspective? The solution does not lie in strict criminalization, which prevents scientific study and fosters the illegal market. On the contrary, the harm reduction strategy must focus on:
- Facilitating access to natural cannabis: Ensuring that people who decide to consume cannabinoids have access to natural products with known potency and relative safety.
- Education on the risks of synthetics: Clearly informing about the cardiovascular, neurological, and psychiatric toxicity associated with these experimental compounds.
- Continuous research: Maintaining an active registry of new molecules appearing on the market to evaluate their effects before they cause irreversible damage.
It is often argued that “natural cannabis doesn’t kill.” While it is true that direct mortality from marijuana use is low compared to other substances, this simplistic phrase ignores the risks of hepatic, renal, and psychiatric toxicity documented in the use of synthetics. The current paradox is that technically legal products are much more dangerous than their natural counterpart.
Closing: Awareness and responsibility
Psiconáutica.org remains dedicated to critical awareness and scientific knowledge. In a world saturated with information, it is vital to distinguish between moral myths and pharmacological evidence. Synthetic cannabinoids remind us that technical legality is not equivalent to health safety.
Prudence requires recognizing that new chemical variants with unpredictable effects emerge every month. The best protection for the user is to have access to known and regulated alternatives, avoiding the trap of products designed to evade controls but destined to harm health. Only through an approach based on objective data, rather than prejudice, can we effectively address this health challenge.
