PORTLAND, Ore. (KOIN) – Poisonings from synthetic cannabinoids are less common in states where cannabis is legal, according to researchers at Washington State University.

The study found a 37% drop in poisoning reports from illicit synthetic cannabinoids in states with legal recreational or “adult use” cannabis compared to states with restrictive policies. 

Synthetic cannabinoids, which can result in dangerous side effects, are hard to detect using standard drug tests. They are not actually cannabis and are known by street names such as K2, Spice or AK-47. 

“This study shows some potential public health benefits to the legalization and regulation of adult use of cannabis,” said study lead author Tracy Klein, a WSU associate professor of nursing. “Based on both past research and this current study, it’s evident that users who have a choice to use a less toxic product would potentially do so.” 

Synthetic cannabinoids are so named because they work on the same cannabinoid receptors in the brain as the psychoactive component in the cannabis plant, tetrahydrocannabinol or THC. 

WSU said the illicit synthetics bind with those brain receptors up to 100 times more strongly and lack any of the mediating constituents of whole plant cannabis, such as cannabidiol or CBD. This is why synthetic cannabinoids have a high toxicity and can lead to severe impairment or even death. 

The WSU study on synthetic cannabinoid poisonings was published in the Journal of Clinical Toxicology. In the study, researchers analyzed data from the National Poison Data System from 2016 to 2019, before the onset of the pandemic. They looked only at states that had relatively stable policies during those years. 

States were placed in one of three categories: permissive, medical, or restrictive. 

Permissive states, like Washington, allow both medical and recreational adult use of cannabis. Medical states, like Hawaii, only allow cannabis for medical use. Restrictive states, like Idaho, prohibit nearly all cannabis use. 

In the sample WSU looked at, there were 7,600 poisoning reports related to synthetic cannabinoid use. About 65% of those calls required medical attention and 61 people died. Over the course of 2016-2019, researchers found that synthetic-related poisoning reports went down overall, but there were 13% fewer reports in medical states and a much more significant drop off of 37% in permissive states. 

A previous study in JAMA Open found that poison control calls related to natural cannabis use increased from 2017 to 2019 across the U.S., but were driven mainly by manufactured products, such as plant-based vaping materials and edibles, which can contain high levels of THC. In contrast, poison control calls for whole plant cannabis declined during the same time period. 

WSU said it’s difficult to enforce laws against synthetic cannabinoids because makers change their formulas frequently. They are also usually undetected in standard urine drug tests, which may be one reason people in restrictive states use them. 

Klein said more research is better needed to understand the use of these drugs and the differences among them. She said the study’s data set does not contain the rising popularity of synthetically derived Delta-8, marketed as a less strong form of Delta-9, which is the psychoactive cannabinoid found in naturally produced plant products. 

“We know that there are many cannabinoids being developed and on the market and the regulators are struggling to catch up,” Klein said. 

Because they’re so difficult to detect, the authors believe their study likely underestimates the use of these drugs.